PRETEST FCCS REVIEW EXAM SCRIPT 2026
COMPLETE QUESTIONS AND SOLUTIONS
◉ A 72-year-old woman with a history of hypertension, type 2 diabetes
mellitus, and smoking develops sudden-onset severe chest pain
associated with difficulty breathing and diaphoresis. Her vital signs on
arrival in the emergency department are: blood pressure, 165/92 mm Hg;
heart rate, 101 beats/min; respiratory rate, 29 breaths/min; and oxygen
saturation as measured by pulse oximetry, 96% on room air. Which of
the following ECG findings is the most significant indicator for
immediate reperfusion in pt management
A. ST segment depression
B. ST segment elevation
C. T wave inversions
D. Peaked T waves. Answer: B. ST segment elevation
◉ A 72-year-old man presents to the emergency department with
congestive heart failure exacerbation. He is awake and alert but in
distress. He is using accessory respiratory muscles and says it is hard to
breathe. His vitals signs are: heart rate, 120 beats/min; blood pressure,
120/80 mm Hg; respiratory rate, 34 breaths/min; and oxygen saturation,
90% on 8 L of oxygen by simple face mask. Physical examination
reveals bilateral lower extremity edema and crackles in the posterior
lung fields. A chest radiograph demonstrates bilateral fluffy infiltrates
, consistent with pulmonary edema. Arterial blood gas analysis
demonstrates: pH 7.30, PCO2 50 mm Hg, and PO2 64 mm Hg. In
addition to diuresis, which of the following is the best next step in this
patient's management?
A. Intubate and initiate invasive mechanical ventilation
B. Initiate noninvasive positive pressure ventilation
C. Switch to nonrebreather oxygen mask
D. Swi. Answer: B noninvasive positive pressure ventilation
◉ A 27-year-old man is admitted to the ICU with a subarachnoid
hemorrhage after a motor vehicle crash. On examination, his initial
Glasgow Coma Scale score was 8 with labored respirations. He was
intubated in the emergency department and placed on a ventilator.
Shortly after arrival to the unit, his pulse oximeter (SpO2) reads 57%,
with heart rate of 46 beats/min and no pulse. Which of the following is
the safest and most immediate method to verify correct endotracheal
tube placement?
A. Palpation over the epigastrium for abdominal distension
B. Manual bag-mask breathing
C. Qualitative exhaled carbon dioxide monitor or detector
D. Portable chest radiograph. Answer: C exhaled CO2 monitor/detector
COMPLETE QUESTIONS AND SOLUTIONS
◉ A 72-year-old woman with a history of hypertension, type 2 diabetes
mellitus, and smoking develops sudden-onset severe chest pain
associated with difficulty breathing and diaphoresis. Her vital signs on
arrival in the emergency department are: blood pressure, 165/92 mm Hg;
heart rate, 101 beats/min; respiratory rate, 29 breaths/min; and oxygen
saturation as measured by pulse oximetry, 96% on room air. Which of
the following ECG findings is the most significant indicator for
immediate reperfusion in pt management
A. ST segment depression
B. ST segment elevation
C. T wave inversions
D. Peaked T waves. Answer: B. ST segment elevation
◉ A 72-year-old man presents to the emergency department with
congestive heart failure exacerbation. He is awake and alert but in
distress. He is using accessory respiratory muscles and says it is hard to
breathe. His vitals signs are: heart rate, 120 beats/min; blood pressure,
120/80 mm Hg; respiratory rate, 34 breaths/min; and oxygen saturation,
90% on 8 L of oxygen by simple face mask. Physical examination
reveals bilateral lower extremity edema and crackles in the posterior
lung fields. A chest radiograph demonstrates bilateral fluffy infiltrates
, consistent with pulmonary edema. Arterial blood gas analysis
demonstrates: pH 7.30, PCO2 50 mm Hg, and PO2 64 mm Hg. In
addition to diuresis, which of the following is the best next step in this
patient's management?
A. Intubate and initiate invasive mechanical ventilation
B. Initiate noninvasive positive pressure ventilation
C. Switch to nonrebreather oxygen mask
D. Swi. Answer: B noninvasive positive pressure ventilation
◉ A 27-year-old man is admitted to the ICU with a subarachnoid
hemorrhage after a motor vehicle crash. On examination, his initial
Glasgow Coma Scale score was 8 with labored respirations. He was
intubated in the emergency department and placed on a ventilator.
Shortly after arrival to the unit, his pulse oximeter (SpO2) reads 57%,
with heart rate of 46 beats/min and no pulse. Which of the following is
the safest and most immediate method to verify correct endotracheal
tube placement?
A. Palpation over the epigastrium for abdominal distension
B. Manual bag-mask breathing
C. Qualitative exhaled carbon dioxide monitor or detector
D. Portable chest radiograph. Answer: C exhaled CO2 monitor/detector
