FPC / CFRN - Review Exam - Version B with complete solutions
(LATEST 2022) 137 Questions with 100% Correct Answers
Myxedema coma is also known as...
A. Thyroid storm
B. Adrenal insufficiency
C. Hypothyroidism
D. Hyperaldosteronism Correct Answer: Hypothyroidism
Most common presentation of a patient with hypothyroidism are all of the following, Except...
A. Cold intolerance with coarse hair
B. Almost exclusively over the age of sixty
C. >90% of cases occur in the winter
D. Primarily in men Correct Answer: Primarily in men
Hypothroidism occurs primarily in women, almost exclusively over the age of sixty, with 90% of
the cases occurring in the winter months.
Your patient presents with following parameters: CVP 0, CI 1, PA S/D 8/4, wedge 3, and SVR
1,800. What is your diagnosis?
A. Hypovolemic shock
B. Right ventricular infarction
C. CHF
D. Sepsis Correct Answer: Hypovolemic shock
Careful interpretation of the CVP is important!
Central venous pressure (CVP) describes the pressure of blood in the thoracic vena cava, near the
right atrium of the heart.
CVP reflects the amount of blood returning to the heart and the ability of the heart to pump the
blood into the arterial system.
Drug of choice for profound hypotension in septic shock is?
A. Isotonic crystalloid solution
B. Levophed
C. Nipride
D. Dobutamine Correct Answer: Levophed
Sepsis is by far the most common cause of distributive shock.
The average normal ICP range is...
,A. 0-10 mmHg
B. 10-20 mmHg
C. 20-30 mmHg
D. >30 mmHg Correct Answer: Normal ICP range is 0-10 mmHg, but range can go as high as
15 mmHg.
The formula to calculate MAP is
A. 2/3 DBP × SBP
B. 2 × DBP + SBP divided by 3
C. 2 × SBP + DBP
D. 2 + DBP × SBP divided by 3 Correct Answer: 2 × DBP + SBP / 3
(normal 80-100 mmHg)
Normal coronary perfusion pressure (CPP) is
A. 50-60 mmHg
B. 70-90 mmHg
C. 80-100 mmHg
D. <50 mmHg Correct Answer: Normal 50-60 mmHg
Coronary perfusion pressure: (CPP) = DBP-PAWP
The patient presents with the following hemodynamic parameters: CVP 1, CI 1.7, PA S/D 12/6,
wedge 6, and SVR 300. Vital signs are 78/40, HR 60, RR 16, SaO2 98%. The most likely cause
is...
A. RVMI
B. Neurogenic shock
C. Septic shock
D. Hypovolemic shock Correct Answer: Neurogenic shock
SVR < 800, think distributive shock. Next look at the CI; is it less than 2.5? Hypotension and
either a normal heart and/or bradycardia present narrows the type of distributive shock as being
neurogenic shock.
Severe hypothermic Pt's are at highest risk for which of the following rhythm?
A. A-Fib
B. Asystole
C. V-Fib
D. Sinus Brady Correct Answer: V-Fib
Severe: 20-28 (coma, VF common)
,The drug of choice for a patient exhibiting signs and symptoms of malignant hyperthermia is:
A. Anectine
B. Sodium bicarbonate
C. Dantrolene
D. Glucagon Correct Answer: Dantrolene
Malignant hyperthermia: Characteristic signs are muscular rigidity, followed by a hypercatabolic
state; with increased oxygen consumption, increased carbon dioxide production (hypercapnea,
usually measured by capnography), tachycardia (fast heart rate), and an increase in body
temperature (hyperthermia) at a rate of up to ~2°C per hour, temperatures up to 42°C (108°F) are
not uncommon.
Induction agent of choice with bronchospastic patients Correct Answer: Ketamine (ketalar)
Ativan: indication dose, max Correct Answer: Lorazepam, seizures, 1-2 mg, max 4 mg
Mannitol dose Correct Answer: 1-2 g/kg
Mannitol: an osmotic diuretic, acts by osmosis to ensure urine production and may prevent heme
deposition in the kidney.
Can be administered to avoid acute renal failure when fluid administration has been ineffective.
Drug choice for cyclic antidepressant OD Correct Answer: Sodium bicarbonate
Drug choice for beta-blocker OD Correct Answer: Glucagon
Fentanyl dose Correct Answer: Sublimaze (3 μg/kg)
Treatment for malignant hyperthermia Correct Answer: Dantrium (dantrolene)
Drug for GI bleeds Correct Answer: Sandostatin (octreotide)
You have been requested to transport a twenty-year-old female from an ICU with a history of
TCA overdose two hours prior to your arrival at the sending facility. Your cardiovascular
assessment of the patient would most likely include all of the following with this type of toxicity,
EXCEPT...
A. Early sinus bradycardia
B. Widening QRS
C. Prolonged QT and PR interval
D. Early tachycardia Correct Answer: Early sinus bradycardia
Sinus tachycardia is the most common cardiac disturbance seen following TCA overdose.
, Rhabdomyolysis treatment Correct Answer: - preventing shock and preserving kidney fxn
- NS with sodium bicarbonate
Your patient presents with ABG's of pH 7.39, pCO2 68 HCO3 32, pO2 82. He has history of
COPD and weighs 65 kg. He presents with a history of SOB for 3 days with a RR 20 and is on 4
L/minute of oxygen by NC. He speaks in four- to five-word sentences. What acid-base disorder
is present?
A. Metabolic acidosis with partial compensation
B. Respiratory acidosis with complete compensation
C. Metabolic alkalosis with no compensation
D. Respiratory alkalosis with no compensation Correct Answer: Respiratory acidosis with
complete compensation.
The pCO2 is elevated, which is the primary disorder, and the compensatory response is the
increased HCO3. The pH is normal, so there is complete compensation.
Which formula can be used when calculating a cerebral perfusion pressure (CPP)?
A. [(DBP × 2) + SBP] divided by 3
B. MAP − ICP
C. ICP − DBP
D. [(DBP + 2) × SBP] divided by 3 Correct Answer: MAP − ICP = CPP
Normal range (mmHg): 70-90
You are managing a patient who has been diagnosed with hepatic encephalopathy. His ammonia
levels are elevated. Your management in preparing this patient for transport is to inhibit elevated
protein level by...
A. Administering whole blood
B. Stop GI bleeding and evacuate bowel of blood
C. Aggressive fluid resuscitation
D. Aggressive pain control Correct Answer: Stop GI bleeding and evacuate bowel of blood
Bowel cleansing is the mainstay of therapy for hepatic encephalopathy. Evacuation of gutderived
toxins (intestinal blood, bacteria) and administration of Lactulose (orally or as an enema) is one
of the cornerstones of the treatment of hepatic encephalopathy.
Lactulose may be given orally to acidify the ammonia in the colon and form the ammonium that
can be easily excreted. It is used as a laxative for evacuating blood from intestines and for
reducing ammonia production by intestinal bacteria. Gastrointestinal bleeding should also be
controlled.
Grey Turner's sign may indicate?
(LATEST 2022) 137 Questions with 100% Correct Answers
Myxedema coma is also known as...
A. Thyroid storm
B. Adrenal insufficiency
C. Hypothyroidism
D. Hyperaldosteronism Correct Answer: Hypothyroidism
Most common presentation of a patient with hypothyroidism are all of the following, Except...
A. Cold intolerance with coarse hair
B. Almost exclusively over the age of sixty
C. >90% of cases occur in the winter
D. Primarily in men Correct Answer: Primarily in men
Hypothroidism occurs primarily in women, almost exclusively over the age of sixty, with 90% of
the cases occurring in the winter months.
Your patient presents with following parameters: CVP 0, CI 1, PA S/D 8/4, wedge 3, and SVR
1,800. What is your diagnosis?
A. Hypovolemic shock
B. Right ventricular infarction
C. CHF
D. Sepsis Correct Answer: Hypovolemic shock
Careful interpretation of the CVP is important!
Central venous pressure (CVP) describes the pressure of blood in the thoracic vena cava, near the
right atrium of the heart.
CVP reflects the amount of blood returning to the heart and the ability of the heart to pump the
blood into the arterial system.
Drug of choice for profound hypotension in septic shock is?
A. Isotonic crystalloid solution
B. Levophed
C. Nipride
D. Dobutamine Correct Answer: Levophed
Sepsis is by far the most common cause of distributive shock.
The average normal ICP range is...
,A. 0-10 mmHg
B. 10-20 mmHg
C. 20-30 mmHg
D. >30 mmHg Correct Answer: Normal ICP range is 0-10 mmHg, but range can go as high as
15 mmHg.
The formula to calculate MAP is
A. 2/3 DBP × SBP
B. 2 × DBP + SBP divided by 3
C. 2 × SBP + DBP
D. 2 + DBP × SBP divided by 3 Correct Answer: 2 × DBP + SBP / 3
(normal 80-100 mmHg)
Normal coronary perfusion pressure (CPP) is
A. 50-60 mmHg
B. 70-90 mmHg
C. 80-100 mmHg
D. <50 mmHg Correct Answer: Normal 50-60 mmHg
Coronary perfusion pressure: (CPP) = DBP-PAWP
The patient presents with the following hemodynamic parameters: CVP 1, CI 1.7, PA S/D 12/6,
wedge 6, and SVR 300. Vital signs are 78/40, HR 60, RR 16, SaO2 98%. The most likely cause
is...
A. RVMI
B. Neurogenic shock
C. Septic shock
D. Hypovolemic shock Correct Answer: Neurogenic shock
SVR < 800, think distributive shock. Next look at the CI; is it less than 2.5? Hypotension and
either a normal heart and/or bradycardia present narrows the type of distributive shock as being
neurogenic shock.
Severe hypothermic Pt's are at highest risk for which of the following rhythm?
A. A-Fib
B. Asystole
C. V-Fib
D. Sinus Brady Correct Answer: V-Fib
Severe: 20-28 (coma, VF common)
,The drug of choice for a patient exhibiting signs and symptoms of malignant hyperthermia is:
A. Anectine
B. Sodium bicarbonate
C. Dantrolene
D. Glucagon Correct Answer: Dantrolene
Malignant hyperthermia: Characteristic signs are muscular rigidity, followed by a hypercatabolic
state; with increased oxygen consumption, increased carbon dioxide production (hypercapnea,
usually measured by capnography), tachycardia (fast heart rate), and an increase in body
temperature (hyperthermia) at a rate of up to ~2°C per hour, temperatures up to 42°C (108°F) are
not uncommon.
Induction agent of choice with bronchospastic patients Correct Answer: Ketamine (ketalar)
Ativan: indication dose, max Correct Answer: Lorazepam, seizures, 1-2 mg, max 4 mg
Mannitol dose Correct Answer: 1-2 g/kg
Mannitol: an osmotic diuretic, acts by osmosis to ensure urine production and may prevent heme
deposition in the kidney.
Can be administered to avoid acute renal failure when fluid administration has been ineffective.
Drug choice for cyclic antidepressant OD Correct Answer: Sodium bicarbonate
Drug choice for beta-blocker OD Correct Answer: Glucagon
Fentanyl dose Correct Answer: Sublimaze (3 μg/kg)
Treatment for malignant hyperthermia Correct Answer: Dantrium (dantrolene)
Drug for GI bleeds Correct Answer: Sandostatin (octreotide)
You have been requested to transport a twenty-year-old female from an ICU with a history of
TCA overdose two hours prior to your arrival at the sending facility. Your cardiovascular
assessment of the patient would most likely include all of the following with this type of toxicity,
EXCEPT...
A. Early sinus bradycardia
B. Widening QRS
C. Prolonged QT and PR interval
D. Early tachycardia Correct Answer: Early sinus bradycardia
Sinus tachycardia is the most common cardiac disturbance seen following TCA overdose.
, Rhabdomyolysis treatment Correct Answer: - preventing shock and preserving kidney fxn
- NS with sodium bicarbonate
Your patient presents with ABG's of pH 7.39, pCO2 68 HCO3 32, pO2 82. He has history of
COPD and weighs 65 kg. He presents with a history of SOB for 3 days with a RR 20 and is on 4
L/minute of oxygen by NC. He speaks in four- to five-word sentences. What acid-base disorder
is present?
A. Metabolic acidosis with partial compensation
B. Respiratory acidosis with complete compensation
C. Metabolic alkalosis with no compensation
D. Respiratory alkalosis with no compensation Correct Answer: Respiratory acidosis with
complete compensation.
The pCO2 is elevated, which is the primary disorder, and the compensatory response is the
increased HCO3. The pH is normal, so there is complete compensation.
Which formula can be used when calculating a cerebral perfusion pressure (CPP)?
A. [(DBP × 2) + SBP] divided by 3
B. MAP − ICP
C. ICP − DBP
D. [(DBP + 2) × SBP] divided by 3 Correct Answer: MAP − ICP = CPP
Normal range (mmHg): 70-90
You are managing a patient who has been diagnosed with hepatic encephalopathy. His ammonia
levels are elevated. Your management in preparing this patient for transport is to inhibit elevated
protein level by...
A. Administering whole blood
B. Stop GI bleeding and evacuate bowel of blood
C. Aggressive fluid resuscitation
D. Aggressive pain control Correct Answer: Stop GI bleeding and evacuate bowel of blood
Bowel cleansing is the mainstay of therapy for hepatic encephalopathy. Evacuation of gutderived
toxins (intestinal blood, bacteria) and administration of Lactulose (orally or as an enema) is one
of the cornerstones of the treatment of hepatic encephalopathy.
Lactulose may be given orally to acidify the ammonia in the colon and form the ammonium that
can be easily excreted. It is used as a laxative for evacuating blood from intestines and for
reducing ammonia production by intestinal bacteria. Gastrointestinal bleeding should also be
controlled.
Grey Turner's sign may indicate?
