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ACCS Oakes practice Exam; Questions & Answers (Latest Update)

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ACCS Oakes practice Exam; Questions & Answers (Latest Update) A difficult intubation is anticipated with an obese pt. The decision is made to intubate by video laryngoscopy. Which of the following is LEAST likely to be needed: A) Cook's Exchanger B) Rigid Stylet C) Cuffed Endotracheal Tube...

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  • August 24, 2024
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ACCS Oakes practice Exam; Questions &
Answers (Latest Update)
A difficult intubation is anticipated with an obese pt. The decision is made to

intubate by video


laryngoscopy. Which of the following is LEAST likely to be needed:


A) Cook's Exchanger


B) Rigid Stylet


C) Cuffed Endotracheal Tube


D) Video-enabled Laryngoscope ✔✔A) cook's exchanger


Video laryngoscopy involves use of a normal ET Tube with the addition of a rigid

stylet, as well


as a video-enabled laryngoscope and other normal intubation equipment.


A Cook's Tube Exchanger is not necessary - this is used to exchange tubes

already in place.


A 5'6" female has been transferred from Intermediate Care to Intensive Care in

respiratory


distress. She is intubated with a silver-coated #7.0 Endotracheal tube. CXR

immediately

, ACCS Oakes practice Exam; Questions &
Answers (Latest Update)
following intubation shows Right Upper Lobe infiltrate with bibasilar atelectasis.

The ET Tube is


noted to be approximately 4 cm above the carina.


The Respiratory Therapist would BEST recommend:


A) Initiation of broad-spectrum antibiotics for probably pneumonia


B)Withdraw Endotracheal tube at least 3 cm


C) Use tube exchanger to replace Endotracheal tube from silver-coated to a low-

pressure/high-


volume cuffed tube


D) Immediate V/Q Scan ✔✔Correct answer is A


This pt has gone into respiratory failure, requiring intubation. The X-ray is

consistent with a


possible pneumonia diagnosis. The best option therefore is to start antibiotics.


Withdrawing ET Tube is not indicated as 4 cm is likely adequate. Pulling back 3

cm could result


in inadvertent extubation and would cause harm to patient

, ACCS Oakes practice Exam; Questions &
Answers (Latest Update)
Use of tube exchanger is unnecessary. A silver-coated endotracheal tube is

intended to help


prevent VAP


Immediate V/Q scan is not indicated - it is a poor use of resources for what is

needed right away.


You are part of Physician Rounding this morning, and consulting on a patient

who is currently


on APRV. They were originally admitted with a pneumonia which developed into

ARDS with a


P/F ratio as low as 110. The patient was transitioned to APRV from PC due to an

elevated


Plateau Pressure required to maintain VT around 4 cc/kg IBW. The patient is

arousable and


taking breaths on their own. The physician has asked you what should be done

to address the


patient's latest ABG.

, ACCS Oakes practice Exam; Questions &
Answers (Latest Update)
Ph 7.16


PaCo2 49

PaO2 88 torr


HCO3 19


Mode- APRV


Phigh- 24


Plow- 0


Thigh- 5.0 sec


Tlow- o.5 sec


PS- 26


FiO2- 80%


A) Increase Phigh to 28 cmH2O


B) Decrease Phigh to 20 cmH2O


C) Increase sedation


D) Increase Thigh to 6.0 sec ✔✔Correct answer is A

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