CCRN Respiratory Exam with Questions and Answers

CCRN Respiratory Exam with Questions and Answers What is indicative of a massive pulmonary embolism? (A) fever, purulent sputum, hypoxemia (B) hypoxemia, hypotension, increased alveolar dead space (C) hypoxemia, shunt, decreased surfactant production (D) hypoventilation, wheezing, air trapping ANSWER (B) A pulmonary embolism results in increased alveolar dead space; hypoxemia and hypotension are present when the pulmonary embolism is massive. Choice (A) is indicative of pneumonia. Choice (C) is indicative of ALI/ARDS. Choice (D) is indicative of asthma. The patient develops agitation with respiratory distress, distended neck veins, hypotension, and diminished breath sounds on the right with tracheal deviation to the left. Which treatment is a priority for this patient? (A) fluid bolus (B) needle aspiration of the chest (C) chest tube insertion (D) intubation ANSWER (B) The patient has signs of tension pneumothorax (right side), which is a life-threatening problem that requires immediate chest decompression. Fluids will not resolve the primary problem, so choice (A) is incorrect. A chest tube will be needed, but it is not the priority intervention, so choice (C) is incorrect. An artificial airway will not address the problem, so choice (D) is incorrect. A 75 kg patient with ARDS is receiving mechanical ventilation with the following settings: assist-control mode, a breath rate of 16 breaths/minute; FiOz 80%; Vt 350 mL; PEEP 10 cm