,BKAT Pulmonary Disorders QUESTION s with Answers and Rationales
PRACTICE EXAM REVIEWS WITH COMPLETE ACTUAL EXAM QUESTION S
AND CORRECT VERIFIED ANSWERS/ ALREADY GRADED A+ (MOST
RECENT!
QUESTION 1: What is the primary diagnostic criterion for Acute
Respiratory Distress Syndrome (ARDS) based on the Berlin definition
regarding the PaO2/FiO2 ratio?
• A) PaO2/FiO2 ratio <= 300 mmHg with PEEP or CPAP >= 5 cmH2O
• B) PaO2/FiO2 ratio <= 200 mmHg regardless of PEEP
• C) PaO2/FiO2 ratio > 400 mmHg
• D) PaO2/FiO2 ratio between 350 and 450 mmHg
Correct Answer: A
Rationale: The Berlin definition categorizes ARDS by severity based on
the PaO2/FiO2 ratio with a minimum PEEP or CPAP requirement of 5
cmH2O: Mild (200-300), Moderate (100-200), and Severe (< 100).
QUESTION 2: What is the primary physiological benefit of applying
Positive End-Expiratory Pressure (PEEP) during mechanical ventilation?
• A) Increasing functional residual capacity (FRC) and preventing
alveolar collapse at the end of expiration
• B) Lowering blood pressure and resting the heart
• C) Eliminating the need for any supplemental oxygen
• D) Completely paralyzing the diaphragm to stop breathing
Correct Answer: A
,Rationale: PEEP maintains positive pressure in the alveoli at the end of
exhalation, preventing them from collapsing (atelectasis), which
improves oxygenation and recruits collapsed lung units.
QUESTION 3: What does continuous bubbling in the water seal
chamber of a chest tube drainage system typically indicate?
• A) An active air leak in the chest tube system or patient's pleural
space
• B) Normal lung re-expansion and healing
• C) Complete blockage of the thoracic drainage tubing
• D) High suction pressure from the wall regulator
Correct Answer: A
Rationale: Continuous bubbling in the water seal chamber indicates an
ongoing air leak (either from the patient's lung/pleura or a loose
connection in the circuit). Intermittent bubbling that occurs only with
coughing or exhalation is expected initially.
QUESTION 4: Which clinical signs are hallmark indicators of an acute
tension pneumothorax requiring immediate needle decompression?
• A) Sudden tracheal deviation away from the affected side, absent
breath sounds, severe respiratory distress, and hemodynamic instability
(hypotension/tachycardia)
• B) Bilateral equal breath sounds and hypertension
• C) Bradycardia and localized wheezing in the lower lobes
• D) Sudden skin flushing and high urine output
Correct Answer: A
, Rationale: Tension pneumothorax creates a one-way valve trapping air
in the pleural space, shifting mediastinal structures, compressing the
heart/opposite lung, and causing tracheal deviation, absent breath
sounds, and shock.
QUESTION 5: An arterial blood gas shows: pH 7.28, PaCO2 55 mmHg,
HCO3 24 mEq/L, PaO2 60 mmHg. How should a critical care nurse
interpret this result?
• A) Acute respiratory acidosis with hypoxemia
• B) Metabolic alkalosis with hyperoxemia
• C) Chronic respiratory alkalosis
• D) Compensated metabolic acidosis
Correct Answer: A
Rationale: A low pH (< 7.35) combined with an elevated PaCO2 (> 45
mmHg) indicates respiratory acidosis. Since the HCO3 is normal (24), it
is uncompensated (acute), and the low PaO2 indicates hypoxemia.
QUESTION 6: What is the primary clinical utility of the Rapid Shallow
Breathing Index (RSBI) when evaluating a mechanically ventilated
patient?
• A) Assessing readiness for extubation by calculating respiratory
frequency divided by tidal volume (f/Vt)
• B) Measuring exact cardiac output and stroke volume
• C) Determining total body fluid overload
• D) Calculating precise caloric nutritional needs
Correct Answer: A
PRACTICE EXAM REVIEWS WITH COMPLETE ACTUAL EXAM QUESTION S
AND CORRECT VERIFIED ANSWERS/ ALREADY GRADED A+ (MOST
RECENT!
QUESTION 1: What is the primary diagnostic criterion for Acute
Respiratory Distress Syndrome (ARDS) based on the Berlin definition
regarding the PaO2/FiO2 ratio?
• A) PaO2/FiO2 ratio <= 300 mmHg with PEEP or CPAP >= 5 cmH2O
• B) PaO2/FiO2 ratio <= 200 mmHg regardless of PEEP
• C) PaO2/FiO2 ratio > 400 mmHg
• D) PaO2/FiO2 ratio between 350 and 450 mmHg
Correct Answer: A
Rationale: The Berlin definition categorizes ARDS by severity based on
the PaO2/FiO2 ratio with a minimum PEEP or CPAP requirement of 5
cmH2O: Mild (200-300), Moderate (100-200), and Severe (< 100).
QUESTION 2: What is the primary physiological benefit of applying
Positive End-Expiratory Pressure (PEEP) during mechanical ventilation?
• A) Increasing functional residual capacity (FRC) and preventing
alveolar collapse at the end of expiration
• B) Lowering blood pressure and resting the heart
• C) Eliminating the need for any supplemental oxygen
• D) Completely paralyzing the diaphragm to stop breathing
Correct Answer: A
,Rationale: PEEP maintains positive pressure in the alveoli at the end of
exhalation, preventing them from collapsing (atelectasis), which
improves oxygenation and recruits collapsed lung units.
QUESTION 3: What does continuous bubbling in the water seal
chamber of a chest tube drainage system typically indicate?
• A) An active air leak in the chest tube system or patient's pleural
space
• B) Normal lung re-expansion and healing
• C) Complete blockage of the thoracic drainage tubing
• D) High suction pressure from the wall regulator
Correct Answer: A
Rationale: Continuous bubbling in the water seal chamber indicates an
ongoing air leak (either from the patient's lung/pleura or a loose
connection in the circuit). Intermittent bubbling that occurs only with
coughing or exhalation is expected initially.
QUESTION 4: Which clinical signs are hallmark indicators of an acute
tension pneumothorax requiring immediate needle decompression?
• A) Sudden tracheal deviation away from the affected side, absent
breath sounds, severe respiratory distress, and hemodynamic instability
(hypotension/tachycardia)
• B) Bilateral equal breath sounds and hypertension
• C) Bradycardia and localized wheezing in the lower lobes
• D) Sudden skin flushing and high urine output
Correct Answer: A
, Rationale: Tension pneumothorax creates a one-way valve trapping air
in the pleural space, shifting mediastinal structures, compressing the
heart/opposite lung, and causing tracheal deviation, absent breath
sounds, and shock.
QUESTION 5: An arterial blood gas shows: pH 7.28, PaCO2 55 mmHg,
HCO3 24 mEq/L, PaO2 60 mmHg. How should a critical care nurse
interpret this result?
• A) Acute respiratory acidosis with hypoxemia
• B) Metabolic alkalosis with hyperoxemia
• C) Chronic respiratory alkalosis
• D) Compensated metabolic acidosis
Correct Answer: A
Rationale: A low pH (< 7.35) combined with an elevated PaCO2 (> 45
mmHg) indicates respiratory acidosis. Since the HCO3 is normal (24), it
is uncompensated (acute), and the low PaO2 indicates hypoxemia.
QUESTION 6: What is the primary clinical utility of the Rapid Shallow
Breathing Index (RSBI) when evaluating a mechanically ventilated
patient?
• A) Assessing readiness for extubation by calculating respiratory
frequency divided by tidal volume (f/Vt)
• B) Measuring exact cardiac output and stroke volume
• C) Determining total body fluid overload
• D) Calculating precise caloric nutritional needs
Correct Answer: A
