Critical Care exam 1: respiratory Practice
questions
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 - CORRECT ANSWER-a
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 - CORRECT ANSWER-a, c, d
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 - CORRECT ANSWER-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 - CORRECT ANSWER-a,b,c
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 - CORRECT ANSWER-b, d
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 less than 91% on room air, PaO2 level less than 60
mmHg, and a pCO2 level of over 50 mmHg.
6) A nurse is caring for a patient who is in respiratory distress because of ARDS.
Which of the following nursing diagnoses would most likely be associated with
this condition?
a. Ineffective thermoregulation
b. Impaired urinary elimination
c. Ineffective tissue perfusion
d. Disturbed personal identity - CORRECT ANSWER-c
7) A nurse walks into a client who is in respiratory distress. The client has a
tracheal deviation to the right side. The nurse knows to prepare for which of the
following emergent procedures?
a. Chest tube insertion on the left side.
questions
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 - CORRECT ANSWER-a
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 - CORRECT ANSWER-a, c, d
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 - CORRECT ANSWER-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 - CORRECT ANSWER-a,b,c
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 - CORRECT ANSWER-b, d
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 less than 91% on room air, PaO2 level less than 60
mmHg, and a pCO2 level of over 50 mmHg.
6) A nurse is caring for a patient who is in respiratory distress because of ARDS.
Which of the following nursing diagnoses would most likely be associated with
this condition?
a. Ineffective thermoregulation
b. Impaired urinary elimination
c. Ineffective tissue perfusion
d. Disturbed personal identity - CORRECT ANSWER-c
7) A nurse walks into a client who is in respiratory distress. The client has a
tracheal deviation to the right side. The nurse knows to prepare for which of the
following emergent procedures?
a. Chest tube insertion on the left side.
