HealthStream CCRN Review Exam Questions with Latest Update
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Course
Healthstream
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Healthstream
The latent phase, the first phase of ARDS development, occurs 6 to 48 hours after injury. Characteristics of this initial phase include which of the following?
A. Chest X-ray shows pulmonary infiltrates consistent with pulmonary edema
B. Chest X-ray remains clear as lung damage cannot yet be id...
HealthStream CCRN Review Exam
Questions with Latest Update
The latent phase, the first phase of ARDS development, occurs 6 to 48 hours after
injury. Characteristics of this initial phase include which of the following?
A. Chest X-ray shows pulmonary infiltrates consistent with pulmonary edema
B. Chest X-ray remains clear as lung damage cannot yet be identified
C. Irreversible loss of functional alveoli
D. Severe hypoxia - Answer-A. Chest X-ray shows pulmonary infiltrates consistent with
pulmonary edema
The acute respiratory failure phase occurs one to four weeks after onset of initial lung
injury. Which of the following occur during this phase? Select all that apply.
A. Increased work of breathing.
B. Progressive pulmonary edema results in hypoxemia and intrapulmonary shunting.
C. Surfactant loss leads to alveolar collapse. - Answer-A, B, C
A patient in the final phase of PARDS is determined to either be in a state of recovery or
in the chronic/fibrotic phase. How is recovery differentiated from chronic fibrosis? Select
all that apply.
A. Hypoxemia resolves
B. Normalization of lung parenchyma occurs
C. Pulmonary compliance improves - Answer-A, B, C
A patient who receives oxygen at concentrations greater than 50 percent for 16 to 24
hours is susceptible to?
A. Atelectasis
B. Oxygen toxicity
C. Pneumonia
D. Pneumothorax
E. Volutrauma - Answer-B. Oxygen toxicity
Weakened lungs, high pressures from the ventilator and the high volume of air increase
the risk for
A. Pneumonia
B. Pneumothorax
C. Volutrauma - Answer-B. Pneumothorax
, Atelectasis is the collapse of alveoli. This can occur as a result of inadequate tidal
volume or secondary to _________.
A. Pneumonia
B. Pneumothorax
C. Volutrauma - Answer-A. Pneumonia
_________ is used as a pharmacological adjunct to help prevent alveolar collapse,
maintain pulmonary compliance and optimize oxygenation.
A. Nitric oxide
B. Prostaglandin inhibitors
C. Steroids
D. Surfactant - Answer-D. Surfactant
Administration of surfactant may help to prevent alveolar collapse, maintain pulmonary
compliance and optimize oxygenation. Administration of surfactant (compared with a
placebo) has provided a significant reduction in mortality in children with PARDS.
The cornerstone of managing the patient with PARDS is:
A. Inotropic support
B. Mechanical ventilation
C. Nutritional support
D. Perfluorocarbons - Answer-B. Mechanical ventilation
Mechanical ventilation (either conventional or high-frequency oscillation) is the
cornerstone of management for patients with PARDS. Maintaining tidal volumes of 5 to
8 mL/kg and an arterial saturation greater than 85 percent on a low FiO2 can reduce
mortality from PARDS.
You are caring for a patient who was admitted to the hospital about one week ago after
suffering a submersion injury. What is one of the first signs you may notice indicating
that the patient has progressed to PARDS?
A. Infiltrates indicative of aspiration
B. Pneumothorax
C. Tachycardia with hypercarbia
D. Tachypnea with hypoxemia - Answer-D. Tachypnea with hypoxemia
The first symptoms of PARDS are usually dyspnea, tachypnea and hypoxemia.
You are caring for Mary Jane, a previously healthy 8-year-old girl. She was rescued
from a house fire and intubated at the scene due to altered mental status and presence
of soot in her mouth and nares. She was admitted to the PICU for management of 30%
TBSA burn of her face and chest. She was initially maintained on 100% oxygen to
decrease carboxy-hemoglobin and weaned to 30% after eight hours of admission. She
is currently sedated, on mechanical ventilation (SIMV PC+PS 24/7 with rate 16, I time
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