2024/2025 FCCS Post Test Review questions
and 100% Answers
What is the most important sign in a critically ill pt? Why? Correct Answer Tachypnea
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
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? Correct Answer 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? Correct Answer 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? Correct Answer Keep the
settings where they are.
You can't hyperventilate the pt to blow off CO2 b/c the asthma will worsen. As long as
the pH is > 7.2, the settings are okay as they are. CO2 will correct over time.
Which two conditions are the most indicated for BiPAP? Correct Answer COPD
exacerbation
Cardiogenic pulmonary edema
A 70 y/o pt with CHF presents with SOB, accessory muscle use, RR 34, SpO2 90% on
8L O2. CXR reveals infiltrates in a bat wing pattern. She also has LE edema. She is dx
with a CHF exacerbation w/ respiratory failure. Her ABG shows pH 7.3, PO2 64, CO2
50.
Indicates metabolic acidosis 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? Correct Answer Cardiac tamponade; obstructive
shock
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
and 100% Answers
What is the most important sign in a critically ill pt? Why? Correct Answer Tachypnea
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
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? Correct Answer 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? Correct Answer 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? Correct Answer Keep the
settings where they are.
You can't hyperventilate the pt to blow off CO2 b/c the asthma will worsen. As long as
the pH is > 7.2, the settings are okay as they are. CO2 will correct over time.
Which two conditions are the most indicated for BiPAP? Correct Answer COPD
exacerbation
Cardiogenic pulmonary edema
A 70 y/o pt with CHF presents with SOB, accessory muscle use, RR 34, SpO2 90% on
8L O2. CXR reveals infiltrates in a bat wing pattern. She also has LE edema. She is dx
with a CHF exacerbation w/ respiratory failure. Her ABG shows pH 7.3, PO2 64, CO2
50.
Indicates metabolic acidosis 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? Correct Answer Cardiac tamponade; obstructive
shock
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
