Peds CCRN Review Questions (from AACN)

PEEP is intended to do which of the fol￾lowing? A. Improve ventilation/perfusion match￾ing B. Decrease functional residual capacity C. Increased venous return to the heart D. Increased cardiac output In an infant with sepsis, factors that im- pair the release of oxygen by negatively affecting oxyhemoglobin dissociation in- clude: A. Hyperthermia B. Metabolic acidosis C. Respiratory acidosis D. Hypothermia In which condition might you observe a decreased V/Q ratio (<0.8)? A. Status asthmaticus B. Sepsis C. Pulmonary emboli D.Tricuspid atresia Factors such as small nostrils, larger tongue, and narrower airways in an in￾fant.... A. Decrease airway resistance B. Make intubation easier C. Increase airway resistance D. Improve airway obstruction A. Improve ventilation/perfusion match￾ing - PEEP increases alveolar volume, thereby improving ventilation/perfusion matching and increasing functional residual capacity. - A detrimental effect of PEEP (especially at high levels) is a decrease in venous return to the heart and a subsequent de- crease in cardiac output. D. Hypothermia - To answer this question, you must con- sider the factors that would cause a left shift of the oxyhemoglobin curve. - Hypothermia, decreased CO2, and in- creased pH (alkalosis) would all cause a left shift. - Hyperthermia and acidosis would cause a right shift of the curve A. Status asthmaticus - A V/Q ratio of <0.8 is indicative of per￾fusion exceeding ventilation. Air trapping from diseases such as asthma is a com- mon cause of this scenario C. Increase airway resistance - There are a number of factors that in- crease airway resistance and obstruction in young infants, including their larger heads and tongues, smaller nostrils, de- creased muscle tone, and narrower air- ways. - Intubation is more difficult because of Peds CCRN Review Questions (from AACN) 2 / 35 Indications that a patient is ready to wean from mechanical ventilation in- clude: A. Hemodynamic instability B. Adequate cough and gag reflexes C. Persistent coma D.PEEP > 8 A toddler who was found unresponsive in a swimming pool is in respiratory distress.On chest x-ray you see bilateral infiltrates and the PaO2/FiO2 ratio is 190. These findings suggest: A. Aspiration pneumonia B.Viral pneumonia C. Acute respiratory distress syndrome D.Pneumothorax An infant with bronchiolitis is intubat- ed due to an acute respiratory fail- ure.Post-intubation ABG results demon- strate: pH 7.22 PaCO2 62 PaO2 75 HCO3 22 O2 sat 90% This blood gas reflects: A. Metabolic acidosis an anterior larynx and narrow cricoid ring.