CCRN Acute Respiratory Failure 4

Question 1

Which patient is the BEST candidate for noninvasive positive pressure ventilation (NIPPV)?

Accepted Answer

Alert COPD patient with hypercapnic acidosis

Answer

Patient with depressed consciousness and absent gag

Answer

Patient with active hematemesis

Answer

Patient in cardiac arrest

Question 2

Which is an absolute contraindication to noninvasive ventilation?

Accepted Answer

Inability to protect the airway

Answer

Mild dyspnea

Answer

Anxiety

Answer

Need for oxygen therapy

Question 3

In a mechanically ventilated patient, increasing the PEEP primarily improves oxygenation by:

Accepted Answer

Recruiting collapsed alveoli and increasing functional residual capacity

Answer

Lowering PaCO2 directly

Answer

Decreasing minute ventilation

Answer

Reducing airway resistance

Question 4

A ventilated patient suddenly desaturates with absent breath sounds on the right and tracheal deviation to the left. The priority action is:

Accepted Answer

Needle decompression for tension pneumothorax

Answer

Increase the FiO2 and observe

Answer

Order a routine chest x-ray and wait

Answer

Administer a bronchodilator

Question 5

To primarily lower an elevated PaCO2 in a volume-controlled ventilated patient, the nurse should anticipate:

Accepted Answer

Increasing the respiratory rate or tidal volume (minute ventilation)

Answer

Increasing PEEP

Answer

Increasing FiO2

Answer

Decreasing the I:E ratio only

Question 6

High peak airway pressure with a NORMAL plateau pressure most likely indicates:

Accepted Answer

Increased airway resistance (e.g., secretions or bronchospasm)

Answer

Decreased lung compliance

Answer

Pneumothorax

Answer

Pulmonary edema

Question 7

Which intervention is part of the ventilator bundle to prevent ventilator-associated pneumonia?

Accepted Answer

Elevate the head of the bed 30–45 degrees

Answer

Keep the patient flat

Answer

Routine saline lavage with every suction

Answer

Change the ventilator circuit every 8 hours