HealthStream CCRN Review UPDATED
ACTUAL Questions and CORRECT
Answers
The latent phase, the first phase of ARDS development, occurs 6 to 48 hours after injury.
Characteristics of this initial phase include which of the following?
A. Chest X-ray shows pulmonary infiltrates consistent with pulmonary edema
B. Chest X-ray remains clear as lung damage cannot yet be identified
C. Irreversible loss of functional alveoli
D. Severe hypoxia - CORRECT ANSWER - A. Chest X-ray shows pulmonary infiltrates
consistent with pulmonary edema
The acute respiratory failure phase occurs one to four weeks after onset of initial lung injury.
Which of the following occur during this phase? Select all that apply.
A. Increased work of breathing.
B. Progressive pulmonary edema results in hypoxemia and intrapulmonary shunting.
C. Surfactant loss leads to alveolar collapse. - CORRECT ANSWER - A, B, C
A patient in the final phase of PARDS is determined to either be in a state of recovery or in the
chronic/fibrotic phase. How is recovery differentiated from chronic fibrosis? Select all that apply.
A. Hypoxemia resolves
B. Normalization of lung parenchyma occurs
C. Pulmonary compliance improves - CORRECT ANSWER - A, B, C
A patient who receives oxygen at concentrations greater than 50 percent for 16 to 24 hours is
susceptible to?
,A. Atelectasis
B. Oxygen toxicity
C. Pneumonia
D. Pneumothorax
E. Volutrauma - CORRECT ANSWER - B. Oxygen toxicity
Weakened lungs, high pressures from the ventilator and the high volume of air increase the risk
for
A. Pneumonia
B. Pneumothorax
C. Volutrauma - CORRECT ANSWER - B. Pneumothorax
Atelectasis is the collapse of alveoli. This can occur as a result of inadequate tidal volume or
secondary to _________.
A. Pneumonia
B. Pneumothorax
C. Volutrauma - CORRECT ANSWER - A. Pneumonia
_________ is used as a pharmacological adjunct to help prevent alveolar collapse, maintain
pulmonary compliance and optimize oxygenation.
A. Nitric oxide
B. Prostaglandin inhibitors
C. Steroids
D. Surfactant - CORRECT ANSWER - D. Surfactant
, Administration of surfactant may help to prevent alveolar collapse, maintain pulmonary
compliance and optimize oxygenation. Administration of surfactant (compared with a placebo)
has provided a significant reduction in mortality in children with PARDS.
The cornerstone of managing the patient with PARDS is:
A. Inotropic support
B. Mechanical ventilation
C. Nutritional support
D. Perfluorocarbons - CORRECT ANSWER - B. Mechanical ventilation
Mechanical ventilation (either conventional or high-frequency oscillation) is the cornerstone of
management for patients with PARDS. Maintaining tidal volumes of 5 to 8 mL/kg and an arterial
saturation greater than 85 percent on a low FiO2 can reduce mortality from PARDS.
You are caring for a patient who was admitted to the hospital about one week ago after suffering
a submersion injury. What is one of the first signs you may notice indicating that the patient has
progressed to PARDS?
A. Infiltrates indicative of aspiration
B. Pneumothorax
C. Tachycardia with hypercarbia
D. Tachypnea with hypoxemia - CORRECT ANSWER - D. Tachypnea with hypoxemia
The first symptoms of PARDS are usually dyspnea, tachypnea and hypoxemia.
You are caring for Mary Jane, a previously healthy 8-year-old girl. She was rescued from a house
fire and intubated at the scene due to altered mental status and presence of soot in her mouth and
nares. She was admitted to the PICU for management of 30% TBSA burn of her face and chest.
She was initially maintained on 100% oxygen to decrease carboxy-hemoglobin and weaned to
30% after eight hours of admission. She is currently sedated, on mechanical ventilation (SIMV
PC+PS 24/7 with rate 16, I time 0.8 sec, and pressure support of 8). She was started on IVF and
NG feeds as per burn protocol. Her vital signs are:HR 120RR 20BP 100/65 MAP 72Temp
96.5O2 sats 99%Ten hours after admission, you notice her respiratory rate increasing into the 60s
and oxygen saturation decreasing to 85% despite increasing the oxygen to 60%. On physical
ACTUAL Questions and CORRECT
Answers
The latent phase, the first phase of ARDS development, occurs 6 to 48 hours after injury.
Characteristics of this initial phase include which of the following?
A. Chest X-ray shows pulmonary infiltrates consistent with pulmonary edema
B. Chest X-ray remains clear as lung damage cannot yet be identified
C. Irreversible loss of functional alveoli
D. Severe hypoxia - CORRECT ANSWER - A. Chest X-ray shows pulmonary infiltrates
consistent with pulmonary edema
The acute respiratory failure phase occurs one to four weeks after onset of initial lung injury.
Which of the following occur during this phase? Select all that apply.
A. Increased work of breathing.
B. Progressive pulmonary edema results in hypoxemia and intrapulmonary shunting.
C. Surfactant loss leads to alveolar collapse. - CORRECT ANSWER - A, B, C
A patient in the final phase of PARDS is determined to either be in a state of recovery or in the
chronic/fibrotic phase. How is recovery differentiated from chronic fibrosis? Select all that apply.
A. Hypoxemia resolves
B. Normalization of lung parenchyma occurs
C. Pulmonary compliance improves - CORRECT ANSWER - A, B, C
A patient who receives oxygen at concentrations greater than 50 percent for 16 to 24 hours is
susceptible to?
,A. Atelectasis
B. Oxygen toxicity
C. Pneumonia
D. Pneumothorax
E. Volutrauma - CORRECT ANSWER - B. Oxygen toxicity
Weakened lungs, high pressures from the ventilator and the high volume of air increase the risk
for
A. Pneumonia
B. Pneumothorax
C. Volutrauma - CORRECT ANSWER - B. Pneumothorax
Atelectasis is the collapse of alveoli. This can occur as a result of inadequate tidal volume or
secondary to _________.
A. Pneumonia
B. Pneumothorax
C. Volutrauma - CORRECT ANSWER - A. Pneumonia
_________ is used as a pharmacological adjunct to help prevent alveolar collapse, maintain
pulmonary compliance and optimize oxygenation.
A. Nitric oxide
B. Prostaglandin inhibitors
C. Steroids
D. Surfactant - CORRECT ANSWER - D. Surfactant
, Administration of surfactant may help to prevent alveolar collapse, maintain pulmonary
compliance and optimize oxygenation. Administration of surfactant (compared with a placebo)
has provided a significant reduction in mortality in children with PARDS.
The cornerstone of managing the patient with PARDS is:
A. Inotropic support
B. Mechanical ventilation
C. Nutritional support
D. Perfluorocarbons - CORRECT ANSWER - B. Mechanical ventilation
Mechanical ventilation (either conventional or high-frequency oscillation) is the cornerstone of
management for patients with PARDS. Maintaining tidal volumes of 5 to 8 mL/kg and an arterial
saturation greater than 85 percent on a low FiO2 can reduce mortality from PARDS.
You are caring for a patient who was admitted to the hospital about one week ago after suffering
a submersion injury. What is one of the first signs you may notice indicating that the patient has
progressed to PARDS?
A. Infiltrates indicative of aspiration
B. Pneumothorax
C. Tachycardia with hypercarbia
D. Tachypnea with hypoxemia - CORRECT ANSWER - D. Tachypnea with hypoxemia
The first symptoms of PARDS are usually dyspnea, tachypnea and hypoxemia.
You are caring for Mary Jane, a previously healthy 8-year-old girl. She was rescued from a house
fire and intubated at the scene due to altered mental status and presence of soot in her mouth and
nares. She was admitted to the PICU for management of 30% TBSA burn of her face and chest.
She was initially maintained on 100% oxygen to decrease carboxy-hemoglobin and weaned to
30% after eight hours of admission. She is currently sedated, on mechanical ventilation (SIMV
PC+PS 24/7 with rate 16, I time 0.8 sec, and pressure support of 8). She was started on IVF and
NG feeds as per burn protocol. Her vital signs are:HR 120RR 20BP 100/65 MAP 72Temp
96.5O2 sats 99%Ten hours after admission, you notice her respiratory rate increasing into the 60s
and oxygen saturation decreasing to 85% despite increasing the oxygen to 60%. On physical
