MECHANICAL VENTILATION (NCLEX)
ACTUAL EXAM PAPER 2026 QUESTIONS
WITH ANSWERS GRADED A+
◍ What does FIO2 stand for?.
Answer: Fraction of inspired oxygen.
◍ Which assessment finding by the nurse when caring for a patient with
ARDS who is being treated with mechanical ventilation and high levels of
positive end-expiratory pressure (PEEP) indicates that the PEEP may need
to be decreased?a. The patient has subcutaneous emphysema.b. The patient
has a sinus bradycardia with a rate of 52.c. The patient's PaO2 is 50 mm Hg
and the SaO2 is 88%.d. The patient has bronchial breath sounds in both the
lung fields..
Answer: ANS: AThe subcutaneous emphysema indicates barotrauma caused
by positive pressure ventilation and PEEP. Bradycardia, hypoxemia, and
bronchial breath sounds are all concerns and will need to be addressed, but
they are not indications that PEEP should be reduced.
◍ The nurse is caring for a patient with emphysema and respiratory failure
who is receiving mechanical ventilation through an endotracheal tube. To
prevent ventilator-associated pneumonia (VAP), which action is most
important to include in the plan of care?a. Administer ordered antibiotics as
scheduled.b. Hyperoxygenate the patient before suctioning.c. Maintain the
head of bed at a 30- to 45-degree angle.d. Suction the airway when coarse
crackles are audible.
Answer: CElevation of the head decreases the risk for aspiration. PEEP is
frequently needed to improve oxygenation in patients receiving mechanical
ventilation. Suctioning should be done only when the patient assessment
indicates that it is necessary. Enteral feedings should provide adequate
, calories for the patient's high energy needs.**How to prevent? → HOB
@30 degrees, daily oral care, early mobiltiy
◍ You're providing care to a patient who is being treated for aspiration
pneumonia. The patient is on a 100% non-rebreather mask. Which finding
below is a HALLMARK sign and symptom that the patient is developing
acute respiratory distress syndrome (ARDS)?
A. The patient is experiencing bradypnea.
B. The patient is tired and confused.
C. The patient's PaO2 remains at 45 mmHg.
D. The patient's blood pressure is 180/96..
Answer: The answer is C. A hallmark sign and symptom found in ARDS is
refractory hypoxemia. This is where that although the patient is receiving a
high amount of oxygen (here a 100% non-rebreather mask) the patient is
STILL hypoxic. Option C is the answer because it states the patient's arterial
oxygen level is remaining at 45 mmHg (a normal is 80 mmHg but when
treating patients with ARDS a goal is at least 60 mmHg). Yes, the patient
can be tired and confused from a low oxygen level BUT this question wants
to know the HALLMARK sign and symptom.
◍ What is a tracheostomy?.
Answer: A surgical procedure that involves placing a small plastic tube in
the trachea for patients requiring long-term ventilation.
◍ What should be done before intubation?.
Answer: Explain the procedure, position the patient, provide analgesia and
sedation, and hyperoxygenate.
◍ What is the role of inspiratory positive airway pressure (IPAP) in Bi-PAP?.
Answer: It helps with CO2 removal.
◍ You're providing care to a patient who was just transferred to your unit for
the treatment of ARD
S. The patient is in the exudative phase. The patient is ordered arterial blood
gases. The results are back. Which results are expected during this early
phase of acute respiratory distress syndrome that correlates with this
ACTUAL EXAM PAPER 2026 QUESTIONS
WITH ANSWERS GRADED A+
◍ What does FIO2 stand for?.
Answer: Fraction of inspired oxygen.
◍ Which assessment finding by the nurse when caring for a patient with
ARDS who is being treated with mechanical ventilation and high levels of
positive end-expiratory pressure (PEEP) indicates that the PEEP may need
to be decreased?a. The patient has subcutaneous emphysema.b. The patient
has a sinus bradycardia with a rate of 52.c. The patient's PaO2 is 50 mm Hg
and the SaO2 is 88%.d. The patient has bronchial breath sounds in both the
lung fields..
Answer: ANS: AThe subcutaneous emphysema indicates barotrauma caused
by positive pressure ventilation and PEEP. Bradycardia, hypoxemia, and
bronchial breath sounds are all concerns and will need to be addressed, but
they are not indications that PEEP should be reduced.
◍ The nurse is caring for a patient with emphysema and respiratory failure
who is receiving mechanical ventilation through an endotracheal tube. To
prevent ventilator-associated pneumonia (VAP), which action is most
important to include in the plan of care?a. Administer ordered antibiotics as
scheduled.b. Hyperoxygenate the patient before suctioning.c. Maintain the
head of bed at a 30- to 45-degree angle.d. Suction the airway when coarse
crackles are audible.
Answer: CElevation of the head decreases the risk for aspiration. PEEP is
frequently needed to improve oxygenation in patients receiving mechanical
ventilation. Suctioning should be done only when the patient assessment
indicates that it is necessary. Enteral feedings should provide adequate
, calories for the patient's high energy needs.**How to prevent? → HOB
@30 degrees, daily oral care, early mobiltiy
◍ You're providing care to a patient who is being treated for aspiration
pneumonia. The patient is on a 100% non-rebreather mask. Which finding
below is a HALLMARK sign and symptom that the patient is developing
acute respiratory distress syndrome (ARDS)?
A. The patient is experiencing bradypnea.
B. The patient is tired and confused.
C. The patient's PaO2 remains at 45 mmHg.
D. The patient's blood pressure is 180/96..
Answer: The answer is C. A hallmark sign and symptom found in ARDS is
refractory hypoxemia. This is where that although the patient is receiving a
high amount of oxygen (here a 100% non-rebreather mask) the patient is
STILL hypoxic. Option C is the answer because it states the patient's arterial
oxygen level is remaining at 45 mmHg (a normal is 80 mmHg but when
treating patients with ARDS a goal is at least 60 mmHg). Yes, the patient
can be tired and confused from a low oxygen level BUT this question wants
to know the HALLMARK sign and symptom.
◍ What is a tracheostomy?.
Answer: A surgical procedure that involves placing a small plastic tube in
the trachea for patients requiring long-term ventilation.
◍ What should be done before intubation?.
Answer: Explain the procedure, position the patient, provide analgesia and
sedation, and hyperoxygenate.
◍ What is the role of inspiratory positive airway pressure (IPAP) in Bi-PAP?.
Answer: It helps with CO2 removal.
◍ You're providing care to a patient who was just transferred to your unit for
the treatment of ARD
S. The patient is in the exudative phase. The patient is ordered arterial blood
gases. The results are back. Which results are expected during this early
phase of acute respiratory distress syndrome that correlates with this
