FCCS REVIEW QUESTIONS & ANSWERS
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
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
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 crackles in her lung fields bilaterally. Room air arterial blood gas
analysis shows: pH 7.28, PCO2 48 mm Hg, and PO2 58 mm Hg. Along with diuresis
and antihypertensive therapy, she is placed on bilevel noninvasive ventilation with an
inspiratory positive airway pressure (IPAP) of 12 cm H 2O and an expiratory positive
airway pressure (EPAP) of 8 cm H2O delivered via full face mask with FIO2 0.5. Two
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
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
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 crackles in her lung fields bilaterally. Room air arterial blood gas
analysis shows: pH 7.28, PCO2 48 mm Hg, and PO2 58 mm Hg. Along with diuresis
and antihypertensive therapy, she is placed on bilevel noninvasive ventilation with an
inspiratory positive airway pressure (IPAP) of 12 cm H 2O and an expiratory positive
airway pressure (EPAP) of 8 cm H2O delivered via full face mask with FIO2 0.5. Two
