CCRN Domain 2: Respiratory Welcome to your CCRN Domain 2: Respiratory 1. CCRN: Respiratory In patients with acute respiratory distress syndrome (ARDS), which ventilator setting adjustment is most appropriate to prevent ventilator-induced lung injury? Increase tidal volume to 10 mL/kg Decrease tidal volume to 4-8 mL/kg Increase PEEP to 20 cm H2O Decrease inspiratory flow rate None 2. CCRN: Respiratory When managing a patient with a flail chest, what is the primary respiratory goal? Ensure high tidal volumes to improve oxygenation Stabilize the chest wall Maximize inspiratory pressure Minimize the use of analgesics to avoid respiratory depression None 3. CCRN: Respiratory In a patient with chronic obstructive pulmonary disease 'COPD' experiencing a severe exacerbation, which of the following arterial blood gas (ABG) results is most concerning? pH 7.35, PaCO2 45 mmHg, PaO2 80 mmHg, HCO3- 24 mEq/L pH 7.32, PaCO2 50 mmHg, PaO2 60 mmHg, HCO3- 28 mEq/L pH 7.28, PaCO2 55 mmHg, PaO2 55 mmHg, HCO3- 30 mEq/L pH 7.40, PaCO2 40 mmHg, PaO2 75 mmHg, HCO3- 22 mEq/L None 4. CCRN: Respiratory For a patient with pulmonary fibrosis, which of the following is the most appropriate ventilator strategy? Low tidal volume and high respiratory rate High tidal volume and low respiratory rate High PEEP and high tidal volume Low PEEP and low inspiratory pressure None 5. CCRN: Respiratory A patient with a pneumothorax has a chest tube placed and is on a ventilator. Which of the following indicates a successful intervention and stabilization of the patient's condition? Decreased respiratory rate and increased PaO2 Increased tidal volumes and decreased PEEP Resolution of subcutaneous emphysema and stable hemodynamics Increased PaCO2 and decreased pH None 6. CCRN: Respiratory In a patient with severe asthma exacerbation not responding to standard treatments, which ventilator adjustment is most likely to improve airway resistance and ventilation? Increase inspiratory flow rate Decrease inspiratory flow rate Increase tidal volume Decrease expiratory time None 7. CCRN: Respiratory For a patient experiencing acute pulmonary edema, which of the following ventilator settings should be prioritized to improve oxygenation? Increase PEEP Decrease PEEP Increase tidal volume Decrease inspiratory time None 8. CCRN: Respiratory In a patient with a tension pneumothorax on mechanical ventilation, which of the following is the most immediate action? Increase the inspiratory flow rate Decrease the PEEP Needle decompression Increase the tidal volume None 9. CCRN: Respiratory When managing a patient with severe ARDS, why is it important to set the inspiratory to expiratory (I:E) ratio to 1:1 or even 1:2? To increase inspiratory time and improve oxygenation To decrease the risk of barotrauma To enhance carbon dioxide removal To reduce the work of breathing None 10. CCRN: Respiratory A patient with a history of smoking presents with a spontaneous pneumothorax. What is the expected change in the affected lung's compliance? Increased compliance Decreased compliance No change in compliance Initial increase followed by a decrease None 11. CCRN: Respiratory In the context of mechanical ventilation, why is it crucial to monitor plateau pressure, especially in patients with acute lung injury? To assess the adequacy of ventilation To evaluate the risk of ventilator-associated pneumonia To prevent barotrauma by ensuring pressures are within safe limits To determine the appropriate level of sedation None 12. CCRN: Respiratory A patient with respiratory failure is on volume control ventilation. If the patient starts to breathe above the set ventilatory rate, which parameter is most likely to change? Tidal volume remains constant while minute ventilation increases Tidal volume increases while minute ventilation remains constant Both tidal volume and minute ventilation decrease Both tidal volume and minute ventilation increase None 13. CCRN: Respiratory In a patient with a large pleural effusion, what ventilatory change is primarily seen? Increased lung compliance Decreased lung compliance Increased tidal volumes Decreased respiratory rate None 14. CCRN: Respiratory For a patient with interstitial lung disease, what is the expected impact on the diffusion capacity of the lungs? Increased diffusion capacity due to thickened alveolar membranes Decreased diffusion capacity due to thickened alveolar membranes No change in diffusion capacity Increased diffusion capacity due to alveolar dilation None 15. CCRN: Respiratory During mechanical ventilation, what does a sudden increase in peak inspiratory pressure (PIP) most likely indicate? Disconnection or leak in the ventilator circuit Improvement in lung compliance Development of a pneumothorax Decreased airway resistance None 16. CCRN: Respiratory In patients with acute respiratory failure, what is the primary goal of using non-invasive positive pressure ventilation (NIPPV)? To reduce the need for endotracheal intubation To increase lung compliance To cure the underlying respiratory condition To decrease cardiac output None 17. CCRN: Respiratory Which of the following strategies is most effective in preventing ventilator-associated pneumonia (VAP)? Administering prophylactic antibiotics Maintaining the head of the bed elevated between 30 to 45 degrees Increasing the rate of ventilator circuit changes Utilizing a high tidal volume ventilation strategy None 18. CCRN: Respiratory For a patient on mechanical ventilation, what is the significance of monitoring the static compliance of the respiratory system? It helps in assessing the need for PEEP adjustments It indicates the level of sedation required It is directly proportional to the risk of barotrauma It provides insight into the patient's effort of breathing None 19. CCRN: Respiratory In managing a patient with a tracheostomy who is on a ventilator, what is a key consideration to prevent tracheal damage? Frequently changing the tracheostomy tube Ensuring the cuff pressure is above 30 cm H2O Regularly assessing and maintaining appropriate cuff pressure Increasing the humidity of the inhaled gas None 20. CCRN: Respiratory When considering lung recruitment maneuvers in a patient with ARDS, what is a crucial factor to monitor to avoid potential complications? Urine output Hemodynamic stability Nutritional status Level of consciousness None 1 out of 20 Time is Up! Time's up
