CEN Respiratory Emergencies 3

Question 1

A patient presents with sudden-onset dyspnea and unilateral leg swelling. Wells score is 6. What is the next step?

Accepted Answer

CT pulmonary angiography

Answer

A Wells score ≥5 indicates high probability of PE; guidelines recommend proceeding directly to CTPA rather than D-dimer, which has limited value in high-probability cases.

Question 2

Which finding best differentiates cardiogenic pulmonary edema from ARDS on chest X-ray?

Accepted Answer

Cardiomegaly and Kerley B lines in cardiogenic edema

Answer

Cardiomegaly and Kerley B lines (representing dilated lymphatics) on CXR support cardiogenic pulmonary edema rather than ARDS.

Question 3

A patient has a suspected foreign body airway obstruction and becomes unconscious. What is the immediate next step?

Accepted Answer

Begin CPR and look for the object during ventilation attempts

Answer

If a choking victim becomes unresponsive, lower them to the floor, begin CPR, and look in the mouth for the object before each breath attempt.

Question 4

Confirmation of endotracheal tube placement should be verified by which MOST reliable method?

Accepted Answer

Continuous waveform capnography

Answer

Continuous waveform capnography (ETCO2) is the most reliable method to confirm and continuously monitor ETT placement in the trachea.

Question 5

A patient with severe asthma exacerbation has a PEFR of 25% predicted. Which disposition is most appropriate?

Accepted Answer

Admit to ICU and consider intubation

Answer

A PEFR below 40% predicted after initial treatment indicates a severe or life-threatening exacerbation requiring ICU admission and possible intubation.

CEN - Certified Emergency Nurse Practice Test

CEN - Certified Emergency Nurse Practice Test

CEN Respiratory Emergencies 3