Acute respiratory distress syndrome Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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A 58-year-old man with a history of hypertension is admitted to the intensive care unit for management of pneumonia and subsequent acute respiratory distress syndrome (ARDS). He was intubated and mechanically ventilated due to worsening hypoxemia. His initial ventilator settings were set to a tidal volume of 6 mL/kg of predicted body weight, with a positive end-expiratory pressure (PEEP) of 5 cm H2O. Temperature is 38.3°C (100.9°F), heart rate is 102/min, respiratory rate is set at 12 breaths/min on the ventilator, blood pressure is 135/85 mmHg, and oxygen saturation is 88% on FiO2 of 50%. The patient is put in a prone position. Lung auscultation reveals bilateral crackles. Arterial blood gas (ABG) analysis shows pH 7.3, PaCO2 40 mm Hg, PaO2 55 mm Hg, and HCO3- 24 mEq/L. PaO2/FiO2 ratio=110. Which of the following is the best next step in management?

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Increase FiO2 to 80%

Increase positive end-expiratory pressure (PEEP) to 8 cm H2O

Increase respiratory rate to 16 breaths/min

Switch the patient to a supine position

Increase tidal volume to 8 mL/kg