Mechanical Ventilation Elaborate Study
Questions with Detailed Answers Already
Graded A+ (Guarantee Pass) | Latest
Edition
1. A patient with acute respiratory distress syndrome (ARDS) who is intubated
and receiving mechanical ventilation develops a right pneumothorax. Which
collaborative action will the nurse anticipate next?
a. Increase the tidal volume and respiratory rate.
b. Decrease the fraction of inspired oxygen (FIO2).
c. Perform endotracheal suctioning more frequently.
d. Lower the positive end-expiratory pressure (PEEP). - ANSWER: D
Because barotrauma is associated with high airway pressures, the level of PEEP
should be decreased. The other actions will not decrease the risk for another
pneumothorax.
2. After receiving change-of-shift report on a medical unit, which patient
should the nurse assess first?
a. A patient with cystic fibrosis who has thick, green-colored sputum.
b. A patient with pneumonia who has crackles bilaterally in the lung
bases.
c. A patient with emphysema who has an oxygen saturation of 90% to
92%.
d. A patient with septicemia who has intercostal and suprasternal
retractions. - ANSWER: D
This patient's history of septicemia and labored breathing suggest the onset of
ARDS, which will require rapid interventions such as administration of O2 and
use of positive-pressure ventilation. The other patients should also be assessed,
but their assessment data are typical of their disease processes and do not
suggest deterioration in their status.
,3. A patient with chronic obstructive pulmonary disease (COPD) arrives in the
emergency department reporting shortness of breath on minimal exertion.
Which assessment finding by
the nurse is most important to report to the health care provider?
a. The patient has bibasilar lung crackles.
b. The patient is sitting in the tripod position.
c. The patient's respiratory rate is 10 breaths/min.
d. The patient's pulse oximetry shows a 91% O2 saturation. -
ANSWER: C
A drop in respiratory rate in a patient with respiratory distress suggests the
onset of fatigue and a high risk for respiratory arrest. Therefore, immediate
action such as positive-pressure ventilation is needed. Patients who are
experiencing respiratory distress frequently sit in the tripod position because it
decreases the work of breathing. Crackles in the lung bases may be the baseline
for a patient with COPD. An O2 saturation of 91% is common in patients with
COPD and will provide adequate gas exchange and tissue oxygenation.
4. When the nurse is explaining respiratory failure to the patient's family, what
is the most accurate description to use?
a. The absence of ventilation.
b. Any episode in which part of the airway is obstructed.
c. Inadequate gas exchange to meet the needs of the body.
d. An episode of acute hypoxemia caused by a pulmonary dysfunction. -
ANSWER: C
5. Which diagnostic test will provide the nurse with the most specific
information to evaluate the effectiveness of interventions for a patient with
ventilator failure?
a. Chest x-ray
b. O2 saturation
c. Arterial blood gas analysis
d. Central venous pressure monitoring - ANSWER: C
,Arterial blood gas (ABG) analysis is most useful in this setting because
ventilatory failure causes problems with CO2 retention, and ABGs give
information about the PaCO2 and pH. The other tests may also be done to help
in assessing oxygenation or determining the cause of the patient's ventilatory
failure.
6. While caring for a patient who has been admitted with a pulmonary
embolism, the nurse notes a change in the patient's oxygen saturation (SpO2)
from 94% to 88%. Which action should the nurse take?
a. Suction the patient's oropharynx.
b. Increase the prescribed O2 flowrate.
c. Teach the patient to cough and deep breath.
d. Help the patient to sit in a more upright position. - ANSWER ANS: B
Increasing O2 flowrate will usually improve O2 saturation in patients with
ventilation-perfusion mismatch, as occurs with pulmonary embolism. Because
the problem is with perfusion, actions that improve ventilation, such as deep
breathing and coughing, sitting upright, and suctioning, are not likely to
improve oxygenation.
7. A patient with respiratory failure has a respiratory rate of 6 breaths/min and
an oxygen saturation (SpO2) of 78%. The patient is increasingly lethargic.
Which intervention will the nurse anticipate?
a. Administration of 100% O2 by non-rebreather mask
b. Endotracheal intubation and positive pressure ventilation
c. Insertion of a mini-tracheostomy with frequent suctioning
d. Initiation of continuous positive pressure ventilation (CPAP) -
ANSWER: B
The patient's lethargy, low respiratory rate, and SpO2 indicate the need for
mechanical ventilation with ventilator-controlled respiratory rate. Giving high-
flow O2 will not be helpful because the patient's respiratory rate is so low.
Insertion of a mini-tracheostomy will promote removal of secretions, but it will
not improve the patient's respiratory rate or oxygenation. CPAP requires that
the patient initiate an adequate respiratory rate to allow adequate gas exchange.
, 8. The oxygen saturation (SpO2) for a patient with left lower lobe pneumonia
is 90%. The patient has wheezes and a weak cough effort. Which action
should the nurse take?
a. Position the patient on the left side.
b. Assist the patient with staged coughing.
c. Place a humidifier in the patient's room.
d. Schedule a 4-hour rest period for the patient. - ANSWER: B
The patient's assessment indicates that assisted coughing is needed to help
remove secretions, which will improve oxygenation. A 4-hour rest period at this
time may allow the O2 saturation to drop further. Humidification will not be
helpful unless the secretions can be mobilized. Positioning on the left side may
cause a further decrease in oxygen saturation because perfusion will be directed
more toward the more poorly ventilated lung.
9. A nurse is caring for a patient with right lower lobe pneumonia who is
obese. Which position will provide the best gas exchange?
a. On the left side
b. On the right side
c. In the tripod position
d. In the high-Fowler's position - ANSWER: A
The patient should be positioned with the "good" lung in the dependent position
to improve the match between ventilation and perfusion. The obese patient's
abdomen will limit respiratory excursion when sitting in the high-Fowler's or
tripod positions.
When admitting a patient with possible respiratory failure and a high PaCO2,
which assessment information should be immediately reported to the health care
provider?
a. The patient appears somnolent.
b. The patient reports feeling weak.
c. The patient's blood pressure is 164/98.
d. The patient's oxygen saturation is 90%. - ANSWER ANS: A
Questions with Detailed Answers Already
Graded A+ (Guarantee Pass) | Latest
Edition
1. A patient with acute respiratory distress syndrome (ARDS) who is intubated
and receiving mechanical ventilation develops a right pneumothorax. Which
collaborative action will the nurse anticipate next?
a. Increase the tidal volume and respiratory rate.
b. Decrease the fraction of inspired oxygen (FIO2).
c. Perform endotracheal suctioning more frequently.
d. Lower the positive end-expiratory pressure (PEEP). - ANSWER: D
Because barotrauma is associated with high airway pressures, the level of PEEP
should be decreased. The other actions will not decrease the risk for another
pneumothorax.
2. After receiving change-of-shift report on a medical unit, which patient
should the nurse assess first?
a. A patient with cystic fibrosis who has thick, green-colored sputum.
b. A patient with pneumonia who has crackles bilaterally in the lung
bases.
c. A patient with emphysema who has an oxygen saturation of 90% to
92%.
d. A patient with septicemia who has intercostal and suprasternal
retractions. - ANSWER: D
This patient's history of septicemia and labored breathing suggest the onset of
ARDS, which will require rapid interventions such as administration of O2 and
use of positive-pressure ventilation. The other patients should also be assessed,
but their assessment data are typical of their disease processes and do not
suggest deterioration in their status.
,3. A patient with chronic obstructive pulmonary disease (COPD) arrives in the
emergency department reporting shortness of breath on minimal exertion.
Which assessment finding by
the nurse is most important to report to the health care provider?
a. The patient has bibasilar lung crackles.
b. The patient is sitting in the tripod position.
c. The patient's respiratory rate is 10 breaths/min.
d. The patient's pulse oximetry shows a 91% O2 saturation. -
ANSWER: C
A drop in respiratory rate in a patient with respiratory distress suggests the
onset of fatigue and a high risk for respiratory arrest. Therefore, immediate
action such as positive-pressure ventilation is needed. Patients who are
experiencing respiratory distress frequently sit in the tripod position because it
decreases the work of breathing. Crackles in the lung bases may be the baseline
for a patient with COPD. An O2 saturation of 91% is common in patients with
COPD and will provide adequate gas exchange and tissue oxygenation.
4. When the nurse is explaining respiratory failure to the patient's family, what
is the most accurate description to use?
a. The absence of ventilation.
b. Any episode in which part of the airway is obstructed.
c. Inadequate gas exchange to meet the needs of the body.
d. An episode of acute hypoxemia caused by a pulmonary dysfunction. -
ANSWER: C
5. Which diagnostic test will provide the nurse with the most specific
information to evaluate the effectiveness of interventions for a patient with
ventilator failure?
a. Chest x-ray
b. O2 saturation
c. Arterial blood gas analysis
d. Central venous pressure monitoring - ANSWER: C
,Arterial blood gas (ABG) analysis is most useful in this setting because
ventilatory failure causes problems with CO2 retention, and ABGs give
information about the PaCO2 and pH. The other tests may also be done to help
in assessing oxygenation or determining the cause of the patient's ventilatory
failure.
6. While caring for a patient who has been admitted with a pulmonary
embolism, the nurse notes a change in the patient's oxygen saturation (SpO2)
from 94% to 88%. Which action should the nurse take?
a. Suction the patient's oropharynx.
b. Increase the prescribed O2 flowrate.
c. Teach the patient to cough and deep breath.
d. Help the patient to sit in a more upright position. - ANSWER ANS: B
Increasing O2 flowrate will usually improve O2 saturation in patients with
ventilation-perfusion mismatch, as occurs with pulmonary embolism. Because
the problem is with perfusion, actions that improve ventilation, such as deep
breathing and coughing, sitting upright, and suctioning, are not likely to
improve oxygenation.
7. A patient with respiratory failure has a respiratory rate of 6 breaths/min and
an oxygen saturation (SpO2) of 78%. The patient is increasingly lethargic.
Which intervention will the nurse anticipate?
a. Administration of 100% O2 by non-rebreather mask
b. Endotracheal intubation and positive pressure ventilation
c. Insertion of a mini-tracheostomy with frequent suctioning
d. Initiation of continuous positive pressure ventilation (CPAP) -
ANSWER: B
The patient's lethargy, low respiratory rate, and SpO2 indicate the need for
mechanical ventilation with ventilator-controlled respiratory rate. Giving high-
flow O2 will not be helpful because the patient's respiratory rate is so low.
Insertion of a mini-tracheostomy will promote removal of secretions, but it will
not improve the patient's respiratory rate or oxygenation. CPAP requires that
the patient initiate an adequate respiratory rate to allow adequate gas exchange.
, 8. The oxygen saturation (SpO2) for a patient with left lower lobe pneumonia
is 90%. The patient has wheezes and a weak cough effort. Which action
should the nurse take?
a. Position the patient on the left side.
b. Assist the patient with staged coughing.
c. Place a humidifier in the patient's room.
d. Schedule a 4-hour rest period for the patient. - ANSWER: B
The patient's assessment indicates that assisted coughing is needed to help
remove secretions, which will improve oxygenation. A 4-hour rest period at this
time may allow the O2 saturation to drop further. Humidification will not be
helpful unless the secretions can be mobilized. Positioning on the left side may
cause a further decrease in oxygen saturation because perfusion will be directed
more toward the more poorly ventilated lung.
9. A nurse is caring for a patient with right lower lobe pneumonia who is
obese. Which position will provide the best gas exchange?
a. On the left side
b. On the right side
c. In the tripod position
d. In the high-Fowler's position - ANSWER: A
The patient should be positioned with the "good" lung in the dependent position
to improve the match between ventilation and perfusion. The obese patient's
abdomen will limit respiratory excursion when sitting in the high-Fowler's or
tripod positions.
When admitting a patient with possible respiratory failure and a high PaCO2,
which assessment information should be immediately reported to the health care
provider?
a. The patient appears somnolent.
b. The patient reports feeling weak.
c. The patient's blood pressure is 164/98.
d. The patient's oxygen saturation is 90%. - ANSWER ANS: A
