Critical Care exam 1: respiratory Practice
questions and answers 100%Correctly verified
answers latest update 2025/2026 RATED A+
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 ANSWERS 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 ANSWERS 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 ANSWERS 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 ANSWERS 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 ANSWERS 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 ANSWERS 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.
b. Chest tube insertion on the right side.
c. Intubation
d. Tracheostomy - CORRECT ANSWERS a
Tracheal deviation indicates a pneumothorax, the direction of the deviation indicates the side the
pneumothorax is on. If the trachea is deviating to the right, then the pneumo is on the left. The
treatment for this is a chest tube on the side of trhe deflated lung.
8) A 26-year-old patient is admitted to the hospital in severe respiratory distress. His oxygen saturations
are 80% despite supplemental oxygen provided by a facemask. The provider decides to intubate the
patient to help with his breathing oxygenation. Which medication would the nurse most likely
administer when assisting with intubation?
a. Modafinil (Provigil)
b. Phentermine (Adipex-P)
c. Etomidate (Amidate)
d. Zolpidem (Ambien) - CORRECT ANSWERS c
"Etomidate (Amidate)" is correct. Intubation is most often performed by inserting a tube into the mouth
and passing it into the trachea in order to provide support for a patient's breathing. Most registered
nurses do not perform endotracheal intubation, but they can assist the provider or respiratory therapist
with placing the tube. The nurse may give medications to sedate the patient during the procedure, since
it can be traumatic for the patient. Some medications given for sedation include etomidate, ketamine or
midazolam. Midazolam (Versed) is used less often due to its need for titration based on weight, which is
an extra step that is undesirable during rapid intubation. This extra step can cause delays and errors
during intubation.
-"Zolpidem (Ambien)" is incorrect because this is an oral tablet used to induce sleep for the patient
suffering from insomnia. This medication is not potent or rapid enough to be used for intubation.
-"Phentermine (Adipex-P)" is incorrect because this is a stimulant, not a sedative and would not be used
during intubation.
-"Modafinil (Provigil)" is incorrect because this is a stimulant drug. Stimulants produce the opposite
effect of what is necessary for patient intubation.
:
A 64-year-old man with moderate chronic obstructive pulmonary disease presents to your office
complaining that for the past 5 days, he has been experiencing worsening shortness of breath. He denies
having fevers or chills, but he does report increasing purulent sputum production. He visited his 6-year-
old grandson this past weekend, and the child had symptoms of an upper respiratory infection. The
patient's vital signs are normal except that oxygen saturation on room air is 88%. Examination reveals
bilateral expiratory wheezing. A chest radiograph is normal. Results of laboratory testing are as follows:
white blood cell count, 12,500/mm3; arterial blood gas pH, 7.35; arterial oxygen tension (PaO2), 65 mm
Hg; and carbon dioxide tension (PCO2), 60 mm Hg. You arrange for hospital admission.
questions and answers 100%Correctly verified
answers latest update 2025/2026 RATED A+
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 ANSWERS 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 ANSWERS 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 ANSWERS 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 ANSWERS 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 ANSWERS 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 ANSWERS 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.
b. Chest tube insertion on the right side.
c. Intubation
d. Tracheostomy - CORRECT ANSWERS a
Tracheal deviation indicates a pneumothorax, the direction of the deviation indicates the side the
pneumothorax is on. If the trachea is deviating to the right, then the pneumo is on the left. The
treatment for this is a chest tube on the side of trhe deflated lung.
8) A 26-year-old patient is admitted to the hospital in severe respiratory distress. His oxygen saturations
are 80% despite supplemental oxygen provided by a facemask. The provider decides to intubate the
patient to help with his breathing oxygenation. Which medication would the nurse most likely
administer when assisting with intubation?
a. Modafinil (Provigil)
b. Phentermine (Adipex-P)
c. Etomidate (Amidate)
d. Zolpidem (Ambien) - CORRECT ANSWERS c
"Etomidate (Amidate)" is correct. Intubation is most often performed by inserting a tube into the mouth
and passing it into the trachea in order to provide support for a patient's breathing. Most registered
nurses do not perform endotracheal intubation, but they can assist the provider or respiratory therapist
with placing the tube. The nurse may give medications to sedate the patient during the procedure, since
it can be traumatic for the patient. Some medications given for sedation include etomidate, ketamine or
midazolam. Midazolam (Versed) is used less often due to its need for titration based on weight, which is
an extra step that is undesirable during rapid intubation. This extra step can cause delays and errors
during intubation.
-"Zolpidem (Ambien)" is incorrect because this is an oral tablet used to induce sleep for the patient
suffering from insomnia. This medication is not potent or rapid enough to be used for intubation.
-"Phentermine (Adipex-P)" is incorrect because this is a stimulant, not a sedative and would not be used
during intubation.
-"Modafinil (Provigil)" is incorrect because this is a stimulant drug. Stimulants produce the opposite
effect of what is necessary for patient intubation.
:
A 64-year-old man with moderate chronic obstructive pulmonary disease presents to your office
complaining that for the past 5 days, he has been experiencing worsening shortness of breath. He denies
having fevers or chills, but he does report increasing purulent sputum production. He visited his 6-year-
old grandson this past weekend, and the child had symptoms of an upper respiratory infection. The
patient's vital signs are normal except that oxygen saturation on room air is 88%. Examination reveals
bilateral expiratory wheezing. A chest radiograph is normal. Results of laboratory testing are as follows:
white blood cell count, 12,500/mm3; arterial blood gas pH, 7.35; arterial oxygen tension (PaO2), 65 mm
Hg; and carbon dioxide tension (PCO2), 60 mm Hg. You arrange for hospital admission.
