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Quizzes > Quizzes for Business > Healthcare

Respiratory Failure Knowledge Test: Challenge Yourself

Evaluate your grasp of respiratory distress cases

Difficulty: Moderate
Questions: 20
Learning OutcomesStudy Material
Colorful paper art depicting elements related to a Respiratory Failure Knowledge Test quiz

Ready to challenge yourself with a comprehensive respiratory failure quiz? This Respiratory System Practice Quiz and our targeted Respiratory Physiology Knowledge Test offer ideal warm-ups before diving into the Respiratory Failure Knowledge Test. Perfect for students, educators, and clinicians seeking to sharpen their skills, this quiz covers key concepts from blood gas interpretation to ventilator troubleshooting. Participants will gain confidence in diagnosis and management strategies. Feel free to customise every question in our quizzes editor to suit your learning goals.

Which arterial oxygen tension defines hypoxemic respiratory failure?
PaO2 <60 mmHg
PaO2 <100 mmHg
PaO2 <45 mmHg
PaO2 <80 mmHg
Hypoxemic respiratory failure is defined by a PaO2 less than 60 mmHg, indicating inadequate arterial oxygenation. This threshold differentiates between adequate and critically low oxygen levels.
Which arterial carbon dioxide tension characterizes hypercapnic respiratory failure?
PaCO2 >70 mmHg
PaCO2 >50 mmHg
PaCO2 <45 mmHg
PaCO2 <35 mmHg
Hypercapnic respiratory failure is diagnosed when PaCO2 rises above 50 mmHg, reflecting inadequate ventilation. Elevated CO2 levels lead directly to respiratory acidosis if uncorrected.
Which clinical sign is most indicative of significant hypoxemia?
Bounding pulses
Bradycardia
Hypotension
Central cyanosis
Central cyanosis, a bluish discoloration of the lips and tongue, indicates deoxygenated hemoglobin above 5 g/dL in arterial blood. It is a key clinical sign of severe hypoxemia.
What is the first step in the emergency management of acute respiratory failure?
Administer diuretics
Start intravenous fluids
Obtain a chest radiograph
Assess airway patency and administer oxygen
The immediate priority in respiratory failure is to secure the airway and improve oxygenation. Early oxygen delivery prevents further hypoxic injury while other interventions are planned.
Which finding suggests impending respiratory muscle fatigue?
Oliguria
Use of accessory muscles
Hyperactive reflexes
Bradycardia
Use of accessory muscles indicates the patient is recruiting additional muscle groups to breathe, signaling fatigue of the primary respiratory muscles. This finding warrants urgent ventilatory support.
A ventilation-perfusion (V/Q) mismatch in respiratory failure occurs when:
There is no blood flow to alveoli
Alveoli are perfused but not ventilated
Alveoli are ventilated but not perfused
Respiration is equal in all lung zones
V/Q mismatch where alveoli receive blood flow without ventilation leads to shunting and hypoxemia. It is the most common cause of hypoxemic respiratory failure.
Which constellation of symptoms is most typical in acute hypercapnic respiratory failure?
Chest pain and diaphoresis
Wheezing and pruritus
Syncope and vertigo
Headache and drowsiness
Hypercapnia causes cerebral vasodilation leading to headache and central nervous system depression manifesting as drowsiness. These signs help distinguish CO2 retention.
An ABG shows pH 7.25, PaCO2 60 mmHg, HCO3− 24 mEq/L. What is the primary disturbance?
Acute respiratory acidosis
Metabolic acidosis
Metabolic alkalosis
Chronic respiratory acidosis
A low pH with elevated PaCO2 and normal bicarbonate indicates an acute respiratory acidosis without metabolic compensation. The kidneys have not yet raised HCO3−.
What is the primary physiological effect of applying positive end-expiratory pressure (PEEP)?
Reduces cardiac preload
Decreases functional residual capacity
Prevents alveolar collapse and improves oxygenation
Increases dead space ventilation
PEEP maintains alveolar patency at end-expiration, preventing collapse and improving gas exchange. This increases functional residual capacity and oxygenation.
Which patient scenario is the best indication for noninvasive positive pressure ventilation (NIPPV)?
Cardiac arrest
COPD exacerbation with acute hypercapnia
Uncontrolled vomiting
Severe facial trauma
NIPPV is indicated in acute COPD exacerbations with CO2 retention to improve ventilation and avoid intubation. Contraindications include facial trauma and poor airway protection.
In assist-control ventilation mode, how are tidal volumes delivered?
Every breath receives the set tidal volume
Only spontaneous breaths are assisted
Volume varies with patient effort
Patient-triggered breaths are unsupported
Assist-control mode ensures that every breath, whether patient-initiated or machine-triggered, is delivered at the preset tidal volume. This guarantees consistent minute ventilation.
To minimize oxygen desaturation during intubation, you should:
Avoid sedative administration
Preoxygenate with 100% O2 for several minutes
Use room air for preoxygenation
Administer an immediate chest X-ray
Preoxygenation with 100% oxygen fills the functional residual capacity, providing a reservoir during apnea. This delays desaturation during the intubation procedure.
A high peak airway pressure alarm on the ventilator most likely indicates:
Bronchospasm
Improved lung compliance
Patient-ventilator synchrony
Circuit disconnection
Elevated peak airway pressures often reflect increased airway resistance such as bronchospasm. Disconnection would lower pressures and improved compliance would reduce pressures.
To reduce ventilator-induced lung injury, tidal volumes should be set to:
10 mL/kg of actual body weight
6 mL/kg of predicted body weight
8 mL/kg of actual body weight
15 mL/kg of predicted body weight
Lung-protective ventilation uses low tidal volumes around 6 mL/kg predicted body weight to prevent overdistension and volutrauma. Higher volumes increase risk of injury.
Which parameter is most predictive of successful weaning from mechanical ventilation?
Central venous pressure
Serum lactate level
Rapid shallow breathing index (f/VT)
Arterial pH
The rapid shallow breathing index (respiratory rate divided by tidal volume) below 105 breaths/min/L correlates with successful extubation. It assesses efficiency of spontaneous breathing.
An ABG shows pH 7.30, PaCO2 55 mmHg, HCO3− 22 mEq/L. What disorder does this represent?
Uncompensated respiratory alkalosis
Acute metabolic acidosis
Compensated respiratory acidosis
Mixed respiratory and metabolic acidosis
The elevated PaCO2 produces respiratory acidosis, while the low bicarbonate indicates a concurrent metabolic acidosis. The combination lowers pH more than either alone.
In ARDS ventilation management, which parameter should be limited to prevent barotrauma?
Plateau pressure to ≤30 cm H2O
PEEP to ≤5 cm H2O
FiO2 to ≤21%
Respiratory rate to ≤10 breaths/min
Limiting plateau pressure to 30 cm H2O reduces alveolar overdistension and barotrauma in ARDS. PEEP and FiO2 are adjusted for oxygenation rather than directly preventing barotrauma.
Auto-PEEP is best detected by:
Measuring plateau pressure
Increasing inspiratory flow
Performing an expiratory hold maneuver
Observing tidal volume
An expiratory hold allows measurement of intrinsic PEEP by occluding airflow and quantifying residual airway pressure. It differentiates auto-PEEP from applied PEEP.
A sudden drop in delivered tidal volume with high leak alarm suggests:
Patient biting the tube
Endotracheal tube cuff leak
Bronchospasm
Increased lung compliance
A cuff leak or circuit disconnection permits gas escape, reducing delivered volume and triggering leak alarms. Bronchospasm increases resistance but doesn't cause a leak.
Which mechanism predominantly contributes to ventilator-associated lung injury?
Alveolar collapse (atelectrauma)
Alveolar overdistension (volutrauma)
Pulmonary vasoconstriction
Surfactant excess
Volutrauma from overdistension of alveoli with excessive tidal volumes is a primary driver of ventilator-induced lung injury. Atelectrauma and shear stress also contribute but overdistension is central.
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Learning Outcomes

  1. Analyse the pathophysiology underlying respiratory failure
  2. Identify clinical signs of hypoxemic and hypercapnic failure
  3. Evaluate arterial blood gas results for diagnosis
  4. Apply appropriate ventilatory support strategies
  5. Demonstrate emergency management protocols
  6. Master troubleshooting mechanical ventilation complications

Cheat Sheet

  1. Distinguish Type 1 and Type 2 Respiratory Failure - Put on your detective hat and unravel the two respiratory failure subtypes! Type 1 (hypoxemic) dives your PaO₂ below 8 kPa with normal or low CO₂ thanks to ventilation - perfusion mismatches, while Type 2 (hypercapnic) mixes low oxygen and high CO₂ (PaCO₂ > 6 kPa) often from alveolar hypoventilation. Geeky Medics: Type 1 vs Type 2 Respiratory Failure
  2. Spot Hypoxemia and Hypercapnia Clues - Channel your inner Sherlock and watch for cyanosis (hello, blue lips!), confusion, and racing heart for low oxygen, plus headaches, sleepiness, and flapping tremors (asterixis) when CO₂ climbs. These red flags demand fast, targeted evaluation. Merck Manual: Ventilatory Failure
  3. Master Arterial Blood Gas (ABG) Interpretation - ABGs are your laboratory crystal ball: PaO₂ indicates how well you're oxygenating, PaCO₂ shows ventilation efficiency, and pH reveals acid - base balance. For instance, PaO₂ < 60 mmHg flags hypoxemia, while PaCO₂ > 45 mmHg warns of hypercapnia. NCBI Bookshelf: Arterial Blood Gas Analysis
  4. Demystify the Alveolar Gas Equation - Roll up your sleeves for the equation PAO₂ = FiO₂ × (PB - PH₂O) - (PaCO₂/R). This gem compares alveolar oxygen pressure to what you actually measure in blood, helping you spot gas exchange issues in a flash. NCBI Bookshelf: Alveolar Gas Equation
  5. Leverage the A - a Gradient Diagnostic Power - The alveolar - arterial (A - a) gradient measures the gap between alveolar and arterial oxygen. A normal gradient suggests pure hypoventilation, while an increased one hints at diffusion defects or V/Q mismatches. NCBI Bookshelf: A - a Gradient Explained
  6. Explore Ventilatory Support Strategies - Choose your weapons wisely: non-invasive options like CPAP and BiPAP can rescue many cases, while severe failure calls for invasive mechanical ventilation. Each method has its ideal use scenario and safety profile. Merck Manual: Ventilatory Failure
  7. Nail Emergency Management Protocols - In acute crises, swiftly secure the airway, dial up supplemental oxygen, and brace for mechanical ventilation if needed. Following a clear, stepwise approach can stop the spiral into deeper respiratory trouble. Cleveland Clinic: Respiratory Failure Overview
  8. Beware Mechanical Ventilation Complications - Mechanical help can backfire: be on the lookout for ventilator-associated pneumonia, barotrauma, and lung injury from overdistension. Monitoring and prevention strategies keep these risks in check. Merck Manual: Ventilation Complications
  9. Recognize Underlying Condition Triggers - Diseases like COPD, asthma, and neuromuscular disorders can tip you into respiratory failure. Managing these root causes early is your best defense against respiratory disaster. NCBI Bookshelf: Causes of Respiratory Failure
  10. Stay Sharp with the Latest Guidelines - Medicine never sleeps, and neither should your knowledge. Keep up with current evidence-based protocols and research updates to deliver top-notch respiratory care. PubMed: Respiratory Failure Best Practices
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