Question 1

All of the following would be low-tidal volume ventilation goals in a patient with ARDS, EXCEPT:

Accepted Answer

A)  decrease barotrauma. 
B)  maintain plateau pressure >30 cm H2O. 
C)  decrease high transpulmonary pressures. 
D)  reduce overdistention of the lungs. 
A)  decrease barotrauma. 
B)  maintain plateau pressure >30 cm H2O. 
C)  decrease high transpulmonary pressures. 
D)  reduce overdistention of the lungs. B

Question 2

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 H2O2

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 C

Question 3

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

Accepted Answer

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

Question 4

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 5

Which of the following clinical manifestations are associated with ARDS?
1) Normal or decreased 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, 2, 3, 4 
A)  1, 2 
B)  3, 4 
C)  2, 3, 4 
D)  1, 2, 3, 4

Question 6

What is the reason for the elevated risk of 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

Question 7

ARDS can result from the inhalation of all of the following EXCEPT:

Accepted Answer

A)  FIO2 >0.60 for prolonged exposure. 
B)  nitrogen dioxide. 
C)  very dry air. 
D)  chlorine gas. 
A)  FIO2 >0.60 for prolonged exposure. 
B)  nitrogen dioxide. 
C)  very dry air. 
D)  chlorine gas.

Question 8

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 9

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 10

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 11

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 12

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 13

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

Question 14

All of the following materials will be found in the alveoli of a patient with ARDS EXCEPT:

Accepted Answer

A)  leukocytes. 
B)  cellular debris. 
C)  fibrin. 
D)  hyaline membrane. 
A)  leukocytes. 
B)  cellular debris. 
C)  fibrin. 
D)  hyaline membrane.

Question 15

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 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

Exam 28: Acute Respiratory Distress Syndrome

All of the following would be low-tidal volume ventilation goals in a patient with ARDS, EXCEPT:

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 H2O2

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

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

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

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

ARDS can result from the inhalation of all of the following EXCEPT:

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

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 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)

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

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

All of the following materials will be found in the alveoli of a patient with ARDS EXCEPT:

What is the most common cause of ARDS?

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

The Patient Interview

The Physical Examination and Its Basis in Physiology

Pulmonary Function Study Assessments

Arterial Blood Gas Assessments

Oxygenation Assessments

Cardiovascular System Assessments

Radiologic Examination of the Chest

Other Important Tests and Procedures

The Therapist-Driven Protocol Program and the Role of the Respiratory Therapist

Respiratory Failure and the Mechanical Ventilation Protocol

Recording Skills: The Basis for Data Collection, Organization, Assessment Skill

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Bronchiectasis

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Pulmonary Edema

Pulmonary Vascular Disease: Pulmonary Embolism and Pulmonary Hypertension

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Interstitial Lung Diseases

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Clinical Manifestations Common with Newborn and Early Childhood Respiratory Dis

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Filters

According to the Berlin definition of ARDS, what does a PaO₂/FIO₂ratio of 150 mm Hg indicate for a patient on mechanical ventilation with a PEEP of 10 cm H₂O₂