CCRN - Review Acute Respiratory Failure Questions and Answers

Question 1

A patient is admitted with pneumonia and sepsis.
Their arterial blood gas (ABG) on 60% FiO2 shows: pH 7.48, PaCO2 32 mmHg, PaO2 55 mmHg, HCO3 24 mEq/L.
Which type of acute respiratory failure is this patient experiencing?

Accepted Answer

Hypoxemic respiratory failure

Answer

Hypercapnic respiratory failure

Answer

Acute-on-chronic respiratory failure

Answer

Ventilatory failure

Question 2

A 68-year-old male with a history of COPD is brought to the emergency department with increased shortness of breath, wheezing, and purulent sputum. His ABG reveals: pH 7.28, PaCO2 65 mmHg, PaO2 58 mmHg, HCO3 28 mEq/L. Which intervention should the critical care nurse anticipate as the most appropriate initial treatment?

Accepted Answer

Non-invasive positive pressure ventilation (NIPPV)

Answer

Immediate endotracheal intubation and mechanical ventilation

Answer

Administration of high-flow oxygen via a non-rebreather mask

Answer

Intravenous sodium bicarbonate administration

Question 3

A patient is intubated and mechanically ventilated for Acute Respiratory Distress Syndrome (ARDS). The ventilator settings are: FiO2 0.8, PEEP 12 cm H2O, Tidal Volume 350 mL, and Respiratory Rate 22 breaths/min. The most recent PaO2 is 70 mmHg. What is the patient's PaO2/FiO2 (P/F) ratio?

Accepted Answer

87.5

Answer

112

Answer

250

Answer

314

Question 4

Which of the following is a primary cause of hypercapnic (Type II) acute respiratory failure?

Accepted Answer

Neuromuscular disease

Answer

Pulmonary embolism

Answer

Cardiogenic pulmonary edema

Answer

Pneumonia

Question 5

A critical care nurse is caring for a patient with severe ARDS who has been placed in a prone position. The nurse understands that the primary goal of this intervention is to:

Accepted Answer

Improve oxygenation by recruiting dependent alveoli and improving V/Q matching.

Answer

Decrease the patient's sedation requirements.

Answer

Improve secretion clearance and prevent ventilator-associated pneumonia.

Answer

Increase lung compliance and functional residual capacity.

Question 6

Which arterial blood gas finding is the hallmark of acute hypercapnic respiratory failure?

Accepted Answer

PaCO2 > 50 mmHg with a pH < 7.35

Answer

PaO2 < 60 mmHg

Answer

SaO2 < 90% on room air

Answer

HCO3 < 22 mEq/L