NURS 4750 Exam 1 Questions With Complete Solutions
A pt. at the end of life is experiencing dysphagia. What is the
best way to administer medications? Correct Answers -
Sublingual
- Rectally
- Buccally
- Crush meds w/ food or drink
ABG/Vent practice:
- pH = 7.30
- PaCO2 = 51
- HCO3 = 27
- PaO2 = 69 Correct Answers Partially compensated resp.
acidosis with hypoxemia
- Increase tidal vol.
- Increase rate
- Increase FIO2
- Increase PEEP
ABG/Vent Practice:
- ph = 7.32
- PaCO2 = 49
- HCO3 = 25
- PaO2 = 88 Correct Answers - Uncompensated resp. acidosis
- Increase tidal vol.
- Increase rate
ABG/Vent Practice:
,- pH = 7.35
- PaCO2 = 30
- HCO3 = 19
- PaO2 = 90 Correct Answers Fully compensated metabolic
acidosis
ABG/Vent Practice:
- pH = 7.45
- PaCO2 = 32
- HCO3 = 20
- PaO2 = 75 Correct Answers Fully compensated resp. alkalosis
with hypoxemia
For alkalosis:
- Decrease tidal vol. and rate
For hypoxemia:
- Increase PEEP
- Increase FIO2
ABG/Vent Practice:
- pH = 7.48
- PaCO2 = 32
- HCO3 = 22
- PaO2 = 76 Correct Answers Uncompensated resp. alkalosis
with hypoxemia
ABG/Vent Practice:
- pH = 7.49
- PaCO2 = 30
- HCO3 = 19
,- PaO2 = 69 Correct Answers Partially compensated resp.
alkalosis with hypoxemia
ALL vent settings require a spontaneously breathing pt. except
which 2? Correct Answers Assist control and SIMV
(synchronized intermittent mandatory ventilation)
ARDS is acute respiratory failure characterized by what?
Correct Answers - Refractory hypoxemia that persists even with
100% O2
- Decrease pulm. compliance
- Dyspnea
- Non-cardiac associated bilateral pulmonary edema
- Dense pulmonary infiltrates on XR (haziness then white-out
appearance -- ground-glass)
Chest tubes would be inserted for air drainage at the ___ ICS
Correct Answers 4th
Chest tubes would be placed at the ____ ICS for fluid drainage
Correct Answers 8th or 9th
CPAP provides pressure on ______ Correct Answers both
inhalation AND exhalation (continuous pressure!)
Drainage from the chest tube is measured how often during the
first 24 hours? Correct Answers Hourly
Emergency care for a pneumothorax? Correct Answers - ABCs
- High flow O2
, - If there is an opening -- cover with a THREE sided
OCCLUSIVE dressing
- Monitor the lung and listen for any changes
- Chest tube
Explain the pathophysiology of ARDS. Correct Answers -
Alveolar-capillary membrane damage
- Increased permeability of the membrane
- Increased fluid and protein into alveoli
- Damage to the surfactant producing cells
- Inflammatory mediators swarm (as a result of sepsis,
pancreatitis, trauma, etc.)
- Decrease diffusion of oxygen
- Reduce blood flow to the lungs
- Diffuse atelectasis
For the pt. with persecutory delusions who refuses food or meds
due to the belief they are poisoned or tainted, how would you
handle their care? Correct Answers - Permit refusal if not life
threatening
- Try back in 20 mins.
- Allow the pt. to choose alternatives or read labels
How can terminal weaning be accomplished? Correct Answers
By removing the pt. from the ventilator and placing the pt. on a
T-tube or by rapidly decreasing the ventilator settings
How is Bi-PAP different from other vent settings? Correct
Answers Pt. gets a set inspiratory pressure and a set expiratory
pressure
- IP --> pressure support (PSV)
A pt. at the end of life is experiencing dysphagia. What is the
best way to administer medications? Correct Answers -
Sublingual
- Rectally
- Buccally
- Crush meds w/ food or drink
ABG/Vent practice:
- pH = 7.30
- PaCO2 = 51
- HCO3 = 27
- PaO2 = 69 Correct Answers Partially compensated resp.
acidosis with hypoxemia
- Increase tidal vol.
- Increase rate
- Increase FIO2
- Increase PEEP
ABG/Vent Practice:
- ph = 7.32
- PaCO2 = 49
- HCO3 = 25
- PaO2 = 88 Correct Answers - Uncompensated resp. acidosis
- Increase tidal vol.
- Increase rate
ABG/Vent Practice:
,- pH = 7.35
- PaCO2 = 30
- HCO3 = 19
- PaO2 = 90 Correct Answers Fully compensated metabolic
acidosis
ABG/Vent Practice:
- pH = 7.45
- PaCO2 = 32
- HCO3 = 20
- PaO2 = 75 Correct Answers Fully compensated resp. alkalosis
with hypoxemia
For alkalosis:
- Decrease tidal vol. and rate
For hypoxemia:
- Increase PEEP
- Increase FIO2
ABG/Vent Practice:
- pH = 7.48
- PaCO2 = 32
- HCO3 = 22
- PaO2 = 76 Correct Answers Uncompensated resp. alkalosis
with hypoxemia
ABG/Vent Practice:
- pH = 7.49
- PaCO2 = 30
- HCO3 = 19
,- PaO2 = 69 Correct Answers Partially compensated resp.
alkalosis with hypoxemia
ALL vent settings require a spontaneously breathing pt. except
which 2? Correct Answers Assist control and SIMV
(synchronized intermittent mandatory ventilation)
ARDS is acute respiratory failure characterized by what?
Correct Answers - Refractory hypoxemia that persists even with
100% O2
- Decrease pulm. compliance
- Dyspnea
- Non-cardiac associated bilateral pulmonary edema
- Dense pulmonary infiltrates on XR (haziness then white-out
appearance -- ground-glass)
Chest tubes would be inserted for air drainage at the ___ ICS
Correct Answers 4th
Chest tubes would be placed at the ____ ICS for fluid drainage
Correct Answers 8th or 9th
CPAP provides pressure on ______ Correct Answers both
inhalation AND exhalation (continuous pressure!)
Drainage from the chest tube is measured how often during the
first 24 hours? Correct Answers Hourly
Emergency care for a pneumothorax? Correct Answers - ABCs
- High flow O2
, - If there is an opening -- cover with a THREE sided
OCCLUSIVE dressing
- Monitor the lung and listen for any changes
- Chest tube
Explain the pathophysiology of ARDS. Correct Answers -
Alveolar-capillary membrane damage
- Increased permeability of the membrane
- Increased fluid and protein into alveoli
- Damage to the surfactant producing cells
- Inflammatory mediators swarm (as a result of sepsis,
pancreatitis, trauma, etc.)
- Decrease diffusion of oxygen
- Reduce blood flow to the lungs
- Diffuse atelectasis
For the pt. with persecutory delusions who refuses food or meds
due to the belief they are poisoned or tainted, how would you
handle their care? Correct Answers - Permit refusal if not life
threatening
- Try back in 20 mins.
- Allow the pt. to choose alternatives or read labels
How can terminal weaning be accomplished? Correct Answers
By removing the pt. from the ventilator and placing the pt. on a
T-tube or by rapidly decreasing the ventilator settings
How is Bi-PAP different from other vent settings? Correct
Answers Pt. gets a set inspiratory pressure and a set expiratory
pressure
- IP --> pressure support (PSV)
