NURS 4110 ATI MED SURG SURG TEST 2 GUIDE QUESTIONS & ANSWERS
ABGs
1. The physician orders the following mechanical ventilation settings for a client.
The client's spontaneous respiratory rate is 22 breaths/min. What arterial
blood gas abnormality may occur if the client continues to be tachypneic at
these ventilator settings?
- Respiratory Alkalosis hyperventilating
2. A client with persistent vomiting of 3 days duration is seen at the urgent care
center because of increasing weakness. IV therapy with Ringer's solution is
started, and an arterial blood gas (ABG) analysis is ordered. Results of the
ABGs that would be expected include: Choice the
- Metabolic Alkalosis pH 7.48; PCO2 40, HCO3 30mEqL
3. A client is admitted to the progressive care unit with a diagnosis of pneumonia.
The client has a history of obstructive pulmonary disease and diabetes. A set
of arterial blood gases is obtained on admission: room air pH is 7.35; PaCo2 is
55 mm Hg; bicarbonate is 30 mEq/L; PaO2 is 65 mm Hg. These levels reflect
hypoxemia:
- Compensated Respiratory Acidosis
4. A client is admitted with a diagnosis of acute respiratory distress syndrome
(ARDS). Which of the following arterial blood gas results indicates acute
respiratory failure?
- pH 7.20, HCO3 23, PO2 40, PCO2 58
5. A post-operative client is being mechanically ventilated in the synchronized
intermittent mandatory ventilation (SIMV) mode at a rate of 4 breaths/min. His
spontaneous respirations are 12 breaths/min. He receives a dose of morphine
sulfate, and his respirations decrease to 4 breaths/min. Which acid-base
disturbance is this client at risk for?
- Hypoventilation Respiratory Acidosis
6. The nurse is assessing a client who is brought to the emergency department
following an overdose of sedatives. Which of the following findings
would indicate to the nurse that the client is having complications?
- Hypoventilation and Respiratory Acidosis
7. Select all question of patient that overdosed on sedative, now has resp. acidosis
- Decrease CNS
- Overdose of sedation
,8. A client is diagnosed with acute respiratory failure. What acid-base abnormality
may occur if the client's receives Ativan 2 mg IV with following ventilator
settings?
Mode: Synchronized Intermittent Mandatory Ventilation
(SIMV) Respiratory rate: 10 breaths per minute (BPM)
Tidal volume: 500
mL FiO2: 75%
Positive end expiratory pressure (PEEP): +5
- Respiratory Acidosis
9. The physician orders the following mechanical ventilation settings for a client.
The client's spontaneous respiratory rate is 22 breaths/min. What arterial
blood gas abnormality may occur if the client continues to be tachypneic at these
ventilator settings?
Mode: Assist Control
Respiratory rate: 14 breaths per minute (BPM)
Tidal volume: 800 mL
FiO2: 0.50%
Positive end expiratory pressure (PEEP): 10 cm
- Respiratory Alkalosis
10. Last time you check respirations at 20bpm
- Have patient deep breath
11. A client who has asthma is admitted to the hospital in acute respiratory
distress. Which of these assessments findings should require priority
intervention by the nurse?
- ABG: pH 7.32, PaCO2 55 mm Hg, PaO2 60 mm Hg
12. A client with an acute exacerbation of COPD has the following ABG
analysis: pH 7.32, PaO2 58 mm Hg, PaCO2 55 mm Hg, HCO3 23 mEq/L, and
SaO2 86%. The nurse knows that this client has
- Respiratory Acidosis
13. SIMV is set at 4 and the patient is breathing 4 breaths over the vent
- The patient would be respiratory acidosis
14. What would be the correct interpretation of the following blood gas
results? PH 7.22, PaCo2- 64, HCO3 24
- Respiratory Acidosis
15. Anxiety and high RR - ph 7 (alkaline)
, ABGs MedSurg Success Book
16. The client is being weaned from a ventilator. Arterial blood gases drawn
prior to intubation reveal PH-7.32 PaO2 90 mmHg PaCO2 56 mmHg, HCO3 26
mEq/L. What acid base imbalance is reflected by these results?
- Metabolic alkalosis
- Respiratory Alkalosis
- Respiratory Acidosis
- Metabolic Acidosis
17. The nurse is caring for a 68 year old client who is scheduled for
discharge later that day. An arterial blood gas (ABG) done the previous morning
reveals PaO2 of 87 mmHg. The client has respiratory rate of 22 and clear lungs
and reports no shortness of breath. What should be the nurse’s response?
- Call the health care provider to report the PaO2
- Monitor the clients more closely because of physiological abnormalities is
beginning
- Do nothing because a PaO2 of 87 is normal in an older adult
- Call the family to tell them to anticipate that the discharge will be cancelled
Mechanical ventilation
18. The COPD patient on mechanical ventilation. What intervention
should the nurse take?
- Give paper and pen to communicate
19. Doctor orders mechanical ventilation with a setting of 10 breaths/min but
also to allow the patient to breath on their own at their own tidal volume. What
kind of setting is this?
- Synchronized Intermittent Mandatory Ventilation (SIMV)
20. What are some of the Nurse interventions in the care of mechanical vents
patients?
- Assess respiratory status
- Keep HOB at 45 degrees
- Oral suction Q2-4 hours
- Monitor readiness to wean
- Reposition Q2 hours
21. The alarm on the mechanical ventilator shows high inspiratory pressure.
Select all of the possible causes for the high-pressure alarm to go off. SATA
- Coughing or attempting to talk
ABGs
1. The physician orders the following mechanical ventilation settings for a client.
The client's spontaneous respiratory rate is 22 breaths/min. What arterial
blood gas abnormality may occur if the client continues to be tachypneic at
these ventilator settings?
- Respiratory Alkalosis hyperventilating
2. A client with persistent vomiting of 3 days duration is seen at the urgent care
center because of increasing weakness. IV therapy with Ringer's solution is
started, and an arterial blood gas (ABG) analysis is ordered. Results of the
ABGs that would be expected include: Choice the
- Metabolic Alkalosis pH 7.48; PCO2 40, HCO3 30mEqL
3. A client is admitted to the progressive care unit with a diagnosis of pneumonia.
The client has a history of obstructive pulmonary disease and diabetes. A set
of arterial blood gases is obtained on admission: room air pH is 7.35; PaCo2 is
55 mm Hg; bicarbonate is 30 mEq/L; PaO2 is 65 mm Hg. These levels reflect
hypoxemia:
- Compensated Respiratory Acidosis
4. A client is admitted with a diagnosis of acute respiratory distress syndrome
(ARDS). Which of the following arterial blood gas results indicates acute
respiratory failure?
- pH 7.20, HCO3 23, PO2 40, PCO2 58
5. A post-operative client is being mechanically ventilated in the synchronized
intermittent mandatory ventilation (SIMV) mode at a rate of 4 breaths/min. His
spontaneous respirations are 12 breaths/min. He receives a dose of morphine
sulfate, and his respirations decrease to 4 breaths/min. Which acid-base
disturbance is this client at risk for?
- Hypoventilation Respiratory Acidosis
6. The nurse is assessing a client who is brought to the emergency department
following an overdose of sedatives. Which of the following findings
would indicate to the nurse that the client is having complications?
- Hypoventilation and Respiratory Acidosis
7. Select all question of patient that overdosed on sedative, now has resp. acidosis
- Decrease CNS
- Overdose of sedation
,8. A client is diagnosed with acute respiratory failure. What acid-base abnormality
may occur if the client's receives Ativan 2 mg IV with following ventilator
settings?
Mode: Synchronized Intermittent Mandatory Ventilation
(SIMV) Respiratory rate: 10 breaths per minute (BPM)
Tidal volume: 500
mL FiO2: 75%
Positive end expiratory pressure (PEEP): +5
- Respiratory Acidosis
9. The physician orders the following mechanical ventilation settings for a client.
The client's spontaneous respiratory rate is 22 breaths/min. What arterial
blood gas abnormality may occur if the client continues to be tachypneic at these
ventilator settings?
Mode: Assist Control
Respiratory rate: 14 breaths per minute (BPM)
Tidal volume: 800 mL
FiO2: 0.50%
Positive end expiratory pressure (PEEP): 10 cm
- Respiratory Alkalosis
10. Last time you check respirations at 20bpm
- Have patient deep breath
11. A client who has asthma is admitted to the hospital in acute respiratory
distress. Which of these assessments findings should require priority
intervention by the nurse?
- ABG: pH 7.32, PaCO2 55 mm Hg, PaO2 60 mm Hg
12. A client with an acute exacerbation of COPD has the following ABG
analysis: pH 7.32, PaO2 58 mm Hg, PaCO2 55 mm Hg, HCO3 23 mEq/L, and
SaO2 86%. The nurse knows that this client has
- Respiratory Acidosis
13. SIMV is set at 4 and the patient is breathing 4 breaths over the vent
- The patient would be respiratory acidosis
14. What would be the correct interpretation of the following blood gas
results? PH 7.22, PaCo2- 64, HCO3 24
- Respiratory Acidosis
15. Anxiety and high RR - ph 7 (alkaline)
, ABGs MedSurg Success Book
16. The client is being weaned from a ventilator. Arterial blood gases drawn
prior to intubation reveal PH-7.32 PaO2 90 mmHg PaCO2 56 mmHg, HCO3 26
mEq/L. What acid base imbalance is reflected by these results?
- Metabolic alkalosis
- Respiratory Alkalosis
- Respiratory Acidosis
- Metabolic Acidosis
17. The nurse is caring for a 68 year old client who is scheduled for
discharge later that day. An arterial blood gas (ABG) done the previous morning
reveals PaO2 of 87 mmHg. The client has respiratory rate of 22 and clear lungs
and reports no shortness of breath. What should be the nurse’s response?
- Call the health care provider to report the PaO2
- Monitor the clients more closely because of physiological abnormalities is
beginning
- Do nothing because a PaO2 of 87 is normal in an older adult
- Call the family to tell them to anticipate that the discharge will be cancelled
Mechanical ventilation
18. The COPD patient on mechanical ventilation. What intervention
should the nurse take?
- Give paper and pen to communicate
19. Doctor orders mechanical ventilation with a setting of 10 breaths/min but
also to allow the patient to breath on their own at their own tidal volume. What
kind of setting is this?
- Synchronized Intermittent Mandatory Ventilation (SIMV)
20. What are some of the Nurse interventions in the care of mechanical vents
patients?
- Assess respiratory status
- Keep HOB at 45 degrees
- Oral suction Q2-4 hours
- Monitor readiness to wean
- Reposition Q2 hours
21. The alarm on the mechanical ventilator shows high inspiratory pressure.
Select all of the possible causes for the high-pressure alarm to go off. SATA
- Coughing or attempting to talk
