FCCS FCCS Patient Monitoring and Safety 2 — Questions and Answers
Question 1: The ICU Liberation ABCDEF bundle 'E' component stands for:
- Electrolyte management
- Early mobility and exercise (Correct answer)
- Extubation readiness
- Empiric antibiotic therapy
Correct answer: Early mobility and exercise
The 'E' in ABCDEF stands for Early mobility and exercise, which reduces delirium, ICU-acquired weakness, and improves long-term functional outcomes.
Question 2: What is the purpose of a spontaneous breathing trial (SBT) in mechanically ventilated patients?
- To determine if the patient needs deeper sedation
- To assess readiness for extubation (Correct answer)
- To diagnose ventilator-associated pneumonia
- To calibrate the ventilator settings
Correct answer: To assess readiness for extubation
An SBT evaluates whether the patient can sustain spontaneous breathing independently, predicting successful extubation when passed.
Question 3: Which parameter in a spontaneous breathing trial indicates failure and need to resume full ventilatory support?
- Respiratory rate 18 breaths/min
- Rapid shallow breathing index (RSBI) > 105 (Correct answer)
- SpO2 99%
- Tidal volume of 400 mL
Correct answer: Rapid shallow breathing index (RSBI) > 105
RSBI (respiratory rate ÷ tidal volume in liters) > 105 predicts SBT failure with high sensitivity, indicating the patient is not ready for extubation.
Question 4: Early enteral nutrition in ICU patients should ideally be started within how many hours of ICU admission?
- 48–72 hours
- 24–48 hours (Correct answer)
- 6–12 hours
- 72–96 hours
Correct answer: 24–48 hours
SCCM/ASPEN guidelines recommend initiating enteral nutrition within 24–48 hours of ICU admission in hemodynamically stable patients to preserve gut integrity.
Question 5: A pressure injury (bedsore) in the ICU is best prevented by repositioning patients every how many hours?
- 6 hours
- 2 hours (Correct answer)
- 8 hours
- 4 hours
Correct answer: 2 hours
Repositioning every 2 hours redistributes pressure over bony prominences, preventing ischemic skin breakdown and pressure injury development.
Question 6: What is the primary rationale for glucose control targeting 140–180 mg/dL (rather than strict normoglycemia) in ICU patients?
- It reduces antibiotic requirements
- Tight glucose control (80–110) increases hypoglycemia risk and mortality, while moderate control balances glycemic harm (Correct answer)
- It reduces the need for insulin infusions
- It improves renal function specifically
Correct answer: Tight glucose control (80–110) increases hypoglycemia risk and mortality, while moderate control balances glycemic harm
The NICE-SUGAR trial showed tight glucose control (80–110 mg/dL) increased mortality and hypoglycemia; moderate control targeting 140–180 mg/dL is now standard.
FCCS FCCS Patient Monitoring and Safety 2
The ICU Liberation ABCDEF bundle 'E' component stands for: