AACN PCCN Review: Pulmonary exam Questions With
Accurate Solutions.
V/Q ratio - accurate answers-A measurement that examines how much gas is
being moved effectively and how much blood is flowing around the alveoli
where gas exchange (perfusion) occurs.
Conditions that cause V/Q mismatch - accurate answers-shunting (pnm, pulm
edema, trauma), dead-space ventilation (PE, hypotension/low cardiac output,
hypovolemia/dehydration), a silent unit (pneumothorax, ARDS)
shunting - accurate answers-blood moving from the right side of the heart to
the left side, through the pulmonary system without gas exchange
V/Q ratio is low- perfusion is ok but oxygenation does that occur
ex. pnm, pulmonary edema, pulmonary contusion/trauma
ARDS pathophysiology - accurate answers-increased capillary permeability-
accumulation of fluid in alveoli thereby releasing proinflammatory cytokines
such as TNF
decreased pulmonary compliance
increased alveolar surface tension
increased pulmonary vascular resistance
lungs become stiff as a result of alveolar collapse and surfactant deficiency.
causes an increased in work of breathing and patient fatigue
multiple organ failure is the leading cause of death
Potential side effects of tracheal suctioning - accurate answers-
tracheobronchial trauma, bleeding
severe hypoxemia
bradycardia, hypotension (vasovagal response)
laryngospasm/bronchospasm
respiratory arrest
most common location for clot to cause PE - accurate answers-veins of leg
blood pools dt inactivity, poor circulation
, cough and gag reflex and ability to swallow are controlled by which nerves? -
accurate answers-X (vagus) and IX (glossopharyngeal)
sepsis causes a release in what hormone(s)? - accurate answers-
catecholamines
growth hormone
cortisol
glucagon
sepsis causes a suppression of what hormone? - accurate answers-thyroid
hormone
Tx for hypoxic resp failure/ ARDS - accurate answers-oxygen
positive pressure ventilation
*prone positioning (on belly)*
diuresis
identify and tx underlying condition
early intubation in extreme cases
hypoxia s/s - accurate answers-*restlessness & agitation*
tachypnea, tachycardia, accessory muscle use
very late sign: cyanosis
late sign of acute respiratory failure - accurate answers-cyanosis
hypercarbia s/s - accurate answers-confusion, irritable
*somnolence; relaxed, sleepy
tachycardia
typically bradypnea
Normal ABGs - accurate answers-pH 7.35- 7.45
paCO2 35-45
paHCO3 22-26
PaO2 80-100
Accurate Solutions.
V/Q ratio - accurate answers-A measurement that examines how much gas is
being moved effectively and how much blood is flowing around the alveoli
where gas exchange (perfusion) occurs.
Conditions that cause V/Q mismatch - accurate answers-shunting (pnm, pulm
edema, trauma), dead-space ventilation (PE, hypotension/low cardiac output,
hypovolemia/dehydration), a silent unit (pneumothorax, ARDS)
shunting - accurate answers-blood moving from the right side of the heart to
the left side, through the pulmonary system without gas exchange
V/Q ratio is low- perfusion is ok but oxygenation does that occur
ex. pnm, pulmonary edema, pulmonary contusion/trauma
ARDS pathophysiology - accurate answers-increased capillary permeability-
accumulation of fluid in alveoli thereby releasing proinflammatory cytokines
such as TNF
decreased pulmonary compliance
increased alveolar surface tension
increased pulmonary vascular resistance
lungs become stiff as a result of alveolar collapse and surfactant deficiency.
causes an increased in work of breathing and patient fatigue
multiple organ failure is the leading cause of death
Potential side effects of tracheal suctioning - accurate answers-
tracheobronchial trauma, bleeding
severe hypoxemia
bradycardia, hypotension (vasovagal response)
laryngospasm/bronchospasm
respiratory arrest
most common location for clot to cause PE - accurate answers-veins of leg
blood pools dt inactivity, poor circulation
, cough and gag reflex and ability to swallow are controlled by which nerves? -
accurate answers-X (vagus) and IX (glossopharyngeal)
sepsis causes a release in what hormone(s)? - accurate answers-
catecholamines
growth hormone
cortisol
glucagon
sepsis causes a suppression of what hormone? - accurate answers-thyroid
hormone
Tx for hypoxic resp failure/ ARDS - accurate answers-oxygen
positive pressure ventilation
*prone positioning (on belly)*
diuresis
identify and tx underlying condition
early intubation in extreme cases
hypoxia s/s - accurate answers-*restlessness & agitation*
tachypnea, tachycardia, accessory muscle use
very late sign: cyanosis
late sign of acute respiratory failure - accurate answers-cyanosis
hypercarbia s/s - accurate answers-confusion, irritable
*somnolence; relaxed, sleepy
tachycardia
typically bradypnea
Normal ABGs - accurate answers-pH 7.35- 7.45
paCO2 35-45
paHCO3 22-26
PaO2 80-100
