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CCRN Respiratory Practice Question with Accurate Answers
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A patient in status asthmaticus would demonstrate which of the following: Decreased peak expiratory flow Decreased functional residual capacity Kussmaul respirations copious clear thin secretions correct answer Decreased peak expiratory flow In status asthmaticus, premature airway closure during exhalation causes an increase in functional residual capacity and air trapping. Status asthmaticus can be measured with a peak flow meter and will show decreased PEF of 30-50% below the patients normal. A patient presents confused and lethargic and complains of a headache. Labs reveal elevated carboxyhemoglobin levels. The nurse should initiate which of the following: STAT ABG Place the patient on Bipap STAT CT scan Place the patient on 100% Non-rebreather correct answer Place the patient on 100% Non-rebreather Elevated carboxyhemoglobin results from carbon monoxide poisoning. Treatment involves high flow oxygen at 100% FiO2 and hyperbaric oxygen therapy.
A patient presents with a history of long-term Amiodarone use. The nurse knows to assess for which of the following: Steven-Johnson syndrome Acute tubular necrosis Prolonged QT syndrome Pulmonary toxicity correct answer Pulmonary toxicity A patient was just intubated and placed on a mechanical ventilator for status asthmaticus. Which of the following ventilator settings are most appropriate: Low tidal volume, low minute ventilation, long expiratory time High tidal volume, high minute ventilation, short expiratory time Low tidal volume, high respiratory rate, short expiratory time High tidal volume, high minute ventilation, long expiratory time correct answer Low tidal volume, low minute ventilation, long expiratory time Acute lung injury (ALI) has which of the following effects on the lung tissue: decreased capillary permeability increased functional capacity decreased compliance decreased alveolar surface tension correct answer decreased compliance In acute lung injury, there is an increase in capillary permeability which promotes edema. There is a decrease in functional capacity due to the fibrotic changes in
expiratory wheezing pink-tinged sputum muffled heart sounds correct answer tricuspid regurgitation The amount of air moved in an out of the lungs during normal breathing is known as: vital capacity tidal volume functional capacity minute ventilation correct answer tidal volume The nurse notices continuous bubbling in the chest tube. What is the most appropriate action: Redo the chest tube Inspect the circuit for leaks Immediately notify the physician Strip the chest tube to dislodge any clots correct answer Inspect the circuit for leaks The nurse notices the patient's chest tube has intermittent bubbling in the water seal chamber. What is the next appropriate action: clamp the chest tube gently milk/strip the tubing continue monitoring immediately notify the physician correct answer continue monitoring
The nurse observes a respiratory therapist instilling saline down the ETT prior to suctioning. The nurse knows the appropriate response is which of the following: "You should suction the patient first, and then instill the saline." "I will perform the next oral care in 2 hours" "Be sure to hyperoxygenate the patient before suctioning" "That practice has been found to be harmful and we should no longer be doing it" correct answer "That practice has been found to be harmful and we should no longer be doing it" The patient is being assessed for extubation. Which of the following ventilator modes is the preferred method during weaning: pressure support volume control SIMV APRV correct answer pressure support What is the definitive diagnosis for pulmonary hypertension? Right heart catheterization Echocardiogram 12 lead EKG Pulmonary function test correct answer Right heart catheterization Which of the following ABG results suggest acute respiratory failure: pH: 7.43, PaCO2: 35 PaO2: 85 HCO3: 24
diabetes hypertension deep venous thrombosis correct answer deep venous thrombosis Which of the following is the normal PaCO2 value as seen on an arterial blood gas? 15-25mmHg 25-35mmHg 25-35mg/dL 35-45mmHg correct answer 35-45mmHg Which of the following receptors are predominantly present in the bronchioles alpha beta 1 beta 2 dopaminergic correct answer beta 2 Which value directly indicates how well a patient is oxygenating? PaO PaCO SpO HCO3 correct answer PaO
Which vent settings would the nurse expect to see on patients with Acute Respiratory Distress Syndrome: PEEP > 5 cmH2O Plateau Pressure >30cmH Tidal volume >8ml/kg FiO2 < 80%. correct answer PEEP > 5 cmH2O ARDS treatment focuses on lung protective strategies. These include PEEP
5cmH20, Low tidal volume ventilation (around 6ml/kg), Plateau pressures <30cmH20, and prone position. FiO2 would be titrated to achieve SpO2 >88%. Your patient was admitted for respiratory failure and cultures were positive for pneumonia. The CXR reveals bilateral opacities. PA Systolic pressure is 45mmHg and the PAOP is 10mmHg. The patient is being mechanically ventilated at 40% FiO2 with a PEEP of 5. The ABG results are the following: pH 7.2, PaCO2 55, HCO 26 and PaO2 50. What is the P/F ratio? 100 125 150 200 correct answer 125