FCCS Quizlet | 350 Questions and Answers | New
2025/2026 Update | With Complete Solutions
What is the most important sign in a critically ill pt? Why?
Tachypnea
Indicates metabolic acidosis (often 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?
Cardiac tamponade; obstructive shock
If a pt has a thyromental distance of 2 cm, what can you expect about their airway?
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?
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?
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?
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?
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?
Targeted temperature management.
32-36 C
,A shunt means there is perfusion without ventilation. What disease process is an example
of a shunt?
Pneumonia
Which type of respiratory failure occurs with CNS depression after an OD?
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?
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?
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?
Decrease the PEEP, even though it will decrease PaO2.
(Note: you can't decrease the VT because it is already on the low end).
A young asthmatic pt is on the vent. His lungs are very tight. He is on the AC setting and
there is a lot of auto-PEEP. You correct it by reducing the rate, giving him more time to
exhale and making sure he has enough flow. FiO2 is at .50. He is sedated and seems
comfortable. On ABG the pH is 7.24, CO2 is 65, O2 is 80, and bicarb is 29.
What would you do with the vent settings in this case?
Keep the settings where they are.
2025/2026 Update | With Complete Solutions
What is the most important sign in a critically ill pt? Why?
Tachypnea
Indicates metabolic acidosis (often 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?
Cardiac tamponade; obstructive shock
If a pt has a thyromental distance of 2 cm, what can you expect about their airway?
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?
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?
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?
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?
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?
Targeted temperature management.
32-36 C
,A shunt means there is perfusion without ventilation. What disease process is an example
of a shunt?
Pneumonia
Which type of respiratory failure occurs with CNS depression after an OD?
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?
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?
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?
Decrease the PEEP, even though it will decrease PaO2.
(Note: you can't decrease the VT because it is already on the low end).
A young asthmatic pt is on the vent. His lungs are very tight. He is on the AC setting and
there is a lot of auto-PEEP. You correct it by reducing the rate, giving him more time to
exhale and making sure he has enough flow. FiO2 is at .50. He is sedated and seems
comfortable. On ABG the pH is 7.24, CO2 is 65, O2 is 80, and bicarb is 29.
What would you do with the vent settings in this case?
Keep the settings where they are.
