NR 325 Ventilation and Respiratory Failure Practice Pack 2026/2027
Chamberlain College
1. A patient with ARDS is being mechanically ventilated. Which of the following
ventilator settings is primarily adjusted to improve oxygenation?
A. Tidal Volume
B. Respiratory Rate
C. PEEP (Positive End-Expiratory Pressure)
D. Sensitivity
Answer: C
Rationale: PEEP improves oxygenation by opening collapsed alveoli (recruitment) and
keeping them open during expiration, thereby increasing the surface area for gas exchange.
2. The nurse is caring for a patient on a ventilator and notes the high-pressure
alarm is sounding. What is the most appropriate first action?
A. Administer a sedative
B. Check for a disconnected tube
C. Decrease the PEEP level
D. Suction the patient to clear possible secretions
Answer: D
Rationale: High-pressure alarms are often caused by obstructions such as secretions,
biting the tube, or kinks. Suctioning is a priority if secretions are suspected.
,3. Which ABG result is most indicative of acute respiratory failure in a patient
with no prior history of lung disease?
A. pH 7.35, PaO2 80, PaCO2 40
B. pH 7.25, PaO2 55, PaCO2 55
C. pH 7.48, PaO2 95, PaCO2 30
D. pH 7.38, PaO2 70, PaCO2 48
Answer: B
Rationale: Acute respiratory failure is generally defined as a PaO2 < 60 mmHg and/or a
PaCO2 > 45-50 mmHg with a pH < 7.35.
4. A patient is diagnosed with ‘Refractory Hypoxemia’. What does this term
imply?
A. Hypoxemia that responds quickly to 2L nasal cannula
B. Hypoxemia that occurs only during sleep
C. Hypoxemia caused only by hypoventilation
D. Hypoxemia that persists even with high concentrations of oxygen
Answer: D
Rationale: Refractory hypoxemia is a hallmark of ARDS where the PaO2 does not
significantly increase despite increasing the FiO2 (Fraction of Inspired Oxygen).
5. The nurse knows that the prone position is used in ARDS primarily to:
A. Decrease the risk of pressure ulcers
B. Improve ventilation-perfusion (V/Q) matching
C. Make it easier to suction the patient
D. Increase cardiac output
Answer: B
Rationale: Prone positioning helps shift perfusion to better-ventilated areas of the lungs
(the dorsal regions), improving oxygenation in severe ARDS.
, 6. Which of the following is an early clinical manifestation of respiratory failure?
A. Cyanosis
B. Coma
C. Tachycardia and restlessness
D. Bradycardia
Answer: C
Rationale: The brain is very sensitive to low oxygen. Early signs of hypoxia include
restlessness, anxiety, and tachycardia. Cyanosis is a late sign.
7. A patient’s ventilator is set to SIMV mode. What is a key characteristic of this
mode?
A. The ventilator delivers a set volume for every breath the patient takes
B. The ventilator does not allow the patient to breathe spontaneously
C. Spontaneous breaths are taken at the patient’s own volume and rate
D. Pressure is applied only during expiration
Answer: C
Rationale: In Synchronized Intermittent Mandatory Ventilation (SIMV), the ventilator
delivers a set number of breaths at a set volume, but spontaneous breaths between those
are not assisted by the set volume.
8. What is the primary purpose of the ET tube cuff?
A. To keep the tube from being bitten
B. To measure the patient’s temperature
C. To seal the airway and prevent aspiration
D. To allow the patient to speak
Answer: C
Rationale: The cuff is inflated to create a seal against the tracheal wall, ensuring that the
ventilated air goes into the lungs and protecting the airway from secretions or gastric
contents.
Chamberlain College
1. A patient with ARDS is being mechanically ventilated. Which of the following
ventilator settings is primarily adjusted to improve oxygenation?
A. Tidal Volume
B. Respiratory Rate
C. PEEP (Positive End-Expiratory Pressure)
D. Sensitivity
Answer: C
Rationale: PEEP improves oxygenation by opening collapsed alveoli (recruitment) and
keeping them open during expiration, thereby increasing the surface area for gas exchange.
2. The nurse is caring for a patient on a ventilator and notes the high-pressure
alarm is sounding. What is the most appropriate first action?
A. Administer a sedative
B. Check for a disconnected tube
C. Decrease the PEEP level
D. Suction the patient to clear possible secretions
Answer: D
Rationale: High-pressure alarms are often caused by obstructions such as secretions,
biting the tube, or kinks. Suctioning is a priority if secretions are suspected.
,3. Which ABG result is most indicative of acute respiratory failure in a patient
with no prior history of lung disease?
A. pH 7.35, PaO2 80, PaCO2 40
B. pH 7.25, PaO2 55, PaCO2 55
C. pH 7.48, PaO2 95, PaCO2 30
D. pH 7.38, PaO2 70, PaCO2 48
Answer: B
Rationale: Acute respiratory failure is generally defined as a PaO2 < 60 mmHg and/or a
PaCO2 > 45-50 mmHg with a pH < 7.35.
4. A patient is diagnosed with ‘Refractory Hypoxemia’. What does this term
imply?
A. Hypoxemia that responds quickly to 2L nasal cannula
B. Hypoxemia that occurs only during sleep
C. Hypoxemia caused only by hypoventilation
D. Hypoxemia that persists even with high concentrations of oxygen
Answer: D
Rationale: Refractory hypoxemia is a hallmark of ARDS where the PaO2 does not
significantly increase despite increasing the FiO2 (Fraction of Inspired Oxygen).
5. The nurse knows that the prone position is used in ARDS primarily to:
A. Decrease the risk of pressure ulcers
B. Improve ventilation-perfusion (V/Q) matching
C. Make it easier to suction the patient
D. Increase cardiac output
Answer: B
Rationale: Prone positioning helps shift perfusion to better-ventilated areas of the lungs
(the dorsal regions), improving oxygenation in severe ARDS.
, 6. Which of the following is an early clinical manifestation of respiratory failure?
A. Cyanosis
B. Coma
C. Tachycardia and restlessness
D. Bradycardia
Answer: C
Rationale: The brain is very sensitive to low oxygen. Early signs of hypoxia include
restlessness, anxiety, and tachycardia. Cyanosis is a late sign.
7. A patient’s ventilator is set to SIMV mode. What is a key characteristic of this
mode?
A. The ventilator delivers a set volume for every breath the patient takes
B. The ventilator does not allow the patient to breathe spontaneously
C. Spontaneous breaths are taken at the patient’s own volume and rate
D. Pressure is applied only during expiration
Answer: C
Rationale: In Synchronized Intermittent Mandatory Ventilation (SIMV), the ventilator
delivers a set number of breaths at a set volume, but spontaneous breaths between those
are not assisted by the set volume.
8. What is the primary purpose of the ET tube cuff?
A. To keep the tube from being bitten
B. To measure the patient’s temperature
C. To seal the airway and prevent aspiration
D. To allow the patient to speak
Answer: C
Rationale: The cuff is inflated to create a seal against the tracheal wall, ensuring that the
ventilated air goes into the lungs and protecting the airway from secretions or gastric
contents.
