CCRN Respiratory Exam 2025
Questions and Answers
Mediastinal chest tubes are used to - ANSWER-remove serosanguinous fluid
from the operative site
- Following cardiac surgery, mediastinal chest tubes are placed to remove fluid
from the mediastinum and to prevent the development of cardiac tamponade.
Mediastinal chest tubes are not placed in the pleural cavity. As such, they will not
improve lung re-expansion or directly improve gas exchange at the alveolar level.
The purpose of using PEEP in the treatment of ARDS and pneumonia is to -
ANSWER-increase alveolar recruitment
- PEEP prevents collapse and recruits alveoli, allowing diffusion of gases across
the alveolar-capillary membrane.
Lowering the ventilator rate is not a treatment strategy in ARDS. The goals in
ARDS management are to promote gas exchange and lower tidal volumes to
minimize airway pressure. PEEP does not promote healing of the alveolar and
capillary membranes. Shunt is the percentage of cardiac output that is not
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 1
,oxygenated and goes to the left heart and out into the systemic circulation. As
PEEP recruits alveoli, shunt will decrease. The purpose of PEEP is to facilitate
alveolar recruitment so the end result will be a decrease in shunt.
A pt is admitted after an MVC and is now reporting right-sided chest pain and
respiratory distress. The pt's BP 1 hr ago was 128/68 and is currently 94/52. What
should be the nurse's priority? - ANSWER-Prepare the pt for chest tube insertion
- Symptoms of a hemothorax include chest pain, respiratory distress, decreased
breath sounds on the affected side and blood loss up to and including shock.
A pt had emergency surgery for a tracheal perforation. What is the nurse's most
important postop intervention? - ANSWER-Securing the endotracheal tube with a
stationary device
- The highest priority is the airway after the surgery. All other measures are also
performed, but airway maintenance is the priority.
A nurse is preparing a pt with tracheal perforation for surgery and notices sudden
hypotension, tachycardia, loss of consciousness and auscultates a loud machinery-
like heart murmur (mill wheel heart murmur). What should the nurse do
INITIALLY? - ANSWER-Place the pt in Trendelenburg with left decubitus tilt
- The pt with tracheal perforation has a high risk of air embolism and will suddenly
become hypotensive without bleeding. Trendelenburg position will help the air
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 2
,float to the left atrium and prevent a stroke. Needle decompression is for tension
pneumothorax. A thoracentesis is performed to drain fluid accumulation from
pleural space.
A pt who is receiving enteral feedings suddenly experiences restlessness, coughing,
hypoxemia, increased WOB, tachypnea, and copious tracheal secretions. A nurse
should suspect - ANSWER-Pulmonary aspiration
- These signs and symptoms occurring immediately after initiation of enteral
feedings are classic for pulmonary aspiration. It could also be d/t malpositioned
feeding tube.
A pt with acute respiratory failure will most likely be drowsy, confused, or have a
decreased LOC d/t hypoxemia, hypercapnia, or acidosis.
The s/s of pulmonary edema are progressive in nature. As the condition worsens,
these s/s in crease in severity, but they are not likely to spontaneously appear all at
once. Copious tracheal secretions and coughing are not hallmark signs of
pneumothorax.
A pt is on CPAP for a spontaneous breathing trial. What should the nurse do to
assess readiness for extubation? - ANSWER-Divide the pt's respiratory rate by the
VT
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 3
, - The nurse should assess the rapid shallow breathing index (RSBI) by dividing the
RR by the VT in liters. If the index is <105 breaths/min/L, the pt demonstrates
higher chance of extubation success.
The ABG results on a 60 kg pt being mechanically ventilated during an episode of
acute respiratory failure are:
pH 7.50
pCO2 30
pO2 84
HCO3 25
Ventilation settings are:
Rate 12 breath/min
VT 600 mL
FiO2 60%
PEEP 5 cm H20
The MOST appropriate action should be to: - ANSWER-decrease the tidal volume
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 4
Questions and Answers
Mediastinal chest tubes are used to - ANSWER-remove serosanguinous fluid
from the operative site
- Following cardiac surgery, mediastinal chest tubes are placed to remove fluid
from the mediastinum and to prevent the development of cardiac tamponade.
Mediastinal chest tubes are not placed in the pleural cavity. As such, they will not
improve lung re-expansion or directly improve gas exchange at the alveolar level.
The purpose of using PEEP in the treatment of ARDS and pneumonia is to -
ANSWER-increase alveolar recruitment
- PEEP prevents collapse and recruits alveoli, allowing diffusion of gases across
the alveolar-capillary membrane.
Lowering the ventilator rate is not a treatment strategy in ARDS. The goals in
ARDS management are to promote gas exchange and lower tidal volumes to
minimize airway pressure. PEEP does not promote healing of the alveolar and
capillary membranes. Shunt is the percentage of cardiac output that is not
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 1
,oxygenated and goes to the left heart and out into the systemic circulation. As
PEEP recruits alveoli, shunt will decrease. The purpose of PEEP is to facilitate
alveolar recruitment so the end result will be a decrease in shunt.
A pt is admitted after an MVC and is now reporting right-sided chest pain and
respiratory distress. The pt's BP 1 hr ago was 128/68 and is currently 94/52. What
should be the nurse's priority? - ANSWER-Prepare the pt for chest tube insertion
- Symptoms of a hemothorax include chest pain, respiratory distress, decreased
breath sounds on the affected side and blood loss up to and including shock.
A pt had emergency surgery for a tracheal perforation. What is the nurse's most
important postop intervention? - ANSWER-Securing the endotracheal tube with a
stationary device
- The highest priority is the airway after the surgery. All other measures are also
performed, but airway maintenance is the priority.
A nurse is preparing a pt with tracheal perforation for surgery and notices sudden
hypotension, tachycardia, loss of consciousness and auscultates a loud machinery-
like heart murmur (mill wheel heart murmur). What should the nurse do
INITIALLY? - ANSWER-Place the pt in Trendelenburg with left decubitus tilt
- The pt with tracheal perforation has a high risk of air embolism and will suddenly
become hypotensive without bleeding. Trendelenburg position will help the air
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 2
,float to the left atrium and prevent a stroke. Needle decompression is for tension
pneumothorax. A thoracentesis is performed to drain fluid accumulation from
pleural space.
A pt who is receiving enteral feedings suddenly experiences restlessness, coughing,
hypoxemia, increased WOB, tachypnea, and copious tracheal secretions. A nurse
should suspect - ANSWER-Pulmonary aspiration
- These signs and symptoms occurring immediately after initiation of enteral
feedings are classic for pulmonary aspiration. It could also be d/t malpositioned
feeding tube.
A pt with acute respiratory failure will most likely be drowsy, confused, or have a
decreased LOC d/t hypoxemia, hypercapnia, or acidosis.
The s/s of pulmonary edema are progressive in nature. As the condition worsens,
these s/s in crease in severity, but they are not likely to spontaneously appear all at
once. Copious tracheal secretions and coughing are not hallmark signs of
pneumothorax.
A pt is on CPAP for a spontaneous breathing trial. What should the nurse do to
assess readiness for extubation? - ANSWER-Divide the pt's respiratory rate by the
VT
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 3
, - The nurse should assess the rapid shallow breathing index (RSBI) by dividing the
RR by the VT in liters. If the index is <105 breaths/min/L, the pt demonstrates
higher chance of extubation success.
The ABG results on a 60 kg pt being mechanically ventilated during an episode of
acute respiratory failure are:
pH 7.50
pCO2 30
pO2 84
HCO3 25
Ventilation settings are:
Rate 12 breath/min
VT 600 mL
FiO2 60%
PEEP 5 cm H20
The MOST appropriate action should be to: - ANSWER-decrease the tidal volume
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 4
