Chapter 29 - Acute Respiratory Distress Syndrome Question and answers rated A+, Exams of Nursing

Download Chapter 29 - Acute Respiratory Distress Syndrome Question and answers rated A+ and more Exams Nursing in PDF only on Docsity! Chapter 29 - Acute Respiratory Distress Syndrome Which of the following factors are associated with a higher risk for ARDS? 1. Gastric aspiration 2. Multiple transfusions 3. Septic shock 4. Burn injury a. 1 and 3 only b. 2 and 4 only c. 1, 2, 3, and 4 d. 3 only - correct answer a Which of the following risk factors for ARDS is classified as a nonpulmonary cause? a. Toxic inhalation b. Gastric aspiration c. Near drowning d. Sepsis - correct answer d Which of the following mechanisms ultimately leads to ARDS regardless of the etiology? a. Disruption of the endothelial and epithelial barriers b. Alveolar flooding c. Interstitial damage d. Increased oncotic pressure - correct answer a Which of the following white blood cells is most commonly implicated in the inflammatory process of ARDS? a. Eosinophils b. Monocytes c. Neutrophils d. Lymphocytes - correct answer c Which of the following clinical features is often common to both ARDS and congestive heart failure (CHF)? a. BALF is proteinaceous and inflammatory. b. Diffuse alveolar and interstitial infiltrates in chest radiograph. c. Pleural effusions on chest radiograph. d. Recent history of trauma. - correct answer b What time does the exudative phase of ARDS typically presents? a. Between days 1 and 7 b. After 1 week c. After 3 weeks d. After 1 month - correct answer a Which of the following is the primary system for removing filtered fluid and protein from the lungs? a. Lymphatic b. Renal c. Circulatory d. Respiratory - correct answer a What is the name of the period that follows the exudative phase in ARDS? a. Fibroproliferative b. Transudative c. Proliferative d. Intraalveolar - correct answer a c. Intermittent mandatory ventilation d. Airway pressure-release ventilation - correct answer b What is the maximal inspiratory pressure that should be targeted when using pressure-control ventilation in patients with ARDS? a. 20 to 25 cm H2O b. 25 to 30 cm H2O c. 30 to 35 cm H2O d. 35 to 40 cm H2O - correct answer c What mode of mechanical ventilation is designed to increase the mean airway pressure to allow recruitment of alveoli while allowing the patient to spontaneously breathe? a. Inverse ratio ventilation b. High-frequency ventilation c. Intermittent mandatory ventilation d. Airway pressure-release ventilation - correct answer d Which of the following statements is true about prone positioning of patients with ARDS? a. May be beneficial to patients with sustained severe ARDS (P/F ratio < 150 for more than 12 to 24 hr on stable ventilator settings). b. It dramatically reduces the mortality of patients with ARDS. c. It is easy to do and helps morbidity rates of patients with ARDS. d. It does not improve gas exchange at all. - correct answer a Which of the following explains the basis for permissive hypercapnia as a ventilator strategy for ARDS? a. Introduction of CO2 into the breathing circuit to stimulate spontaneous breaths. b. Use of lower tidal volumes and accepting a gradual rise in PCO2 to avoid associated hazards of high Paw. c. Allow patients with ARDS to breathe spontaneously to build their respiratory muscular endurance. d. To use exhaled CO2 to increase residual volume and improve gas exchange. - correct answer b What time does the fibroproliferative phase of ARDS typically present? a. Between days 1 and 7 b. After 3 days to weeks c. After 3 weeks d. After 1 month - correct answer b When administering oxygen, which of the following should be considered regarding oxygen toxicity? 1. It is only a concern with premature infants. 2. The longer the exposure, the worse the injury. 3. The higher the FiO2, the worse the injury. 4. The target SpO2 is in the range of 88% to 95%. a. 1 and 2 only b. 2 and 3 only c. 3 and 4 only d. 2, 3, and 4 only - correct answer d In most ARDS patients, PEEP levels below __________ are generally preferred. a. 10 cm H2O b. 15 cm H2O c. 20 cm H2O d. 25 cm H2O - correct answer c Which of the following are common causes of volume overload in patients with hydrostatic pulmonary edema? 1. Renal failure 2. Hepatic failure 3. Hypoalbuminemia 4. Hyperkalemia a. 1 and 3 only b. 1, 2, and 3 only c. 3 and 4 only d. 2, 3, and 4 only - correct answer b Using which of the following medications carries the greatest risk of persistent memory and cognition problems in the survivors of ARDS? a. Benzodiazepines b. Beta-2 agonists c. Exogenous surfactants d. Corticosteroids - correct answer a Which of the following are clinical features that favor congestive heart failure over ARDS? 1. Elevated PA catheter wedge pressure 2. Asymmetric, peripheral infiltrates on chest x-ray 3. Prompt (<12 to 24 hr) and lasting response to diuretics 4. Bronchoalveolar lavage fluid low protein and minimally increased cellularity a. 1 and 4 only b. 1, 2, and 3 only c. 3 and 4 only d. 2, 3, and 4 only - correct answer a Which of the following is an indirect injury that can cause ARDS? a. Pneumonia b. Lung contusion c. High concentrations of oxygen d. Transfusions - correct answer d Which of the following are ways to prevent further lung injury in an ARDS patient?