CCRN Acute Respiratory Failure 4

Question 1

Which patient is the BEST candidate for noninvasive positive pressure ventilation (NIPPV)?

Accepted Answer

Alert COPD patient with hypercapnic acidosis

Answer

Awake, cooperative COPD patients with hypercapnic respiratory failure benefit most from NIPPV.

Question 2

Which is an absolute contraindication to noninvasive ventilation?

Accepted Answer

Inability to protect the airway

Answer

Patients who cannot protect their airway risk aspiration and require intubation rather than NIPPV.

Question 3

In a mechanically ventilated patient, increasing the PEEP primarily improves oxygenation by:

Accepted Answer

Recruiting collapsed alveoli and increasing functional residual capacity

Answer

PEEP keeps alveoli open at end-expiration, improving FRC and reducing shunt.

Question 4

A ventilated patient suddenly desaturates with absent breath sounds on the right and tracheal deviation to the left. The priority action is:

Accepted Answer

Needle decompression for tension pneumothorax

Answer

Tracheal deviation with unilateral absent breath sounds and desaturation indicates a tension pneumothorax requiring immediate decompression.

Question 5

To primarily lower an elevated PaCO2 in a volume-controlled ventilated patient, the nurse should anticipate:

Accepted Answer

Increasing the respiratory rate or tidal volume (minute ventilation)

Answer

CO2 elimination depends on minute ventilation, so raising rate or tidal volume lowers PaCO2.

CCRN Review Practice Test