Critical Care Exam 1: respiratory Exam
Practice Questions and Answers
Question 1
Which clients are at highest risk for pulmonary embolism (PE)? (Select all that apply)
a. Middle-aged client awaiting surgery
b. Older adult with a 20-pack-year history of smoking
c. Client who has been on bedrest for 3 weeks
d. Obese client who has elevated platelets
e. Middle-aged client with diabetes mellitus type 1
f. Older adult who has just had abdominal surgery
Correct Answer
B, C, D, F
Question 2
The nurse auscultates the lungs of a client on mechanical ventilation and hears
vesicular breath sounds throughout the right side but decreased sounds on the left
side of the chest. What is the nurse's best action?
a. Turn the client to the right side.
b. Elevate the head of the bed.
c. Assess placement of the endotracheal (ET) tube.
d. Suction the client.
Correct Answer
c
Question 3
A client admitted with respiratory difficulty and decreased oxygen saturation keeps
pulling off the oxygen mask. What action does the nurse take?
a. Stays with the client and replaces the oxygen mask
b. Asks the client's spouse to hold the oxygen mask in place
c. Restrains the client per facility policy
d. Contacts the health care provider and requests sedation
Correct Answer
a
Page 1 of 47
,Question 4
Which treatment would the nurse expect for a client with spontaneous
pneumothorax?
a) Hyperbaric chamber
b) Antibiotics
c) Chest tube placement
d) Bronchodilators
Correct Answer
c
Question 5
1) A nurse is caring for a patient with ARDS. The nurse views the ABG. What value
should the nurse report to the physician?
pH: 7.35
PaCO2: 26mmhg
PaO2:95
HCO3: 22
a) PaCO2
b)pH
c)HCO3
d)PaO2
Correct Answer
a
The normal range for PaCO2 is 35-45. This patient is experiencing a superimposed
respiratory alkalosis likely due to hyperventilation. The nurse should report the
PaCO2 to the physician.
Page 2 of 47
,Question 6
The nurse is suctioning a client via an endotracheal tube. During the suctioning
procedure, the nurse notes on the monitor that the heart rate is decreasing. which of
the following interventions is appropriate?
a. continue to suction
b. notify the health care provider immediately
c. stop the procedure and reoxygenate the client
d. ensure that the suction is limited to 15 seconds
Correct Answer
c
Question 7
The nurse is assessing arterial blood gases (ABGs). The client with which ABG reading
requires the nurse's immediate attention?
a. pH, 7.32; PaCO2, 55 mm Hg; PaO2, 70 mm Hg
b. pH, 7.45; PaCO2, 42 mm Hg; PaO2, 70 mm Hg
c. pH, 7.48; PaCO2, 38 mm Hg; PaO2, 60 mm Hg
d. pH, 7.55; PaCO2, 32 mm Hg; PaO2, 50 mm Hg
Correct Answer
:D
This client has the most severe hypoxia and respiratory alkalosis, indicated by low
partial pressure of arterial carbon dioxide (PaCO2) values on ABG analysis.
Question 8
A patient in acute respiratory failure is receiving assist-control mechanical ventilation
with a peak end-expiration. A pressure (PEEP) of 10 cm H2O. A sign that alerts the
nurse to undesirable effects of increased airway and thoracic pressure is?
a. decreased BP.
b. decreased PaO2.
c. increased crackles.
d. decreased spontaneous respirations.
Correct Answer
a
Page 3 of 47
, Question 9
The nurse notes that each time the mechanical ventilator delivers a breath to a client
with acute respiratory distress syndrome (ARDS), the peak inspiratory pressure alarm
sounds. What is the nurse's best intervention?
a. Suction the client.
b. Perform chest physiotherapy.
c. Administer an inhaler.
d. Assess the airway.
Correct Answer
D
An increase in peak inspiratory pressure (PIP) in the ARDS client is indicative of
decreased lung compliance, making it more difficult to ventilate diseased lungs. The
nurse first should assess the airway to make sure no sputum is present in the airway
and that no kinks are noted in the tubing. The nurse is not able to make changes in
the ventilator settings, so an order is needed to increase inspiratory pressure to
oxygenate the client.
Question 10
The low-pressure alarm sounds on a ventilator. the nurse assesses the client and then
attempts to determine the cause of the alarm. If unsuccessful in determining the
cause of the alarm, the nurse should take what initial action?
a. administer oxygen
b. check the client's vital signs
c. ventilate the client manually
d. start cardiopulmonary resuscitation
Correct Answer
c
Page 4 of 47
Practice Questions and Answers
Question 1
Which clients are at highest risk for pulmonary embolism (PE)? (Select all that apply)
a. Middle-aged client awaiting surgery
b. Older adult with a 20-pack-year history of smoking
c. Client who has been on bedrest for 3 weeks
d. Obese client who has elevated platelets
e. Middle-aged client with diabetes mellitus type 1
f. Older adult who has just had abdominal surgery
Correct Answer
B, C, D, F
Question 2
The nurse auscultates the lungs of a client on mechanical ventilation and hears
vesicular breath sounds throughout the right side but decreased sounds on the left
side of the chest. What is the nurse's best action?
a. Turn the client to the right side.
b. Elevate the head of the bed.
c. Assess placement of the endotracheal (ET) tube.
d. Suction the client.
Correct Answer
c
Question 3
A client admitted with respiratory difficulty and decreased oxygen saturation keeps
pulling off the oxygen mask. What action does the nurse take?
a. Stays with the client and replaces the oxygen mask
b. Asks the client's spouse to hold the oxygen mask in place
c. Restrains the client per facility policy
d. Contacts the health care provider and requests sedation
Correct Answer
a
Page 1 of 47
,Question 4
Which treatment would the nurse expect for a client with spontaneous
pneumothorax?
a) Hyperbaric chamber
b) Antibiotics
c) Chest tube placement
d) Bronchodilators
Correct Answer
c
Question 5
1) A nurse is caring for a patient with ARDS. The nurse views the ABG. What value
should the nurse report to the physician?
pH: 7.35
PaCO2: 26mmhg
PaO2:95
HCO3: 22
a) PaCO2
b)pH
c)HCO3
d)PaO2
Correct Answer
a
The normal range for PaCO2 is 35-45. This patient is experiencing a superimposed
respiratory alkalosis likely due to hyperventilation. The nurse should report the
PaCO2 to the physician.
Page 2 of 47
,Question 6
The nurse is suctioning a client via an endotracheal tube. During the suctioning
procedure, the nurse notes on the monitor that the heart rate is decreasing. which of
the following interventions is appropriate?
a. continue to suction
b. notify the health care provider immediately
c. stop the procedure and reoxygenate the client
d. ensure that the suction is limited to 15 seconds
Correct Answer
c
Question 7
The nurse is assessing arterial blood gases (ABGs). The client with which ABG reading
requires the nurse's immediate attention?
a. pH, 7.32; PaCO2, 55 mm Hg; PaO2, 70 mm Hg
b. pH, 7.45; PaCO2, 42 mm Hg; PaO2, 70 mm Hg
c. pH, 7.48; PaCO2, 38 mm Hg; PaO2, 60 mm Hg
d. pH, 7.55; PaCO2, 32 mm Hg; PaO2, 50 mm Hg
Correct Answer
:D
This client has the most severe hypoxia and respiratory alkalosis, indicated by low
partial pressure of arterial carbon dioxide (PaCO2) values on ABG analysis.
Question 8
A patient in acute respiratory failure is receiving assist-control mechanical ventilation
with a peak end-expiration. A pressure (PEEP) of 10 cm H2O. A sign that alerts the
nurse to undesirable effects of increased airway and thoracic pressure is?
a. decreased BP.
b. decreased PaO2.
c. increased crackles.
d. decreased spontaneous respirations.
Correct Answer
a
Page 3 of 47
, Question 9
The nurse notes that each time the mechanical ventilator delivers a breath to a client
with acute respiratory distress syndrome (ARDS), the peak inspiratory pressure alarm
sounds. What is the nurse's best intervention?
a. Suction the client.
b. Perform chest physiotherapy.
c. Administer an inhaler.
d. Assess the airway.
Correct Answer
D
An increase in peak inspiratory pressure (PIP) in the ARDS client is indicative of
decreased lung compliance, making it more difficult to ventilate diseased lungs. The
nurse first should assess the airway to make sure no sputum is present in the airway
and that no kinks are noted in the tubing. The nurse is not able to make changes in
the ventilator settings, so an order is needed to increase inspiratory pressure to
oxygenate the client.
Question 10
The low-pressure alarm sounds on a ventilator. the nurse assesses the client and then
attempts to determine the cause of the alarm. If unsuccessful in determining the
cause of the alarm, the nurse should take what initial action?
a. administer oxygen
b. check the client's vital signs
c. ventilate the client manually
d. start cardiopulmonary resuscitation
Correct Answer
c
Page 4 of 47
