ARDS NCLEX Practice Questions 2023

The nurse is caring for a client with suspected acute respiratory distress syndrome (ARDS). Which symptom of ARDS should the nurse anticipate will appear within 24 to 48 hours after the initial insult? (Select all that apply.) Shortness of breath Rapid breathing Fluid imbalance Chest x-ray clear of infiltrates Arterial blood gases varying from normal limits - Shortness of breath Rapid breathing Chest x-ray clear of infiltrates Rapid breathing and shortness of breath are two early symptoms of ARDS that manifest in the first day or two after the initial injury. On chest x-ray, no infiltrates will be noted in the early stages and lung sounds will be clear. Fluid imbalance and abnormal arterial blood gas levels will be noted later in the disease process. A client is diagnosed with acute respiratory distress syndrome (ARDS). The client's spouse asks the nurse what caused ARDS. Which etiology of indirect injury to the lungs should the nurse include in the response? (Select all that apply.) Smoke inhalation Systemic sepsis Fat embolism Multiple blood transfusions Pancreatitis - Systemic sepsis Multiple blood transfusions Pancreatitis Pancreatitis, systemic sepsis, and multiple blood transfusions are causes of indirect injury to the lungs. Smoke inhalation and fat embolisms are causes of direct injury to the lungs. The nurse is caring for a client who had an episode of near-drowning 5 days ago. This morning, the nurse noted rhonchi in the lower lung lobes on auscultation. Which action by the nurse is best? Documenting the findings as normal Preparing for intubation Notifying the healthcare provider Monitoring vital signs and oxygen saturation every 2 hours - Notifying the healthcare provider Changes in lung sounds after a pulmonary injury, like near-drowning, can indicate that the client is developing acute respiratory distress syndrome (ARDS). The nurse should notify the healthcare provider of the change in the client's condition. Intubation is not necessary unless the client is in respiratory distress. Rhonchi on auscultation are not a normal finding and require the nurse to take action. It is not appropriate for the nurse to simply monitor the client without taking action to prevent a worsening of the client's condition. A client is brought into the emergency department after aspirating on pureed foods at the long-term care facility. The nurse knows that which physiologic change can trigger acute respiratory distress syndrome? Release of chemical mediators Increased surfactant production Destruction of extracellular platelets Intracellular edema - Release of chemical mediators After the initial pulmonary injury, such as aspiration, chemical mediators are released, which damage the alveolar-capillary membrane and trigger other changes associated with ARDS. This damage can cause interstitial (not intracellular) edema and decreased (not increased) surfactant production. Destruction of platelets is not associated with ARDS. The nurse is caring for a client with respiratory acidosis secondary to end-stage acute respiratory distress syndrome (ARDS). Which result should the nurse anticipate on the arterial blood gas? High PaO2 and low PaCO2 Low PaO2 and low PaCO2 Low PaO2 and high PaCO2 High PaO2 and high PaCO2 - Low PaO2 and high PaCO2 In end-stage ARDS, physiological changes in the alveoli prevent CO2 from diffusing across the alveolar membranes, causing the PaCO2 to rise and PaO2 to fall. Eventually, respiratory distress and respiratory failure will develop, and without further intervention, death will result. A pediatric client is not responding to treatment for acute respiratory distress syndrome (ARDS) and requires intubation. The mother is anxious that the procedure will hurt. Which is the best response by the nurse? "We will administer medication to help him sleep through the intubation and as needed while he is on the ventilator." "Don't worry; intubation and using a ventilator doesn't hurt at all." "He may feel a little nervous, but he will get used to the ventilator soon enough." "He will actually feel better and may even like the ventilator because he will be able to breathe more comfortably." - "We will administer medication to help him sleep through the intubation and as needed while he is on the ventilator." Pediatric clients have higher sedation needs to limit stress, anxiety, and pain and to minimize the risk that they will pull at the tube. Intubation and mechanical ventilation can produce anxiety and agitation in all clients and require some sedation. A pregnant woman presents with worsening dyspnea and tachypnea since being diagnosed with pneumonia last week. The client is currently at 28 weeks of gestation and asks the nurse if she will need to deliver early. Which is the best reply by the nurse? "Yes, we will need to delivery your baby as soon as possible." "It's hard to know right now." "There's no need to deliver your baby early. The baby is safer in your womb." "We'll monitor the baby very closely and plan for delivery if needed for the baby's safety." - "We'll monitor the baby very closely and plan for delivery if needed for the baby's safety."