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FCCS Questions and Answers () (Verified Answers)
Question 1: What is the most important sign in a critically ill pt?
Why?
CORRECT ANSWER : Tachypnea Indicates metabolic acidosis
w/ respiratory alkalosis compensation
Question 2: 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?
CORRECT ANSWER : Cardiac tamponade; obstructive shock
Question 3: If a pt has a thyromental distance of 2 cm, what can
you expect about their airway?
CORRECT ANSWER : Difficult airway w/ an anteriorly
displaced larynx
Question 4: A COPD pt comes in with difficulty breathing. He
then becomes apneic and unresponsive. How would you ventilate this pt?
CORRECT ANSWER : BVM
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Question 5: 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?
CORRECT ANSWER : Cerebral edema/increasing ICP
Intubation tends to cause an increase in ICP. Administer lidocaine prior to intubation to inhibit vagal stimulation.
Question 6: An ESRD pt w/ hyperkalemia develops dyspnea and
requires intubation. Which paralytic agent/NMB should you avoid and why?
CORRECT ANSWER : Succinylcholine Worsens hyperkalemia
Question 7: 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?
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CORRECT ANSWER : The pt is having apneic episodes, which
means that administering high-flow O2 will be ineffective.Choose an LMA if the BVM fails.
Question 8: What intervention improves outcomes with ROSC
after cardiac arrest?
CORRECT ANSWER : Targeted temperature management. 32-
36 C
Question 9: A shunt means there is perfusion without
ventilation. What disease process is an example of a shunt?
CORRECT ANSWER : Pneumonia
Question 10: Which type of respiratory failure occurs with CNS
depression after an OD?
CORRECT ANSWER : Acute hypercapnic respiratory failure --
> mixed
Question 11: 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.
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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
- What is the cause of this pt's HoTN and why?
CORRECT ANSWER : 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
Question 12: 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
- 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?
CORRECT ANSWER : Tension pneumothorax Needle
decompression/chest tube