Midterml Exam:l NRl 572/l NR572l (Newl
2025/l 2026l Update)l Advancedl Acutel
Carel Managementl Guide|l Questionsl &l
Answers|l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l Chamberlain
QUESTION
A-al gradient
Answer:
alveolarl tol arteriall oxygenl gradient
Clinicall importancel inl determiningl thel causel ofl hypoxemial byl measuringl thel overalll
efficiencyl ofl oxygenl uptakel froml thel alveolarl gasl tol pulmonaryl capillaryl bloodl
PAO2-PaO2
QUESTION
Normall A-al gradient
Answer:
5-10l mmHgl (increasesl w/l age)
2.5l +l FiO2l xl agel inl years
QUESTION
Howl arel A-al gradientl resultsl reported?
Answer:
Elevatedl orl normal
QUESTION
Causesl ofl elevatedl A-al gradient
Answer:
-V/Ql mismatch
-pneumonia
-pulmonaryl edema
-COPDl exacerbation
,-shuntl disorders
-ARDS
-Atriall septall defect
-atelectasis
-diffusionl disorder
-interstitiall lungl disease
QUESTION
Causesl ofl normall A-al gradientl results
Answer:
-hypoventilation
-CNSl depressants
-neuromuscularl disease
-lowl inspiredl oxygenl concentration
-Highl altitude
QUESTION
adultl respiratoryl distressl syndromel (ARDS)
Answer:
Life-threateningl conditionl andl commonl causel ofl respiratoryl failurel duel tol hypoxemia
Clinicall syndromel ofl lungsl ratherl thanl al diseasel andl canl bel triggeredl byl anyl insultl
resultingl inl lungl parenchymal inflammation
Causedl byl inflammatoryl responsel associatedl withl capillary,l endotheliall injury,l andl
diffusel alveolarl damagel
Bloodl andl plasmal arel leakedl intol airl spacesl andl hypoxemial ensues
Mayl leadl tol systemic,l inflammation,l causingl injury,l dysfunction,l orl shockl tol thel
kidneys,l heart,l and/orl muscles
QUESTION
Threel phasesl ofl ARDS
Answer:
1.l Exudative
2.l Proliferative
3.l Fibrotic
QUESTION
Exudativel stagel ofl ARDS
,Answer:
-occursl w/inl 5l tol 7l daysl andl markedl byl systemicl inflammation
-Resultsl inl permeabilityl ofl alveolar-l capillaryl barrierl &l formationl ofl protein,l rich,l
hyalinl membranesl alongl alveolarl walls
-Accumulationl ofl highl proteinl alveolarl exudatel withinl alveolarl airl spacesl representsl non-
cardiogenicl pulmonaryl edema
-Extravasationl ofl neutrophill migratel tol thel lungl parenchymal leadingl tol extensivel
alveolarl damagel andl diffusel alveolarl hemorrhage
QUESTION
Proliferativel phasel ofl ARDS
Answer:
-occursl inl firstl 7l tol 21l days
-fibroblastl proliferation,l collagenl deposition,l earlyl fibroticl changesl arel observedl withinl
thel pulmonaryl interstitiall areal asl thel alveolarl exudatel andl hyalinl membranesl arel
absorbed
QUESTION
Fibroticl phasel ofl ARDS
Answer:
-occursl withinl severall weeks
-Mayl leadl tol pulmonaryl fibrosis
-atl leastl 1/4l ofl thosel willl gol ontol developl clinically,l significantl fibroid,l lungl disease
-Causesl al restrictivel ventilatoryl defectl onl PFTs
-Developmentl andl extentl ofl pulmonaryl fibrosisl isl duel tol ARDSl andl correlatesl withl
increasedl mortalityl risk
QUESTION
Chestl x-rayl findingsl inl ARDS
Answer:
Al baselinel chestl x-rayl willl reveall findings,l consistentl withl multil lowl bar,l infiltratesl andl
al "l whitel out"l appearancel (bilaterall opacities).
QUESTION
Indicationsl forl NIPPV
Answer:
, Respiratoryl failurel associatedl with:l
-COPD
-cardiogenicl pulmonaryl edema
-immunocompromisedl states
QUESTION
Absolutel contraindicationsl ofl NIPPV
Answer:
1.l Decreasedl thel levell ofl consciousness.
2.l Vomiting.
3.l Upperl G.I.l bleed.
4.l Conditionsl thatl increasel riskl ofl aspiration.
QUESTION
Relativel contraindicationsl tol NIPPV
Answer:
1-l hemodynamicl instability
2-l agitation
3-l inabilityl tol obtainl properlyl fittingl mask
QUESTION
Risl factorsl forl ARDS
Answer:
-elderly
-chronicl ETOHl abusers
-Previousl respiratoryl pathology
-Patientl alreadyl criticallyl illl withl otherl pathology
QUESTION
Etiologyl ofl ARDS
Answer:
Intrapulmonaryl versusl systemic
Aspirationl ofl gastricl contentsl
Traumal
Multiplel bloodl transfusionsl
Severel traumal
Nearl drowningl
2025/l 2026l Update)l Advancedl Acutel
Carel Managementl Guide|l Questionsl &l
Answers|l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l Chamberlain
QUESTION
A-al gradient
Answer:
alveolarl tol arteriall oxygenl gradient
Clinicall importancel inl determiningl thel causel ofl hypoxemial byl measuringl thel overalll
efficiencyl ofl oxygenl uptakel froml thel alveolarl gasl tol pulmonaryl capillaryl bloodl
PAO2-PaO2
QUESTION
Normall A-al gradient
Answer:
5-10l mmHgl (increasesl w/l age)
2.5l +l FiO2l xl agel inl years
QUESTION
Howl arel A-al gradientl resultsl reported?
Answer:
Elevatedl orl normal
QUESTION
Causesl ofl elevatedl A-al gradient
Answer:
-V/Ql mismatch
-pneumonia
-pulmonaryl edema
-COPDl exacerbation
,-shuntl disorders
-ARDS
-Atriall septall defect
-atelectasis
-diffusionl disorder
-interstitiall lungl disease
QUESTION
Causesl ofl normall A-al gradientl results
Answer:
-hypoventilation
-CNSl depressants
-neuromuscularl disease
-lowl inspiredl oxygenl concentration
-Highl altitude
QUESTION
adultl respiratoryl distressl syndromel (ARDS)
Answer:
Life-threateningl conditionl andl commonl causel ofl respiratoryl failurel duel tol hypoxemia
Clinicall syndromel ofl lungsl ratherl thanl al diseasel andl canl bel triggeredl byl anyl insultl
resultingl inl lungl parenchymal inflammation
Causedl byl inflammatoryl responsel associatedl withl capillary,l endotheliall injury,l andl
diffusel alveolarl damagel
Bloodl andl plasmal arel leakedl intol airl spacesl andl hypoxemial ensues
Mayl leadl tol systemic,l inflammation,l causingl injury,l dysfunction,l orl shockl tol thel
kidneys,l heart,l and/orl muscles
QUESTION
Threel phasesl ofl ARDS
Answer:
1.l Exudative
2.l Proliferative
3.l Fibrotic
QUESTION
Exudativel stagel ofl ARDS
,Answer:
-occursl w/inl 5l tol 7l daysl andl markedl byl systemicl inflammation
-Resultsl inl permeabilityl ofl alveolar-l capillaryl barrierl &l formationl ofl protein,l rich,l
hyalinl membranesl alongl alveolarl walls
-Accumulationl ofl highl proteinl alveolarl exudatel withinl alveolarl airl spacesl representsl non-
cardiogenicl pulmonaryl edema
-Extravasationl ofl neutrophill migratel tol thel lungl parenchymal leadingl tol extensivel
alveolarl damagel andl diffusel alveolarl hemorrhage
QUESTION
Proliferativel phasel ofl ARDS
Answer:
-occursl inl firstl 7l tol 21l days
-fibroblastl proliferation,l collagenl deposition,l earlyl fibroticl changesl arel observedl withinl
thel pulmonaryl interstitiall areal asl thel alveolarl exudatel andl hyalinl membranesl arel
absorbed
QUESTION
Fibroticl phasel ofl ARDS
Answer:
-occursl withinl severall weeks
-Mayl leadl tol pulmonaryl fibrosis
-atl leastl 1/4l ofl thosel willl gol ontol developl clinically,l significantl fibroid,l lungl disease
-Causesl al restrictivel ventilatoryl defectl onl PFTs
-Developmentl andl extentl ofl pulmonaryl fibrosisl isl duel tol ARDSl andl correlatesl withl
increasedl mortalityl risk
QUESTION
Chestl x-rayl findingsl inl ARDS
Answer:
Al baselinel chestl x-rayl willl reveall findings,l consistentl withl multil lowl bar,l infiltratesl andl
al "l whitel out"l appearancel (bilaterall opacities).
QUESTION
Indicationsl forl NIPPV
Answer:
, Respiratoryl failurel associatedl with:l
-COPD
-cardiogenicl pulmonaryl edema
-immunocompromisedl states
QUESTION
Absolutel contraindicationsl ofl NIPPV
Answer:
1.l Decreasedl thel levell ofl consciousness.
2.l Vomiting.
3.l Upperl G.I.l bleed.
4.l Conditionsl thatl increasel riskl ofl aspiration.
QUESTION
Relativel contraindicationsl tol NIPPV
Answer:
1-l hemodynamicl instability
2-l agitation
3-l inabilityl tol obtainl properlyl fittingl mask
QUESTION
Risl factorsl forl ARDS
Answer:
-elderly
-chronicl ETOHl abusers
-Previousl respiratoryl pathology
-Patientl alreadyl criticallyl illl withl otherl pathology
QUESTION
Etiologyl ofl ARDS
Answer:
Intrapulmonaryl versusl systemic
Aspirationl ofl gastricl contentsl
Traumal
Multiplel bloodl transfusionsl
Severel traumal
Nearl drowningl
