CCRN Acute Respiratory Failure 5

Question 1

A patient with acute respiratory failure from a narcotic overdose presents with slow shallow breathing and PaCO2 of 70. The most appropriate reversal agent is:

Accepted Answer

Naloxone

Answer

Flumazenil

Answer

Albuterol

Answer

Sodium bicarbonate

Question 2

Which lab/monitoring tool provides the EARLIEST noninvasive warning of falling ventilation in a sedated patient?

Accepted Answer

Continuous capnography (end-tidal CO2)

Answer

Daily chest x-ray

Answer

Intermittent pulse oximetry alone

Answer

Serum lactate

Question 3

In acute hypoxemic respiratory failure, high-flow nasal cannula (HFNC) improves oxygenation primarily by:

Accepted Answer

Delivering high FiO2 with a low level of positive pressure and flushing dead space

Answer

Providing full ventilatory support

Answer

Reversing bronchospasm pharmacologically

Answer

Eliminating the need for humidification

Question 4

A patient with Guillain-Barré syndrome is monitored for respiratory failure. The most useful bedside measure to anticipate the need for intubation is:

Accepted Answer

Declining vital capacity / negative inspiratory force

Answer

Rising blood pressure

Answer

Improving hand grip

Answer

Increasing urine output

Question 5

Refractory hypoxemia despite optimal ventilator settings and prone positioning may warrant which advanced therapy?

Accepted Answer

Venovenous ECMO

Answer

Increasing tidal volume to 12 mL/kg

Answer

Discontinuing PEEP

Answer

Routine bronchoscopy

Question 6

A patient on the ventilator becomes acutely agitated and desaturates. Using the DOPE mnemonic, which should be assessed FIRST?

Accepted Answer

Displacement of the tube, Obstruction, Pneumothorax, Equipment failure

Answer

Diuretics, Oxygen, Position, Eating status

Answer

Drains, Output, Pain, Electrolytes

Answer

Diet, Oxygenation, Pulse, ECG

Question 7

Which finding best indicates a patient is ready for a spontaneous breathing trial (weaning readiness)?

Accepted Answer

Adequate oxygenation on low PEEP/FiO2 with resolving underlying cause and intact respiratory drive

Answer

PaCO2 of 70 with somnolence

Answer

Requirement for high FiO2 of 0.8

Answer

Hemodynamic instability on vasopressors