BCEN BCEN Respiratory Emergencies

Question 1

A patient presents with sudden pleuritic chest pain, dyspnea, and absent breath sounds on the left. What is the most likely diagnosis?

Accepted Answer

Pneumothorax

Answer

Absent breath sounds with acute pleuritic pain and dyspnea are classic signs of pneumothorax, especially spontaneous in tall young patients.

Question 2

What is the immediate treatment for a tension pneumothorax?

Accepted Answer

Needle decompression at 2nd ICS midclavicular line

Answer

Tension pneumothorax is a clinical emergency requiring immediate needle decompression without waiting for imaging.

Question 3

Which ABG pattern is most consistent with acute respiratory failure (Type 1)?

Accepted Answer

pH 7.48, PaCO2 30, PaO2 55

Answer

Type 1 (hypoxemic) respiratory failure is characterized by low PaO2 with normal or low PaCO2 due to ventilation-perfusion mismatch.

Question 4

A patient with a known history of asthma presents with severe wheezing, accessory muscle use, and SpO2 of 88%. What is the priority intervention?

Accepted Answer

Nebulized albuterol and supplemental oxygen

Answer

Short-acting beta-2 agonists like albuterol combined with supplemental oxygen are the first-line treatment for acute asthma exacerbations.

Question 5

Which sign indicates impending respiratory arrest in a patient with severe asthma exacerbation?

Accepted Answer

Silent chest with markedly decreased air movement

Answer

A 'silent chest' indicates near-complete airway obstruction with no air movement, a pre-arrest finding requiring immediate intervention.

(BCEN) Board of Certification of Emergency Nursing Practice Test