AACN practice questions
hyperresonace and dullness over lung indicates...ANSWERhyperresonance= air
dullness= fluid
decreasing the TV on ventilator will do what to co2?ANSWERincrease co2
The major effect of ARDS on lung tissue isANSWERDecreased 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 microatelectasis.
Decreased surfactant
What is functional residual capacity?ANSWERamount of air remaining in lungs after a normal tidal
expiration
Clinical symptoms of hypoxic respiratory failureANSWERCyanosis' restlessness delirium confusion
hypertension tachycardia tachynpnea decreased UO
What to do before deflating cuffANSWERSuction orophayrnx
What is plateau pressure and what does it reflectANSWERPressure 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, jvd, LE edema and ascites - symptoms of
?ANSWERPulmonary hypertension
,Signs of chronic bronchitisANSWERSimilar to r sided heart failure
Peripheral edema
Distended neck veins
Cyanosis
No signs of respiratory distress or dysnpea at rest
Tracheal deviation in hemothoraxANSWERToward unaffected side
Early stage of status asthmaticus abgANSWERMetabolic alkalosis
Loud machinery like heart murmur indicates?ANSWERAir embolism
What position would you put a patient with air embolism?ANSWERTrendenlenberg with left lateral
decubitus tilt
Needle compression is for what?
Thoracenetisis is for what?ANSWERNeedle compression tension pneumo
Thoracentesis is to drain fluid from pleural space
Normal minute ventilationANSWER5-8
What pa02/fi02 ratio is indicative of ARDSANSWERLess than 300
Criteria for passing spontaneous breathing trialANSWER-Rapid shallow breathing index of less
than105 (RR/VT)
-pao2/fio2 ration over 150
-VT more than 5ml/kg
If tidaling in cheat tube stops what should you check forANSWERObstruction, clots, kinks
Purpose of PEEP in ARDSANSWERIncrease alveolar recruitment
, Ventilator tx for ARDSANSWERLow tidal volumes
Thin, barrel-chested pt w/ pursed lip breathing think.....ANSWEREmphysema
What are patients with emphysema at risk for?ANSWERRisk of infection due to long term
corticosteroid use
How long is spontaneous breathing trialANSWER30 minutes
ARDS is characterized by what?ANSWERAn antecedent event, refractory hypoexmia, and tachypnea
ABG of acute respitartoeg failureANSWERPao2 less than 60
Paco2 greater than 45
Emergency tx of status asthmaticsANSWERBronchodilators
Abg results for acute respiratory failureANSWERPo2 less than 60
Pco2 greater than 45
Formula for RSBIANSWERRR / TV
What to do for pleural effusionANSWERThoracenetsis
What type of pneumo happens in status asthmaticusANSWERSpontaneous pneumo
High incidence of arrhythmias in patient with copdANSWER
Cor Pulmonale is due toANSWEREnlargement of RV secondary to pulmonary disease
Recommended tidal volume for patientsANSWER6-8 ml/kg
hyperresonace and dullness over lung indicates...ANSWERhyperresonance= air
dullness= fluid
decreasing the TV on ventilator will do what to co2?ANSWERincrease co2
The major effect of ARDS on lung tissue isANSWERDecreased 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 microatelectasis.
Decreased surfactant
What is functional residual capacity?ANSWERamount of air remaining in lungs after a normal tidal
expiration
Clinical symptoms of hypoxic respiratory failureANSWERCyanosis' restlessness delirium confusion
hypertension tachycardia tachynpnea decreased UO
What to do before deflating cuffANSWERSuction orophayrnx
What is plateau pressure and what does it reflectANSWERPressure 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, jvd, LE edema and ascites - symptoms of
?ANSWERPulmonary hypertension
,Signs of chronic bronchitisANSWERSimilar to r sided heart failure
Peripheral edema
Distended neck veins
Cyanosis
No signs of respiratory distress or dysnpea at rest
Tracheal deviation in hemothoraxANSWERToward unaffected side
Early stage of status asthmaticus abgANSWERMetabolic alkalosis
Loud machinery like heart murmur indicates?ANSWERAir embolism
What position would you put a patient with air embolism?ANSWERTrendenlenberg with left lateral
decubitus tilt
Needle compression is for what?
Thoracenetisis is for what?ANSWERNeedle compression tension pneumo
Thoracentesis is to drain fluid from pleural space
Normal minute ventilationANSWER5-8
What pa02/fi02 ratio is indicative of ARDSANSWERLess than 300
Criteria for passing spontaneous breathing trialANSWER-Rapid shallow breathing index of less
than105 (RR/VT)
-pao2/fio2 ration over 150
-VT more than 5ml/kg
If tidaling in cheat tube stops what should you check forANSWERObstruction, clots, kinks
Purpose of PEEP in ARDSANSWERIncrease alveolar recruitment
, Ventilator tx for ARDSANSWERLow tidal volumes
Thin, barrel-chested pt w/ pursed lip breathing think.....ANSWEREmphysema
What are patients with emphysema at risk for?ANSWERRisk of infection due to long term
corticosteroid use
How long is spontaneous breathing trialANSWER30 minutes
ARDS is characterized by what?ANSWERAn antecedent event, refractory hypoexmia, and tachypnea
ABG of acute respitartoeg failureANSWERPao2 less than 60
Paco2 greater than 45
Emergency tx of status asthmaticsANSWERBronchodilators
Abg results for acute respiratory failureANSWERPo2 less than 60
Pco2 greater than 45
Formula for RSBIANSWERRR / TV
What to do for pleural effusionANSWERThoracenetsis
What type of pneumo happens in status asthmaticusANSWERSpontaneous pneumo
High incidence of arrhythmias in patient with copdANSWER
Cor Pulmonale is due toANSWEREnlargement of RV secondary to pulmonary disease
Recommended tidal volume for patientsANSWER6-8 ml/kg
