Pulmonary CCRN study Questions and Answers well Explained Latest 2024/2025 Update 100% Correct.
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Course
Pulmonary CCRN
Institution
Pulmonary CCRN
Which of the following is considered to be an absolute contraindication for anticoagulation therapy in
managing a VTE?
A. Hypertensive patient
B. Intracranial hemorrhage
C. Postoperative patient
D. Presence of epidural catheter - B
Intracranial hemorrhage is an absolute contraindication to re...
Pulmonary CCRN study questions
Which of the following is considered to be an absolute contraindication for anticoagulation therapy in
managing a VTE?
A. Hypertensive patient
B. Intracranial hemorrhage
C. Postoperative patient
D. Presence of epidural catheter - B
Intracranial hemorrhage is an absolute contraindication to receiving anticoagulation or antithrombolytic
therapy. Hypertension should be managed prior to initiation of anticoagulation therapy. Uncontrolled
hypertension is a relative contraindication and can increase the risk of bleeding. Postoperative patients
may receive anticoagulation therapy to prevent or manage a VTE unless actively bleeding or determined
to be at a higher risk of bleeding. Anticoagulation therapy should be held at least 12 hours before or
after placement of an epidural catheter.
Which of the following findings would indicate the presence of obstructive airway disease?
A. FEV1/FVC ratio of < 60%
B. FEV1/FVC ratio 75% to 80%
C. FEV1/FVC ratio > 80%
D. Normal FEV1/FVC ratio - A
An obstructive airway disease causes a decrease in FEV1 with a relatively normal FVC resulting in a
decrease in the FEV1/FVC ratio. A normal ratio is 75% to 80%. The lower the ratio, the greater the
obstruction of airflow. This test is used to assess asthma patients during bronchodilator treatments. A
normal FEV1/FVC ratio would indicate a restrictive airway disease.
Which of the following signs would be the most significant finding in a COPD patient indicating the need
for ventilatory support?
A. PaCO2 > 55 mmHg
B. Production of purulent sputum
C. Inspiratory wheezing
D. Paradoxical breathing - D
, Paradoxical breathing indicates diaphragmatic fatigue, impending ventilatory failure, and respiratory
arrest. The patient requires ventilatory support at this time due to the ventilatory fatigue. Hypercapnia
and sputum production occur chronically in a COPD patient and by themselves are not indications for
ventilation. Inspiratory wheezing needs to be managed in a COPD patient but does not necessarily
indicate the need for ventilation.
A patient presents with labored breathing and an RR of 40 beats per minute (bpm). The following ABG is
obtained:
PaO2 68
PaCO2 50
pH 7.34
SaO2 91%
HCO3 22
Which of the following is the most accurate interpretation of the above situation?
A. Normal ABG for COPD patient
B. Respiratory failure due to metabolic acidosis
C. Obstructive upper airway most likely causing respiratory failure
D. Respiratory failure due to dead space - D
Normally, as the minute ventilation (MV) increases, the PaCO2 should decrease. The normal pattern is an
inverse relationship. In dead space, the alveolar ventilation decreases even as the respiratory rate
increases. This results in an increase in CO2 and an abnormal relationship between MV and PaCO2. The
patient has respiratory acidosis, not metabolic acidosis. It is not a normal blood gas for a patient with
COPD because the pH is abnormal. There is no indication in this scenario that this would be an upper
airway obstruction.
What is the compensatory mechanism for VQ shunting?
A. Decrease MV
B. Bronchoconstriction
C. Pulmonary vasoconstriction
D. Increase cardiac output - C
VQ shunting is perfusion without ventilation. A compensatory mechanism for the VQ shunt is pulmonary
vasoconstriction to redistribute blood flow to ventilated alveolar units. In VQ shunts, patients increase
their respiratory rate, causing an increase in min- ute ventilation. Bronchoconstriction occurs with dead
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