FCCS Exam Questions with Correct Answers
A patient arrives in the emergency department with a respiratory rate of 4
breaths/minute. She is not intubated. Overdose with a centrally acting nervous system
depressant is suspected. Which of the following is the most likely finding on the initial
blood gas?
Acute hypercapnic respiratory failure only
A patient is neurologically devastated, mechanically ventilated, and undergoing dialysis.
The neurology service says there is no expectation of neurologic recovery or
improvement. The family is resistant to any decision regarding limiting or stopping any
life-sustaining treatment. Multiple discussions have occurred during the past 6 weeks.
Which of the following is the most appropriate next step?
Begin formal conflict-resolution process
A 52-year-old man presents to the emergency department with shortness of breath and
new-onset lower extremity edema. His vital signs are: temperature 37.0 °C (98.6 °F);
heart rate 114 beats/min; respiratory rate 28 breaths/min; blood pressure 86/62 mm
Hg; and oxygen saturation as measured by pulse oximetry, (SpO2) 92% on
nonrebreather mask. He is transferred to the ICU, intubated, and a central line is
placed. His hemoglobin is 9.2 g/dL, lactic acid is 4.2 mg/dL, SpO2 has improved to 98%,
and central venous oxygen saturation is (ScvO2) 43%. This Scvo2 level indicates which
of the following findings?
Decrease oxygen delivery and/or increased oxygen consumption
A 75-year-old patient with severe chronic obstructive pulmonary disease (COPD) has a
cardiac arrest due to ventricular fibrillation and requires CPR. The patient is being
, ventilated at 10 breaths/min as CPR ensues. A medical student believes the patient has a
do-not-resuscitate (DNR) order on file. The nurse is concerned that the patient has only
1 working IV line. Which of the following is the most appropriate approach?
Ensure quantitative end-tidal CO2 monitoring during CPR
A 52-year-old man presents to the emergency department with shortness of breath and
new-onset lower extremity edema. Vital signs are: temperature 37.0 °C (98.6 °F), heart
rate 114 beats/min, respiratory rate 28 breaths/min, blood pressure 86/62 mm Hg, and
oxygen saturation as measured by pulse oximetry (Spo2) 92% on nonrebreather mask.
He is transferred to the ICU, intubated, and a central line is placed. Transthoracic
echocardiogram shows significantly reduced left ventricular function. Hemoglobin is 9.2
g/dL, lactic acid 4.2 mg/dL, and central venous oxygen saturation 43%. Which of the
following interventions will significantly improve oxygen delivery?
Start vasopressors to increase systolic blood pressure
Which of the following are expected physiologic changes during pregnancy?
Decreased functional residual capacity in the third trimester
A 72-year-old woman with a history of hypertension, type 2 diabetes mellitus, and
smoking develops sudden-onset severe chest pain associated with difficulty breathing
and diaphoresis. Her vital signs on arrival in the emergency department are: blood
pressure, 165/92 mm Hg; heart rate, 101 beats/min; respiratory rate, 29 breaths/min;
and oxygen saturation as measured by pulse oximetry, 96% on room air. Which of the
following ECG findings is the most significant indicator for immediate reperfusion in
this patient?
ST segment elevation
A patient arrives in the emergency department with a respiratory rate of 4
breaths/minute. She is not intubated. Overdose with a centrally acting nervous system
depressant is suspected. Which of the following is the most likely finding on the initial
blood gas?
Acute hypercapnic respiratory failure only
A patient is neurologically devastated, mechanically ventilated, and undergoing dialysis.
The neurology service says there is no expectation of neurologic recovery or
improvement. The family is resistant to any decision regarding limiting or stopping any
life-sustaining treatment. Multiple discussions have occurred during the past 6 weeks.
Which of the following is the most appropriate next step?
Begin formal conflict-resolution process
A 52-year-old man presents to the emergency department with shortness of breath and
new-onset lower extremity edema. His vital signs are: temperature 37.0 °C (98.6 °F);
heart rate 114 beats/min; respiratory rate 28 breaths/min; blood pressure 86/62 mm
Hg; and oxygen saturation as measured by pulse oximetry, (SpO2) 92% on
nonrebreather mask. He is transferred to the ICU, intubated, and a central line is
placed. His hemoglobin is 9.2 g/dL, lactic acid is 4.2 mg/dL, SpO2 has improved to 98%,
and central venous oxygen saturation is (ScvO2) 43%. This Scvo2 level indicates which
of the following findings?
Decrease oxygen delivery and/or increased oxygen consumption
A 75-year-old patient with severe chronic obstructive pulmonary disease (COPD) has a
cardiac arrest due to ventricular fibrillation and requires CPR. The patient is being
, ventilated at 10 breaths/min as CPR ensues. A medical student believes the patient has a
do-not-resuscitate (DNR) order on file. The nurse is concerned that the patient has only
1 working IV line. Which of the following is the most appropriate approach?
Ensure quantitative end-tidal CO2 monitoring during CPR
A 52-year-old man presents to the emergency department with shortness of breath and
new-onset lower extremity edema. Vital signs are: temperature 37.0 °C (98.6 °F), heart
rate 114 beats/min, respiratory rate 28 breaths/min, blood pressure 86/62 mm Hg, and
oxygen saturation as measured by pulse oximetry (Spo2) 92% on nonrebreather mask.
He is transferred to the ICU, intubated, and a central line is placed. Transthoracic
echocardiogram shows significantly reduced left ventricular function. Hemoglobin is 9.2
g/dL, lactic acid 4.2 mg/dL, and central venous oxygen saturation 43%. Which of the
following interventions will significantly improve oxygen delivery?
Start vasopressors to increase systolic blood pressure
Which of the following are expected physiologic changes during pregnancy?
Decreased functional residual capacity in the third trimester
A 72-year-old woman with a history of hypertension, type 2 diabetes mellitus, and
smoking develops sudden-onset severe chest pain associated with difficulty breathing
and diaphoresis. Her vital signs on arrival in the emergency department are: blood
pressure, 165/92 mm Hg; heart rate, 101 beats/min; respiratory rate, 29 breaths/min;
and oxygen saturation as measured by pulse oximetry, 96% on room air. Which of the
following ECG findings is the most significant indicator for immediate reperfusion in
this patient?
ST segment elevation
