FCCS POST TEST BRAND NEW EXAM WITH 70 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) [ALREADY GRADED A+]

FCCS POST TEST BRAND NEW EXAM WITH 70 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) [ALREADY GRADED A+] A 56-year-old man presents to the emergency department with a three-day history of fever, shaking chills, cough, and sputum production. He was previously in good health and takes only amlodipine for a history of hypertension. In the emergency department, his heart rate is 130 beats/min, respiratory rate 32breaths/min, blood pressure 80/40 mm Hg, temperature 38.8°C (102°F), and oxygen saturation 92% on 6 liters of oxygen by nasal cannula. Pulmonary examination demonstrates crackles and bronchial breath sounds in both lower lobes. A chest radiograph shows multilobar consolidations. Although awake and alert, he appears visibly distressed and has marked accessory muscle use. Apart from antibiotics and resuscitation for sepsis, 2 | P a g e which of the following is the next best step for management of his respiratory failure? A. Trial of noninvasive mechanical ventilation by face mask B. Intubation and initiation of invasive mechani - B A 56-year-old man is admitted to the ICU for pneumonia. He is intubated, with the following settings: assist control, tidal volume 550 mL, respiratory rate 12 breaths/min, positive end-expiratory pressure 5 cm H2O, FIO2 1.0. Vital signs are: temperature 38.7°C (101.6°F), heart rate 122 beats/min, respiratory rate 20 breaths/min, blood pressure (BP) 88/46 mmHg, SpO2 97%. A central venous line and arterial line have been placed. He has been started on broad-spectrum antibiotics. Which of the following is a clinical indicator that he would benefit from further fluid resuscitation? A. Heart rate persistently greater than 90 beats/min 3 | P a g e B. Passive leg raise resulting in at least 20% increase in systolic BP C. Urine output of less than 0.5 mL/kg/hour D. Systolic BP less than 90 mm Hg - B A 75-year-old man with a history of hypertension is evaluated in the emergency department for nausea, vomiting, and abdominal pain. He is lethargic but can answer questions appropriately. His pulse is 130 beats/min, blood pressure 70/30 mm Hg, and respiratory rate 28 breaths/min. On physical examination, he is noted to have dry mucous membranes, poor capillary refill, and a distended abdomen with rebound tenderness. Arterial blood gas analysis reveals: pH 7.32, PCO2 28 mmHg, PO2 74 mm Hg, bicarbonate 13 mmol/L. Serum lactate is 8.0 mEq/L. Which of the following findings has been shown to correlate with a worse prognosis in a patient with this clinical picture? 4 | P a g e A. Hypotension B. Acidemia on blood gas analysis C. Elevated serum lactic acid D. Tachypnea - C A 65-year-old man is septic, with perforated diverticulitis. He undergoes emergent colectomy with creation of a colostomy. Multiple areas of purulence are identified in the peritoneal cavity. Postoperatively, he continues to be febrile and hypotensive. Chest radiograph is clear. Central venous pressure is 18 mm Hg, and hemoglobin is 13g/dL. Which of the following vasoactive drugs is most appropriate to administer next? A. Epinephrine B. Phenylephrine C. Norepinephrine D. Dobutamine - C