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ARDS

Total questions: 16

Worksheet time: 32mins

Name
Class
Date
1.

All of the following materials will be found in the alveoli of a patient with ARDS EXCEPT:

a)

leukocytes

b)

cellular debris

c)

fibrin

d)

hyaline membrane

2.

A patient has a prolonged case of ARDS. What changes would be expected in the patient's alveolar cells?

a)

Multiplication of the type I cells

b)

Influx of macrophages

c)

Hyperplasia and swelling of the type II cells

d)

Development of emphysema

3.

Which of the following pulmonary changes are associated with ARDS?

1. Abnormal surfactant

2. Interstitial edema

3. Decreased shunt

4. Narrowing of the alveolar-capillary membrane

a)

1, 2

b)

3, 4

c)

1, 3

d)

1, 2, 3

4.

What is the reason for the elevated risk of developing ARDS associated with massive blood transfusions?

a)

Shock (hypovolemia)

b)

Fat emboli

c)

Receiving the wrong blood type

d)

Blockages in pulmonary blood vessels

5.

ARDS can result from the inhalation of all of the following EXCEPT:

a)

FIO2 >0.60 for prolonged exposure.

b)

nitrogen dioxide

c)

very dry air

d)

chlorine gas

6.

Which of the following are causes of ARDS?

1. Liver failure

2. Heroin abuse

3. Septicemia

4. Goodpasture's syndrome

a)

1, 4

b)

2, 3

c)

2, 3, 4

d)

All the above

7.

Which of the following are recommended to treat alveolar consolidation and atelectasis associated with ARDS?

1. Aerosolized bronchodilator medications

2. Continuous positive airway pressure (CPAP)

3. Chest percussion and postural drainage

4. Positive end-expiratory pressure (PEEP)

a)

1, 2

b)

4

c)

1, 3

d)

2, 4

8.

Which of the following are current ventilatory strategies in the treatment of ARDS?

1. Large tidal volume

2. Small tidal volume

3. Rapid respiratory rates

4. Slow respiratory rates

a)

2

b)

3

c)

1, 4

d)

2, 3

9.

What initial tidal volume setting on the ventilator would be recommended for a 70-kg adult male with ARDS?

a)

350 mL

b)

420 mL

c)

560 mL

d)

500 ml

e)

700 mL

10.

All of the following would be low–tidal volume ventilation goals in a patient with ARDS, EXCEPT:

a)

decrease barotrauma

b)

maintain plateau pressure >30 cm H2O

c)

decrease high transpulmonary pressures.

d)

reduce overdistention of the lungs

11.

Breath sounds associated with ARDS include:

1. vesicular.

2. bronchovesicular.

3. crackles.

4. bronchial.

a)

4

b)

1, 2

c)

3, 4

d)

2, 3, 4

e)

All the above

12.

Which of the following clinical manifestations are associated with ARDS?

1. Normal or decreased pulmonary capillary wedge pressure (PCWP)

2. Increased CVP

3. Intercostal retractions

4. Cyanosis

a)

1, 2

b)

3, 4

c)

2, 3, 4

d)

2, 4

e)

All the above

13.

The chest radiograph finding indicative of severe ARDS is:

a)

"ground-glass" appearance of the lungs

b)

pleural effusion

c)

bilateral hyperinflation of the lungs

d)

tracheal deviation

e)

All the above

14.

According to the Berlin definition of ARDS, what does a PaO2/FIO2 ratio of 150 mm Hg indicate for a patient on mechanical ventilation with a PEEP of 10 cm H2O?

a)

Normal lungs

b)

Mild ARDS

c)

Moderate ARDS

d)

Severe ARDS

15.

What is the most common cause of ARDS?

a)

Sepsis

b)

Fat embolism

c)

Oxygen toxicity

d)

Terrible pulmonary MD

e)

Aspiration of gastric contents

16.

When would symptoms of ARDS associated with a fat embolism from a long bone fracture be most likely to develop?

a)

2 to 4 hours following the fracture

b)

4 to 12 hours following the fracture

c)

12 to 48 hours following the fracture

d)

48 to 96 hours following the fracture

e)

All the above