CFRN Respiratory Emergencies and Mechanical Ventilation 2

Question 1

A patient's end-tidal CO2 (ETCO2) drops suddenly to near zero after intubation. What is the most likely cause?

Accepted Answer

Esophageal intubation

Answer

Right mainstem intubation

Answer

Kinked ETT

Answer

Mucus plug

Question 2

What is the maximum recommended cuff pressure for an endotracheal tube to prevent tracheal mucosal ischemia?

Accepted Answer

20–30 cmH2O

Answer

10–15 cmH2O

Answer

35–45 cmH2O

Answer

50–60 cmH2O

Question 3

Which finding is most consistent with a right mainstem bronchus intubation?

Accepted Answer

Absent left-sided breath sounds, high peak pressures, and SpO2 decline

Answer

Bilateral equal breath sounds and high ETCO2

Answer

Bilateral wheezing and low peak pressures

Answer

No ETCO2 waveform

Question 4

A transport patient with COPD has a PaCO2 of 78 mmHg and pH of 7.22. What ventilator adjustment addresses the respiratory acidosis?

Accepted Answer

Increase respiratory rate or tidal volume to increase minute ventilation

Answer

Increase PEEP

Answer

Decrease FiO2

Answer

Add bronchodilators only

Question 5

Which intervention is indicated for a massive hemothorax identified during air transport?

Accepted Answer

Chest tube insertion at the fourth or fifth ICS, anterior axillary line

Answer

Immediate needle decompression at the second ICS

Answer

High-dose furosemide IV

Answer

Pericardiocentesis

Question 6

What does an increasing plateau pressure with unchanged peak pressure suggest in a ventilated patient during transport?

Accepted Answer

Decreased lung or chest wall compliance

Answer

Worsening bronchospasm

Answer

Endotracheal tube obstruction

Answer

Auto-PEEP development