Q.1 Which of the following best defines respiratory failure?
Failure of the lungs to ventilate adequately
Failure of the heart to pump blood effectively
Inability of kidneys to excrete waste products
Failure of the brain to regulate breathing
Explanation - Respiratory failure is defined as the inability of the lungs to maintain adequate oxygenation or ventilation.
Correct answer is: Failure of the lungs to ventilate adequately
Q.2 Which arterial blood gas (ABG) value indicates hypoxemia?
PaO2 < 60 mmHg
PaCO2 > 50 mmHg
HCO3- < 22 mEq/L
pH > 7.45
Explanation - Hypoxemia is defined as low arterial oxygen tension, typically PaO2 < 60 mmHg.
Correct answer is: PaO2 < 60 mmHg
Q.3 Type I respiratory failure is primarily due to:
Hypercapnia
Hypoxemia
Metabolic acidosis
Alkalosis
Explanation - Type I respiratory failure is hypoxemic respiratory failure characterized by PaO2 < 60 mmHg with normal or low PaCO2.
Correct answer is: Hypoxemia
Q.4 Type II respiratory failure is characterized by:
High PaO2
Low PaCO2
High PaCO2
Normal PaCO2
Explanation - Type II respiratory failure occurs due to alveolar hypoventilation leading to PaCO2 > 50 mmHg.
Correct answer is: High PaCO2
Q.5 A patient with COPD develops respiratory failure. What type is most likely?
Type I
Type II
Mixed type
Neither
Explanation - COPD patients often develop Type II respiratory failure due to alveolar hypoventilation.
Correct answer is: Type II
Q.6 What is the first-line diagnostic test for respiratory failure?
Chest X-ray
Arterial blood gas (ABG)
ECG
Pulmonary function test
Explanation - ABG is the gold standard for diagnosing respiratory failure, identifying hypoxemia and/or hypercapnia.
Correct answer is: Arterial blood gas (ABG)
Q.7 Which clinical sign is most commonly associated with hypoxemia?
Cyanosis
Bradycardia
Dry skin
Hypertension
Explanation - Hypoxemia leads to bluish discoloration of skin and mucous membranes due to low oxygen saturation.
Correct answer is: Cyanosis
Q.8 Hypercapnia typically causes which acid-base disturbance?
Metabolic acidosis
Respiratory acidosis
Respiratory alkalosis
Metabolic alkalosis
Explanation - Excess CO2 retention increases carbonic acid, leading to respiratory acidosis.
Correct answer is: Respiratory acidosis
Q.9 Which oxygen delivery device provides the highest concentration of oxygen?
Nasal cannula
Simple face mask
Non-rebreather mask
Venturi mask
Explanation - Non-rebreather masks can deliver nearly 100% oxygen, making them the highest concentration device without intubation.
Correct answer is: Non-rebreather mask
Q.10 Which condition is a common cause of Type I respiratory failure?
Asthma
Pulmonary edema
Neuromuscular disease
Drug overdose
Explanation - Type I respiratory failure results from conditions that impair oxygen exchange, such as pulmonary edema.
Correct answer is: Pulmonary edema
Q.11 Which ventilator mode delivers a set tidal volume at a fixed rate regardless of patient effort?
SIMV
Assist-control (AC)
CPAP
BiPAP
Explanation - In assist-control mode, the ventilator provides full tidal volume whether initiated by the patient or ventilator.
Correct answer is: Assist-control (AC)
Q.12 What is the most immediate priority in managing acute respiratory failure?
Provide antibiotics
Ensure adequate oxygenation
Administer IV fluids
Start nutritional support
Explanation - The first priority is to correct hypoxemia and maintain oxygen delivery to vital organs.
Correct answer is: Ensure adequate oxygenation
Q.13 In non-invasive ventilation, CPAP mainly helps by:
Improving alveolar ventilation
Decreasing oxygen requirement
Providing continuous positive airway pressure
Removing CO2
Explanation - CPAP provides continuous pressure to keep alveoli open and improve oxygenation.
Correct answer is: Providing continuous positive airway pressure
Q.14 ARDS is characterized by:
Pulmonary fibrosis
Non-cardiogenic pulmonary edema
Bronchospasm
Pleural effusion
Explanation - ARDS is marked by increased capillary permeability causing non-cardiogenic pulmonary edema.
Correct answer is: Non-cardiogenic pulmonary edema
Q.15 Which ABG finding suggests Type II respiratory failure?
Low PaO2, high PaCO2
Low PaO2, low PaCO2
Normal PaO2, low PaCO2
High PaO2, high PaCO2
Explanation - Type II respiratory failure is defined by hypoxemia with hypercapnia.
Correct answer is: Low PaO2, high PaCO2
Q.16 Which electrolyte imbalance can worsen respiratory muscle weakness?
Hypokalemia
Hypernatremia
Hypermagnesemia
Hypercalcemia
Explanation - Low potassium impairs muscle contraction, worsening respiratory muscle weakness.
Correct answer is: Hypokalemia
Q.17 Which condition is most commonly associated with ARDS?
Sepsis
Asthma
Emphysema
Pneumothorax
Explanation - Sepsis is the leading cause of ARDS due to systemic inflammatory response.
Correct answer is: Sepsis
Q.18 Which physical sign suggests impending respiratory failure?
Use of accessory muscles
Clear breath sounds
Stable vital signs
Mild dyspnea
Explanation - Use of accessory muscles indicates increased work of breathing and risk of respiratory failure.
Correct answer is: Use of accessory muscles
Q.19 Which diagnostic imaging is most useful in detecting ARDS?
CT scan of chest
Chest X-ray
Ultrasound
MRI
Explanation - Chest X-ray typically shows bilateral infiltrates in ARDS.
Correct answer is: Chest X-ray
Q.20 Which of the following is a contraindication for non-invasive ventilation?
Severe hypoxemia
Patient cooperation
Hemodynamic instability
Mild hypercapnia
Explanation - Patients with unstable blood pressure or shock require invasive mechanical ventilation, not NIV.
Correct answer is: Hemodynamic instability
Q.21 A patient with ARDS is placed on low tidal volume ventilation to prevent:
Hypoventilation
Barotrauma
Hyperoxia
Atelectasis
Explanation - Low tidal volume ventilation prevents lung injury and barotrauma in ARDS.
Correct answer is: Barotrauma
Q.22 What is the main goal of PEEP in mechanical ventilation?
Increase tidal volume
Prevent alveolar collapse
Reduce respiratory rate
Increase FiO2
Explanation - Positive end-expiratory pressure (PEEP) keeps alveoli open during expiration, improving oxygenation.
Correct answer is: Prevent alveolar collapse
Q.23 Which ABG pattern is typical in early ARDS?
Respiratory alkalosis
Respiratory acidosis
Metabolic acidosis
Metabolic alkalosis
Explanation - Early ARDS presents with tachypnea and hyperventilation, leading to respiratory alkalosis.
Correct answer is: Respiratory alkalosis
Q.24 Which symptom differentiates hypercapnia from hypoxemia?
Headache and confusion
Cyanosis
Dyspnea
Tachycardia
Explanation - Hypercapnia commonly causes cerebral vasodilation, leading to headache, confusion, and drowsiness.
Correct answer is: Headache and confusion
Q.25 What is the normal range of PaO2 in arterial blood?
35–45 mmHg
80–100 mmHg
50–60 mmHg
95–105 mmHg
Explanation - The normal PaO2 range is 80–100 mmHg; values below 60 indicate hypoxemia.
Correct answer is: 80–100 mmHg