FCCS Post Test Review questions and 100% Answers
Question : Most important indicator that a patient has a severe
illness?
CORRECT ANSWER : Tachypnea
Question : 3 respiratory types, and their criteria
CORRECT ANSWER : Hypoxemic (PaO2 <50-60)
Hypercapnic (PaCO2 >50, pH <7.36) Mixed
Question : Delta gap (formula, when and why it's used)
CORRECT ANSWER : Difference in AG from normal -
Difference in HCO3 from normal. In AG metabolic acidosis it's used. It tells you if there's underlying metabolic alkalosis or respiratory acidosis with bicarb compensation IN ADDITION to the AG metabolic acidosis. Both of those would result in a high bicarb to begin with, and a smaller change in bicarb from normal.
Question : Winter's formula (equation, what it measures)
CORRECT ANSWER : 1.5[HCO3] + 8 +/- 2. If
compensation is adequate in acid/base issues
Question : How AG changes with albumin changes
CORRECT ANSWER : Decreases 2.5-3 for every 1 decrease
in albumin
Question : Hemodynamic changes after intubation
CORRECT ANSWER: Hypo/hypertension Arrhythmia
Tachycardia
Question : Pressure support equation for BiPAP
CORRECT ANSWER : IPAP - EPAP
Question : 3 types of vent cycles
CORRECT ANSWER : Volume (preset tidal volume,
relieves WOB the most) Time (constant pressure of time) Flow (constant pressure until inspiratory flow is below 25% of peak)
Question : Goal tidal volume
CORRECT ANSWER : 10 cc/kg
Question : Goal FiO2 on vent
CORRECT ANSWER : Start at 1.0, then decrease as SpO2
tolerates (goal of 92-94 saturation)
Question : Ppeak
CORRECT ANSWER : Peak inspiratory pressure
Question : Pplat (try to keep it below ?)
CORRECT ANSWER : Inspiratory plateau pressure (shows
alveolar distention) 30
Question : AutoPEEP (what it is, what it causes, how to fix it)
CORRECT ANSWER : Breath stacking. Decreases preload
to the heart with positive pressure on the lungs --> hypotension. Decrease RR, decrease inspiration time (goal is to have more time for the lungs to exhale)
Question : Danger of increased PEEP
CORRECT ANSWER : Increases autoPEEP, increases Pplat
Question : PaO2 we're usually happy with
CORRECT ANSWER : >60
Question : When to consider NPPV vs invasive
CORRECT ANSWER : When it's a quickly solved problem
in 1-2 days (e.g. COPD exacerbation). When the patient can be compliant with working with NPPV
Question : When to consider switching from NPPV to
invasive ventilation support
CORRECT ANSWER : If things aren't really improving in a
matter of hours. If your therapeutic goals haven't been met in 4-6 hours