PCCN REVIEW - PULMONARY EXAM QUESTIONS
AND ANSWERS GUARANTEED SUCCESS LATEST
UPDATE
Your patient had an exacerbation of COPD. The rapid response team was called and is
currently intubating the patient and preparing him for transfer to ICU. When the family
visits, they are shocked to see the people working with the patient. No one had told
them the patient had deteriorated and required intubation. After the patient is intubated
and is being wheeled past them, family members try to communicate verbally with the
patient, but he does not respond except to gesture. The nurse should tell the family
members:
-They must leave the area because they are exciting the patient.
-The tube used for breathing prevents the patient from speaking
-They must speak with the doctor, who will explain why the patient cannot speak
-The patient is very ill and may die.
The tube used for breathing prevents the patient from speaking
This is a case where communication is clearly the problem. The family should have
been informed by someone that the patient needed assistance with breathing and that
they should expect a transfer. It should also have been mentioned how the patient might
look in the ICU. In addition, it could have been communicated about the patient's
inability to speak.
The other answers are all non-therapeutic responses. The family is clearly distressed,
so a simple explanation in best.
,Ben was just transferred to the PCU. He had been in ICU for 2 weeks. Ben was
intubated for a time because of his ARDs. On arrival to your unit, you note that he is
tachycardic and restless. Ben states, "I can't be here now. What if something like this
happens to me again?" The nurse's best response would be:
-The nurses in our unit can take care of you
-We are not very far away at the nurses' station
-Your insurance will not cover another day there
-You sound concerned about leaving the ICU
You sound concerned about leaving the ICU
Therapeutic communication occurs when the patient's feelings are validated. This
response allows for the patient to express the concerns he has about the transfer. The
other answers are closed and judgmental and do not allow for any expression of feeling
from the patient.
Ben was just transferred to the PCU. He had been in ICU for 2 weeks. Ben was
intubated for a time because of his ARDs. On arrival to your unit, you note that he is
tachycardic and restless. A set of blood gases drawn just prior to his transfer show:
pH 7.52, PaCO2 31, HCO3 22, PaO2 87.
These results would indicate:
-Respiratory acidosis
-Respiratory alkalosis
-Metabolic acidosis
-Metabolic alkalosis
Respiratory alkalosis
,Ben was quite anxious and tachycardic. His RR probably was increased because of
both anxiety and his condition.
He would blow off CO2.
His pH is below normal, so it is uncompensated.
The HCO3 is low, indicating alkalosis
The interpretation would be:
Uncompensated Respiratory Alkalosis
Ben was just transferred to the PCU. He had been in ICU for 2 weeks. Ben was
intubated for a time because of his ARDs. On arrival to your unit, you note that he is
tachycardic and restless. Ben is finally released from the hospital. He plans to visit his
family in Denver. Part of the patient teaching for Ben should include information on the
effects of high altitude on his ability to oxygenate effectively. Which of the following
changes would be expected on his blood gas results?
-The pH would decrease
-No effect
-The O2 saturation would decrease
-The PaO2 would increase
The O2 saturation would decrease
At higher altitudes, there is decreased atmospheric pressure to force oxygen into the
lungs. To compensate for the lower pressure, the person must breathe faster. The
percentage of oxygen remains the same, but the partial pressure of the oxygen
decreases. Arterial PaO2 decreases, as does O2 saturation. The rapid breathing will
result in hyperventilation, raising the pH and lowering the PaCO2 level.
, SaO2 values account for what % of O2 carried within the bloodstream?
-2-3%
-10-24%
-97-98%
-100%
97-98%
The % of total oxygen carried within the bloodstream attributed to the SaO2 is 97-98%.
SaO2 is the arterial saturation of hemoglobin. The % corresponds to the % of
hemoglobin on the red blood cells that carries O2. Typically this % is documented as
normal when within 93-99%.
PaO2 is the % of O2 within the bloodstream that is free or dissolved in the plasma. This
value is documented in mmHg and is considered normal when within the range of 80-
100 mmHg.
Hypoxemia is best defined as:
-A decrease in O2 at the cellular level
-A decrease in O2 levels in arterial blood
-A decrease in O2 levels in venous blood
-A decrease in O2 levels from the brain
A decrease in O2 levels in arterial blood
Hypoxemia is a decrease in O2 levels in arterial blood or PaO2 < 80 mmHg.
Hypoxia is defined as a decreased oxygen level at the cellular level.
AND ANSWERS GUARANTEED SUCCESS LATEST
UPDATE
Your patient had an exacerbation of COPD. The rapid response team was called and is
currently intubating the patient and preparing him for transfer to ICU. When the family
visits, they are shocked to see the people working with the patient. No one had told
them the patient had deteriorated and required intubation. After the patient is intubated
and is being wheeled past them, family members try to communicate verbally with the
patient, but he does not respond except to gesture. The nurse should tell the family
members:
-They must leave the area because they are exciting the patient.
-The tube used for breathing prevents the patient from speaking
-They must speak with the doctor, who will explain why the patient cannot speak
-The patient is very ill and may die.
The tube used for breathing prevents the patient from speaking
This is a case where communication is clearly the problem. The family should have
been informed by someone that the patient needed assistance with breathing and that
they should expect a transfer. It should also have been mentioned how the patient might
look in the ICU. In addition, it could have been communicated about the patient's
inability to speak.
The other answers are all non-therapeutic responses. The family is clearly distressed,
so a simple explanation in best.
,Ben was just transferred to the PCU. He had been in ICU for 2 weeks. Ben was
intubated for a time because of his ARDs. On arrival to your unit, you note that he is
tachycardic and restless. Ben states, "I can't be here now. What if something like this
happens to me again?" The nurse's best response would be:
-The nurses in our unit can take care of you
-We are not very far away at the nurses' station
-Your insurance will not cover another day there
-You sound concerned about leaving the ICU
You sound concerned about leaving the ICU
Therapeutic communication occurs when the patient's feelings are validated. This
response allows for the patient to express the concerns he has about the transfer. The
other answers are closed and judgmental and do not allow for any expression of feeling
from the patient.
Ben was just transferred to the PCU. He had been in ICU for 2 weeks. Ben was
intubated for a time because of his ARDs. On arrival to your unit, you note that he is
tachycardic and restless. A set of blood gases drawn just prior to his transfer show:
pH 7.52, PaCO2 31, HCO3 22, PaO2 87.
These results would indicate:
-Respiratory acidosis
-Respiratory alkalosis
-Metabolic acidosis
-Metabolic alkalosis
Respiratory alkalosis
,Ben was quite anxious and tachycardic. His RR probably was increased because of
both anxiety and his condition.
He would blow off CO2.
His pH is below normal, so it is uncompensated.
The HCO3 is low, indicating alkalosis
The interpretation would be:
Uncompensated Respiratory Alkalosis
Ben was just transferred to the PCU. He had been in ICU for 2 weeks. Ben was
intubated for a time because of his ARDs. On arrival to your unit, you note that he is
tachycardic and restless. Ben is finally released from the hospital. He plans to visit his
family in Denver. Part of the patient teaching for Ben should include information on the
effects of high altitude on his ability to oxygenate effectively. Which of the following
changes would be expected on his blood gas results?
-The pH would decrease
-No effect
-The O2 saturation would decrease
-The PaO2 would increase
The O2 saturation would decrease
At higher altitudes, there is decreased atmospheric pressure to force oxygen into the
lungs. To compensate for the lower pressure, the person must breathe faster. The
percentage of oxygen remains the same, but the partial pressure of the oxygen
decreases. Arterial PaO2 decreases, as does O2 saturation. The rapid breathing will
result in hyperventilation, raising the pH and lowering the PaCO2 level.
, SaO2 values account for what % of O2 carried within the bloodstream?
-2-3%
-10-24%
-97-98%
-100%
97-98%
The % of total oxygen carried within the bloodstream attributed to the SaO2 is 97-98%.
SaO2 is the arterial saturation of hemoglobin. The % corresponds to the % of
hemoglobin on the red blood cells that carries O2. Typically this % is documented as
normal when within 93-99%.
PaO2 is the % of O2 within the bloodstream that is free or dissolved in the plasma. This
value is documented in mmHg and is considered normal when within the range of 80-
100 mmHg.
Hypoxemia is best defined as:
-A decrease in O2 at the cellular level
-A decrease in O2 levels in arterial blood
-A decrease in O2 levels in venous blood
-A decrease in O2 levels from the brain
A decrease in O2 levels in arterial blood
Hypoxemia is a decrease in O2 levels in arterial blood or PaO2 < 80 mmHg.
Hypoxia is defined as a decreased oxygen level at the cellular level.
