PEDS CCRN REVIEW QUESTIONS (FROM AACN) WITH CORRECT ANSWERS & RATIONALE A+ SOLUTION .

CCRN PEDS




@LOS LIBROS




PEDS CCRN REVIEW
QUESTIONS (FROM AACN)
WITH CORRECT ANSWERS
& RATIONALE A+
SOLUTION

,TERMS IN THIS SET (100)


PEEP is intended to do which of A. Improve ventilation/perfusion matching
the following?

- PEEP increases alveolar volume, thereby improving
A. Improve ventilation/perfusion matching and increasing functional
ventilation/perfusion residual capacity.
matching - A detrimental effect of PEEP (especially at high levels) is a
B. Decrease functional decrease in venous return to the heart and a subsequent
residual capacity decrease in cardiac output.
C. Increased venous
return to the heart
D. Increased cardiac
output


In an infant with sepsis, D. Hypothermia
factors that impair the
release of oxygen by
- To answer this question, you must consider the factors
negatively
that would cause a left shift of the oxyhemoglobin curve.
affecting oxyhemoglobin
dissociation include: - Hypothermia, decreased CO2, and increased pH (alkalosis)
would all cause a left shift.
- Hyperthermia and acidosis would cause a right shift of
A. Hyperthermia
the curve
B. Metabolic acidosis
C. Respiratory acidosis
D. Hypothermia

In which condition might you A. Status asthmaticus
observe a decreased V/Q ratio
(<0.8)?
- AV/Q ratio of <0.8 is indicative of perfusion exceeding
ventilation. Air trapping from diseases such as asthma is a
A. Status asthmaticus common cause of this scenario
B. Sepsis
C. Pulmonary emboli
D. Tricuspid atresia




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, Factors such as small C. Increase airway resistance
nostrils, larger tongue, and
narrower airways in an
- There are a number of factors that increase airway resistance
infant....
and obstruction in young infants, including their larger heads
and tongues, smaller nostrils, decreased muscle tone, and
A. Decrease airway narrower airways.
resistance - Intubation is more difficult because of an anterior
B. Make intubation easier larynx and narrow cricoid ring.
C. Increase airway
resistance
D. Improve airway
obstruction


Indications that a patient is B. Adequate cough and gag reflexes
ready to wean from
mechanical ventilation
- Before being extubated, a child needs to have an adequate
include:
level of consciousness to protect his or her airway. This includes
having an adequate cough and gag; hemodynamic stability (not
A. Hemodynamic instability); and a PEEP <5, with an oxygen requirement generally
instability less than an FiO2 of 0.4.
B. Adequate cough and gag
reflexes
C. Persistent coma
D. PEEP > 8




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, A toddler who was found C. Acute respiratory distress syndrome
unresponsive in a swimming
pool is in respiratory distress.
- This child has signs of acute respiratory distress syndrome
On chest x-ray you see
(ARDS), which include bilateral infiltrates on chest x-ray,
bilateral infiltrates and the
PaO2/FiO2 ratio <200, and pulmonary edema, among other
PaO2/FiO2 ratio is 190.
things.
These findings suggest:
- Both aspiration and viral pneumonia may lead to ARDS, but
that's not the correct answer for this question.
A. Aspiration pneumonia - The symptoms described are not
B. Viral pneumonia consistent with a pneumothorax.

C. Acute respiratory
distress syndrome
D. Pneumothorax




An infant with bronchiolitis is B. Respiratory acidosis
intubated due to an acute
respiratory failure. Post-
This child's blood gas results include a decreased pH and an
intubation ABG results
increase in PaCO2 — both of which indicate a state of
demonstrate:
respiratory acidosis.



pH 7.22
PaCO2 62
PaO2 75
HCO3 22
O2 sat 90%

This blood gas reflects:


A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis




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