CRITICAL CARE EXAM 1: RESPIRATORY PRACTICE
QUESTIONS AND VERIFIED ANSWERS | TRIED AND
TESTED | GRAGED A+ | WITH RATIONALE 2026
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
a
Rationale…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.
2) A nurse must position the patient prone after his diagnosis of acute
respiratory distress syndrome (ARDS). Which of the following is a benefit
of using this position? Select all that apply.
A)Decreased atelectasis
B)Reduced need for endotracheal intubation
c)Mobilization of secretions
d)Decreased pleural pressure
e)Increased response to corticosteroid therapy
,a, c, d
Rationale…Decreased atelectasis", "Mobilization of secretions" and
"Decreased pleural pressure" are correct. Prone positioning, or placing the
patient face down with the head turned to the side, helps with pulmonary
function in the patient diagnosed with ARDS. When the patient is placed
in a prone position, the heart and diaphragm are not pressing against the
lungs, which means that pleural pressure is reduced. When there is less
pressure exerted on the lungs, atelectasis decreases. Studies have shown
that many patients in the prone position have increased lung secretions,
which improves oxygenation.
-"Reduced need for endotracheal intubation" is incorrect. The prone
position has not been shown to decrease the likelihood of intubation.
-"Increased response to corticosteroid therapy" is incorrect because
positioning does not change the body's response to steroid therapy.
3) A 25-year-old patient in the ICU is being treated for acute respiratory
distress syndrome (ARDS). The patient is on a ventilator and requires 80
percent FiO2. Which information would the nurse most likely need to
report about the patient to the respiratory therapist working with her?
a)The patient needs endotracheal suctioning
b)The patient needs more oxygen because of his saturation
c)The patient needs an arterial blood gas drawn
d)The patient needs a hemoglobin level drawn
c
4) A patient who has recovered from ARDS in the ICU is now malnourished
and has lost a significant amount of weight. The physician orders TPN to
add nutrition for the patient, who then develops re-feeding syndrome.
Which of the following signs or symptoms would the nurse expect to see
with re-feeding syndrome? Select all that apply.
a. Impaired mental status
b. Insulin resistance
, c. Seizures
d. Persistent weight loss
e. Constipation
a,b,c
Rationale…impaired mental status", "Insulin resistance" and "Seizures" are
correct. Re-feeding syndrome can occur as a response to nutrient
reintroduction after a period of starvation. When an extremely
malnourished patient receives TPN, the body has to adjust to receiving
nutrients again, which can cause shifts in electrolytes in the body. These
shifts in electrolytes can result in sudden and often fatal complications.
Signs and symptoms of re-feeding syndrome include confusion and
impaired mental status, insulin resistance, seizures, coma and death.
-"Persistent weight loss" is incorrect because by the time a patient
develops re-feeding syndrome, the onset of symptoms is so sudden that
weight loss cannot be measured as part of the syndrome.
-"Constipation" is incorrect, as it is not a symptom of refeeding syndrome.
5) A nurse is caring for a patient with ARDS. Which of the following
clinical indicators would signify that this client is in respiratory failure?
Select all that apply.
a. Pulse oximetry of 94% on room air
b. A PaO2 level below 60 mmHg
c. An ABG pH level of 7.35
d. A pCO2 level over 50 mmHg
e. A respiratory rate of over 16/minute
b, d
Rationale…Respiratory diseases can cause such compromise that the
patient will suffer symptoms; however, there are certain clinical
indicators that can clarify whether the patient is actually in respiratory
failure. Clinical indicators of respiratory failure include pulse oximetry of
QUESTIONS AND VERIFIED ANSWERS | TRIED AND
TESTED | GRAGED A+ | WITH RATIONALE 2026
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
a
Rationale…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.
2) A nurse must position the patient prone after his diagnosis of acute
respiratory distress syndrome (ARDS). Which of the following is a benefit
of using this position? Select all that apply.
A)Decreased atelectasis
B)Reduced need for endotracheal intubation
c)Mobilization of secretions
d)Decreased pleural pressure
e)Increased response to corticosteroid therapy
,a, c, d
Rationale…Decreased atelectasis", "Mobilization of secretions" and
"Decreased pleural pressure" are correct. Prone positioning, or placing the
patient face down with the head turned to the side, helps with pulmonary
function in the patient diagnosed with ARDS. When the patient is placed
in a prone position, the heart and diaphragm are not pressing against the
lungs, which means that pleural pressure is reduced. When there is less
pressure exerted on the lungs, atelectasis decreases. Studies have shown
that many patients in the prone position have increased lung secretions,
which improves oxygenation.
-"Reduced need for endotracheal intubation" is incorrect. The prone
position has not been shown to decrease the likelihood of intubation.
-"Increased response to corticosteroid therapy" is incorrect because
positioning does not change the body's response to steroid therapy.
3) A 25-year-old patient in the ICU is being treated for acute respiratory
distress syndrome (ARDS). The patient is on a ventilator and requires 80
percent FiO2. Which information would the nurse most likely need to
report about the patient to the respiratory therapist working with her?
a)The patient needs endotracheal suctioning
b)The patient needs more oxygen because of his saturation
c)The patient needs an arterial blood gas drawn
d)The patient needs a hemoglobin level drawn
c
4) A patient who has recovered from ARDS in the ICU is now malnourished
and has lost a significant amount of weight. The physician orders TPN to
add nutrition for the patient, who then develops re-feeding syndrome.
Which of the following signs or symptoms would the nurse expect to see
with re-feeding syndrome? Select all that apply.
a. Impaired mental status
b. Insulin resistance
, c. Seizures
d. Persistent weight loss
e. Constipation
a,b,c
Rationale…impaired mental status", "Insulin resistance" and "Seizures" are
correct. Re-feeding syndrome can occur as a response to nutrient
reintroduction after a period of starvation. When an extremely
malnourished patient receives TPN, the body has to adjust to receiving
nutrients again, which can cause shifts in electrolytes in the body. These
shifts in electrolytes can result in sudden and often fatal complications.
Signs and symptoms of re-feeding syndrome include confusion and
impaired mental status, insulin resistance, seizures, coma and death.
-"Persistent weight loss" is incorrect because by the time a patient
develops re-feeding syndrome, the onset of symptoms is so sudden that
weight loss cannot be measured as part of the syndrome.
-"Constipation" is incorrect, as it is not a symptom of refeeding syndrome.
5) A nurse is caring for a patient with ARDS. Which of the following
clinical indicators would signify that this client is in respiratory failure?
Select all that apply.
a. Pulse oximetry of 94% on room air
b. A PaO2 level below 60 mmHg
c. An ABG pH level of 7.35
d. A pCO2 level over 50 mmHg
e. A respiratory rate of over 16/minute
b, d
Rationale…Respiratory diseases can cause such compromise that the
patient will suffer symptoms; however, there are certain clinical
indicators that can clarify whether the patient is actually in respiratory
failure. Clinical indicators of respiratory failure include pulse oximetry of
