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Pulmonary CCRN study Questions and Correct Answers | Latest Update

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  • Pulmonary CCRN

A patient presents with labored breathing and an RR of 40 beats per minute (bpm). The following ABG is obtained: PaO2 68 PaCO2 50 pH 7.34 SaO2 91% HCO3 22 Which of the following is the most accurate interpretation of the above situation? A. Normal ABG for COPD patient B. Respiratory fai...

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  • September 20, 2024
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  • 2024/2025
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  • Questions & answers
  • Pulmonary CCRN
  • Pulmonary CCRN
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2024 /2025 | © copyright | This work may not be copied for profit gain Excel!




Pulmonary CCRN study Questions and
Correct Answers | Latest Update
A patient presents with labored breathing and an RR of 40 beats per minute (bpm). The

following ABG is obtained:


PaO2 68


PaCO2 50


pH 7.34


SaO2 91%


HCO3 22


Which of the following is the most accurate interpretation of the above situation?


A. Normal ABG for COPD patient


B. Respiratory failure due to metabolic acidosis


C. Obstructive upper airway most likely causing respiratory failure


D. Respiratory failure due to dead space


✓ -:- D

Normally, as the minute ventilation (MV) increases, the PaCO2 should decrease. The

normal pattern is an inverse relationship. In dead space, the alveolar ventilation decreases

even as the respiratory rate increases. This results in an increase in CO2 and an abnormal

relationship between MV and PaCO2. The patient has respiratory acidosis, not metabolic

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,2024 /2025 | © copyright | This work may not be copied for profit gain Excel!



acidosis. It is not a normal blood gas for a patient with COPD because the pH is abnormal.

There is no indication in this scenario that this would be an upper airway obstruction.




What is the compensatory mechanism for VQ shunting?


A. Decrease MV


B. Bronchoconstriction


C. Pulmonary vasoconstriction


D. Increase cardiac output


✓ -:- C

VQ shunting is perfusion without ventilation. A compensatory mechanism for the VQ shunt

is pulmonary vasoconstriction to redistribute blood flow to ventilated alveolar units. In VQ

shunts, patients increase their respiratory rate, causing an increase in min- ute ventilation.

Bronchoconstriction occurs with dead space in an attempt to shunt ven- tilation to perfused

alveoli. An increase in cardiac output can occur in response to tissue hypoxia but is not

considered a compensatory mechanism for a pulmonary shunt.




Which of the following findings would indicate the presence of obstructive airway disease?


A. FEV1/FVC ratio of < 60%


B. FEV1/FVC ratio 75% to 80%


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, 2024 /2025 | © copyright | This work may not be copied for profit gain Excel!



C. FEV1/FVC ratio > 80%


D. Normal FEV1/FVC ratio


✓ -:- A

An obstructive airway disease causes a decrease in FEV1 with a relatively normal FVC

resulting in a decrease in the FEV1/FVC ratio. A normal ratio is 75% to 80%. The lower the

ratio, the greater the obstruction of airflow. This test is used to assess asthma patients

during bronchodilator treatments. A normal FEV1/FVC ratio would indicate a restrictive

airway disease.




A patient in the ICU is diagnosed with ARDS. The following are the ventilator settings and

ABG results:


SIMV 550 mL TV, Rate 16, 40%, PEEP 5


7.46 pH


48 PaCO2


82 PaO2


94% SaO2


What is the calculated PaO2/FiO2 ratio?


A. 120


B. 20

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