FCCS FCCS Patient Monitoring and Safety 1 — Questions and Answers
Question 1: Arterial line placement provides which advantage over non-invasive blood pressure monitoring?
- It reduces medication administration errors
- Continuous beat-to-beat blood pressure monitoring and arterial blood gas sampling access (Correct answer)
- It prevents vasospasm
- It measures central venous pressure
Correct answer: Continuous beat-to-beat blood pressure monitoring and arterial blood gas sampling access
Arterial lines enable continuous real-time blood pressure monitoring and provide ready access for frequent arterial blood gas sampling without repeated punctures.
Question 2: Central venous pressure (CVP) measurement is most accurately obtained with the transducer zeroed at which anatomical landmark?
- Sternal notch
- Phlebostatic axis (4th ICS, midaxillary line) (Correct answer)
- Left ventricular apex
- Subclavian vein level
Correct answer: Phlebostatic axis (4th ICS, midaxillary line)
The phlebostatic axis (4th intercostal space, midaxillary line) approximates the right atrium level and is the standard reference for zeroing CVP and arterial line transducers.
Question 3: Pulse oximetry (SpO2) can be falsely HIGH in which condition?
- Severe anemia
- Carbon monoxide poisoning (Correct answer)
- Hypothermia
- Hypotension
Correct answer: Carbon monoxide poisoning
Carboxyhemoglobin absorbs light at the same wavelength as oxyhemoglobin, causing the pulse oximeter to read falsely normal or high despite severe CO poisoning.
Question 4: In ICU patients, which daily safety check is recommended for patients on mechanical ventilation per the VAP bundle?
- Routine antibiotic dosing review
- Sedation interruption (daily awakening trial) (Correct answer)
- Parenteral nutrition order renewal
- Chest X-ray every morning
Correct answer: Sedation interruption (daily awakening trial)
Daily sedation interruption (daily awakening trial) is a core VAP bundle element that reduces ventilator days, ICU stays, and associated infections.
Question 5: Medication reconciliation in the ICU is primarily aimed at preventing which type of error?
- Prescribing the wrong antibiotic dose
- Omission of home medications or introduction of harmful drug-drug interactions (Correct answer)
- Administering medications too quickly
- Using the wrong IV fluid type
Correct answer: Omission of home medications or introduction of harmful drug-drug interactions
Medication reconciliation identifies discrepancies between pre-admission medications and ICU orders, preventing harmful omissions and drug-drug interactions.
Question 6: What is the recommended frequency of endotracheal tube cuff pressure checks in ventilated patients?
- Every shift (every 8–12 hours) (Correct answer)
- Once after intubation only
- Every 2 hours
- Once per week
Correct answer: Every shift (every 8–12 hours)
Cuff pressure should be checked and maintained at 20–30 cmH2O every 8–12 hours to prevent microaspiration above the cuff and tracheal injury below it.
FCCS FCCS Patient Monitoring and Safety 1
Arterial line placement provides which advantage over non-invasive blood pressure monitoring?