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FCCS Review and Pretest Questions with Complete Solutions

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FCCS Review and Pretest Questions with Complete Solutions Which of the following anatomic features is most likely to contribute to difficulty in maintaining a patent airway in a supine patient? A. Edentulous mandible B. Posteriorly displaced tongue C. Deviated nasal septum D. Anteriorly displaced thyroid cartilage - ANSWERS-B An elderly patient is on the medical ward for respiratory distress. Which of the following is correct regarding airway assessment? A. Laryngeal displacement toward the chest during inspiration occurs only with upper airway obstruction B. Chest rise with inspiration indicates an adequate tidal volume C. Unilateral absent breath sounds on auscultation is a tension pneumothorax D. Complete airway obstruction is likely when chest retraction and movement is present, but there are no breath sounds - ANSWERS-D An 82-year-old man who awoke with chest pain in the morning is being evaluated in the emergency department. He is alert and oriented. Shortly after being placed on a cardiac monitor in normal sinus rhythm with ST segment elevations, he becomes unresponsive and develops ventricular fibrillation. Which of the following initial interventions is most appropriate for this patient?

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FCCS Review and Pretest Questions
with Complete Solutions16

Which of the following anatomic features is most likely to contribute to difficulty in maintaining
a patent airway in a supine patient?



A. Edentulous mandible

B. Posteriorly displaced tongue

C. Deviated nasal septum

D. Anteriorly displaced thyroid cartilage - ANSWERS-B



An elderly patient is on the medical ward for respiratory distress. Which of the following is
correct regarding airway assessment?



A. Laryngeal displacement toward the chest during inspiration occurs only with upper airway
obstruction

B. Chest rise with inspiration indicates an adequate tidal volume

C. Unilateral absent breath sounds on auscultation is a tension pneumothorax

D. Complete airway obstruction is likely when chest retraction and movement is present, but
there are no breath sounds - ANSWERS-D



An 82-year-old man who awoke with chest pain in the morning is being evaluated in the
emergency department. He is alert and oriented. Shortly after being placed on a cardiac
monitor in normal sinus rhythm with ST segment elevations, he becomes unresponsive and
develops ventricular fibrillation. Which of the following initial interventions is most appropriate
for this patient?

,A. Do not initiate treatment because, due to his age, he probably has a do-not-resuscitate order
on file.

B. Attempt to contact the family before treating to discuss the level of intervention.

C. Start cardiopulmonary resuscitation while preparing to defibrillate.

D. Start bag-mask-valve ventilation while preparing to intubate. - ANSWERS-C



Which of the following is the purpose of cardiopulmonary resuscitation?



A. To reverse symptomatic bradycardia in an ICU patient who is on multiple vasoactive infusions

B. To reverse sudden cardiac death in a patient who is in the palliative care unit

C. To prolong the life of a patient who has a do-not-resuscitate order on file to allow time for
family to arrive

D. To reverse sudden, unexpected death from a reversible disease process or iatrogenic
complications - ANSWERS-D



Which of the following parameters may be a late sign of cardiovascular disturbance signaling
failure of the compensatory mechanisms?



A. Tachycardia

B. Bradycardia

C. Hypotension

D. Hypertension - ANSWERS-C



Investigative tests should be based on the patient's history and physical examination as well as
on previous tests. Which of the following is one of the most important indicators of critical
illness?



A. Respiratory acidosis

, B. Metabolic acidosis

C. Elevated creatinine

D. Hyponatremia - ANSWERS-B



A 22-year-old man is brought to the emergency room after falling from a horse. He is awaiting
transfer to another facility. He has a chest contusion and a non-displaced femur fracture. He is
in spinal motion restriction with a cervical collar and long backboard. He has worsening
respiratory distress and hypoxemia requiring endotracheal intubation. Which of the following
modifications of the manual assisted ventilation technique is appropriate?



A. Place an oral airway one size larger than usual.

B. Add additional downward pressure on the face mask once it is sealed.

C. Use a jaw thrust technique in place of neck extension.

D. Increase the tidal volume with each manual assisted breath. - ANSWERS-C



A 75-year-old man with a long history of smoking, chronic lung disease, and treatment
noncompliance is brought to the emergency department by his daughter. He has had
progressive dyspnea. He is awake, alert, and in moderate distress, with the use of accessory
muscles during inspiration and expiration and a respiratory rate of 30 beats/min. There are
audible expiratory wheezes. Which of the following pharmacologic treatments should be
initiated?



A. Inhaled beta2-agonist

B. Aerosolized racemic epinephrine

C. Transtracheal lidocaine

D. N-acetylcysteine - ANSWERS-A



A 65-year-old woman is admitted with pulmonary edema due to acute diastolic left ventricular
failure. She is alert and oriented but has a respiratory rate of 30 breaths/min and a room air
SpO2 of 88%. On examination, she has 4 cm jugular venous distention and end-inspiratory

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