Question 1

Which of the following white blood cells is most commonly implicated in the inflammatory process of ARDS?

Accepted Answer

A)  Eosinophils 
B)  Monocytes 
C)  Neutrophils 
D)  Lymphocytes 
A)  Eosinophils 
B)  Monocytes 
C)  Neutrophils 
D)  Lymphocytes C

Question 2

Which of the following is the likely cause of nonhydrostatic pulmonary edema?

Accepted Answer

A)  Injury to the vascular endothelium and/or alveolar epithelium 
B)  Abnormalities in intravascular hydrostatic pressures 
C)  An influx of polymorphonuclear neutrophils 
D)  Medication overdose 
A)  Injury to the vascular endothelium and/or alveolar epithelium 
B)  Abnormalities in intravascular hydrostatic pressures 
C)  An influx of polymorphonuclear neutrophils 
D)  Medication overdose A

Question 3

Which of the following is the primary system for removing filtered fluid and protein from the lungs?

Accepted Answer

A)  Lymphatic 
B)  Renal 
C)  Circulatory 
D)  Respiratory 
A)  Lymphatic 
B)  Renal 
C)  Circulatory 
D)  Respiratory A

Question 4

Which of the following factors are associated with a higher risk for ARDS?
1) Gastric aspiration
2) Multiple transfusions
3) Septic shock
4) Burn injury

Accepted Answer

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

Question 5

In most ARDS patients, PEEP levels below __________ are generally preferred.

Accepted Answer

A)  10 cm H2O 
B)  15 cm H2O 
C)  20 cm H2O 
D)  25 cm H2O 
A)  10 cm H2O 
B)  15 cm H2O 
C)  20 cm H2O 
D)  25 cm H2O

Question 6

What range is now recommended for tidal volumes (VT) in a patient with ARDS who is being mechanically ventilated?

Accepted Answer

A)  4 to 6 ml/kg 
B)  6 to 10 ml/kg 
C)  6 to 8 ml/kg 
D)  10 to 12 ml/kg 
A)  4 to 6 ml/kg 
B)  6 to 10 ml/kg 
C)  6 to 8 ml/kg 
D)  10 to 12 ml/kg

Question 7

What mode of mechanical ventilation is designed to increase the mean airway pressure to allow recruitment of alveoli while allowing the patient to spontaneously breathe?

Accepted Answer

A)  Inverse ratio ventilation 
B)  High-frequency ventilation 
C)  Intermittent mandatory ventilation 
D)  Airway pressure-release ventilation 
A)  Inverse ratio ventilation 
B)  High-frequency ventilation 
C)  Intermittent mandatory ventilation 
D)  Airway pressure-release ventilation

Question 8

What mode of mechanical ventilation is designed to optimize ventilation by reducing alveolar collapse while using small tidal volumes in patients with ARDS?

Accepted Answer

A)  Inverse ratio ventilation 
B)  High-frequency ventilation (HFV) 
C)  Intermittent mandatory ventilation 
D)  Airway pressure-release ventilation 
A)  Inverse ratio ventilation 
B)  High-frequency ventilation (HFV) 
C)  Intermittent mandatory ventilation 
D)  Airway pressure-release ventilation

Question 9

Which of the following complications has been associated with the use of PEEP in patients with ARDS?

Accepted Answer

A)  Lung infection 
B)  Reduced cardiac output 
C)  Hepatic failure 
D)  Myocardial infarction 
A)  Lung infection 
B)  Reduced cardiac output 
C)  Hepatic failure 
D)  Myocardial infarction

Question 10

What time does the exudative phase of ARDS typically presents?

Accepted Answer

A)  Between days 1 and 7 
B)  After 1 week 
C)  After 3 weeks 
D)  After 1 month 
A)  Between days 1 and 7 
B)  After 1 week 
C)  After 3 weeks 
D)  After 1 month

Question 11

What ventilatory strategy has been found to be useful for avoiding barotrauma in the treatment of patients with ARDS?

Accepted Answer

A)  Prolonged expiratory time 
B)  Permissive hypercapnia 
C)  Inverse ratio ventilation 
D)  Intermittent mandatory ventilation 
A)  Prolonged expiratory time 
B)  Permissive hypercapnia 
C)  Inverse ratio ventilation 
D)  Intermittent mandatory ventilation

Question 12

What is the name of the period that follows the exudative phase in ARDS?

Accepted Answer

A)  Fibroproliferative 
B)  Transudative 
C)  Proliferative 
D)  Intraalveolar 
A)  Fibroproliferative 
B)  Transudative 
C)  Proliferative 
D)  Intraalveolar

Question 13

Which of the following explains the basis for permissive hypercapnia as a ventilator strategy for ARDS?

Accepted Answer

A)  Introduction of CO2 into the breathing circuit to stimulate spontaneous breaths. 
B)  Use of lower tidal volumes and accepting a gradual rise in PCO2 to avoid associated hazards of high Paw. 
C)  Allow patients with ARDS to breathe spontaneously to build their respiratory muscular endurance. 
D)  To use exhaled CO2 to increase residual volume and improve gas exchange. 
A)  Introduction of CO2 into the breathing circuit to stimulate spontaneous breaths. 
B)  Use of lower tidal volumes and accepting a gradual rise in PCO2 to avoid associated hazards of high Paw. 
C)  Allow patients with ARDS to breathe spontaneously to build their respiratory muscular endurance. 
D)  To use exhaled CO2 to increase residual volume and improve gas exchange.

Question 14

Which of the following clinical features is often common to both ARDS and congestive heart failure (CHF)?

Accepted Answer

A)  BALF is proteinaceous and inflammatory. 
B)  Diffuse alveolar and interstitial infiltrates in chest radiograph. 
C)  Pleural effusions on chest radiograph. 
D)  Recent history of trauma. 
A)  BALF is proteinaceous and inflammatory. 
B)  Diffuse alveolar and interstitial infiltrates in chest radiograph. 
C)  Pleural effusions on chest radiograph. 
D)  Recent history of trauma.

Question 15

Which of the following mechanisms ultimately leads to ARDS regardless of the etiology?

Accepted Answer

A)  Disruption of the endothelial and epithelial barriers 
B)  Alveolar flooding 
C)  Interstitial damage 
D)  Increased oncotic pressure 
A)  Disruption of the endothelial and epithelial barriers 
B)  Alveolar flooding 
C)  Interstitial damage 
D)  Increased oncotic pressure

Question 16

What time does the fibroproliferative phase of ARDS typically present?

Accepted Answer

A)  Between days 1 and 7 
B)  After 3 days to weeks 
C)  After 3 weeks 
D)  After 1 month 
A)  Between days 1 and 7 
B)  After 3 days to weeks 
C)  After 3 weeks 
D)  After 1 month

Question 17

Which of the following parameters is important in determining the optimal level of positive end expiratory pressure (PEEP) in a patient with ARDS?

Accepted Answer

A)  PaO2 
B)  SaO2 
C)  DO2 
D)  CaO2 
A)  PaO2 
B)  SaO2 
C)  DO2 
D)  CaO2

Question 18

When administering oxygen, which of the following should be considered regarding oxygen toxicity?
1) It is only a concern with premature infants.
2) The longer the exposure, the worse the injury.
3) The higher the FiO2, the worse the injury.
4) The target SpO2 is in the range of 88% to 95%.

Accepted Answer

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

Question 19

Which of the following are ways to prevent further lung injury in an ARDS patient?
1) Avoid barotrauma and volutrauma
2) Permissive hypercapnia
3) Keep plateau pressure between 30 and 40 cm H2O
4) Tidal volume ideally between 6 and 8 ml/kg IBW

Accepted Answer

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

Question 20

What is recommended in terms of fluid management of patients with ARDS?

Accepted Answer

A)  Conservative 
B)  Aggressive volume replacement 
C)  Increased dieresis 
D)  Only administer colloids 
A)  Conservative 
B)  Aggressive volume replacement 
C)  Increased dieresis 
D)  Only administer colloids

Exam 29: Acute Respiratory Distress Syndrome

Which of the following white blood cells is most commonly implicated in the inflammatory process of ARDS?

Which of the following is the likely cause of nonhydrostatic pulmonary edema?

Which of the following is the primary system for removing filtered fluid and protein from the lungs?

Which of the following factors are associated with a higher risk for ARDS? 1) Gastric aspiration 2) Multiple transfusions 3) Septic shock 4) Burn injury

In most ARDS patients, PEEP levels below __________ are generally preferred.

What range is now recommended for tidal volumes (VT) in a patient with ARDS who is being mechanically ventilated?

What mode of mechanical ventilation is designed to increase the mean airway pressure to allow recruitment of alveoli while allowing the patient to spontaneously breathe?

What mode of mechanical ventilation is designed to optimize ventilation by reducing alveolar collapse while using small tidal volumes in patients with ARDS?

Which of the following complications has been associated with the use of PEEP in patients with ARDS?

What time does the exudative phase of ARDS typically presents?

What ventilatory strategy has been found to be useful for avoiding barotrauma in the treatment of patients with ARDS?

What is the name of the period that follows the exudative phase in ARDS?

Which of the following explains the basis for permissive hypercapnia as a ventilator strategy for ARDS?

Which of the following clinical features is often common to both ARDS and congestive heart failure (CHF)?

Which of the following mechanisms ultimately leads to ARDS regardless of the etiology?

What time does the fibroproliferative phase of ARDS typically present?

Which of the following parameters is important in determining the optimal level of positive end expiratory pressure (PEEP) in a patient with ARDS?

When administering oxygen, which of the following should be considered regarding oxygen toxicity? 1) It is only a concern with premature infants. 2) The longer the exposure, the worse the injury. 3) The higher the FiO2, the worse the injury. 4) The target SpO2 is in the range of 88% to 95%.

Which of the following are ways to prevent further lung injury in an ARDS patient? 1) Avoid barotrauma and volutrauma 2) Permissive hypercapnia 3) Keep plateau pressure between 30 and 40 cm H2O 4) Tidal volume ideally between 6 and 8 ml/kg IBW

What is recommended in terms of fluid management of patients with ARDS?

History of Respiratory Care

Delivering Evidence-Based Respiratory Care

Quality, Patient Safety, and Communication, and Recordkeeping

Principles of Infection Prevention and Control

Ethical and Legal Implications of Practice

Physical Principles of Respiratory Care

E-Medicine in Respiratory Care

Fundamentals of Respiratory Care Research

The Respiratory System

The Cardiovascular System

Ventilation

Gas Exchange and Transport

Solutions, Body Fluids, and Electrolytes

Acid-Base Balance

Regulation of Breathing

Bedside Assessment of the Patient

Interpreting Clinical and Laboratory Data

Interpreting the Electrocardiogram

Analysis and Monitoring of Gas Exchange

Pulmonary Function Testing

Review of Thoracic Imaging

Flexible Bronchoscopy and the Respiratory Therapist

Nutrition Assessment

Pulmonary Infections

Obstructive Lung Disease: Chronic Obstructive Pulmonary Disease Copd, Asthma, and Related Diseases

Interstitial Lung Disease

Pleural Diseases

Pulmonary Vascular Disease

Trauma, Burns and Near Drowning

Lung Cancer

Neuromuscular and Other Diseases of the Chest Wall

Disorders of Sleep

Neonatal and Pediatric Respiratory Disorders

Airway Pharmacology

Airway Management

Emergency Cardiovascular Life Support

Humidity and Bland Aerosol Therapy

Aerosol Drug Therapy

Storage and Delivery of Medical Gases

Medical Gas Therapy

Lung Expansion Therapy

Airway Clearance Therapy Act

Respiratory Failure and the Need for Ventilatory Support

Mechanical Ventilators

Physiology of Ventilatory Support

Patient Ventilator Interaction

Initiating and Adjusting Invasive Ventilatory Support

Noninvasive Ventilation

Extracorporeal Life Support Ecls

Monitoring the Patient in the Intensive Care Unit

Discontinuing Ventilatory Support

Neonatal and Pediatric Respiratory Care

Patient Education and Health Promotion

Cardiopulmonary Rehabilitation

Respiratory Care in Alternative Settings

Filters

What range is now recommended for tidal volumes (V_T) in a patient with ARDS who is being mechanically ventilated?

When administering oxygen, which of the following should be considered regarding oxygen toxicity? 1) It is only a concern with premature infants. 2) The longer the exposure, the worse the injury. 3) The higher the FiO₂, the worse the injury. 4) The target SpO₂ is in the range of 88% to 95%.

Which of the following are ways to prevent further lung injury in an ARDS patient? 1) Avoid barotrauma and volutrauma 2) Permissive hypercapnia 3) Keep plateau pressure between 30 and 40 cm H₂O 4) Tidal volume ideally between 6 and 8 ml/kg IBW