CEN Review (Section 4: Respiratory)

Which of the following findings is most consistent with an open pneumothorax?

• bubbling of blood at the wound throughout the respiratory cycle
• a “sucking” sound at the wound throughout the respiratory cycle
• bubbling of blood at the wound during inspiration with a “sucking” sound at the wound duringexhalation
• bubbling of blood at the wound during exhalation with a “sucking” sound at the wound duringinspiration
  

Which of the following assessment findings is most likely to point to an evolving pulmonary contusion?

• crackles on auscultation
• egophony in the lower chest
• hyperresonnance to percussion
• increased fremitus over the affected lung
  

Which of the following injuries is specific to a flail-chest segment?

• dyspnea
• hemoptysis
• crackles on auscultation
• paradoxical chest-wall movement

A colorimetric capnometer (CO2detector) is placed on the end of an endotracheal tube at the time of intubation. After the endotracheal tube is placed, the patient is provided a respiration utilizing a compressible bag with 100% oxygen. As the patient exhales, the emergency nurse notes that thecolorimetric device is purple. The next course of action should be to:

• Continue assisting respirations utilizing a compressible bag.
• Withdraw the endotracheal tube 1 to 2 centimeters, then attempt ventilation.
• Discontinue providing ventilations until placement can be confirmed via ausculatation.
• Withdraw the tube and commence ventilations utilizing a bag-mask device until intubation can bereattempted.
  

Which of the following symptoms is most closely associated with a pulmonary embolism that completelyoccludes the left pulmonary artery?

• jugular venous distension
• sudden onset hypertension
• appearance of splinter hemorrhages
• decreased respiratory excursion on the left side of the chest
  

At what point during pregnancy is an amniotic fluid pulmonary embolism most likely?

• during the first trimester
• during the second trimester
• during the third trimester
• immediately after birth

A patient with a pulmonary contusion is repositioned so that the uninjured side is against the bed. Which ofthe following manifestations should the emergency nurse assess for after this has been accomplished?

• onset of acidosis
• increasing dyspnea
• decreased hemoptysis
• improving oxygen saturations

Severe anemia may contribute to which form of pulmonary edema?

• neurogenic pulmonary edema
• cardiogenic pulmonary edema
• high-altitude pulmonary edema
• acute respiratory distress syndrome (ARDS)

Infection of the lower terminal airways is also known as:

• croup
• pneumonia
• bronchiolitis
• acute bronchitis

A patient has rapid, deep respirations, increasing fatigue and confusion. The most likely blood gas resultsassociated with this clinical picture is a:

• serum pH of 7.51, carbon dioxide of 20 mm Hg, bicarbonate of 18 mEq, base excess of -5
• serum pH of 7.41, carbon dioxide of 61 mm Hg, bicarbonate of 25 mEq, base excess of +1
• serum pH of 7.31, carbon dioxide of 22 mm Hg, bicarbonate of 34 mEq, base excess of +5
• serum pH of 7.21, carbon dioxide of 68 mm Hg, bicarbonate of 19 mEq, base excess of -4