FCCS Review Exam Questions and
Answers10
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? - ANSWERS-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? - ANSWERS-Targeted
temperature management.
32-36 C
A shunt means there is perfusion without ventilation. What disease process is an example of a
shunt? - ANSWERS-Pneumonia
Which type of respiratory failure occurs with CNS depression after an OD? - ANSWERS-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? - ANSWERS-Auto-peep is the cause.
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? - ANSWERS-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? - ANSWERS-Decrease the PEEP, even though it will
decrease PaO2.
(Note: you can't decrease the VT because it is already on the low end).
Answers10
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? - ANSWERS-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? - ANSWERS-Targeted
temperature management.
32-36 C
A shunt means there is perfusion without ventilation. What disease process is an example of a
shunt? - ANSWERS-Pneumonia
Which type of respiratory failure occurs with CNS depression after an OD? - ANSWERS-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? - ANSWERS-Auto-peep is the cause.
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? - ANSWERS-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? - ANSWERS-Decrease the PEEP, even though it will
decrease PaO2.
(Note: you can't decrease the VT because it is already on the low end).
