1|Page
FCCS EXAM/ FCCS CERTIFICATION LATEST 2025
ACTUAL EXAM TEST BANK| COMPLETE EXAM WITH
500 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+|
FUNDAMENTAL CRITICAL CARE SUPPORT EXAM
(BRAND NEW!!)
What intervention improves outcomes with ROSC after cardiac arrest? -
ANSWER - Targeted temperature management.
32-36 C
A shunt means there is perfusion without ventilation. What disease
process is an example of a shunt? - ANSWER - Pneumonia
Which type of respiratory failure occurs with CNS depression after an
OD? - ANSWER - Acute hypercapnic respiratory failure --> mixed
A 50 y/o pt is having a COPD exacerbation. You have tried steroids,
bronchodilators, etc. with no improvement. PCO2 is in the 90s, pH is
7.20. You decide to intubate. Vent settings are: VT 375, RR 20, FiO2 .35,
PEEP 5. CXR is normal. A few minutes later, his BP drops to 70/40.
Lungs are clear/equal. Vent shows peak airway pressure of 55 (high) and
plateau pressure of 15. End expiratory hold gives auto-peep of 15.
What is the cause of this pt's HoTN and why? - ANSWER - Auto-peep is
the cause.
pg. 1
,2|Page
COPD pts have difficulty exhaling --> pressure buildup in alveoli.
We use PEEP for the pressure and to improve oxygenation. Auto-peep
comes from breath-stacking --> intrinsic peep. Alveoli enlarge --> high
peak airway pressure. All leads to low venous return --> low CO -->
HoTN
A COPD pt is admitted to the ICU for exacerbation. Pt is on a vent. Pt is
tx w/ bronchodilators, steroids, and Abx. ABG was normal 1 hr ago, but
now the peak airway pressure is up to 55 and plateau pressure is also
high at 50. Pt becomes hypotensive at 70/40. You observe tracheal
deviation to the R. Normal breath sounds on the right, diminished on the
left. No wheezing. WBC is normal.
What is the dx and treatment? - ANSWER - Tension pneumothorax
Needle decompression/chest tube
A pt in ARDS s/p pneumonia is on 100% FiO2 with PEEP of 22. PO2 is
88%. Peak airway pressure and plateau are both high. VT is 5 ml/kg.
How can you decrease the airway pressures? - ANSWER - Decrease the
PEEP, even though it will decrease PaO2.
(Note: you can't decrease the VT because it is already on the low end).
A young asthmatic pt is on the vent. His lungs are very tight. He is on
the AC setting and there is a lot of auto-PEEP. You correct it by reducing
the rate, giving him more time to exhale and making sure he has enough
flow. FiO2 is at .50. He is sedated and seems comfortable. On ABG the
pH is 7.24, CO2 is 65, O2 is 80, and bicarb is 29.
pg. 2
,3|Page
What would you do with the vent settings in this case? - ANSWER -
Keep the settings where they are.
You can't hyperventilate the pt to blow off CO2 b/c the asthma will
worsen. As long as the pH is > 7.2, the settings are okay as they are.
CO2 will correct over time.
Which two conditions are the most indicated for BiPAP? - ANSWER -
COPD exacerbation
Cardiogenic pulmonary edema
A 70 y/o pt with CHF presents with SOB, accessory muscle use, RR 34,
SpO2 90% on 8L O2. CXR reveals infiltrates in a bat wing pattern. She
also has LE edema. She is dx with a CHF exacerbation w/ respiratory
failure. Her ABG shows pH 7.3, PO2 64, CO2 50.
What is the best tx for this pt? - ANSWER - Non-invasive BiPAP.
A pt comes in w/ a femur fx and a rod is placed. Post-op he develops
dyspnea and fever. HR 140, RR 30, SpO2 92% on non-rebreather. He is
transferred to the ICU where you intubate, place a central line, and start
resuscitating him. Hb 8.2, lactate 3.2, SVO2 is 52%.
Why is his SVO2 low? How can we improve it? - ANSWER -
Decreased O2 delivery and increased consumption.
(normal is 65-70)
Administer packed RBCs - 1U of blood will change his Hb from 8.2 to
9.2. O2, fluid, and VT would not work.
pg. 3
, 4|Page
A young pt after an MVA comes to the ER hypotensive and tachycardic.
CXR is clear. He has a contusion on his chest wall and torso. He is
unconscious. What will give you the best insight on what is causing his
shock?
Hb
SCV
Urine Output
FAST exam - ANSWER - FAST exam
41 y/o pt in the SICU following debridement of b/l lower extremities for
necrotizing fasciitis is intubated on AC. Temp 102, HR 116, RR 16, BP
92/46. ABG shows pH 7.23, PO2 133, PCO2 38, Na 139, K 3.7, Cl 102,
Bicarb 16, lactate 4. Dx is metabolic acidosis w/ anion gap d/t infection.
What is the most appropriate intervention?
Increase VT
Continue resuscitation
Decrease RR
Administer bicarb - ANSWER - Continue resuscitation. Don't need to
increase VT bc the pt doesn't have respiratory acidosis. If you decrease
the RR, the pt will go into respiratory acidosis.
A pt has obstructive uropathy. A catheter is placed d/t the obstructive
kidney injury. After the cath is placed, he has massive diuresis to the
point where he is hypotensive, tachy, and lactate is 2x the ULN from
decreased perfusion.
pg. 4
FCCS EXAM/ FCCS CERTIFICATION LATEST 2025
ACTUAL EXAM TEST BANK| COMPLETE EXAM WITH
500 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+|
FUNDAMENTAL CRITICAL CARE SUPPORT EXAM
(BRAND NEW!!)
What intervention improves outcomes with ROSC after cardiac arrest? -
ANSWER - Targeted temperature management.
32-36 C
A shunt means there is perfusion without ventilation. What disease
process is an example of a shunt? - ANSWER - Pneumonia
Which type of respiratory failure occurs with CNS depression after an
OD? - ANSWER - Acute hypercapnic respiratory failure --> mixed
A 50 y/o pt is having a COPD exacerbation. You have tried steroids,
bronchodilators, etc. with no improvement. PCO2 is in the 90s, pH is
7.20. You decide to intubate. Vent settings are: VT 375, RR 20, FiO2 .35,
PEEP 5. CXR is normal. A few minutes later, his BP drops to 70/40.
Lungs are clear/equal. Vent shows peak airway pressure of 55 (high) and
plateau pressure of 15. End expiratory hold gives auto-peep of 15.
What is the cause of this pt's HoTN and why? - ANSWER - Auto-peep is
the cause.
pg. 1
,2|Page
COPD pts have difficulty exhaling --> pressure buildup in alveoli.
We use PEEP for the pressure and to improve oxygenation. Auto-peep
comes from breath-stacking --> intrinsic peep. Alveoli enlarge --> high
peak airway pressure. All leads to low venous return --> low CO -->
HoTN
A COPD pt is admitted to the ICU for exacerbation. Pt is on a vent. Pt is
tx w/ bronchodilators, steroids, and Abx. ABG was normal 1 hr ago, but
now the peak airway pressure is up to 55 and plateau pressure is also
high at 50. Pt becomes hypotensive at 70/40. You observe tracheal
deviation to the R. Normal breath sounds on the right, diminished on the
left. No wheezing. WBC is normal.
What is the dx and treatment? - ANSWER - Tension pneumothorax
Needle decompression/chest tube
A pt in ARDS s/p pneumonia is on 100% FiO2 with PEEP of 22. PO2 is
88%. Peak airway pressure and plateau are both high. VT is 5 ml/kg.
How can you decrease the airway pressures? - ANSWER - Decrease the
PEEP, even though it will decrease PaO2.
(Note: you can't decrease the VT because it is already on the low end).
A young asthmatic pt is on the vent. His lungs are very tight. He is on
the AC setting and there is a lot of auto-PEEP. You correct it by reducing
the rate, giving him more time to exhale and making sure he has enough
flow. FiO2 is at .50. He is sedated and seems comfortable. On ABG the
pH is 7.24, CO2 is 65, O2 is 80, and bicarb is 29.
pg. 2
,3|Page
What would you do with the vent settings in this case? - ANSWER -
Keep the settings where they are.
You can't hyperventilate the pt to blow off CO2 b/c the asthma will
worsen. As long as the pH is > 7.2, the settings are okay as they are.
CO2 will correct over time.
Which two conditions are the most indicated for BiPAP? - ANSWER -
COPD exacerbation
Cardiogenic pulmonary edema
A 70 y/o pt with CHF presents with SOB, accessory muscle use, RR 34,
SpO2 90% on 8L O2. CXR reveals infiltrates in a bat wing pattern. She
also has LE edema. She is dx with a CHF exacerbation w/ respiratory
failure. Her ABG shows pH 7.3, PO2 64, CO2 50.
What is the best tx for this pt? - ANSWER - Non-invasive BiPAP.
A pt comes in w/ a femur fx and a rod is placed. Post-op he develops
dyspnea and fever. HR 140, RR 30, SpO2 92% on non-rebreather. He is
transferred to the ICU where you intubate, place a central line, and start
resuscitating him. Hb 8.2, lactate 3.2, SVO2 is 52%.
Why is his SVO2 low? How can we improve it? - ANSWER -
Decreased O2 delivery and increased consumption.
(normal is 65-70)
Administer packed RBCs - 1U of blood will change his Hb from 8.2 to
9.2. O2, fluid, and VT would not work.
pg. 3
, 4|Page
A young pt after an MVA comes to the ER hypotensive and tachycardic.
CXR is clear. He has a contusion on his chest wall and torso. He is
unconscious. What will give you the best insight on what is causing his
shock?
Hb
SCV
Urine Output
FAST exam - ANSWER - FAST exam
41 y/o pt in the SICU following debridement of b/l lower extremities for
necrotizing fasciitis is intubated on AC. Temp 102, HR 116, RR 16, BP
92/46. ABG shows pH 7.23, PO2 133, PCO2 38, Na 139, K 3.7, Cl 102,
Bicarb 16, lactate 4. Dx is metabolic acidosis w/ anion gap d/t infection.
What is the most appropriate intervention?
Increase VT
Continue resuscitation
Decrease RR
Administer bicarb - ANSWER - Continue resuscitation. Don't need to
increase VT bc the pt doesn't have respiratory acidosis. If you decrease
the RR, the pt will go into respiratory acidosis.
A pt has obstructive uropathy. A catheter is placed d/t the obstructive
kidney injury. After the cath is placed, he has massive diuresis to the
point where he is hypotensive, tachy, and lactate is 2x the ULN from
decreased perfusion.
pg. 4
