FCCS REVIEW QUESTIONS WITH 100% CORRECT ANSWERS

What is the most important sign in a critically ill pt? Why? CORRECT ANSWER Tachypnea Indicates metabolic acidosis w/ respiratory alkalosis compensation A pt misses dialysis for a few days and comes in with fluid overload. He's tachycardic and tachypneic. On physical exam, you find JVD, pulsus paradoxus (20 mmHg drop during inspiration), and HoTN (80/40) with distant, muffled heart sounds. Lungs are clear to auscultation. What is the dx? CORRECT ANSWER Cardiac tamponade; obstructive shock If a pt has a thyromental distance of 2 cm, what can you expect about their airway? CORRECT ANSWER Difficult airway w/ an anteriorly displaced larynx A COPD pt comes in with difficulty breathing. He then becomes apneic and unresponsive. How would you ventilate this pt? CORRECT ANSWER BVM A pt arrives after falling from a ladder and has a frontal laceration. On examination, you find papilledema and labored breathing w/o being able to clear secretions. What is your biggest concern when intubating this pt? CORRECT ANSWER Cerebral edema/increasing ICP Intubation tends to cause an increase in ICP. Administer lidocaine prior to intubation to inhibit vagal stimulation. An ESRD pt w/ hyperkalemia develops dyspnea and requires intubation. Which paralytic agent/NMB should you avoid and why? CORRECT ANSWER Succinylcholine Worsens hyperkalemia A pt is admitted after an OD. He starts to have apneic episodes and his SpO2 is dropping. You place him on a non-rebreather mask w/ 100% O2, yet his SpO2 remains at 80%. Why is it not being corrected? Then, if you try a BVM and it also fails, and video laryngoscopy is unavailable, what is your next best choice for an airway? CORRECT ANSWER The pt is having apneic episodes, which means that administering high-flow O2 will be ineffective. Choose an LMA if the BVM fails.