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

IV magnesium sulfate causes bronchial smooth muscle relaxation and is indicated for severe asthma exacerbations not responding to standard beta-agonist therapy.

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

The presentation describes a tension pneumothorax, a life-threatening emergency requiring immediate needle thoracostomy at the second intercostal space, midclavicular line, before imaging.

Question 3

Which ABG result is most consistent with acute respiratory acidosis?

Accepted Answer

pH 7.28, PaCO2 58, HCO3 24

Answer

A low pH with an elevated PaCO2 and normal bicarbonate (no metabolic compensation yet) indicates acute respiratory acidosis.

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

Near-drowning victims are at high risk for developing ARDS due to aspiration of fluid causing diffuse alveolar damage and refractory hypoxemia.

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

A massive pleural effusion causes opacification of the hemithorax with tracheal deviation toward the affected side due to atelectasis, unlike tension pneumothorax where the trachea deviates away.

CEN - Certified Emergency Nurse Practice Test

CEN - Certified Emergency Nurse Practice Test

CEN Respiratory Emergencies