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ADVANCE DIPLOMA IN INTENSIVE CARE

PEPERIKSAAN PERCUBAAN
(MCQ-T/F)
ADIC 510302
Managing Critically Ill Patient I

1.
I II
pH 7.35 7.22
PaO2 59 49
PaCO2 45 55
HCO3 26 12
FiO2 0.5 0.21

The above ABG results indicate:

A. In column I, ABG indicates hypercapnea.

B. In column I, ABG indicates severe hypoxaemia.

C. In column I, the ABG shows acute respiratory failure type I.

D. In column II, the ABG shows acute respiratory failure type II.

2. Ventilator Associated Pneumonia can be prevented by

A. daily change of ventilator tubing is recommended.

B. performing oral suction prior to deflating ETT cuff.

C. cuff pressure with minimal leak technique is encourage.

D. elevation of head of bed at 30°-45° for a patient with high risk of

aspiration.

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3. The Following are the facts to prevent Ventilated Associated Pneumonia(VAP)

by preventing the occurrence of colonization by

A. provide oral care.

B. suction of ETT only as necessary.
C. prevent from accidental extubation.
D. elevate head of bed 30-40 degree unless contraindicated.

4. Mechanical ventilation strategy in acute respiratory distress syndrome is/are

A. permissive hypercapnia resulting from hypoventilation.

B. maintain Oxygenation Sa02 at least 90% with FiO2 <0.6.
C. plateau pressure <30cmH20 to reduce chest wall compliance.
D. high PEEP with high Tidal Volume to prevent from ventilation –induce
lung injury.

5. Protective lung strategy in mechanical ventilation of a patient with Acute

Respiratory Distress Syndrome (ARDS) include

A. plateau pressure < 30cmH2O.

B. peak airway pressure >30 cmH20.

C. tidal volume 6-8mls/kg of ideal body weight.

D. mandatory respiratory rate of 35 breaths/min.

6. Ventilator strategies used in the management of Acute Respiratory Distress

Syndrome(ARDS) include

A. high PEEP setting.

B. use of high FiO2 >0.8.

C. keep plateau pressure >45cmH20.

D. inverse inspiratory to expiratory ratio.

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7. In the management of acute severe airway obstruction,

A. it allow the concept of permissive hypercapnia.

B. keep peak inspiratory pressure less than 35 cmH2O.

C. the goal of mechanical ventilation is to normalised the PaCO2.

D. prolonged inspiratory time and shorter exhalation time to promote good

gas exchange.

8. Regarding chronic obstructive pulmonary disease (COPD),

A. ABG indicates hypercapnea.

B. Mechanical ventilation is essential for all the patient.

C. an emphysematous lung has increased surface area for gas exchange.

D. as a compensatory mechanism the kidney will increase bicarbonate

production to keep the pH within normal limit.

9. These statement is/are reqarding Massive Pulmonary Embolism that can be

prevented among critically ill patient by

A. elevation of head of bed to 30o at all time .

B. antiplatelet theraphy should be given without delay.
C. perform frequent passive range of motion exercise of the lower limbs.
D. application of intermittent pneumatic compression of lower limbs.

10. The statement below is/are the preparation for bronchoscopy on ventilated
patient.

A. Maintain the FIO2 level.

B. Position the patient to lateral.
C. Prepare of IV propofol as sedation.
D. Ensure resuscitation equipment is readily available.

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A 24 years old gentlemen was admitted to ICU intubated and ventilated for
11.
airway protection after severe bee sting.

His hemodynamic parameter were as follows:

BP 70/50 mmHg
CVP 2 mmHg
HR 150 bpm
RR: 38/min

Based on the above information,

A. dyspnoea due to bronchoconstriction.

B. hypotension due to massive vasodilatation.

C. altered mental status due to increase perfusion to the brain.

D. tachycardia due to decrease in systemic vascular resistance.

12. In septic shock,

A. start IV antibiotic immediately without septic workup.

B. high serum lactate level indicates tissue hypoperfusion.

C. volume replacement with crystalloid solution 20-30ml/kg.
D. infusion of vasopressor is to increase cardiac contractility.

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ADIC 510302 MCQ TF TRIAL NOVEMBER 2023 [PP] MANAGING THE CRITICALLY ILL PATIENT 1
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ADVANCE DIPLOMA IN INTENSIVE CARE

13. In cardiogenic shock,

A. oxygen is given to improve tissue perfusion.

B. infusion of vasopressors to increase afterload.

C. rapid fluid resuscitation to increase the preload.

D. infusion of inotropes to increase cardiac contractility.

14. The immediate management for hypertensive emergencies is/are

A. immediate hospitalization to ICU.

B. manage with oral antihypertensives only.

C. observe closely for multiple organ damage.

D. should be lowered aggressively over minutes.

Question 15 to 17 are related

15. Mr. A admitted to emergency department with complain of having severe chest
pain radiating to the neck and jaw associated with shortness of breath and
profuse sweating. On examination B/P reveal 150/90mmHg HR: 120 bpm and
RR: 28/min SPO2: 95%. Auscultation shows fine crackles base of the lung
extending upward. The immediate management for the patient is/are

A. do 12 lead ECG stat.

B. send patient for chest x-ray.

C. put patient in supine position.

D. administer oxygen supplement via venturymask.

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16. The management and the rational for the intervention include

A. administer Tab Aspirin 300mg as antiplatelet agent.

B. administer IV Streptokinase as anticoagulant agent .

C. IV Morphine given as vasoconstrictor to increase pulmonary congestion.

D. administer IV GTN instead to decrease cardiac workload and as

vasodilator.

The following are ECG changes in relation to the location of myocardial

17.
infarction.

A. ST segment elevation in lead II, III and aVF indicate inferior myocardial
infarction.
B. ST segment elevation in lead V1 and V2 indicate posterior myocardial
infarction.
C. ST segment elevation in lead V3 and V4 indicates inferior myocardial
infarction.
D. ST segment elevation in lead V5, V6, I and aVL indicates lateral
myocardial infarction.

18. The Following classes of medication maximize cardiac performance in patients

with heart failure by increasing ventricular contractility.

A. Digitalis.
B. Diuretics.
C. Inotropic agents.
D. calcium channel blockers.

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19. Mr. P admitted to emergency department with complains of having shortness of

breath for the past one week associated with coughing. History taken showed
that he needs two pillows to sleep at night. On examination B/P reveal
160/90mmHg HR: 125 bpm and RR: 30/min SPO2: 95%. Auscultation shows
crackles base of the lung extending upward. The immediate management for
the patient is/are

A. administer antidiuretic drugs .

B. administer beta blocker to reduce the heart rate.
C. intubation and ventilation must be done promptly.
D. administer IV GTN as vasodilator to decrease the blood pressure and
decrease cardiac workload.

20. Regarding Pulmonary Hypertension.

A. Acute hypoxia.
B. Elevation of MAP > 20mmHg.
C. Rising in pulmonary artery pressure, increase vascular resistance.
D. Increased Pulmonary vascular resistant cause increase in cardiac output.

THE END OF QUESTION PAPER

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