FCCS LATEST EXAMS TEST PAPER QUESTIONS AND
ANSWERS SURE A+
✔✔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 - ✔✔D) acute hypercapnic respiratory
failure only
✔✔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 - ✔✔A) increase PEEP to 14 cm
H2O
✔✔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 - ✔✔D) vasoconstriction
✔✔A 46yoM PMHx polysubstance abuse, BMI 20, and prominent thyroid cartilage is
found obtunded. He is intubated and admitted to the ICU. Subsequently regains
consciousness, becomes agitated, violently pulls out his ET tube. He is unable to
breathe; attempts to assist with bag mask ventilation are unsuccessful. Direct
laryngoscopy reveals swollen, edematous vocal cords with no glottic opening seen. His
SpO2 is now 76%.
Which of the following methods is most appropriate to re-establish an airway?
A) establish airway patency by using Rapid Sequence Intubation
B) attempt placement of a supraglottic airway (laryngeal mask airway) and call for
immediate surgical backup
C) placement of a nasopharyngeal airway
, D) videolaryngoscopy with size 7.5 endotracheal tube - ✔✔B) attempt placement of a
supraglottic airway (laryngeal mask airway) and call for immediate surgical backup
✔✔A 53yoF presents to the ED with epigastric pain that began acutely. She has
tachycardia and hypotension. An upright CXR reveals pneumoperitoneum. Her lactic
acid is 4.3. After administering 30 mL/kg normal saline, her BP is 78/43 and her MAP is
55. After the bolus dynamic monitoring demonstrates low pulse pressure variation and
an IVC US shows little variability with respiration.
Which of the following is the most appropriate next intervention to achieve a MAP target
of 65?
A) 1 L bolus of normal saline
B) norepinephrine infusion
C) phenylephrine infusion
D) transfusion of 1 unit whole blood - ✔✔B) norepinephrine infusion
✔✔A 51yoM, helmeted motorcyclist with PMHx HTN is hit by a car. He is found away
from his motorcycle. He is intubated at the scene and transported by helicopter to the
nearest trauma center. On arrival, he is unresponsive and on no sedation. HR is around
140, BP 80/40, and he is mechanically ventilated. He has negligible urine output. He is
pale. Massive transfusion protocol is initiated.
Which of the following classes of shock is this patient exhibiting?
A) class I shock
B) class II shock
C) class III shock
D) class IV shock - ✔✔D) class IV shock
✔✔A 55yoF presents to the ED with SOB and SpO2 84%. She was discharged from the
hospital 2 days ago after a UTI for which she received IV antibiotics and was sent home
on an oral regimen for 5 more days. Blood and sputum cultures are obtained and
empiric IV antibiotics are started for presumed nosocomial pneumonia.
Which of the following antimicrobial regimens is most appropriate for this patient?
A) cefepime plus levofloxacin plus vancomycin
B) levofloxacin plus tobramycin plus imipenem
C) meropenem plus trimethoprim-sulfamethoxazole plus vancomycin
D) piperacillin/tazobactam plus cefepime plus linezolid - ✔✔A) cefepime plus
levofloxacin plus vancomycin
✔✔A 55 yoM with PMHx ESRD on hemodialysis presents to the ED with
lightheadedness and dizziness. He undergoes dialysis sessions regularly every M/W/F,
but he was told that he has received "lower doses" because his Bs have been too low.
He is due for dialysis tomorrow. HR 65, BP 87/49, RR 22, and SpO2 92% on 6L NC. His
ECG is shown.
While waiting for laboratory results, which of the following is the most appropriate next
step in management?
A) IV calcium chloride, 10% solution
ANSWERS SURE A+
✔✔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 - ✔✔D) acute hypercapnic respiratory
failure only
✔✔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 - ✔✔A) increase PEEP to 14 cm
H2O
✔✔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 - ✔✔D) vasoconstriction
✔✔A 46yoM PMHx polysubstance abuse, BMI 20, and prominent thyroid cartilage is
found obtunded. He is intubated and admitted to the ICU. Subsequently regains
consciousness, becomes agitated, violently pulls out his ET tube. He is unable to
breathe; attempts to assist with bag mask ventilation are unsuccessful. Direct
laryngoscopy reveals swollen, edematous vocal cords with no glottic opening seen. His
SpO2 is now 76%.
Which of the following methods is most appropriate to re-establish an airway?
A) establish airway patency by using Rapid Sequence Intubation
B) attempt placement of a supraglottic airway (laryngeal mask airway) and call for
immediate surgical backup
C) placement of a nasopharyngeal airway
, D) videolaryngoscopy with size 7.5 endotracheal tube - ✔✔B) attempt placement of a
supraglottic airway (laryngeal mask airway) and call for immediate surgical backup
✔✔A 53yoF presents to the ED with epigastric pain that began acutely. She has
tachycardia and hypotension. An upright CXR reveals pneumoperitoneum. Her lactic
acid is 4.3. After administering 30 mL/kg normal saline, her BP is 78/43 and her MAP is
55. After the bolus dynamic monitoring demonstrates low pulse pressure variation and
an IVC US shows little variability with respiration.
Which of the following is the most appropriate next intervention to achieve a MAP target
of 65?
A) 1 L bolus of normal saline
B) norepinephrine infusion
C) phenylephrine infusion
D) transfusion of 1 unit whole blood - ✔✔B) norepinephrine infusion
✔✔A 51yoM, helmeted motorcyclist with PMHx HTN is hit by a car. He is found away
from his motorcycle. He is intubated at the scene and transported by helicopter to the
nearest trauma center. On arrival, he is unresponsive and on no sedation. HR is around
140, BP 80/40, and he is mechanically ventilated. He has negligible urine output. He is
pale. Massive transfusion protocol is initiated.
Which of the following classes of shock is this patient exhibiting?
A) class I shock
B) class II shock
C) class III shock
D) class IV shock - ✔✔D) class IV shock
✔✔A 55yoF presents to the ED with SOB and SpO2 84%. She was discharged from the
hospital 2 days ago after a UTI for which she received IV antibiotics and was sent home
on an oral regimen for 5 more days. Blood and sputum cultures are obtained and
empiric IV antibiotics are started for presumed nosocomial pneumonia.
Which of the following antimicrobial regimens is most appropriate for this patient?
A) cefepime plus levofloxacin plus vancomycin
B) levofloxacin plus tobramycin plus imipenem
C) meropenem plus trimethoprim-sulfamethoxazole plus vancomycin
D) piperacillin/tazobactam plus cefepime plus linezolid - ✔✔A) cefepime plus
levofloxacin plus vancomycin
✔✔A 55 yoM with PMHx ESRD on hemodialysis presents to the ED with
lightheadedness and dizziness. He undergoes dialysis sessions regularly every M/W/F,
but he was told that he has received "lower doses" because his Bs have been too low.
He is due for dialysis tomorrow. HR 65, BP 87/49, RR 22, and SpO2 92% on 6L NC. His
ECG is shown.
While waiting for laboratory results, which of the following is the most appropriate next
step in management?
A) IV calcium chloride, 10% solution
