FCCS Questions WITH ANSWERS

FCCS Questions WITH ANSWERS |\ |\ |\




A 76yoF PMHx CHF, HTN is admitted with AMS and mild upper
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respiratory sxs. According to family, her mental status gradually |\ |\ |\ |\ |\ |\ |\ |\ |\


declined over the last 3 days. Because generalized weakness and
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upper respiratory sxs, limited amount of food/drink in the last
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72hrs. Home meds: metoprolol, lisinopril, furosemide. Family
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states she's compliant. |\ |\




Vitals: HR 118, BP 96/53, RR 14, SpO2 98% RA
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Dry mucous membranes, poor skin turgor, absence of JVD. Clear
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on auscultation. Opens eyes to voice, mumbles incomprehensible
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sounds, generalized weakness. 2 minute tonic-clonic seizure in
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ED which resolves without intervention.
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Na 110, K 4.5, Cl 80, Bicarb 26, BUN 57, Cr 1.2, glucose 89.
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Most appropriate next step? |\ |\ |\




A) free water restriction
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B) hypertonic (3%) saline, 100mL for rapid early correction, goal
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serum Na 118 in 24 hrs |\ |\ |\ |\ |\




C) Normal saline bolus, 1L over 10 min, repeat for goal serum Na
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128 in 24hrs
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D) oral tolvaptan, 15mg - CORRECT ANSWERS ✔✔B) Hypertonic
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(3%) saline, 100 mL for rapid early correction, with goal serum
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sodium of 118 mEq/L in 24 hours |\ |\ |\ |\ |\ |\




A 72yoF PMHx HTN, T2DM, smoking develops sudden-onset
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severe CP associated with difficulty breathing and diaphoresis.
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Vitals on arrival in ED: BP 165/92, HR 101, RR 29, SpO2 96% RA.
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,Which of the following ECG findings is most significant indicator
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for immediate reperfusion in this patient?
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A) ST segment depression
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B) ST segment elevation
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C) T wave inversions
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D) Peaked T waves - CORRECT ANSWERS ✔✔B) ST segment
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elevation


A 72yoM presents to ED with CHF exacerbation. Awake and alert
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but in distress. Using accessory respiratory muscles and says it's
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hard to breathe. |\ |\




Vitals: HR 120, BP 120/80, RR 34, SpO2 90% on 8L simple face
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maks. |\




PE: bilateral lower extremity edema, crackles in posterior lung
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fields.
CXR: bilateral fluffy infiltrates consistent with pulmonary edema
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ABG: pH 7.3, PCO2 50, PO2 64
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In addition to diuresis, which of the following is the best next
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step in this patient's management?
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A) intubate and initiate invasive mechanical ventilation
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B) initiate noninvasive positive pressure ventilation
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C) switch to nonrebreather oxygen mask
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D) switch to high-flow, high-humidity oxygen - CORRECT
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ANSWERS ✔✔B) initiate noninvasive positive pressure ventilation |\ |\ |\ |\ |\ |\




A 27yoM admitted to ICU with SAH after MVC. Initial GCS 8 with
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labored respirations. He was intubated in the ED and placed on a
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, ventilator. Shortly after arrival to the unit, SpO2 reads 57% with
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HR 46 and no pulse.
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Which of the following is the safest and most immediate method
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to verify correct ET tube placement?
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A) palpation over the epigastrum for abdominal distention
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B) manual bag-mask breathing
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C) qualitative exhaled carbon dioxide monitor or detector
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D) portable chest radiograph - CORRECT ANSWERS ✔✔C)
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qualitative exhaled carbon dioxide monitor or detector |\ |\ |\ |\ |\ |\




A 52yoM presents after a MVC with hypotension and obvious
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signs of hemorrhagic shock. FAST exam is positive, and an
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emergent surgical consult is obtained for operative intervention.
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While awaiting surgeon and transport to OR for definitive
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hemorrhage control, his BP continues to decline and resuscitation |\ |\ |\ |\ |\ |\ |\ |\


begins.
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Which of the following is the best strategy for resuscitation in this
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setting of massive hemorrhage?
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A) infusion of packed red blood cells only until laboratory results
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are available to assess for the presence of coagulopathy and
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thrombocytopenia
B) balanced resuscitation using a combination of packed red
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blood cells, fresh frozen plasma, and platelets in a 1:1:1 ratio
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C) limited infusion of IV fluids or blood products until definitive
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control of hemorrhage is achieved, regardless of blood pressure
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or hemodynamic status
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D) aggressive isotonic crystalloid infusion to maintain normal
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blood pressure - CORRECT ANSWERS ✔✔B) balanced
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