Adult Health II Exam 1 Complete Practice Test 2026

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Pulmonary contusion in the ICU is generally managed with supportive care. Which ventilation approach is commonly used when mechanical ventilation is required?

Lung-protective ventilation with low tidal volumes.

When pulmonary contusion requires ventilation, the goal is to support gas exchange while minimizing further lung injury. The best approach is lung-protective ventilation with low tidal volumes, typically around 6 mL/kg predicted body weight, to prevent overdistension of injured lung units. Keeping plateau pressures under about 30 cm H2O helps limit barotrauma and volutrauma, which contusion-patched lungs are especially vulnerable to. PEEP is used to prevent alveolar collapse and improve oxygenation, but it should be carefully titrated rather than applied at high levels indiscriminately. Higher tidal volumes or a rigid “high-PEEP regardless” strategy can worsen lung injury and outcomes in pulmonary contusion. If ventilation is necessary, this protective strategy provides a balance between adequate ventilation and minimizing additional lung damage.

High tidal volumes to ensure full lung recruitment.

No mechanical ventilation unless absolutely necessary.

Immediate use of ARDSnet protocol with high PEEP irrespective of oxygenation.