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

Pulse pressure variation >13% during mechanical ventilation reliably predicts fluid responsiveness, outperforming static pressures like CVP.

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

Diabetes insipidus causes massive free water loss due to absent or ineffective ADH, resulting in dilute urine, hypernatremia, and polyuria.

Question 3

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

Accepted Answer

Symptomatic acute hyponatremia with seizures or severe altered consciousness

Answer

Hypertonic saline is reserved for severe symptomatic acute hyponatremia (seizures, coma) where rapid partial correction is necessary to prevent herniation.

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

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

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

Rising filling pressures combined with worsening oxygenation and pulmonary infiltrates indicate fluid overload causing pulmonary edema in the ICU.

FCCS - Fundamentals of Critical Care Support Practice Test

FCCS - Fundamentals of Critical Care Support Practice Test

FCCS FCCS Fluid and Electrolyte Management 3