FCCS FCCS Fluid and Electrolyte Management 3

Question 1

Which dynamic parameter is most useful for predicting fluid responsiveness in a mechanically ventilated patient?

Accepted Answer

Pulse pressure variation (PPV)

Answer

Central venous pressure (CVP)

Answer

Pulmonary artery occlusion pressure

Answer

Mean arterial pressure

Question 2

A patient with polyuria (>300 mL/hr), hypernatremia, and very dilute urine (specific gravity 1.001) in the ICU most likely has which condition?

Accepted Answer

Diabetes insipidus

Answer

SIADH

Answer

Primary polydipsia

Answer

Hyperglycemic hyperosmolar state

Question 3

When is hypertonic saline (3% NaCl) indicated for hyponatremia?

Accepted Answer

Symptomatic acute hyponatremia with seizures or severe altered consciousness

Answer

Any patient with sodium < 135 mEq/L

Answer

All cases of chronic mild hyponatremia

Answer

Asymptomatic hyponatremia with sodium 128–134 mEq/L

Question 4

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

Accepted Answer

Restrict free water intake and consider diuretics

Answer

Administer 2 L normal saline bolus

Answer

Administer 3% hypertonic saline rapidly

Answer

Give albumin infusion to expand intravascular volume

Question 5

Which clinical finding most strongly suggests fluid overload in a mechanically ventilated ICU patient?

Accepted Answer

Rising CVP with worsening hypoxemia and bilateral pulmonary infiltrates

Answer

Urine output of 1.5 mL/kg/hr

Answer

Serum lactate decreasing from 4 to 2 mmol/L

Answer

Heart rate decreasing from 110 to 90 bpm

Question 6

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

Accepted Answer

Phosphate

Answer

Sodium

Answer

Potassium

Answer

Chloride

Question 7

A patient is being resuscitated for septic shock. After 30 mL/kg IV fluid bolus, urine output remains low and CVP is 14 mmHg. What is the best next step?

Accepted Answer

Reassess fluid responsiveness with a dynamic test before giving more fluids

Answer

Administer another 30 mL/kg fluid bolus immediately

Answer

Start immediate hemodialysis

Answer

Give furosemide to force urine output