Adult Health 3 - Exam 1, 2, 3 & 4
questions and Answers
Someone with ARDS and their incubated and receiving mechanical ventilation and
develop a right pneumo? What is the first thing you do? - Turn down the PEEP
PEEP vent - Pressure given at the end of each breathing cycle to KEEP ALVEOLI
OPEN
Caring for someone they have ARF, bronchitis what medication prescription should we
question? - Methylprednisolone by neb
Someone with COPD into the ER with dyspnea and SOB? Which findings is priority? -
Resp. rate of 10
Receive report on 4 clients, which is priority to see first? - 12 month old with
diminished lung sounds
Assessment pt. is SOB, diminished breath sounds in R lower lobe, x-ray shows large
right plural effusion, what procedure is coming next? - Thoracentesis
Evaluation of assist control vent. For ARF. What finding would indicate the client is
tolerating this mode of ventilation? - Initiating spontaneous breath
Preparing to suction a client with ET tube, what would be the first thing we do? - Listen
to lung sounds and look at SaO2 (assess client first)
Plan of care for pt. low potassium level, provide information on effects of medications
and the dietary intakes of foods high in potassium. Outcome of plan would be evaluated
how? - labs
Caring for a client with ARDS with mechanical ventilation, looking at labs results, what
would indicate to the RN that the ventilation is providing adequate gas exchange of the
client? - Decrease CO2 and increase PO2
Administer IV morphine to a client who is 18hrs. post op and the pt.s reports feeling
anxious and having incisional pain, 7.50, po2 29, Hco3 of 23. After morphine what
would be expected to happen? - Decreased respiration, decrease pain, decrease pH
Caring for client who had lung surgery and now has shallow respiration pattern and
reluctant to cough? what should we assess for? - Atelectasis
,Assess a client who has metabolic alkalosis due to food poisoning, we gave them fluid
therapy? How do we evaluate if the treatment was successful? - pH decreased and
HCO3 decreased
Caring for a client with ARDS, vent. Evaluate gas exchange, adequate findings - VQ
adequate ventilation perfusion ratio
Child has cystic fibrosis. What prescribed intervention would we provide in the
teaching? - Chest PT., digestive enzymes, postural drainage
Caring for patient who has increased urination, blurred vision. Ph 7.30, HCO3 19, PCO2
35? - (DKA) give fluids and insulin
Explaining how to do postural drainage to a client, what intervention is appropriate when
providing postural drainage? - Use pillows to help position the client
Caring for client in ER, look at x-ray and see rib fractures and small flail chest injury,
what is the appropriate action to take for this patient? - suction
Long term aminoglycoside amnio therapy for infection, potassium is 5.4, ecg shows
peak t-waves. What action do we take? - Polystyrene sulfonate
Acute hypoxemic respiratory failure due to VQ mismatch, what intervention is
appropriate for their care? - 24% to 32 % O2 via face mask
Assessing a client with end stage kidney disease, serum lab results hypocalcemia, and
hyperphosphatemia? - - LABS/FINDINGS
- Cardiac arrhythmia
- trousseau sign
- Fractures
Acute resp. failure ineffective airway clearance? - - Promote fluid hydration
- encourage deep breathing
- incentive spirometry
- monitor secretions
Provide DC resp. acidosis for COPD, what information would you include to prevent
episodes of Resp. acidosis? - - Purse lipped breathing
Blood gases with resp. failure.
pH 7.58
poc2 20
o2 75
HCo3 28
sat. 92 (metabolic alkalosis) - - Vent. Patient
, Caring for client receiving high levels of PEEP via ET tube due to ARDS. Contact Resp.
therapy for which finding? - - Blood pressure (lower the peep)
Bowel obstruction, NG tube cont. suction. ABGS indicate complication of NG?
(metabolic alkalosis) - - pH would be high bicarb is high
Pt. with ARDS, peep going. Pt. having complications from PEEP? - - Decreased
Cardiac output
- tachycardia
- decreased urine output,
Providing D/C teaching for client with COPH about breathing exercises? Which
statement is correct by the patient regarding the teaching? - - Diaphoretic breathing in
sitting position
Assess with COPD auscultate diminished breath sounds, which is a change from
baseline, monitor for what potential complication? - - Dyspnea and hypoxemia
Parents of child with asthma, ask how do beta agonist works? - - Relaxes smooth
muscles, results in bronchodilation
Metabolic Alkalosis, tele shows flattened T waves and U waves. Which complication
should be explained to client? - - Low potassium causes metabolic alkalosis, going to
require potassium therapy
Prepare to assist with weening on mechanical vent. Priority would be? - - ABG
baseline
Bronchodilator which findings would be an improvement for COPD? - - Relief of
dyspnea (SATA)
Caring for client, going to surgery, have IV Midazolam going, pt. shows overdose? What
should the response be? - - Ventilate with BVM
Mechanical Vent. What actions by the nurse would help prevent VAP? - - Practice
hand hygiene
Pt. with ARF, with percussion and vibration. What interventions would be appropriate to
implement before therapy? - - Administer albuterol before therapy
90 sec. Tonic clinic seizure. pH 6.88, pco2 60, bicarb 22, po2 50? - - Mask/nasal
cannula Give o2
CPAP with delivery of O2, prescription should be for which client? - - Muscular
dystrophy and experiencing acute respiratory failure
questions and Answers
Someone with ARDS and their incubated and receiving mechanical ventilation and
develop a right pneumo? What is the first thing you do? - Turn down the PEEP
PEEP vent - Pressure given at the end of each breathing cycle to KEEP ALVEOLI
OPEN
Caring for someone they have ARF, bronchitis what medication prescription should we
question? - Methylprednisolone by neb
Someone with COPD into the ER with dyspnea and SOB? Which findings is priority? -
Resp. rate of 10
Receive report on 4 clients, which is priority to see first? - 12 month old with
diminished lung sounds
Assessment pt. is SOB, diminished breath sounds in R lower lobe, x-ray shows large
right plural effusion, what procedure is coming next? - Thoracentesis
Evaluation of assist control vent. For ARF. What finding would indicate the client is
tolerating this mode of ventilation? - Initiating spontaneous breath
Preparing to suction a client with ET tube, what would be the first thing we do? - Listen
to lung sounds and look at SaO2 (assess client first)
Plan of care for pt. low potassium level, provide information on effects of medications
and the dietary intakes of foods high in potassium. Outcome of plan would be evaluated
how? - labs
Caring for a client with ARDS with mechanical ventilation, looking at labs results, what
would indicate to the RN that the ventilation is providing adequate gas exchange of the
client? - Decrease CO2 and increase PO2
Administer IV morphine to a client who is 18hrs. post op and the pt.s reports feeling
anxious and having incisional pain, 7.50, po2 29, Hco3 of 23. After morphine what
would be expected to happen? - Decreased respiration, decrease pain, decrease pH
Caring for client who had lung surgery and now has shallow respiration pattern and
reluctant to cough? what should we assess for? - Atelectasis
,Assess a client who has metabolic alkalosis due to food poisoning, we gave them fluid
therapy? How do we evaluate if the treatment was successful? - pH decreased and
HCO3 decreased
Caring for a client with ARDS, vent. Evaluate gas exchange, adequate findings - VQ
adequate ventilation perfusion ratio
Child has cystic fibrosis. What prescribed intervention would we provide in the
teaching? - Chest PT., digestive enzymes, postural drainage
Caring for patient who has increased urination, blurred vision. Ph 7.30, HCO3 19, PCO2
35? - (DKA) give fluids and insulin
Explaining how to do postural drainage to a client, what intervention is appropriate when
providing postural drainage? - Use pillows to help position the client
Caring for client in ER, look at x-ray and see rib fractures and small flail chest injury,
what is the appropriate action to take for this patient? - suction
Long term aminoglycoside amnio therapy for infection, potassium is 5.4, ecg shows
peak t-waves. What action do we take? - Polystyrene sulfonate
Acute hypoxemic respiratory failure due to VQ mismatch, what intervention is
appropriate for their care? - 24% to 32 % O2 via face mask
Assessing a client with end stage kidney disease, serum lab results hypocalcemia, and
hyperphosphatemia? - - LABS/FINDINGS
- Cardiac arrhythmia
- trousseau sign
- Fractures
Acute resp. failure ineffective airway clearance? - - Promote fluid hydration
- encourage deep breathing
- incentive spirometry
- monitor secretions
Provide DC resp. acidosis for COPD, what information would you include to prevent
episodes of Resp. acidosis? - - Purse lipped breathing
Blood gases with resp. failure.
pH 7.58
poc2 20
o2 75
HCo3 28
sat. 92 (metabolic alkalosis) - - Vent. Patient
, Caring for client receiving high levels of PEEP via ET tube due to ARDS. Contact Resp.
therapy for which finding? - - Blood pressure (lower the peep)
Bowel obstruction, NG tube cont. suction. ABGS indicate complication of NG?
(metabolic alkalosis) - - pH would be high bicarb is high
Pt. with ARDS, peep going. Pt. having complications from PEEP? - - Decreased
Cardiac output
- tachycardia
- decreased urine output,
Providing D/C teaching for client with COPH about breathing exercises? Which
statement is correct by the patient regarding the teaching? - - Diaphoretic breathing in
sitting position
Assess with COPD auscultate diminished breath sounds, which is a change from
baseline, monitor for what potential complication? - - Dyspnea and hypoxemia
Parents of child with asthma, ask how do beta agonist works? - - Relaxes smooth
muscles, results in bronchodilation
Metabolic Alkalosis, tele shows flattened T waves and U waves. Which complication
should be explained to client? - - Low potassium causes metabolic alkalosis, going to
require potassium therapy
Prepare to assist with weening on mechanical vent. Priority would be? - - ABG
baseline
Bronchodilator which findings would be an improvement for COPD? - - Relief of
dyspnea (SATA)
Caring for client, going to surgery, have IV Midazolam going, pt. shows overdose? What
should the response be? - - Ventilate with BVM
Mechanical Vent. What actions by the nurse would help prevent VAP? - - Practice
hand hygiene
Pt. with ARF, with percussion and vibration. What interventions would be appropriate to
implement before therapy? - - Administer albuterol before therapy
90 sec. Tonic clinic seizure. pH 6.88, pco2 60, bicarb 22, po2 50? - - Mask/nasal
cannula Give o2
CPAP with delivery of O2, prescription should be for which client? - - Muscular
dystrophy and experiencing acute respiratory failure
