FCCS Practice Exam 2025 Verified Questions and Correct Answer
1. A patient arrives in the emergency department with a respiratory rate oƒ 4
breaths/minute. She is not intubated. Overdose with a centrally acting nervous system
depressant is suspected. Which oƒ the ƒollowing is the most likely ƒinding on the initial
blood gas?: Acute hypercapnic respiratory ƒailure only
2. A patient is neurologically devastated, mechanically ventilated, and under- going
dialysis.The neurology service says there is no expectation oƒ neurolog- ic recovery or
improvement. The ƒamily is resistant to any decision regarding limiting or stopping any
liƒe-sustaining treatment. Multiple discussions have occurred during the past 6 weeks.
Which oƒ the ƒollowing is the most appro- priate next step?: Begin ƒormal conƒlict-
resolution process
3. A 52-year-old man presents to the emergency department with shortness oƒ breath and
new-onset lower extremity edema. His vital signs are: temperature
37.0 °C (98.6 °Ƒ); heart rate 114 beats/min; respiratory rate 28 breaths/min; blood
pressure 86/62 mm Hg; and oxygen saturation as measured by pulse oximetry, (SpO2)
92% on nonrebreather mask. He is transƒerred to the ICU, intubated, and a central line is
placed. His hemoglobin is 9.2 g/dL, lactic acid is 4.2 mg/dL, SpO2 has improved to 98%,
and central venous oxygen saturation is (ScvO2) 43%. This Scvo2 level indicates which oƒ
the ƒollowing ƒindings?: Decrease oxygen delivery and/or increased oxygen consumption
4. A 75-year-old patient with severe chronic obstructive pulmonary disease (COPD) has a
cardiac arrest due to ventricular ƒibrillation and requires CPR. The patient is being
ventilated at 10 breaths/min as CPR ensues. A medical student believes the patient has a
do-not-resuscitate (DNR) order on ƒile. The nurse is concerned that the patient has only 1
working IV line. Which oƒ the ƒollowing is the most appropriate approach?: Ensure
quantitative end-tidal CO2 monitoring during CPR
5. A 52-year-old man presents to the emergency department with shortness oƒ breath and
new-onset lower extremity edema.Vital signs are: temperature 37.0
°C (98.6 °Ƒ), heart rate 114 beats/min, respiratory rate 28 breaths/min, blood pressure
86/62 mm Hg, and oxygen saturation as measured by pulse oximetry (Spo2) 92% on
nonrebreather mask. He is transƒerred to the ICU, intubated, and a central line is placed.
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,Transthoracic echocardiogram shows signiƒicantly reduced leƒt ventricular ƒunction.
Hemoglobin is 9.2 g/dL, lactic acid 4.2 mg/dL, and central venous oxygen saturation 43%.
Which oƒ the ƒollowing interven- tions will signiƒicantly improve oxygen delivery?: Start
vasopressors to increase systolic blood pressure
6. Which oƒ the ƒollowing are expected physiologic changes during pregnan- cy?:
Decreased ƒunctional residual capacity in the third trimester
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17
, 7. A 72-year-old woman with a history oƒ hypertension, type 2 diabetes mel- litus, and
smoking develops sudden-onset severe chest pain associated with diƒƒiculty breathing
and diaphoresis. Her vital signs on arrival in the emergency department are: blood
pressure, 165/92 mm Hg; heart rate, 101 beats/min; respiratory rate, 29 breaths/min;
and oxygen saturation as mea- sured by pulse oximetry, 96% on room air.Which oƒ the
ƒollowing ECG ƒindings is the most signiƒicant indicator ƒor immediate reperƒusion in this
patient?: ST segment elevation
8. A 69-year-old man is brought to the emergency department aƒter a
high-speed motor vehicle collision. He is conƒused and has signiƒicant abdom- inal
tenderness to palpation and labored breathing.Vital signs show hypoten- sion despite
crystalloid bolus and hypoxemia not responsive to supplemental oxygen. Which oƒ the
ƒollowing is the most appropriate induction agent ƒor intubation?: Ketamine
9. A 22-year-old man is admitted to the hospital aƒter a motorcycle accident. He was
wearing a helmet that sustained obvious damage. On initial examination, he will not open
his eyes to painƒul stimuli, but makes incomprehensible sounds; he withdraws ƒrom pain
but cannot localize it. His vital signs are as ƒollows: respiratory rate, 14/min; heart rate,
88/min; and blood pressure, 110/60 mm Hg. His oxygen saturation (SpO2) is 93% on high-
ƒlow oxygen via ƒace mask. During his initial management, the patient is cleared ƒor
spinal cord injury, intubated, and placed on assist-control ventilation. His initial brain CT
scan demonstrates a small subdural hematoma and evidence oƒ increased intracranial
pressure (ICP). A neurosurgical consultation is obtained, and an ICP device is placed.
Which oƒ the ƒollowing is the most appropriate initial man- agement ƒor this patient?:
Elevation oƒ the head oƒ bed 30-45° while maintaining the head and neck in neutral position
10. An 80-kg (176-lb), 55-year-old man was in a house ƒire and sustained
circumƒerential burns to the entire right upper extremity, anterior chest, and anterior
abdomen. Aƒter initiating lactated Ringer solution at 500 mL/hr, what is the estimated
weight-based ƒluid volume ƒor this patient in the ƒirst 24 hours?: 8640 mL
11. A 68-year-old man with Crohn disease was admitted with a small bowel ƒistula. Now
on postoperative day 2 aƒter a small bowel resection, he has hematochezia, nausea,
vomiting, abdominal pain, and distention. Heart rate is 134 beats/min and blood pressure
is 84/52 mm Hg. Hemoglobin is 6.2 g/dL. Pulse oximetry has a poor waveƒorm and
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1. A patient arrives in the emergency department with a respiratory rate oƒ 4
breaths/minute. She is not intubated. Overdose with a centrally acting nervous system
depressant is suspected. Which oƒ the ƒollowing is the most likely ƒinding on the initial
blood gas?: Acute hypercapnic respiratory ƒailure only
2. A patient is neurologically devastated, mechanically ventilated, and under- going
dialysis.The neurology service says there is no expectation oƒ neurolog- ic recovery or
improvement. The ƒamily is resistant to any decision regarding limiting or stopping any
liƒe-sustaining treatment. Multiple discussions have occurred during the past 6 weeks.
Which oƒ the ƒollowing is the most appro- priate next step?: Begin ƒormal conƒlict-
resolution process
3. A 52-year-old man presents to the emergency department with shortness oƒ breath and
new-onset lower extremity edema. His vital signs are: temperature
37.0 °C (98.6 °Ƒ); heart rate 114 beats/min; respiratory rate 28 breaths/min; blood
pressure 86/62 mm Hg; and oxygen saturation as measured by pulse oximetry, (SpO2)
92% on nonrebreather mask. He is transƒerred to the ICU, intubated, and a central line is
placed. His hemoglobin is 9.2 g/dL, lactic acid is 4.2 mg/dL, SpO2 has improved to 98%,
and central venous oxygen saturation is (ScvO2) 43%. This Scvo2 level indicates which oƒ
the ƒollowing ƒindings?: Decrease oxygen delivery and/or increased oxygen consumption
4. A 75-year-old patient with severe chronic obstructive pulmonary disease (COPD) has a
cardiac arrest due to ventricular ƒibrillation and requires CPR. The patient is being
ventilated at 10 breaths/min as CPR ensues. A medical student believes the patient has a
do-not-resuscitate (DNR) order on ƒile. The nurse is concerned that the patient has only 1
working IV line. Which oƒ the ƒollowing is the most appropriate approach?: Ensure
quantitative end-tidal CO2 monitoring during CPR
5. A 52-year-old man presents to the emergency department with shortness oƒ breath and
new-onset lower extremity edema.Vital signs are: temperature 37.0
°C (98.6 °Ƒ), heart rate 114 beats/min, respiratory rate 28 breaths/min, blood pressure
86/62 mm Hg, and oxygen saturation as measured by pulse oximetry (Spo2) 92% on
nonrebreather mask. He is transƒerred to the ICU, intubated, and a central line is placed.
1/
17
,Transthoracic echocardiogram shows signiƒicantly reduced leƒt ventricular ƒunction.
Hemoglobin is 9.2 g/dL, lactic acid 4.2 mg/dL, and central venous oxygen saturation 43%.
Which oƒ the ƒollowing interven- tions will signiƒicantly improve oxygen delivery?: Start
vasopressors to increase systolic blood pressure
6. Which oƒ the ƒollowing are expected physiologic changes during pregnan- cy?:
Decreased ƒunctional residual capacity in the third trimester
2/
17
, 7. A 72-year-old woman with a history oƒ hypertension, type 2 diabetes mel- litus, and
smoking develops sudden-onset severe chest pain associated with diƒƒiculty breathing
and diaphoresis. Her vital signs on arrival in the emergency department are: blood
pressure, 165/92 mm Hg; heart rate, 101 beats/min; respiratory rate, 29 breaths/min;
and oxygen saturation as mea- sured by pulse oximetry, 96% on room air.Which oƒ the
ƒollowing ECG ƒindings is the most signiƒicant indicator ƒor immediate reperƒusion in this
patient?: ST segment elevation
8. A 69-year-old man is brought to the emergency department aƒter a
high-speed motor vehicle collision. He is conƒused and has signiƒicant abdom- inal
tenderness to palpation and labored breathing.Vital signs show hypoten- sion despite
crystalloid bolus and hypoxemia not responsive to supplemental oxygen. Which oƒ the
ƒollowing is the most appropriate induction agent ƒor intubation?: Ketamine
9. A 22-year-old man is admitted to the hospital aƒter a motorcycle accident. He was
wearing a helmet that sustained obvious damage. On initial examination, he will not open
his eyes to painƒul stimuli, but makes incomprehensible sounds; he withdraws ƒrom pain
but cannot localize it. His vital signs are as ƒollows: respiratory rate, 14/min; heart rate,
88/min; and blood pressure, 110/60 mm Hg. His oxygen saturation (SpO2) is 93% on high-
ƒlow oxygen via ƒace mask. During his initial management, the patient is cleared ƒor
spinal cord injury, intubated, and placed on assist-control ventilation. His initial brain CT
scan demonstrates a small subdural hematoma and evidence oƒ increased intracranial
pressure (ICP). A neurosurgical consultation is obtained, and an ICP device is placed.
Which oƒ the ƒollowing is the most appropriate initial man- agement ƒor this patient?:
Elevation oƒ the head oƒ bed 30-45° while maintaining the head and neck in neutral position
10. An 80-kg (176-lb), 55-year-old man was in a house ƒire and sustained
circumƒerential burns to the entire right upper extremity, anterior chest, and anterior
abdomen. Aƒter initiating lactated Ringer solution at 500 mL/hr, what is the estimated
weight-based ƒluid volume ƒor this patient in the ƒirst 24 hours?: 8640 mL
11. A 68-year-old man with Crohn disease was admitted with a small bowel ƒistula. Now
on postoperative day 2 aƒter a small bowel resection, he has hematochezia, nausea,
vomiting, abdominal pain, and distention. Heart rate is 134 beats/min and blood pressure
is 84/52 mm Hg. Hemoglobin is 6.2 g/dL. Pulse oximetry has a poor waveƒorm and
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17
