Question 1

Permissive hypercapnia is typically allowed to:

Accepted Answer

A)  protect the lungs from high airway pressures. 
B)  protect the lungs from high PaO2 levels. 
C)  protect the lungs from high tidal volumes. 
D)  protect the lungs from fluid accumulation. 
A)  protect the lungs from high airway pressures. 
B)  protect the lungs from high PaO2 levels. 
C)  protect the lungs from high tidal volumes. 
D)  protect the lungs from fluid accumulation. A

Question 2

What is the reason for the elevated risk for developing ARDS associated with massive blood transfusions?

Accepted Answer

A)  Shock (hypovolemia) 
B)  Receiving the wrong blood type 
C)  Fat emboli 
D)  Blockages in pulmonary blood vessels 
A)  Shock (hypovolemia) 
B)  Receiving the wrong blood type 
C)  Fat emboli 
D)  Blockages in pulmonary blood vessels D

Question 3

Which of the following are current ventilatory strategies in the treatment of ARDS?
1) Large tidal volume
2) Small tidal volume
3) Rapid respiratory rates
4) Slow respiratory rates

Accepted Answer

A) 2 
B) 3 
C) 1, 4 
D) 2, 3 
A) 2 
B) 3 
C) 1, 4 
D) 2, 3 D

Question 4

Which of the following pulmonary changes are associated with ARDS?
1) Abnormal surfactant
2) Interstitial edema
3) Decreased shunt
4) Narrowing of the alveolar-capillary membrane

Accepted Answer

A) 1, 2 
B) 3, 4 
C) 1, 3 
D) 1, 2, 3 
A) 1, 2 
B) 3, 4 
C) 1, 3 
D) 1, 2, 3

Question 5

What is the most common cause of ARDS?

Accepted Answer

A)  Sepsis 
B)  Fat embolism 
C)  Inhalation of irritants 
D)  Aspiration of gastric contents 
A)  Sepsis 
B)  Fat embolism 
C)  Inhalation of irritants 
D)  Aspiration of gastric contents

Question 6

Which of the following are causes of ARDS?
1) Liver failure
2) Drug abuse
3) Septicemia
4) Goodpasture's syndrome

Accepted Answer

A) 1, 4 
B) 2, 3 
C) 2, 3, 4 
D) 1, 3, 4 
A) 1, 4 
B) 2, 3 
C) 2, 3, 4 
D) 1, 3, 4

Question 7

Which of the following are recommended to treat alveolar consolidation and atelectasis associated with ARDS?
1) Aerosolized bronchodilator medications
2) Continuous positive airway pressure (CPAP)
3) Chest percussion and postural drainage
4) Positive end-expiratory pressure (PEEP)

Accepted Answer

A) 4 
B) 1, 2 
C) 1, 3 
D) 2, 4 
A) 4 
B) 1, 2 
C) 1, 3 
D) 2, 4

Question 8

Which of the following clinical manifestations are associated with ARDS?
1) Increased pulmonary capillary wedge pressure (PCWP)
2) Increased CVP
3) Intercostal retractions
4) Cyanosis

Accepted Answer

A) 1, 2 
B) 3, 4 
C) 2, 3, 4 
D) 1, 3, 4 
A) 1, 2 
B) 3, 4 
C) 2, 3, 4 
D) 1, 3, 4

Question 9

Which of the following would be low tidal volume ventilation goals in a patient with ARDS?
1) Decrease barotrauma.
2) Maintain plateau pressure >30 cm H2O.
3) Decrease high transpulmonary pressures.
4) Reduce overdistention of the lungs.

Accepted Answer

A) 1 
B) 2, 3 
C) 2, 3, 4 
D) 1, 3, 4 
A) 1 
B) 2, 3 
C) 2, 3, 4 
D) 1, 3, 4

Question 10

The clinical manifestations associated with ARDS usually appear:

Accepted Answer

A)  2 to 4 hours following the inciting event. 
B)  4 to 12 hours following the inciting event. 
C)  6 to 72 hours following the inciting event. 
D)  72 to 96 hours following the inciting event. 
A)  2 to 4 hours following the inciting event. 
B)  4 to 12 hours following the inciting event. 
C)  6 to 72 hours following the inciting event. 
D)  72 to 96 hours following the inciting event.

Question 11

The chest radiograph finding indicative of severe ARDS is:

Accepted Answer

A)  "ground-glass" appearance of the lungs. 
B)  pleural effusion. 
C)  bilateral hyperinflation of the lungs. 
D)  tracheal deviation. 
A)  "ground-glass" appearance of the lungs. 
B)  pleural effusion. 
C)  bilateral hyperinflation of the lungs. 
D)  tracheal deviation.

Question 12

Breath sounds associated with ARDS include:
1) vesicular.
2) bronchovesicular.
3) crackles.
4) bronchial.

Accepted Answer

A) 4 
B) 1, 2 
C) 3, 4 
D) 2, 3, 4 
A) 4 
B) 1, 2 
C) 3, 4 
D) 2, 3, 4

Question 13

Which of the following materials will be found in the intraalveolar walls of a patient with ARDS?
1) Leukocytes
2) Cellular debris
3) Fibrin
4) Hyaline membrane

Accepted Answer

A) 1, 4 
B) 2, 3 
C) 2, 3, 4 
D) 1, 2, 3 
A) 1, 4 
B) 2, 3 
C) 2, 3, 4 
D) 1, 2, 3

Question 14

During permissive hypercapnia, at what pH level does the increasing PaCO2 become a concern?

Accepted Answer

A)  7.2 
B)  7.3 
C)  7.5 
D)  7.6 
A)  7.2 
B)  7.3 
C)  7.5 
D)  7.6

Question 15

When would symptoms of ARDS associated with a fat embolism from a long bone fracture be most likely to develop?

Accepted Answer

A)  2 to 4 hours following the fracture 
B)  4 to 12 hours following the fracture 
C)  12 to 48 hours following the fracture 
D)  48 to 96 hours following the fracture 
A)  2 to 4 hours following the fracture 
B)  4 to 12 hours following the fracture 
C)  12 to 48 hours following the fracture 
D)  48 to 96 hours following the fracture

Question 16

What initial tidal volume setting on the ventilator would be recommended for a 70-kg adult male with ARDS?

Accepted Answer

A)  350 mL 
B)  420 mL 
C)  560 mL 
D)  700 mL 
A)  350 mL 
B)  420 mL 
C)  560 mL 
D)  700 mL

Question 17

A patient has a prolonged case of ARDS. What changes would be expected in the patient's alveolar cells?

Accepted Answer

A)  Multiplication of the type I cells 
B)  Influx of macrophages 
C)  Hyperplasia and swelling of the type II cells 
D)  Development of emphysema 
A)  Multiplication of the type I cells 
B)  Influx of macrophages 
C)  Hyperplasia and swelling of the type II cells 
D)  Development of emphysema

Question 18

According to the Berlin definition of ARDS, what does a PaO2/FIO2 ratio of 150 mm Hg indicate for a patient on mechanical ventilation with a PEEP of 10 cm H2O?

Accepted Answer

A)  Normal lungs 
B)  Mild ARDS 
C)  Moderate ARDS 
D)  Severe ARDS 
A)  Normal lungs 
B)  Mild ARDS 
C)  Moderate ARDS 
D)  Severe ARDS

Question 19

ARDS can result from the inhalation of all of:
1) FIO2 >0.60 for prolonged exposure.
2) nitrogen dioxide.
3) very dry air.
4) chlorine gas.

Accepted Answer

A) 1, 3 
B) 1, 2, 4 
C) 2, 3, 4 
D) 1, 2, 3 
A) 1, 3 
B) 1, 2, 4 
C) 2, 3, 4 
D) 1, 2, 3

Exam 28: Acute Respiratory Distress Syndrome

Permissive hypercapnia is typically allowed to:

What is the reason for the elevated risk for developing ARDS associated with massive blood transfusions?

Which of the following are current ventilatory strategies in the treatment of ARDS? 1) Large tidal volume 2) Small tidal volume 3) Rapid respiratory rates 4) Slow respiratory rates

Which of the following pulmonary changes are associated with ARDS? 1) Abnormal surfactant 2) Interstitial edema 3) Decreased shunt 4) Narrowing of the alveolar-capillary membrane

What is the most common cause of ARDS?

Which of the following are causes of ARDS? 1) Liver failure 2) Drug abuse 3) Septicemia 4) Goodpasture's syndrome

Which of the following are recommended to treat alveolar consolidation and atelectasis associated with ARDS? 1) Aerosolized bronchodilator medications 2) Continuous positive airway pressure (CPAP) 3) Chest percussion and postural drainage 4) Positive end-expiratory pressure (PEEP)

Which of the following clinical manifestations are associated with ARDS? 1) Increased pulmonary capillary wedge pressure (PCWP) 2) Increased CVP 3) Intercostal retractions 4) Cyanosis

Which of the following would be low tidal volume ventilation goals in a patient with ARDS? 1) Decrease barotrauma. 2) Maintain plateau pressure >30 cm H2O. 3) Decrease high transpulmonary pressures. 4) Reduce overdistention of the lungs.

The clinical manifestations associated with ARDS usually appear:

The chest radiograph finding indicative of severe ARDS is:

Breath sounds associated with ARDS include: 1) vesicular. 2) bronchovesicular. 3) crackles. 4) bronchial.

Which of the following materials will be found in the intraalveolar walls of a patient with ARDS? 1) Leukocytes 2) Cellular debris 3) Fibrin 4) Hyaline membrane

During permissive hypercapnia, at what pH level does the increasing PaCO2 become a concern?

When would symptoms of ARDS associated with a fat embolism from a long bone fracture be most likely to develop?

What initial tidal volume setting on the ventilator would be recommended for a 70-kg adult male with ARDS?

A patient has a prolonged case of ARDS. What changes would be expected in the patient's alveolar cells?

According to the Berlin definition of ARDS, what does a PaO2/FIO2 ratio of 150 mm Hg indicate for a patient on mechanical ventilation with a PEEP of 10 cm H2O?

ARDS can result from the inhalation of all of: 1) FIO2 >0.60 for prolonged exposure. 2) nitrogen dioxide. 3) very dry air. 4) chlorine gas.

The Patient Interview

The Physical Examination

The Pathophysiologic Basis for Common Clinical Manifestations

Pulmonary Function Testing

Blood Gas Assessment

Assessment of Oxygenation

Assessment of the Cardiovascular System

Radiologic Examination of the Chest

Other Important Tests and Procedures

The Therapist-Driven Protocol Program

Respiratory Insufficiency, Respiratory Failure and Ventilatory Management Protocols

Recording Skills and Intra-Professional Communication

Chronic Obstructive Pulmonary Disease, Chronic Bronchitis and Emphysema

Asthma

Cystic Fibrosis

Bronchiectasis

Atelectasis

Pneumonia, Lung Abscess Formation, and Important Fungal Diseases

Tuberculosis

Pulmonary Edema

Pulmonary Vascular Disease: Pulmonary Embolism and Pulmonary Hypertension

Flail Chest

Pneumothorax

Pleural Effusion and Empyema

Kyphoscoliosis

Cancer of the Lung, Prevention and Palliation

Interstitial Lung Diseases

Guillain-Barré Syndrome

Myasthenia Gravis

Cardiopulmonary Assessment and Care of Patients With Neuromuscular Disease

Sleep Apnea

Newborn Assessment and Management

Pediatric Assessment, Protocols, and Pals Management

Meconium Aspiration Syndrome

Transient Tachypnea of the Newborn

Respiratory Distress Syndrome

Pulmonary Air Leak Syndrome

Respiratory Syncytial Virus Infection Bronchiolitis

Chronic Lung Disease of Infancy

Congenital Diaphragmatic Hernia

Congenital Heart Disease

Croup and Croup-Like Syndromes: Laryngotracheobronchitis, Bacterial Tracheitis, and Acute Epiglottitis

Near Drowningwet Drowning

Smoke Inhalation, Thermal Injuries, and Carbon Monoxide Intoxication

Filters

Which of the following would be low tidal volume ventilation goals in a patient with ARDS? 1) Decrease barotrauma. 2) Maintain plateau pressure >30 cm H₂O. 3) Decrease high transpulmonary pressures. 4) Reduce overdistention of the lungs.

During permissive hypercapnia, at what pH level does the increasing PaCO₂ become a concern?

According to the Berlin definition of ARDS, what does a PaO₂/FIO₂ ratio of 150 mm Hg indicate for a patient on mechanical ventilation with a PEEP of 10 cm H₂O?

ARDS can result from the inhalation of all of: 1) FIO₂ >0.60 for prolonged exposure. 2) nitrogen dioxide. 3) very dry air. 4) chlorine gas.