Exam (elaborations)
AACN PRACTICE EXAM QUESTIONS AND ANSWERS
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AACN PRACTICE EXAM QUESTIONS AND ANSWERS...
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Hyperresonance and dullness over the lung imply... - ANSWERHyperresonance = air
dullness = fluid.
What effect will reducing the TV on the ventilator have on CO2 levels? -
ANSWER: boost CO2.
The main consequence of ARDS on lung tissue is decreased compliance.
Decreased compliance is associated with changes in the lung endothelium and
vascular tissue. Pathophysiologic alterations in lung vascular tissue, as well as
increasing lung oedema, all lead to decreased compliance. The final effect is
stiffness in the fluid-filled, non-aerated airways. Capillary permeability
increases as cytokines are released, whereas functional residual capacity
decreases due to pathophysiologic changes in the lung. The inflammatory phase
of ARDS causes inactivation, degradation, and reduced surfactant production.
This increases surface tension at the alveolar air-fluid interface, resulting in
microatelectasis.
Decreased surfactant
What is functional residual capacity? - ANSWER: the amount of air remaining
in lungs following a typical tidal expiration.
Symptoms of hypoxia respiratory failure include cyanosis, restlessness,
disorientation, confusion, hypertension, tachycardia, and reduced UO.
,What to do before deflating the cuff - Suction oropharynx
What is plateau pressure and what does it reflect? ANSWER Pressure applied to
the airways and alveoli.
reflects airway resistance.
Decrease could indicate an obstruction, bronchospasm, tube blockage, or biting.
Loud s2, systolic murmur across the left everlasting border, jvd, LE edema, and
ascites - signs of what? - ANSWER Pulmonary hypertension.
Signs of chronic bronchitis - Similar to right-sided heart failure.
Peripheral edema
Distended neck veins
Cyanosis
No symptoms of respiratory distress or dysnpea during rest.
Tracheal deviation in hemothorax - ANSWER: To unaffected side.
Early stage of asthmaticus abg - ANSWER Metabolic alkalosis
What does loud machinery, such as a heart murmur, indicate? - Answer: Air
embolism.
, What posture would you place a patient with an air embolism? - ANSWER
Trendenlenberg with left lateral decubitus tilt.
What exactly is needle compression used for?
Thoracentesis is used for what? - ANSWER Needle compression, tension
pneumo
Thoracentesis is to remove fluid from the pleural space.
Normal minute ventilation (ANSWER 5-8)
What pa02/fi02 ratio is symptomatic of ARDS? ANSWER: Less than 300
Criteria for passing the spontaneous breathing trial - ANSWER: Rapid shallow
breathing index of less than 105 (RR/VT)
-pao2/fio2 ratio exceeds 150
-VT more than 5 mL/kg
If tidaling in cheat tube stops, what should you check for? ANSWER:
Obstruction, clots, kinks.
The purpose of PEEP in ARDS is to increase alveolar recruitment.
Ventilator therapy for ARDS - Answer: Low tidal volumes.
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