CEN Respiratory Emergencies

Question 1

A patient with asthma is in severe bronchospasm and is not responding to nebulized albuterol. What is the next most appropriate pharmacological intervention?

Accepted Answer

IV magnesium sulfate 2 g over 20 minutes

Answer

Oral prednisone 40 mg

Answer

Inhaled ipratropium bromide only

Answer

Subcutaneous terbutaline

Question 2

A patient presents with sudden pleuritic chest pain and absent breath sounds on the left side. Tracheal deviation is noted to the right. What is the priority intervention?

Accepted Answer

Administer high-flow oxygen and prepare for needle thoracostomy

Answer

Obtain a chest X-ray immediately

Answer

Insert a chest tube at the fourth intercostal space

Answer

Start broad-spectrum antibiotics

Question 3

Which ABG result is most consistent with acute respiratory acidosis?

Accepted Answer

pH 7.28, PaCO2 58, HCO3 24

Answer

pH 7.52, PaCO2 28, HCO3 22

Answer

pH 7.38, PaCO2 40, HCO3 24

Answer

pH 7.30, PaCO2 35, HCO3 16

Question 4

A drowning victim is brought in apneic and pulseless. After resuscitation, they regain a pulse but remain comatose with SpO2 88% on room air. What condition should be anticipated?

Accepted Answer

Acute respiratory distress syndrome (ARDS)

Answer

Pulmonary embolism

Answer

Aspiration pneumonia

Answer

Spontaneous pneumothorax

Question 5

Which finding on a chest X-ray is most consistent with a massive pleural effusion?

Accepted Answer

Tracheal deviation toward the affected side with opacification

Answer

Bilateral fluffy infiltrates

Answer

Tracheal deviation away from the affected side with opacification

Answer

Air-fluid levels in both lung fields

Question 6

A patient with COPD and a history of CO2 retention presents in respiratory distress. Which oxygen delivery target is most appropriate?

Accepted Answer

SpO2 88–92% via controlled oxygen delivery

Answer

SpO2 98–100% via non-rebreather mask

Answer

SpO2 95% via simple face mask

Answer

Immediate intubation without supplemental oxygen