FCCS Test Questions with Correct Answers
A 52-year-old man presents after a motor vehicle crash with hypotension and obvious
signs of hemorrhagic shock. His focused assessment with sonography in trauma (FAST)
examination is positive, and an emergent surgical consultation is obtained for operative
intervention. While awaiting the surgeon and transportation to the operating room for
definitive hemorrhage control, his blood pressure continues to decline and resuscitation
is begun. Which of the following is the best strategy for resuscitation in this setting of
massive hemorrhage?
Balanced resuscitation using a combination of packed red blood cells, fresh frozen plasma,
and platelets in a 1:1:1 ratio
A 51-year-old male, helmeted motorcyclist with a history of hypertension is hit by a car.
He is found away from his motorcycle. He is intubated at the scene and transported by
helicopter to the nearest trauma center. On arrival, he is unresponsive and on no
sedation. Heart rate is around 140 beats/min, blood pressure is 80/40 mm Hg, and he is
mechanically ventilated. He has had negligible urine output. He is pale. Massive
transfusion protocol is initiated. Which of the following classes of shock is this patient
exhibiting?
Class IV Shock
A 46-year-old man with a history of polysubstance abuse, body mass index of 20, and
prominent thyroid cartilage is found obtunded. He is intubated and admitted to the
ICU. He subsequently regains consciousness, becomes agitated, and violently pulls out
his endotracheal tube. He is unable to breathe; attempts to assist him with bag mask
ventilation are unsuccessful. Direct laryngoscopy reveals swollen, edematous vocal
, cords with no glottic opening seen. His oxygen saturation is now 76%. Which of the
following methods is most appropriate to re-establish an airway?
Attempt placement of a supraglottic airway (laryngeal mask airway) and call for immediate
surgical backup
A 75-year-old woman is admitted to the emergency department with altered mental
status. A CT scan of her head shows an intracranial hemorrhage. A decision is made to
intubate her, but there is concern for increased intracranial pressure. Which of the
following pretreatment agents is most appropriate before performing rapid sequence
intubation?
NEED TO CHECK
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?
Initiate noninvasive positive pressure ventilation
A 68-year-old man with Crohn disease was admitted with a small bowel fistula. Now on
postoperative day 2 after a small bowel resection, he has hematochezia, nausea,
vomiting, abdominal pain, and distention. Heart rate is 134 beats/min and blood
A 52-year-old man presents after a motor vehicle crash with hypotension and obvious
signs of hemorrhagic shock. His focused assessment with sonography in trauma (FAST)
examination is positive, and an emergent surgical consultation is obtained for operative
intervention. While awaiting the surgeon and transportation to the operating room for
definitive hemorrhage control, his blood pressure continues to decline and resuscitation
is begun. Which of the following is the best strategy for resuscitation in this setting of
massive hemorrhage?
Balanced resuscitation using a combination of packed red blood cells, fresh frozen plasma,
and platelets in a 1:1:1 ratio
A 51-year-old male, helmeted motorcyclist with a history of hypertension is hit by a car.
He is found away from his motorcycle. He is intubated at the scene and transported by
helicopter to the nearest trauma center. On arrival, he is unresponsive and on no
sedation. Heart rate is around 140 beats/min, blood pressure is 80/40 mm Hg, and he is
mechanically ventilated. He has had negligible urine output. He is pale. Massive
transfusion protocol is initiated. Which of the following classes of shock is this patient
exhibiting?
Class IV Shock
A 46-year-old man with a history of polysubstance abuse, body mass index of 20, and
prominent thyroid cartilage is found obtunded. He is intubated and admitted to the
ICU. He subsequently regains consciousness, becomes agitated, and violently pulls out
his endotracheal tube. He is unable to breathe; attempts to assist him with bag mask
ventilation are unsuccessful. Direct laryngoscopy reveals swollen, edematous vocal
, cords with no glottic opening seen. His oxygen saturation is now 76%. Which of the
following methods is most appropriate to re-establish an airway?
Attempt placement of a supraglottic airway (laryngeal mask airway) and call for immediate
surgical backup
A 75-year-old woman is admitted to the emergency department with altered mental
status. A CT scan of her head shows an intracranial hemorrhage. A decision is made to
intubate her, but there is concern for increased intracranial pressure. Which of the
following pretreatment agents is most appropriate before performing rapid sequence
intubation?
NEED TO CHECK
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?
Initiate noninvasive positive pressure ventilation
A 68-year-old man with Crohn disease was admitted with a small bowel fistula. Now on
postoperative day 2 after a small bowel resection, he has hematochezia, nausea,
vomiting, abdominal pain, and distention. Heart rate is 134 beats/min and blood
