CCRN Plan

CCRN practice question: Respiratory

RespiratoryDifficulty 3/5

A ventilated patient's peak inspiratory pressure rises from 28 to 42 cmH2O while the plateau pressure stays at 22 cmH2O. What does this indicate?

  1. ATension pneumothorax with mediastinal shift and cardiovascular collapse
  2. BVentilator circuit disconnection causing loss of delivered pressure
  3. CReduced lung compliance from developing acute respiratory distress syndrome
  4. DIncreased airway resistance from secretions, bronchospasm or a kinked tube
Show answer and rationale

Correct: D. The difference between peak and plateau reflects airway resistance; an isolated rise in peak with an unchanged plateau points to a resistance problem. A compliance problem such as ARDS or pneumothorax raises the plateau as well.

  • C — Reduced compliance raises the plateau pressure.
  • A — Tension pneumothorax raises both peak and plateau and causes haemodynamic collapse.
  • B — A disconnection produces low pressures and an alarm, not high peak pressures.

Concept being tested

12% of the exam. Acute pulmonary edema and embolus, ARDS, acute respiratory failure and infection, chronic conditions, mechanical-ventilation complications, pleural-space abnormalities, pulmonary hemorrhage and hypertension, status asthmaticus, thoracic and airway trauma, and thoracic surgery. — 12% of the exam. Study guide for Respiratory.

Related questions

Practice this topic

Blueprint-mapped questions with full rationales for every choice.

Start practice

Primary references

  1. CCRN Exam Handbook — Direct Care (July 2026) — AACN Certification Corporation · primary · retrieved 2026-09-22, verified 2026-09-22
Last reviewed: 2026-10-07Reviewed by: Marcus Vance, MSN, RN, CCRN-CSC, Critical care nursing curriculum & clinical item reviewHow we verify facts