FCCS Comprehensive Exam Questions
and
Answers Verified Solutions Latest
Update
Question:
A 72yoF PMHx HTN, T2DM, smoking develops sudden-onset severe CP associated with
difficulty breathing and diaphoresis. Vitals on arrival in ED: BP 165/92, HR 101, RR 29,
SpO2 96% RA. Which of the following ECG findings is most significant indicator for
immediate reperfusion in this patient? A) ST segment depression B) ST segment
elevation C) T wave inversions D) Peaked T waves
Answer:
B) ST segment elevation
Question:
A 72yoM presents to ED with CHF exacerbation. Awake and alert but in distress. Using
accessory respiratory muscles and says it's hard to breathe. Vitals: HR 120, BP 120/80,
RR 34, SpO2 90% on 8L simple face maks. PE: bilateral lower extremity edema,
crackles in posterior lung fields. CXR: bilateral fluffy infiltrates consistent with
pulmonary edema ABG: pH 7.3, PCO2 50, PO2 64 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) switch to high-flow, high-humidity oxygen
Answer:
B) initiate noninvasive positive pressure ventilation
,Question:
A 27yoM admitted to ICU with SAH after MVC. Initial GCS 8 with labored respirations.
He was intubated in the ED and placed on a ventilator. Shortly after arrival to the unit,
SpO2 reads 57% with HR 46 and no pulse. Which of the following is the safest and most
immediate method to verify correct ET tube placement? A) palpation over the
epigastrum for abdominal distention B) manual bag-mask breathing C) qualitative
exhaled carbon dioxide monitor or detector D) portable chest radiograph
Answer:
C) qualitative exhaled carbon dioxide monitor or detector
Question:
A 52yoM presents after a MVC with hypotension and obvious signs of hemorrhagic
shock. FAST exam is positive, and an emergent surgical consult is obtained for
operative intervention. While awaiting surgeon and transport to OR for definitive
hemorrhage control, his BP continues to decline and resuscitation begins. Which of the
following is the best strategy for resuscitation in this setting of massive hemorrhage?
A) infusion of packed red blood cells only until laboratory results are available to assess
for the presence of coagulopathy and thrombocytopenia B) balanced resuscitation
using a combination of packed red blood cells, fresh frozen plasma, and platelets in a
1:1:1 ratio C) limited infusion of IV fluids or blood products until definitive control of
hemorrhage is achieved, regardless of blood pressure or hemodynamic status D)
aggressive isotonic crystalloid infusion to maintain normal blood pressure
Answer:
B) balanced resuscitation using a combination of packed red blood cells, fresh frozen
plasma, and platelets in a 1:1:1 ratio
Question:
A 75yoF is admitted to the ED with AMS. A CTH shows intracranial hemorrhage.
Decision is made to intubate her, but there is concern fro increased ICP. Which of the
following pretreatment agents is most appropriate before performing RSI? A)
cisatracurium B) succinylcholine C) lidocaine D) rocuronium
Answer:
B) succinylcholine
, Question:
A patient arrives in the ED with RR 4. She is not intubated. Overdose with a centrally
acting nervous system depressant is suspected. Which of the following is the most
likely finding on the initial blood gas? A) chronic hypercapnic respiratory failure only B)
acute hypoxemic respiratory failure only C) mixed hypoxemic and hypercapnic
respiratory failure D) acute hypercapnic respiratory failure only
Answer:
D) acute hypercapnic respiratory failure only
Question:
A 35yoM develops ARDS from smoke inhalation injury. He is receiving invasive
mechanical ventilation in volume assist control mode. His ventilator settings are: TV
350 (6mL/kg IBW), RR 28, gas flow rate 80, PEEP 10. His plateau pressure on these
settings is 26. ABG: pH 7.28, PCO2 50, PO2 50, bicarb 26, SpO2 82%. Which of the
following is the most appropriate next step in management? A) increase PEEP to 14 cm
H2O B) increase the respiratory rate to 35 breaths/min C) start a bicarbonate infusion
D) lower the tidal volume to 5 mL/kg ideal body weight
Answer:
A) increase PEEP to 14 cm H2O
Question:
A 68yoM with Crohn disease was admitted with a small bowel fistula. Now POD#2 after
a small bowel resection, he has hematochezia, n/v, abdominal pain, and distention. HR
134, BPP 84/52, Hgb 6.2. POX has poor waveform and readings are poor and
inconsistent. Which of the following is most likely causing the poor pulse oximetry
readings? A) drop in hemoglobin B) excessive nail polish C) elevated carbon dioxide D)
vasoconstriction
Answer:
D) vasoconstriction
and
Answers Verified Solutions Latest
Update
Question:
A 72yoF PMHx HTN, T2DM, smoking develops sudden-onset severe CP associated with
difficulty breathing and diaphoresis. Vitals on arrival in ED: BP 165/92, HR 101, RR 29,
SpO2 96% RA. Which of the following ECG findings is most significant indicator for
immediate reperfusion in this patient? A) ST segment depression B) ST segment
elevation C) T wave inversions D) Peaked T waves
Answer:
B) ST segment elevation
Question:
A 72yoM presents to ED with CHF exacerbation. Awake and alert but in distress. Using
accessory respiratory muscles and says it's hard to breathe. Vitals: HR 120, BP 120/80,
RR 34, SpO2 90% on 8L simple face maks. PE: bilateral lower extremity edema,
crackles in posterior lung fields. CXR: bilateral fluffy infiltrates consistent with
pulmonary edema ABG: pH 7.3, PCO2 50, PO2 64 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) switch to high-flow, high-humidity oxygen
Answer:
B) initiate noninvasive positive pressure ventilation
,Question:
A 27yoM admitted to ICU with SAH after MVC. Initial GCS 8 with labored respirations.
He was intubated in the ED and placed on a ventilator. Shortly after arrival to the unit,
SpO2 reads 57% with HR 46 and no pulse. Which of the following is the safest and most
immediate method to verify correct ET tube placement? A) palpation over the
epigastrum for abdominal distention B) manual bag-mask breathing C) qualitative
exhaled carbon dioxide monitor or detector D) portable chest radiograph
Answer:
C) qualitative exhaled carbon dioxide monitor or detector
Question:
A 52yoM presents after a MVC with hypotension and obvious signs of hemorrhagic
shock. FAST exam is positive, and an emergent surgical consult is obtained for
operative intervention. While awaiting surgeon and transport to OR for definitive
hemorrhage control, his BP continues to decline and resuscitation begins. Which of the
following is the best strategy for resuscitation in this setting of massive hemorrhage?
A) infusion of packed red blood cells only until laboratory results are available to assess
for the presence of coagulopathy and thrombocytopenia B) balanced resuscitation
using a combination of packed red blood cells, fresh frozen plasma, and platelets in a
1:1:1 ratio C) limited infusion of IV fluids or blood products until definitive control of
hemorrhage is achieved, regardless of blood pressure or hemodynamic status D)
aggressive isotonic crystalloid infusion to maintain normal blood pressure
Answer:
B) balanced resuscitation using a combination of packed red blood cells, fresh frozen
plasma, and platelets in a 1:1:1 ratio
Question:
A 75yoF is admitted to the ED with AMS. A CTH shows intracranial hemorrhage.
Decision is made to intubate her, but there is concern fro increased ICP. Which of the
following pretreatment agents is most appropriate before performing RSI? A)
cisatracurium B) succinylcholine C) lidocaine D) rocuronium
Answer:
B) succinylcholine
, Question:
A patient arrives in the ED with RR 4. She is not intubated. Overdose with a centrally
acting nervous system depressant is suspected. Which of the following is the most
likely finding on the initial blood gas? A) chronic hypercapnic respiratory failure only B)
acute hypoxemic respiratory failure only C) mixed hypoxemic and hypercapnic
respiratory failure D) acute hypercapnic respiratory failure only
Answer:
D) acute hypercapnic respiratory failure only
Question:
A 35yoM develops ARDS from smoke inhalation injury. He is receiving invasive
mechanical ventilation in volume assist control mode. His ventilator settings are: TV
350 (6mL/kg IBW), RR 28, gas flow rate 80, PEEP 10. His plateau pressure on these
settings is 26. ABG: pH 7.28, PCO2 50, PO2 50, bicarb 26, SpO2 82%. Which of the
following is the most appropriate next step in management? A) increase PEEP to 14 cm
H2O B) increase the respiratory rate to 35 breaths/min C) start a bicarbonate infusion
D) lower the tidal volume to 5 mL/kg ideal body weight
Answer:
A) increase PEEP to 14 cm H2O
Question:
A 68yoM with Crohn disease was admitted with a small bowel fistula. Now POD#2 after
a small bowel resection, he has hematochezia, n/v, abdominal pain, and distention. HR
134, BPP 84/52, Hgb 6.2. POX has poor waveform and readings are poor and
inconsistent. Which of the following is most likely causing the poor pulse oximetry
readings? A) drop in hemoglobin B) excessive nail polish C) elevated carbon dioxide D)
vasoconstriction
Answer:
D) vasoconstriction
