FCCS Exam Questions and Answers Rated A Score

FCCS Exam Questions and Answers Rated A Score Which of the following parameters may be a late sign of cardiovascular disturbance signaling failure of the compensatory mechanisms? A. Tachycardia B. Bradycardia C. Hypotension D. Hypertension - C Investigative tests should be based on the patient's history and physical examination as well as on previous tests. Which of the following is one of the most important indicators of critical illness? A. Respiratory acidosis B. Metabolic acidosis C. Elevated creatinine D. Hyponatremia - B A 22-year-old man is brought to the emergency room after falling from a horse. He is awaiting transfer to another facility. He has a chest contusion and a non-displaced femur fracture. He is in spinal motion restriction with a cervical collar and long backboard. He has worsening respiratory distress and hypoxemia requiring endotracheal intubation. Which of the following modifications of the manual assisted ventilation technique is appropriate? A. Place an oral airway one size larger than usual. B. Add additional downward pressure on the face mask once it is sealed. C. Use a jaw thrust technique in place of neck extension. D. Increase the tidal volume with each manual assisted breath. - C Which of the following anatomic features is most likely to contribute to difficulty in maintaining a patent airway in a supine patient? A. Edentulous mandible B. Posteriorly displaced tongue C. Deviated nasal septum D. Anteriorly displaced thyroid cartilage - B An elderly patient is on the medical ward for respiratory distress. Which of the following is correct regarding airway assessment? A. Laryngeal displacement toward the chest during inspiration occurs only with upper airway obstruction B. Chest rise with inspiration indicates an adequate tidal volume C. Unilateral absent breath sounds on auscultation is a tension pneumothorax D. Complete airway obstruction is likely when chest retraction and movement is present, but there are no breath sounds - D An 82-year-old man who awoke with chest pain in the morning is being evaluated in the emergency department. He is alert and oriented. Shortly after being placed on a cardiac monitor in normal sinus rhythm with ST segment elevations, he becomes unresponsive and develops ventricular fibrillation. Which of the following initial interventions is most appropriate for this patient? A. Do not initiate treatment because, due to his age, he probably has a do-not-resuscitate order on file. B. Attempt to contact the family before treating to discuss the level of intervention. C. Start cardiopulmonary resuscitation while preparing to defibrillate. D. Start bag-mask-valve ventilation while preparing to intubate. - C Which of the following is the purpose of cardiopulmonary resuscitation? A. To reverse symptomatic bradycardia in an ICU patient who is on multiple vasoactive infusions B. To reverse sudden cardiac death in a patient who is in the palliative care unit C. To prolong the life of a patient who has a do-not-resuscitate order on file to allow time for family to arrive D. To reverse sudden, unexpected death from a reversible disease process or iatrogenic complications - D A 75-year-old man with a long history of smoking, chronic lung disease, and treatment noncompliance is brought to the emergency department by his daughter. He has had progressive dyspnea. He is awake, alert, and in moderate distress, with the use of accessory muscles during inspiration and expiration and a respiratory rate of 30 beats/min. There are audible expiratory wheezes. Which of the following pharmacologic treatments should be initiated? A. Inhaled beta2-agonist B. Aerosolized racemic epinephrine C. Transtracheal lidocaine D. N-acetylcysteine - A A 65-year-old woman is admitted with pulmonary edema due to acute diastolic left ventricular failure. She is alert and oriented but has a respiratory rate of 30 breaths/min and a room air SpO2 of 88%. On examination, she has 4 cm jugular venous distention and end-inspiratory crackles in her lung fields bilaterally. Room air arterial blood gas analysis shows: pH 7.28, PCO2 48 mm Hg, and PO2 58 mm Hg. Along with diuresis and antihypertensive therapy, she is placed on bilevel noninvasive ventilation with an inspiratory positive airway pressure (IPAP) of 12 cm H 2O and an expiratory positive airway pressure (EPAP) of 8 cm H2O delivered via full face mask with FIO2 0.5. Two hours after initiating noninvasive positive pressure ventilation (NPPV), the bedside nurse calls the physician to reassess the patient. The patient is now agitated and fails to follow commands. SpO2 is now 85%. Repeat arterial blood gas analysis shows: - C An 18-year-old, 55-kg (121-lb) woman has just been intubated for an acute asthma attack. She has been sedated and paralyzed in order to facilitate ventilation. Arterial blood gas analysis immediately before intubation revealed: pH 7.08, PCO2 75 mm Hg, and PO2 63 mm Hg on FIO2 0.4. On bagging, diffuse high-pitched wheezes are heard. Which of the following is the most appropriate initial ventilator mode for this patient? A. Continuous positive airway pressure B. Pressure support ventilation C. Assist control volume ventilation D. Assist control pressure ventilation - C