Mixed Deck — All FCCS Topics Flashcards

Catheter-associated urinary tract infection (CAUTI) prevention is best achieved by:

Answer: Removing the urinary catheter as soon as it is no longer needed

The most effective CAUTI prevention measure is daily reassessment and prompt removal of urinary catheters when no longer clinically indicated.

In diabetic ketoacidosis (DKA), why may serum potassium appear normal or elevated despite total body potassium depletion?

Answer: Acidosis shifts potassium from intracellular to extracellular fluid

Metabolic acidosis drives hydrogen ions into cells in exchange for potassium moving out, falsely elevating serum potassium despite total body depletion.

A patient with decompensated heart failure and hyponatremia (Na = 128 mEq/L) presents to the ICU. What is the most appropriate initial fluid management?

Answer: Restrict free water intake and consider diuretics

Dilutional hyponatremia in heart failure is treated with free water restriction and diuresis; adding more fluid worsens volume overload without correcting sodium.

A patient's SpO2 drops from 96% to 88% after suctioning. What is the best immediate action?

Answer: Reconnect to ventilator and increase FiO2 temporarily

After suctioning, reconnecting to supplemental oxygen and temporarily increasing FiO2 rapidly corrects hypoxemia caused by the interruption of ventilation.

A pressure injury (bedsore) in the ICU is best prevented by repositioning patients every how many hours?

Answer: 2 hours

Repositioning every 2 hours redistributes pressure over bony prominences, preventing ischemic skin breakdown and pressure injury development.

Which of the following are common initial settings for mechanical ventilation in an adult with acute respiratory distress syndrome (ARDS)?

Answer: Tidal volume of 4-6 mL/kg of predicted body weight

For adults with Acute Respiratory Distress Syndrome (ARDS), a lung-protective ventilation strategy is crucial, which includes a low tidal volume of 4-6 mL/kg of predicted body weight. This setting minimizes volutrauma and barotrauma to the fragile lungs, preventing further injury and improving outcomes. High tidal volumes can overdistend damaged alveoli, exacerbating lung injury.

Which ECG change is most characteristic of hypokalemia?

Answer: U-waves and flattened T-waves

Hypokalemia classically produces U-waves (positive deflection after T-wave), T-wave flattening, and in severe cases ST depression and prolonged QU interval.

What is the primary indication for endotracheal intubation in critically ill patient?

Answer: To ensure a patient airway in a patient with altered mental status

The primary indication for endotracheal intubation in a critically ill patient is to ensure a patent airway, particularly in those with altered mental status. This intervention protects the airway from aspiration of gastric contents and allows for effective ventilation and oxygenation. It is a fundamental step to secure the airway and support respiratory function when a patient cannot do so independently.

High-flow nasal cannula (HFNC) therapy can deliver oxygen at flows up to what rate?

Answer: 60 L/min

HFNC can deliver heated, humidified oxygen at flow rates up to 60 L/min, providing FiO2 near 1.0.

Which international patient safety goal addresses the risk of wrong-site, wrong-patient procedures in the ICU?

Answer: Universal protocol: patient identification, site marking, and time-out before procedures

The Universal Protocol (patient ID verification, surgical/procedural site marking, and pre-procedure time-out) prevents wrong-patient and wrong-site procedural errors.

Inadvertent hypothermia in critically ill patients is associated with which complication?

Answer: Coagulopathy, cardiac arrhythmias, and increased infection risk

Hypothermia impairs platelet function and coagulation factors, increases arrhythmia risk, and suppresses immune function, worsening outcomes in most critically ill patients.

Source control in sepsis refers to:

Answer: Physically removing or draining the infectious focus (e.g., abscess drainage)

Source control involves definitive measures to eliminate the infection source — debridement, drainage, or removal of infected devices — and is a critical Surviving Sepsis recommendation.

Which of the following is the most appropriate first step in managing a patient with a suspected airway obstruction?

Answer: Insert an oropharyngeal airway

In a patient with a suspected airway obstruction, especially if unconscious, the initial step is to open the airway using basic maneuvers. If these are insufficient, inserting an oropharyngeal airway (OPA) is the most appropriate first device-based intervention. It helps maintain an open airway by preventing the tongue from obstructing the pharynx, serving as a crucial bridge to more advanced airway management if needed.

Which parameters can be directly measured using a central venous catheter?

Answer: Central venous pressure (CVP)

A central venous catheter (CVC) allows for the direct measurement of central venous pressure (CVP). CVP reflects the pressure in the right atrium and provides an estimate of right ventricular preload and overall fluid status. While specialized CVCs can measure other parameters, CVP is a fundamental direct measurement obtained from any standard central line.

Which isolation precaution is required for a patient with suspected pulmonary tuberculosis?

Answer: Airborne precautions with negative pressure room

Pulmonary TB is transmitted via airborne droplet nuclei < 5 µm requiring airborne precautions: N95 respirator and negative pressure isolation room.

In acute decompensated heart failure, what is the primary goal of IV nitroglycerin?

Answer: Reduce preload and afterload to decrease pulmonary congestion

Nitroglycerin dilates venous and arterial beds, reducing both preload and afterload and rapidly relieving pulmonary congestion in acute heart failure.

Sepsis-3 defines sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection, identified clinically by a SOFA score change of how many points?

Answer: ≥ 2 points

Sepsis-3 criteria use an acute SOFA score increase of ≥ 2 points to identify organ dysfunction associated with infection.

What is the classic ECG finding in hyperkalemia that precedes ventricular fibrillation?

Answer: Peaked T waves progressing to wide QRS

Hyperkalemia produces progressive ECG changes from peaked T waves to widened QRS complex, which can degenerate into ventricular fibrillation if untreated.

Refeeding syndrome in a malnourished ICU patient is primarily characterized by a dangerous drop in which electrolyte?

Answer: Phosphate

Refeeding syndrome causes severe hypophosphatemia as insulin release during refeeding drives phosphate rapidly into cells, leading to cardiac, respiratory, and neurological complications.

A critically ill patient develops carpopedal spasm and a positive Chvostek's sign. Which electrolyte abnormality is most likely?

Answer: Hypocalcemia

Hypocalcemia causes neuromuscular excitability, manifesting as carpopedal spasm, Chvostek's sign (facial nerve tapping), and Trousseau's sign.