FCCS exam questions and answers
2025
What is the most important sign in a critically ill pt? Why? - ANSWER Tachypnea
Indicates metabolic acidosis w/ respiratory alkalosis compensation
A pt misses dialysis for a few days and comes in with fluid overload. He's tachycardic and
tachypneic. On physical exam, you find JVD, pulsus paradoxus (20 mmHg drop during
inspiration), and HoTN (80/40) with distant, muffled heart sounds. Lungs are clear to
auscultation. What is the dx? - ANSWER Cardiac tamponade; obstructive shock
If a pt has a thyromental distance of 2 cm, what can you expect about their airway? - ANSWER
Difficult airway w/ an anteriorly displaced larynx
A COPD pt comes in with difficulty breathing. He then becomes apneic and unresponsive. How
would you ventilate this pt? - ANSWER BVM
A pt arrives after falling from a ladder and has a frontal laceration. On examination, you find
papilledema and labored breathing w/o being able to clear secretions. What is your biggest
concern when intubating this pt? - ANSWER Cerebral edema/increasing ICP
Intubation tends to cause an increase in ICP. Administer lidocaine prior to intubation to inhibit
vagal stimulation.
An ESRD pt w/ hyperkalemia develops dyspnea and requires intubation. Which paralytic
agent/NMB should you avoid and why? - ANSWER Succinylcholine
, Worsens hyperkalemia
A pt is admitted after an OD. He starts to have apneic episodes and his SpO2 is dropping. You
place him on a non-rebreather mask w/ 100% O2, yet his SpO2 remains at 80%. Why is it not
being corrected?
Then, if you try a BVM and it also fails, and video laryngoscopy is unavailable, what is your next
best choice for an airway? - ANSWER The pt is having apneic episodes, which means that
administering high-flow O2 will be ineffective.
Choose an LMA if the BVM fails.
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.
2025
What is the most important sign in a critically ill pt? Why? - ANSWER Tachypnea
Indicates metabolic acidosis w/ respiratory alkalosis compensation
A pt misses dialysis for a few days and comes in with fluid overload. He's tachycardic and
tachypneic. On physical exam, you find JVD, pulsus paradoxus (20 mmHg drop during
inspiration), and HoTN (80/40) with distant, muffled heart sounds. Lungs are clear to
auscultation. What is the dx? - ANSWER Cardiac tamponade; obstructive shock
If a pt has a thyromental distance of 2 cm, what can you expect about their airway? - ANSWER
Difficult airway w/ an anteriorly displaced larynx
A COPD pt comes in with difficulty breathing. He then becomes apneic and unresponsive. How
would you ventilate this pt? - ANSWER BVM
A pt arrives after falling from a ladder and has a frontal laceration. On examination, you find
papilledema and labored breathing w/o being able to clear secretions. What is your biggest
concern when intubating this pt? - ANSWER Cerebral edema/increasing ICP
Intubation tends to cause an increase in ICP. Administer lidocaine prior to intubation to inhibit
vagal stimulation.
An ESRD pt w/ hyperkalemia develops dyspnea and requires intubation. Which paralytic
agent/NMB should you avoid and why? - ANSWER Succinylcholine
, Worsens hyperkalemia
A pt is admitted after an OD. He starts to have apneic episodes and his SpO2 is dropping. You
place him on a non-rebreather mask w/ 100% O2, yet his SpO2 remains at 80%. Why is it not
being corrected?
Then, if you try a BVM and it also fails, and video laryngoscopy is unavailable, what is your next
best choice for an airway? - ANSWER The pt is having apneic episodes, which means that
administering high-flow O2 will be ineffective.
Choose an LMA if the BVM fails.
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.
