FCCS pre-test Questions and Correct Answers & Latest Updated

A 76-year-old woman with a history of congestive heart failure and hypertension is admitted with altered mental status and mild upper respiratory symptoms. According to family, her mental status has been gradually declining over the past 3 days. Because of generalized weakness and upper respiratory symptoms, she has had a limited amount of food and drink for the past 72 hours. Her home medications include metoprolol, lisinopril, and furosemide. Her family states that she has been compliant with these medications. On physical examination, vital signs are: heart rate, 118 beats/min; blood pressure, 96/53 mm Hg; respiratory rate, 14 breaths/min; and oxygen saturation, 98% on room air. Other findings included dry mucous membranes, poor skin turgor, and the absence of jugular venous distention. Pulmonary examination is clear on auscultation. She opens her eyes to voice, but mumbles incomprehensible sounds and has generali o :## B. Hypertonic (3%) saline, 100 mL for rapid early correction, with goal serum sodium of 118 mEq/L in 24 hours 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 pt management A. ST segment depression 2 | P a g e : 2 0 2 4 / 2 0 2 5 G r a d e A + Master01: DO NOT COPY AND PASTE!! August 25, 2024 Latest Update B. ST segment elevation C. T wave inversions D. Peaked T waves o :## B. ST segment elevation A 72-year-old man presents to the emergency department with congestive heart failure exacerbation. He is awake and alert but in distress. He is using accessory respiratory muscles and says it is hard to breathe. His vitals signs are: heart rate, 120 beats/min; blood pressure, 120/80 mm Hg; respiratory rate, 34 breaths/min; and oxygen saturation, 90% on 8 L of oxygen by simple face mask. Physical examination reveals bilateral lower extremity edema and crackles in the posterior lung fields. A chest radiograph demonstrates bilateral fluffy infiltrates consistent with pulmonary edema. Arterial blood gas analysis demonstrates: pH 7.30, PCO2 50 mm Hg, and PO2 64 mm Hg. In addition to diuresis, which of the following is the best next step in this patient's management? A. Intubate and initiate invasive mechanical ventilation B. Initiate noninvasive positive pressure ventilation C. Switch to nonrebreather oxygen mask D. Swi o :## B noninvasive positive pressure ventilation A 27-year-old man is admitted to the ICU with a subarachnoid hemorrhage after a motor vehicle crash. On examination, his initial Glasgow Coma Scale score was 8 with labored 3 | P a g e : 2 0 2 4 / 2 0 2 5 G r a d e A + Master01: DO NOT COPY AND PASTE!! August 25, 2024 Latest Update respirations. He was intubated in the emergency department and placed on a ventilator. Shortly after arrival to the unit, his pulse oximeter (SpO2) reads 57%, with heart rate of 46 beats/min and no pulse. Which of the following is the safest and most immediate method to verify correct endotracheal tube placement? A. Palpation over the epigastrium for abdominal distension B. Manual bag-mask breathing C. Qualitative exhaled carbon dioxide monitor or detector