BCEN BCEN Respiratory Emergencies 2

Question 1

A patient on anticoagulation presents with dyspnea, tachycardia, and pleuritic chest pain after a long flight. What diagnosis must be ruled out?

Accepted Answer

Pulmonary embolism

Answer

Pulmonary embolism classically follows prolonged immobility and presents with dyspnea, tachycardia, and pleuritic chest pain.

Question 2

Which diagnostic test is the gold standard for confirming pulmonary embolism?

Accepted Answer

CT pulmonary angiography (CTPA)

Answer

CT pulmonary angiography is the gold standard for diagnosing PE due to its high sensitivity, specificity, and wide availability.

Question 3

What does the CURB-65 score assess in pneumonia patients?

Accepted Answer

Severity and need for hospitalization

Answer

CURB-65 evaluates confusion, urea, respiratory rate, blood pressure, and age ≥65 to determine pneumonia severity and disposition.

Question 4

A COPD patient presents with worsening dyspnea and a PaCO2 of 65 mmHg. What ventilatory support should be initiated first?

Accepted Answer

Non-invasive positive pressure ventilation (NIPPV/BiPAP)

Answer

BiPAP is the preferred initial ventilatory support for hypercapnic COPD exacerbations, reducing the need for intubation.

Question 5

Which intervention is contraindicated in a patient with epiglottitis suspected in the ED?

Accepted Answer

Direct visualization of the throat with a tongue blade

Answer

Forcing visualization of the throat in epiglottitis can trigger complete airway obstruction and should be avoided unless in a controlled setting.

(BCEN) Board of Certification of Emergency Nursing Practice Test