Clinical Simulation Review Exam 49 Questions with Verified Answers
Visuals (things you will always choose...) - CORRECT ANSWER -general
... [Show More] appearance
-appearance of chest
-respiratory pattern
-sensorium
-posture
-patient color
-pulse
"egg shaped heart" - CORRECT ANSWER Transposition of the Great Vessels
"boot-shaped heart" - CORRECT ANSWER Tetralogy of Fallot
Infant norms.... - CORRECT ANSWER Pulse: 110 - 160
BP: 60/40 mm Hg
RR: 30 to 60
Birth Wt: 3000g
APGAR: 7 to 10
Hemodynamic Norms... - CORRECT ANSWER BP: 120/80 (90/60 to 140/90)
MAP: 93 to 94
CVP: 2 to 6 mm Hg (4 to 12 cmH2O)
PAP: 25/8 (mean 13 to 14)
PWP/PCWP: 4 to 12 mm Hg
CO: 4 to 8 LPM
CI: 2.5 to 4 L/min/sq m
UNACCEPTABLE bedside ventilatory parameters - CORRECT ANSWER VC: < 10mL/kg (or < 2 x VT)
MIP/NIF: <20 cm H2O
RR: >20 bmp or < 8
Vt: < 5mL/kg
Ve: > 10 LPM
MEP: < 40 cm H2O
Vent Parameters... - CORRECT ANSWER Tidal Volume: 5 to 10 mL/kg
-------asthma/ards use 4 mL/kg
Pressure: Pplat from VC or up to 3 cm H2O
Rate: 10 to 20
FiO2: 40 to 60% or set to prior
PEEP: 2 to 6 or set to prior
Ideal body weight - CORRECT ANSWER 50 kg + (2 x inches over 5 ft)
Infant vent settings - CORRECT ANSWER PIP: 20 to 30
Rate: 20 to 30
FiO2: 40 to 60%
PEEP: 2 to 4
Ziehl Neelsen - CORRECT ANSWER AFB
Albumin - CORRECT ANSWER Norm: 3.5 to 5 g/dL
important in maintaining osmotic pressures of the blood and has a primary role in lipid metabolism. Decreased levels are seen with protein malnutrition and severe liver disease. Chronic inflammation, severe acute disease and kidney disease lead to low albumin levels. Severe hypoalbuminemia may result in a loss of fluid from the vascular space and contribute to PULMONARY EDEMA>
Babinski Reflex - CORRECT ANSWER Neurologic test to evaluate brainstem and spinal cord function. (performed by stroking the sole of the foot and observing the reaction of the toes. Dorsiflextion of the toes is a positive test and may indicate a lesion in the pyramidal tract.)
Basal metabolic rate - CORRECT ANSWER rate at which energy is produced according to how much is available. May also be referred to as Basal Energy Expenditure (BEE) or Minimal Energy Expenditure (MEE). Determined through direct or indirect calorimetry.
Basic metabolic panel (BMP) - CORRECT ANSWER blood test that includes assessment of glucose, electrolytes, fluid levels and kidney function. Measures Na, K, Ca, Cl, CO2, glucose, urea nitrogen and creatinine.
BCG Vaccine - CORRECT ANSWER tuberculosis vaccine
mycobacterium bovis
bilirubin level - CORRECT ANSWER normal: 0.1 to 1.0 mg/dL
Blood alcohol level - CORRECT ANSWER Legal driving level is 80mg/dL or less
>400mg/dL can be fatal
Blood digoxin level - CORRECT ANSWER (Digoxin is an inotropic agent used to increase cardiac contractility in pts with CHF)
therapeutic blood level is 0.9 to 2.0 ng/mL
potentially toxic over 3.0 ng/mL
Blood glucose level - CORRECT ANSWER normal...
preterm infant: 20 to 30 mg/100mL
term infant: 30mg/100mL
adults: 80 to 120 mg/100mL
Blood magnesium level - CORRECT ANSWER normal is 1.5 to 2.5 mEq/L
BNP - CORRECT ANSWER blood natriuretic peptide
secreted by the cardiac muscle when heart failure develops or worsens. Can be used to determine CHF v. COPD. Normal: <100 pg/mL
BUN - CORRECT ANSWER blood urea nitrogen
normal 8 to 25 mg/dL
elevated may indicate renal disease
BAL - CORRECT ANSWER bronchoalveolar lavage
instillation and aspiration of the lungs using saline solution
bronchogram - CORRECT ANSWER diagnosing bronchiectasis or presence of airway lesions
calcium chloride - CORRECT ANSWER can be given to counteract calcium channel blocker OD
COHb levels.. - CORRECT ANSWER normal: 0 to 1%
normal for smokers: 2 to 12%
>20% indicative of CO poisoning
Cardiac enzymes/CPK isoenzymes - CORRECT ANSWER measurement of the MB isoenzyme of creatine phosphokinase and troponin in order to detect myocardial damage. May be used to assess the degree of muscle damage in pts who have had an MI.
CPP - CORRECT ANSWER Cerebral perfusion pressure
pressure gradient between the mean arterial pressure and the intracranial pressure (MAP -ICP)
normal range is 70 to 90 mm Hg. Less than 70 results in reduction of blood flow to the brain and increases risk of ischemia.
Chaddock Reflex - CORRECT ANSWER extension of great toe resulting from irritation around external malleolus. Flexion of wrist and fanning of fingers when forearm is irritated above and near wrist.
Chest Fluoroscopy - CORRECT ANSWER may be worthwhile in initial assessment of pts with congenital heart defects or valvular disease
Coag... - CORRECT ANSWER APTT: 24 to 32 seconds
PT: 12 to 15
Colloid infusion - CORRECT ANSWER administration of an intravenous solution containing albumin. should NOT be administered to pts with leaky pulmonary capillaries (i.e. ARDS)
colloid osmotic (oncotic) pressure - CORRECT ANSWER the pressure created by serum albumin and globulin particles, which are large molecules which cannot diffuse through normal endothelium. May be used to determine the cause of pulmonary edema.
CBC - CORRECT ANSWER rbc, wbc, Hb, hem, erythrocyte index, differential, platelets... indicated as one of the basic lab tests in a stable pt
CT - CORRECT ANSWER produces an image representing a detailed cross-section of tissue structure. useful for the diagnosis of PE or bronchiectasis
Coombs' Test - CORRECT ANSWER Antiglobulin test
A test for the presence of antibodies that coat and damage red blood cells. Can detect Rh antibodies in maternal blood and is used to anticipate hemolytic disease in newborns. Also used to determine the compatibility of blood types.
Corneal reflex - CORRECT ANSWER closure of eyelids resulting from direct corneal irritation
coronary angiogram - CORRECT ANSWER used to define the size, shape and patency of blood vessels. May be useful in evaluating coronary blood flow following an acute MI
creatinine - CORRECT ANSWER formed from the metabolism of creatine and found in the blood, urine, and muscle tissue. An increase is indicative of renal malfunction (normal 0.7 to 1.3.)
Creatinine clearance - CORRECT ANSWER measurement of the amount of creatinine present in a 24 hour urine collection. A useful indicator of renal function. Normal value 90 to 120 mL/min
C & S - CORRECT ANSWER culture and sensitivity..
results are not generally available for at least 48 hours
D-Dimer - CORRECT ANSWER one of the fibrin degradation products (FDP) measurable in the blood after a clot has formed and is in the process of breaking down. May be indicated to determine the presence of a PE.
Delee suction device - CORRECT ANSWER device designed to remove meconium from the upper airway in a neonate
Dubowitz score - CORRECT ANSWER method of estimating the gestational age of a neonate.
Edrophonium chloride test - CORRECT ANSWER (Tensilon Test)
(edrophonium chloride is a rapid-acting, short-lasting cholinesterase inhibitor)
diagnosis of myasthenia gravis
ELISA Test - CORRECT ANSWER detects presence of antibodies to specific infections agents, such as HIV
GERD - CORRECT ANSWER gastroesophageal reflux...
note: aspiration of gastric contents may cause asthma-like symptoms
Hering-Breuer Inflation Reflex - CORRECT ANSWER parasympathetic inflation reflex mediated by the lung's stretch receptors. appears to influence the duration of the expiratory pause between spontaneous breaths.
Indirect Calorimetry - CORRECT ANSWER uses measurements of O2 consumption, CO2 production, and urinary N2 to calculate: 1. respiratory exchange ratio 2. resting energy expenditure 3. respiratory quotient and 4. caloric equivalents [Show Less]