ARDS COMPLETE EXAM QUESTIONS
FULLY SOLVED
which pathphys process results in surfactant dysfunction during the injury phase of ARDS? - correct
answers damage to alveolar type 1 and 2 cells
(along with the accumulation of fluid and proteins, this cell damage results in surfactant dysfunction)
what position is used to decrease atelectasis and improve refractory hypoxemia in patients with ARDS? -
correct answers PRONE
(helps to recruit alveoli in the posterior part of the lung, which are compressed by the heart and
mediastinal structures in the supine position; prone also improves blood flow to the better ventilated
anterior alveoli, improving VQ mismatch)
during which phase of ARDS does atelectasis occur due to decrease synthesis of surfactant and
inactivation of existing surfactant? - correct answers INJURY
(injury/exudative phase: atelectasis occurs due to decreased synthesis of surfactant and inactivation of
existing surfactant)
(during fibrotic phase: remodeling of the lung with collagenous and fibrous tissues)
(proliferative phase: continued inflammation leads to damage to the pulmonary vasculature, fibrosis,
and further decreased compliance)
which of the following conditions is an example of an indirect lung injury that increases the risk for
developing ARDS?
a. near drowning
b. aspiration
c. pneumonia
d. severe trauma - correct answers d. severe trauma
which interprofessional action will the nurse implement to prevent barotrauma in a pt with ARDS?
a. utilize low vt volumes
, b. set ventilator for higher peak inspiratory pressure
c. set PEEPs as high as tolerated
d. allow PaCO2 levels as high as 60 mmHg - correct answers a. UTILIZE LOW VENTILATOR TIDAL
VOLUMES
(because barotrauma is cause by alveolar stretching and rupture during positive pressure ventilation)
Calculate PaO2/FiO2 ratio (PaO2 of 60) (FIO2 of 80%) - correct answers 75
(60/0.8)
which clinical manifestation of ARDS is caused by increase pulmonary capillary permeability during the
initial phase of ARDS?
a. crackles
b. tracheal deviation
c. intercostal retractions
d. decreasing oxygen saturation
e. hyperresonance to percussion - correct answers a. CRACKLES
c. INTERCOSTAL RETRACTIONS
d. DECREASING OXYGEN SATURATION
(an increase in pulmonary capillary permeability results in fluid movement from the pulmonary
capillaries into the interstitial space and alveoli, causing crackles breathing)
(tachypnea and intercostal retractions can occur due to the increase in fluid and secretions that
accumulate in the lungs)
Pt with ARDS is on mechanical vent. The tx plan includes a ventilator bundle protocol prescription. what
components does this include? - correct answers -HOB 30-45 degrees
-extubation readiness assessment
-stress ulcer prophylaxis
-VTE prophylaxis
-oral care daily with chlorhexidine (0.12%) therapy
FULLY SOLVED
which pathphys process results in surfactant dysfunction during the injury phase of ARDS? - correct
answers damage to alveolar type 1 and 2 cells
(along with the accumulation of fluid and proteins, this cell damage results in surfactant dysfunction)
what position is used to decrease atelectasis and improve refractory hypoxemia in patients with ARDS? -
correct answers PRONE
(helps to recruit alveoli in the posterior part of the lung, which are compressed by the heart and
mediastinal structures in the supine position; prone also improves blood flow to the better ventilated
anterior alveoli, improving VQ mismatch)
during which phase of ARDS does atelectasis occur due to decrease synthesis of surfactant and
inactivation of existing surfactant? - correct answers INJURY
(injury/exudative phase: atelectasis occurs due to decreased synthesis of surfactant and inactivation of
existing surfactant)
(during fibrotic phase: remodeling of the lung with collagenous and fibrous tissues)
(proliferative phase: continued inflammation leads to damage to the pulmonary vasculature, fibrosis,
and further decreased compliance)
which of the following conditions is an example of an indirect lung injury that increases the risk for
developing ARDS?
a. near drowning
b. aspiration
c. pneumonia
d. severe trauma - correct answers d. severe trauma
which interprofessional action will the nurse implement to prevent barotrauma in a pt with ARDS?
a. utilize low vt volumes
, b. set ventilator for higher peak inspiratory pressure
c. set PEEPs as high as tolerated
d. allow PaCO2 levels as high as 60 mmHg - correct answers a. UTILIZE LOW VENTILATOR TIDAL
VOLUMES
(because barotrauma is cause by alveolar stretching and rupture during positive pressure ventilation)
Calculate PaO2/FiO2 ratio (PaO2 of 60) (FIO2 of 80%) - correct answers 75
(60/0.8)
which clinical manifestation of ARDS is caused by increase pulmonary capillary permeability during the
initial phase of ARDS?
a. crackles
b. tracheal deviation
c. intercostal retractions
d. decreasing oxygen saturation
e. hyperresonance to percussion - correct answers a. CRACKLES
c. INTERCOSTAL RETRACTIONS
d. DECREASING OXYGEN SATURATION
(an increase in pulmonary capillary permeability results in fluid movement from the pulmonary
capillaries into the interstitial space and alveoli, causing crackles breathing)
(tachypnea and intercostal retractions can occur due to the increase in fluid and secretions that
accumulate in the lungs)
Pt with ARDS is on mechanical vent. The tx plan includes a ventilator bundle protocol prescription. what
components does this include? - correct answers -HOB 30-45 degrees
-extubation readiness assessment
-stress ulcer prophylaxis
-VTE prophylaxis
-oral care daily with chlorhexidine (0.12%) therapy
