Question 1

Which of the following clinical features is often common to both ARDS and congestive heart failure (CHF)?

Accepted Answer

A) PCWP >18 mm Hg 
B) diffuse alveolar and interstitial infiltrates in chest radiograph 
C) pleural effusions on chest radiograph 
D) recent history of trauma 
A) PCWP >18 mm Hg 
B) diffuse alveolar and interstitial infiltrates in chest radiograph 
C) pleural effusions on chest radiograph 
D) recent history of trauma B

Question 2

Which of the following complications has been associated with the use of PEEP in patients with ARDS?

Accepted Answer

A) lung infection 
B) reduced cardiac output 
C) hepatic failure 
D) myocardial infarction 
A) lung infection 
B) reduced cardiac output 
C) hepatic failure 
D) myocardial infarction B

Question 3

Which of the following tests provides useful information in making the diagnosis of ARDS for patients with inconclusive results on traditional tests?

Accepted Answer

A) examination of bronchoalveolar lavage fluid (BALF) 
B) measurement of mixed venous oxygen level 
C) measurement of total white blood-cell count 
D) ventilation/perfusion ratio ( $\dot { V } / \dot { Q }$ ) scanning 
A) examination of bronchoalveolar lavage fluid (BALF) 
B) measurement of mixed venous oxygen level 
C) measurement of total white blood-cell count 
D) ventilation/perfusion ratio ( $\dot { V } / \dot { Q }$ ) scanning A

Question 4

Which of the following risk factors for ARDS is considered a secondary risk factor?

Accepted Answer

A) viral pneumonia 
B) gastric aspiration 
C) near-drowning 
D) sepsis 
A) viral pneumonia 
B) gastric aspiration 
C) near-drowning 
D) sepsis

Question 5

What mode of mechanical ventilation is designed to optimize ventilation by reducing alveolar collapse while using small tidal volumes in patients with ARDS?

Accepted Answer

A) inverse-ratio ventilation 
B) high-frequency ventilation (HFV) 
C) intermittent mandatory ventilation 
D) airway pressure-release ventilation 
A) inverse-ratio ventilation 
B) high-frequency ventilation (HFV) 
C) intermittent mandatory ventilation 
D) airway pressure-release ventilation

Question 6

Which of the following is not a common finding in the exudative phase of ARDS?

Accepted Answer

A) dyspnea 
B) bradypnea 
C) refractory hypoxemia 
D) tachypnea 
A) dyspnea 
B) bradypnea 
C) refractory hypoxemia 
D) tachypnea

Question 7

Which of the following factors are associated with a higher risk for ARDS?
I.gastric aspiration
II.multiple transfusions
III.septic shock
IV.burn injury

Accepted Answer

A) I and III 
B) II and IV 
C) I, II, III, and IV 
D) III only 
A) I and III 
B) II and IV 
C) I, II, III, and IV 
D) III only

Question 8

What time does the exudative phase of ARDS typically presents?

Accepted Answer

A) between days 1 and 3 
B) between days 4 and 7 
C) after 1 week 
D) after 1 month 
A) between days 1 and 3 
B) between days 4 and 7 
C) after 1 week 
D) after 1 month

Question 9

What is the maximal inspiratory pressure that should be targeted when using pressure control ventilation in patients with ARDS?

Accepted Answer

A) 20 to 25 cm H2O 
B) 25 to 30 cm H2O 
C) 30 to 35 cm H2O 
D) 35 to 40 cm H2O 
A) 20 to 25 cm H2O 
B) 25 to 30 cm H2O 
C) 30 to 35 cm H2O 
D) 35 to 40 cm H2O

Question 10

Which of the following terms describes programmed cell death?

Accepted Answer

A) osmosis 
B) apoptosis 
C) mitosis 
D) necrosis 
A) osmosis 
B) apoptosis 
C) mitosis 
D) necrosis

Question 11

Which of the following parameters are important in the management of patients with ARDS?
I .Keep systolic blood pressure below 90 mm Hg.
II.Keep hemoglobin saturation above 90%.
III.Ensure adequate urine output.
IV.Keep mean arterial pressure above 60 mm Hg.

Accepted Answer

A) I only 
B) I and IV 
C) II, III, and IV 
D) I, II, III, and IV 
A) I only 
B) I and IV 
C) II, III, and IV 
D) I, II, III, and IV

Question 12

Which of the following risk factors for ARDS is considered a secondary risk factor?

Accepted Answer

A) viral pneumonia 
B) gastric aspiration 
C) near-drowning 
D) sepsis 
A) viral pneumonia 
B) gastric aspiration 
C) near-drowning 
D) sepsis

Question 13

What is recommended in terms of fluid management of patients with ARDS?

Accepted Answer

A) conservative 
B) aggressive volume replacement 
C) increased dieresis 
D) only administer colloids 
A) conservative 
B) aggressive volume replacement 
C) increased dieresis 
D) only administer colloids

Question 14

According to the Starling's equation, which forces influence the movement of fluid from the bloodstream to the interstitium?
I.microvascular hydrostatic pressure
II.interstitial osmotic pressure
III.microvascular osmotic pressure
IV.interstitial hydrostatic pressure

Accepted Answer

A) I only 
B) I and II 
C) III and IV 
D) I and IV 
A) I only 
B) I and II 
C) III and IV 
D) I and IV

Question 15

The lungs of a patient with ARDS are effectively reduced to 20% to 30% of their normal size.

Accepted Answer

A) True 
 B)False

Question 16

The routine use of extracorporeal membrane oxygenation (ECMO) in the treatment of patients with ARDS is not recommended at this time.

Accepted Answer

A) True 
 B)False

Question 17

Which of the following white blood cells is most commonly implicated in the inflammatory process of ARDS?

Accepted Answer

A) eosinophils 
B) monocytes 
C) neutrophils 
D) lymphocytes 
A) eosinophils 
B) monocytes 
C) neutrophils 
D) lymphocytes

Question 18

What range is now recommended for tidal volumes (VT) in a patient with ARDS who is being mechanically ventilated?

Accepted Answer

A) 3 to 5 ml/kg 
B) 5 to 7 ml/kg 
C) 10 to 12 ml/kg 
D) 13 to 15 ml/kg 
A) 3 to 5 ml/kg 
B) 5 to 7 ml/kg 
C) 10 to 12 ml/kg 
D) 13 to 15 ml/kg

Question 19

What mode of mechanical ventilation is designed to optimize ventilation by recruiting alveolar units while minimizing ventilator-induced barotrauma in patients with ARDS?

Accepted Answer

A) inverse-ratio ventilation 
B) high-frequency ventilation 
C) intermittent mandatory ventilation 
D) airway pressure-release ventilation (APRV) 
A) inverse-ratio ventilation 
B) high-frequency ventilation 
C) intermittent mandatory ventilation 
D) airway pressure-release ventilation (APRV)

Question 20

Which of the following parameters is important in determining the optimal level of positive end-expiratory pressure (PEEP) in a patient with ARDS?

Accepted Answer

A) PaO2 
B) SaO2 
C) DO2 
D) CaO2 
A) PaO2 
B) SaO2 
C) DO2 
D) CaO2

Exam 27: Acute Lung Injury, Pulmonary Edema, and Multiple System Organ

Which of the following clinical features is often common to both ARDS and congestive heart failure (CHF)?

Which of the following complications has been associated with the use of PEEP in patients with ARDS?

Which of the following tests provides useful information in making the diagnosis of ARDS for patients with inconclusive results on traditional tests?

Which of the following risk factors for ARDS is considered a secondary risk factor?

What mode of mechanical ventilation is designed to optimize ventilation by reducing alveolar collapse while using small tidal volumes in patients with ARDS?

Which of the following is not a common finding in the exudative phase of ARDS?

Which of the following factors are associated with a higher risk for ARDS? I.gastric aspiration II.multiple transfusions III.septic shock IV.burn injury

What time does the exudative phase of ARDS typically presents?

What is the maximal inspiratory pressure that should be targeted when using pressure control ventilation in patients with ARDS?

Which of the following terms describes programmed cell death?

Which of the following parameters are important in the management of patients with ARDS? I .Keep systolic blood pressure below 90 mm Hg. II.Keep hemoglobin saturation above 90%. III.Ensure adequate urine output. IV.Keep mean arterial pressure above 60 mm Hg.

Which of the following risk factors for ARDS is considered a secondary risk factor?

What is recommended in terms of fluid management of patients with ARDS?

According to the Starling's equation, which forces influence the movement of fluid from the bloodstream to the interstitium? I.microvascular hydrostatic pressure II.interstitial osmotic pressure III.microvascular osmotic pressure IV.interstitial hydrostatic pressure

The lungs of a patient with ARDS are effectively reduced to 20% to 30% of their normal size.

The routine use of extracorporeal membrane oxygenation (ECMO) in the treatment of patients with ARDS is not recommended at this time.

Which of the following white blood cells is most commonly implicated in the inflammatory process of ARDS?

What range is now recommended for tidal volumes (VT) in a patient with ARDS who is being mechanically ventilated?

What mode of mechanical ventilation is designed to optimize ventilation by recruiting alveolar units while minimizing ventilator-induced barotrauma in patients with ARDS?

Which of the following parameters is important in determining the optimal level of positive end-expiratory pressure (PEEP) in a patient with ARDS?

History of Respiratory Care

Quality and Evidence-Based Respiratory Care

Patient Safety, Communication, and Record Keeping

Principles of Infection Control

Ethical and Legal Implications of Practice

Physical Principles of Respiratory Care

Computer Applications in Respiratory Care

The Respiratory System

The Cardiovascular System

Ventilation

Gas Exchange and Transport

Solutions, Body Fluids, and Electrolytes

Acid-Base Balance

Regulation of Breathing

Bedside Assessment of the Patient

Interpretation of Clinical Laboratory Data

Interpreting the Electrocardiogram

Analysis and Monitoring of Gas Exchange

Pulmonary Function Testing

A Review of Thoracic Imaging

Nutrition Assessment

Pulmonary Infections

Obstructive Lung Disease: Copd, Asthma, and Related Diseases

Interstitial Lung Disease

Pleural Diseases

Pulmonary Vascular Disease

Lung Cancer

Neuromuscular and Other Diseases of the Chest Wall

Disorders of Sleep

Neonatal and Pediatric Respiratory Disorders

Airway Pharmacology

Airway Management

Emergency Cardiovascular Life Support

Humidity and Bland Aerosol Therapy

Aerosol Drug Therapy

Storage and Delivery of Medical Gases

Medical Gas Therapy

Lung Expansion Therapy

Bronchial Hygiene Therapy

Respiratory Failure and the Need for Ventilatory Support

Mechanical Ventilators

Physiology of Ventilatory Support

Initiating and Adjusting Ventilatory Support

Noninvasive Positive Pressure Ventilation

Monitoring and Management of the Patient in the Intensive Care Unit

Discontinuing Ventilatory Support

Neonatal and Pediatric Respiratory Care

Patient Education and Health Promotion

Cardiopulmonary Rehabilitation

Respiratory Care in Alternative Settings

Filters

What range is now recommended for tidal volumes (V_T) in a patient with ARDS who is being mechanically ventilated?