FCCS PRE TEST AND POST TEST ACTUAL EXAM |70
QUESTIONS AND COMPLETE SOLUTIONS 2026/2027
GRADED A+ LATEST UPDATE .
A 35-year-old man develops acute respiratory distress syndrome from smoke
inhalation injury. He is receiving invasive mechanical ventilation in volume assist
control mode. His ventilator settings are: tidal volume 350 mL (6 mL/kg ideal body
weight), respiratory rate 28 breaths/min, gas flow rate 80 L/min, and positive
end-expiratory pressure (PEEP) 10 cm H2O. His plateau pressure on these settings
is 26 cm H2O. Arterial blood gas analysis reveals: pH 7.28, PCO2 50 mm Hg, PO2
50 mm Hg, bicarbonate 26 mmol/L, and oxygenation saturation 82%. Which of
the following is the most appropriate next step in management?
A. Increase PEEP to 14 cm H2O.
B. Increase the respiratory rate to 35 breaths/min.
C. Start a bicarbonate infusion.
D. Lower the tidal volume to 5 mL/kg ideal body weight. - CORRECT ANSWER ✔✔
- A increase PEEP to 14
A 68-year-old man with Crohn disease was admitted with a small bowel fistula.
Now on postoperative day 2 after a small bowel resection, he has hematochezia,
nausea, vomiting, abdominal pain, and distention. Heart rate is 134 beats/min
and blood pressure is 84/52 mm Hg. Hemoglobin is 6.2 g/dL. Pulse oximetry has a
poor waveform and readings are poor and inconsistent. Which of the following is
the most likely causing the poor pulse oximetry readings
A. Drop in hemoglobin
B. Excessive nail polish
C. Elevated carbon dioxide
D. Vasoconstriction - CORRECT ANSWER ✔✔ - D vasoconstriction
,A 46-year-old man with a history of polysubstance abuse, body mass index of 20,
and prominent thyroid cartilage is found obtunded. He is intubated and admitted
to the ICU. He subsequently regains consciousness, becomes agitated, and
violently pulls out his endotracheal tube. He is unable to breathe; attempts to
assist him with bag mask ventilation are unsuccessful. Direct laryngoscopy reveals
swollen, edematous vocal cords with no glottic opening seen. His oxygen
saturation is now 76%. Which of the following methods is most appropriate to re-
establish an airway?
A. Establish airway patency by using Rapid Sequence Intubation
B. Attempt placement of a supraglottic airway (laryngeal mask airway) and call for
immediate surgical backup
C. Placement of a nasopharyngeal airway
D. Videolaryngoscopy with size 7.5 endotracheal tube - CORRECT ANSWER ✔✔ - B
B. Attempt placement of a supraglottic airway (laryngeal mask airway) and call for
immediate surgical backup
A 53-year-old woman presents to the emergency department with epigastric pain
that began acutely. She has tachycardia and hypotension. An upright chest
radiograph reveals pneumoperitoneum. Her lactic acid is 4.3 mmol/L. After
administering 30 mL/kg normal saline solution, her blood pressure is 78/43 mm
Hg and her mean arterial pressure is 55 mm Hg. After the bolus dynamic
monitoring demonstrates low pulse pressure variation and an IVC ultrasound
shows little variability with respiration. Which of the following is the most
appropriate next intervention to achieve a mean arterial pressure target of 65
mm Hg?
A. 1-L bolus of normal saline
B norepinephrine
C phenylepherine
D tx 1 unit whole blood - CORRECT ANSWER ✔✔ - B norepinephrine
, A 51-year-old male, helmeted motorcyclist with a history of hypertension is hit by
a car. He is found away from his motorcycle. He is intubated at the scene and
transported by helicopter to the nearest trauma center. On arrival, he is
unresponsive and on no sedation. Heart rate is around 140 beats/min, blood
pressure is 80/40 mm Hg, and he is mechanically ventilated. He has had negligible
urine output. He is pale. Massive transfusion protocol is initiated. Which of the
following classes of shock is this patient exhibiting?
A class I shock
B class II shock
C class III Shock
D class IV shock - CORRECT ANSWER ✔✔ - Class IV shock
A 55-year-old woman presents to the emergency department with shortness of
breath and oxygen saturation 84%. She was discharged from the hospital 2 days
ago after a urinary tract infection for which she received IV antibiotics and was
sent home on an oral regimen for 5 more days. Blood and sputum cultures are
obtained and empiric IV antibiotics are started for presumed nosocomial
pneumonia. Which of the following antimicrobial regimens is most appropriate
for this patient?
A. Cefepime plus levofloxacin plus vancomycin
B. Levofloxacin plus tobramycin plus imipenem
C. Meropenem plus trimethoprim-sulfamethoxazole plus vancomycin
D. Piperacillin/tazobactam plus cefepime plus linezolid - CORRECT ANSWER ✔✔ -
A. Cefepime plus levofloxacin plus vancomycin
A 55-year-old man with a history of end-stage renal disease on hemodialysis
presents to the emergency department with lightheadedness and dizziness. He
undergoes dialysis sessions regularly every Monday, Wednesday, and Friday, but
QUESTIONS AND COMPLETE SOLUTIONS 2026/2027
GRADED A+ LATEST UPDATE .
A 35-year-old man develops acute respiratory distress syndrome from smoke
inhalation injury. He is receiving invasive mechanical ventilation in volume assist
control mode. His ventilator settings are: tidal volume 350 mL (6 mL/kg ideal body
weight), respiratory rate 28 breaths/min, gas flow rate 80 L/min, and positive
end-expiratory pressure (PEEP) 10 cm H2O. His plateau pressure on these settings
is 26 cm H2O. Arterial blood gas analysis reveals: pH 7.28, PCO2 50 mm Hg, PO2
50 mm Hg, bicarbonate 26 mmol/L, and oxygenation saturation 82%. Which of
the following is the most appropriate next step in management?
A. Increase PEEP to 14 cm H2O.
B. Increase the respiratory rate to 35 breaths/min.
C. Start a bicarbonate infusion.
D. Lower the tidal volume to 5 mL/kg ideal body weight. - CORRECT ANSWER ✔✔
- A increase PEEP to 14
A 68-year-old man with Crohn disease was admitted with a small bowel fistula.
Now on postoperative day 2 after a small bowel resection, he has hematochezia,
nausea, vomiting, abdominal pain, and distention. Heart rate is 134 beats/min
and blood pressure is 84/52 mm Hg. Hemoglobin is 6.2 g/dL. Pulse oximetry has a
poor waveform and readings are poor and inconsistent. Which of the following is
the most likely causing the poor pulse oximetry readings
A. Drop in hemoglobin
B. Excessive nail polish
C. Elevated carbon dioxide
D. Vasoconstriction - CORRECT ANSWER ✔✔ - D vasoconstriction
,A 46-year-old man with a history of polysubstance abuse, body mass index of 20,
and prominent thyroid cartilage is found obtunded. He is intubated and admitted
to the ICU. He subsequently regains consciousness, becomes agitated, and
violently pulls out his endotracheal tube. He is unable to breathe; attempts to
assist him with bag mask ventilation are unsuccessful. Direct laryngoscopy reveals
swollen, edematous vocal cords with no glottic opening seen. His oxygen
saturation is now 76%. Which of the following methods is most appropriate to re-
establish an airway?
A. Establish airway patency by using Rapid Sequence Intubation
B. Attempt placement of a supraglottic airway (laryngeal mask airway) and call for
immediate surgical backup
C. Placement of a nasopharyngeal airway
D. Videolaryngoscopy with size 7.5 endotracheal tube - CORRECT ANSWER ✔✔ - B
B. Attempt placement of a supraglottic airway (laryngeal mask airway) and call for
immediate surgical backup
A 53-year-old woman presents to the emergency department with epigastric pain
that began acutely. She has tachycardia and hypotension. An upright chest
radiograph reveals pneumoperitoneum. Her lactic acid is 4.3 mmol/L. After
administering 30 mL/kg normal saline solution, her blood pressure is 78/43 mm
Hg and her mean arterial pressure is 55 mm Hg. After the bolus dynamic
monitoring demonstrates low pulse pressure variation and an IVC ultrasound
shows little variability with respiration. Which of the following is the most
appropriate next intervention to achieve a mean arterial pressure target of 65
mm Hg?
A. 1-L bolus of normal saline
B norepinephrine
C phenylepherine
D tx 1 unit whole blood - CORRECT ANSWER ✔✔ - B norepinephrine
, A 51-year-old male, helmeted motorcyclist with a history of hypertension is hit by
a car. He is found away from his motorcycle. He is intubated at the scene and
transported by helicopter to the nearest trauma center. On arrival, he is
unresponsive and on no sedation. Heart rate is around 140 beats/min, blood
pressure is 80/40 mm Hg, and he is mechanically ventilated. He has had negligible
urine output. He is pale. Massive transfusion protocol is initiated. Which of the
following classes of shock is this patient exhibiting?
A class I shock
B class II shock
C class III Shock
D class IV shock - CORRECT ANSWER ✔✔ - Class IV shock
A 55-year-old woman presents to the emergency department with shortness of
breath and oxygen saturation 84%. She was discharged from the hospital 2 days
ago after a urinary tract infection for which she received IV antibiotics and was
sent home on an oral regimen for 5 more days. Blood and sputum cultures are
obtained and empiric IV antibiotics are started for presumed nosocomial
pneumonia. Which of the following antimicrobial regimens is most appropriate
for this patient?
A. Cefepime plus levofloxacin plus vancomycin
B. Levofloxacin plus tobramycin plus imipenem
C. Meropenem plus trimethoprim-sulfamethoxazole plus vancomycin
D. Piperacillin/tazobactam plus cefepime plus linezolid - CORRECT ANSWER ✔✔ -
A. Cefepime plus levofloxacin plus vancomycin
A 55-year-old man with a history of end-stage renal disease on hemodialysis
presents to the emergency department with lightheadedness and dizziness. He
undergoes dialysis sessions regularly every Monday, Wednesday, and Friday, but
