AACN practice questions and correct
answers with complete solutions
hyperpresence and dullness over lung indicates... - ANSWER - hyper resonance= air
dullness= fluid
decreasing the TV on ventilator will do what to co2? - ANSWER - increase co2
The major effect of ARDS on lung tissue is - ANSWER - Decreased compliance
Decreased compliance is related to alteration of lung endothelium and vascular tissue. Pathophysiologic
changes in lung vascular tissue and increased lung edema contribute to the decrease in compliance. The
end result is stiffness of the fluid-filled non-aerated airways. There is an increase in capillary
permeability due to the release of cytokines and a decrease in functional residual capacity due to
pathophysiologic changes in the lung. The inflammatory process of ARDS causes inactivation,
destruction and decreased production of surfactant. This leads to increased surface tension at the
alveolar air-fluid interface, which causes micro atelectasis.
Decreased surfactant
What is functional residual capacity? - ANSWER - amount of air remaining in lungs after a normal tidal
expiration
Clinical symptoms of hypoxic respiratory failure - ANSWER - Cyanosis' restlessness delirium confusion
hypertension tachycardia tachypnea decreased UO
What to do before deflating cuff - ANSWER - Suction oropharynx
What is plateau pressure and what does it reflect - ANSWER - Pressure applied to airways and alveoli
Reflects airway resistance
,Decrease would indicate an obstruction, bronchospasm, tube blockage, or biting
Loud s2, systolic murmur over left eternal border, jived, LE edema and ascites - symptoms of? - ANSWER
- Pulmonary hypertension
Signs of chronic bronchitis - ANSWER - Similar to r sided heart failure
Peripheral edema
Distended neck veins
Cyanosis
No signs of respiratory distress or dyspnea at rest
Tracheal deviation in hem thorax - ANSWER - Toward unaffected side
Early stage of status asthmatics bag - ANSWER - Metabolic alkalosis
Loud machinery like heart murmur indicates? - ANSWER - Air embolism
What position would you put a patient with air embolism? - ANSWER - Trendelenburg with left lateral
decubitus tilt
Needle compression is for what?
Thoracentesis is for what? - ANSWER - Needle compression tension pneumonia
Thoracentesis is to drain fluid from pleural space
Normal minute ventilation - ANSWER - 5-8
What pa02/fi02 ratio is indicative of ARDS - ANSWER - Less than 300
Criteria for passing spontaneous breathing trial - ANSWER - -Rapid shallow breathing index of less
than105 (RR/VT)
, -pao2/fio2 ration over 150
-VT more than 5ml/kg
If tiddling in cheat tube stops what should you check for - ANSWER - Obstruction, clots, kinks
Purpose of PEEP in ARDS - ANSWER - Increase alveolar recruitment
Ventilator TX for ARDS - ANSWER - Low tidal volumes
Thin, barrel-chested pt. w/ pursed lip breathing think.... - ANSWER - Emphysema
What are patients with emphysema at risk for? - ANSWER - Risk of infection due to long term
corticosteroid use
How long is spontaneous breathing trial - ANSWER - 30 minutes
ARDS is characterized by what? - ANSWER - An antecedent event, refractory hypoxemia, and tachypnea
ABG of acute respitartoeg failure - ANSWER - Pao2 less than 60
Paco2 greater than 45
Emergency TX of status asthmatics - ANSWER - Bronchodilators
Bag results for acute respiratory failure - ANSWER - Po2 less than 60
Pco2 greater than 45
Formula for RSBI - ANSWER - RR / TV
What to do for pleural effusion - ANSWER - Thoracentesis
answers with complete solutions
hyperpresence and dullness over lung indicates... - ANSWER - hyper resonance= air
dullness= fluid
decreasing the TV on ventilator will do what to co2? - ANSWER - increase co2
The major effect of ARDS on lung tissue is - ANSWER - Decreased compliance
Decreased compliance is related to alteration of lung endothelium and vascular tissue. Pathophysiologic
changes in lung vascular tissue and increased lung edema contribute to the decrease in compliance. The
end result is stiffness of the fluid-filled non-aerated airways. There is an increase in capillary
permeability due to the release of cytokines and a decrease in functional residual capacity due to
pathophysiologic changes in the lung. The inflammatory process of ARDS causes inactivation,
destruction and decreased production of surfactant. This leads to increased surface tension at the
alveolar air-fluid interface, which causes micro atelectasis.
Decreased surfactant
What is functional residual capacity? - ANSWER - amount of air remaining in lungs after a normal tidal
expiration
Clinical symptoms of hypoxic respiratory failure - ANSWER - Cyanosis' restlessness delirium confusion
hypertension tachycardia tachypnea decreased UO
What to do before deflating cuff - ANSWER - Suction oropharynx
What is plateau pressure and what does it reflect - ANSWER - Pressure applied to airways and alveoli
Reflects airway resistance
,Decrease would indicate an obstruction, bronchospasm, tube blockage, or biting
Loud s2, systolic murmur over left eternal border, jived, LE edema and ascites - symptoms of? - ANSWER
- Pulmonary hypertension
Signs of chronic bronchitis - ANSWER - Similar to r sided heart failure
Peripheral edema
Distended neck veins
Cyanosis
No signs of respiratory distress or dyspnea at rest
Tracheal deviation in hem thorax - ANSWER - Toward unaffected side
Early stage of status asthmatics bag - ANSWER - Metabolic alkalosis
Loud machinery like heart murmur indicates? - ANSWER - Air embolism
What position would you put a patient with air embolism? - ANSWER - Trendelenburg with left lateral
decubitus tilt
Needle compression is for what?
Thoracentesis is for what? - ANSWER - Needle compression tension pneumonia
Thoracentesis is to drain fluid from pleural space
Normal minute ventilation - ANSWER - 5-8
What pa02/fi02 ratio is indicative of ARDS - ANSWER - Less than 300
Criteria for passing spontaneous breathing trial - ANSWER - -Rapid shallow breathing index of less
than105 (RR/VT)
, -pao2/fio2 ration over 150
-VT more than 5ml/kg
If tiddling in cheat tube stops what should you check for - ANSWER - Obstruction, clots, kinks
Purpose of PEEP in ARDS - ANSWER - Increase alveolar recruitment
Ventilator TX for ARDS - ANSWER - Low tidal volumes
Thin, barrel-chested pt. w/ pursed lip breathing think.... - ANSWER - Emphysema
What are patients with emphysema at risk for? - ANSWER - Risk of infection due to long term
corticosteroid use
How long is spontaneous breathing trial - ANSWER - 30 minutes
ARDS is characterized by what? - ANSWER - An antecedent event, refractory hypoxemia, and tachypnea
ABG of acute respitartoeg failure - ANSWER - Pao2 less than 60
Paco2 greater than 45
Emergency TX of status asthmatics - ANSWER - Bronchodilators
Bag results for acute respiratory failure - ANSWER - Po2 less than 60
Pco2 greater than 45
Formula for RSBI - ANSWER - RR / TV
What to do for pleural effusion - ANSWER - Thoracentesis
