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MDC4 EXAM 1 QUESTIONS AND ANSWERS
2025
Airway & Assessment - ....ANSWER ....✔✔ Assess
airway patency, work of breathing, breath sounds,
respiratory rate, O₂ saturation, and mental status.
(Rationale: airway/ventilation first — identifies
immediate threats to oxygenation.)
Hypoxemia definition - ....ANSWER ....✔✔ Low
arterial oxygen tension (PaO₂ < 80 mm Hg) or O₂
saturation < 90% on pulse oximetry. (Rationale:
threshold for supplemental O₂ and escalation.)
Hypercapnia definition - ....ANSWER ....✔✔ Elevated
arterial CO₂ (PaCO₂ > 45 mm Hg). (Rationale: indicates
hypoventilation or respiratory failure needing
ventilatory support.)
Acute respiratory failure - ....ANSWER ....✔✔
Inability of the respiratory system to maintain adequate
gas exchange (PaO₂ < 60 mm Hg or PaCO₂ > 50 mm
,2|Page
Hg with pH < 7.30). (Rationale: defines need for urgent
intervention or mechanical ventilation.)
ARDS (acute respiratory distress syndrome) -
....ANSWER ....✔✔ Noncardiogenic pulmonary
edema, severe hypoxemia refractory to O₂, bilateral
infiltrates on CXR; often after systemic
inflammation/injury. (Rationale: needs lung-protective
ventilation and treat underlying cause.)
Primary nursing priorities in respiratory distress -
....ANSWER ....✔✔ Maintain airway, provide O₂,
monitor vitals/ABGs, call for advanced support.
(Rationale: prevents hypoxic injury and guides
interventions.)
Inhalation injury signs - ....ANSWER ....✔✔ Facial
burns, singed nasal hair, carbonaceous sputum,
hoarseness, stridor. (Rationale: predict airway edema →
early intubation sometimes required.)
Indications for early intubation in burns/inhalation -
....ANSWER ....✔✔ Stridor, hoarseness, increasing
work of breathing, upper airway edema signs.
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(Rationale: edema can progress rapidly making
intubation difficult later.)
Pulse oximetry limitations - ....ANSWER ....✔✔ Falsely
normal in CO poisoning, poor perfusion, dark nail polish.
(Rationale: ABG and clinical correlation often needed.)
ABG use - ....ANSWER ....✔✔ Assess PaO₂, PaCO₂,
pH, HCO₃⁻ to guide oxygenation/ventilation
management. (Rationale: objective measurement of gas
exchange and acid-base status.)
Oxygen delivery devices — nasal cannula - ....ANSWER
....✔✔ Low-flow O₂ 1-6 L/min; useful for mild
hypoxemia. (Rationale: low FiO₂ increments, comfortable
for patients.)
Simple face mask - ....ANSWER ....✔✔ 5-10 L/min
provides higher O₂ than nasal cannula. (Rationale: used
when cannula insufficient.)
Nonrebreather mask - ....ANSWER ....✔✔ 10-15
L/min, high FiO₂ approaching 60-100% with reservoir.
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(Rationale: for severe hypoxemia emergently before
intubation.)
High-flow nasal cannula (HFNC) - ....ANSWER ....✔✔
Delivers warmed, humidified O₂ at high flow with
variable FiO₂ and some positive airway pressure.
(Rationale: useful for hypoxemic respiratory failure, may
avoid intubation.)
CPAP/BiPAP - ....ANSWER ....✔✔ Noninvasive
positive pressure ventilation to improve
oxygenation/ventilation; CPAP for oxygenation, BiPAP
for ventilatory support. (Rationale: supports alveolar
recruitment, reduces work of breathing.)
Indications/contraindications for NIPPV - ....ANSWER
....✔✔ Good for COPD exacerbation/CHF with
respiratory distress; contraindicated if unable to protect
airway, massive secretions, facial trauma. (Rationale:
requires patient cooperation & intact airway reflexes.)
Ventilator complications — VAP (ventilator-associated
pneumonia) - ....ANSWER ....✔✔ Pneumonia occurring
>48 hrs after intubation. (Rationale: prevention bundles
reduce incidence.)
MDC4 EXAM 1 QUESTIONS AND ANSWERS
2025
Airway & Assessment - ....ANSWER ....✔✔ Assess
airway patency, work of breathing, breath sounds,
respiratory rate, O₂ saturation, and mental status.
(Rationale: airway/ventilation first — identifies
immediate threats to oxygenation.)
Hypoxemia definition - ....ANSWER ....✔✔ Low
arterial oxygen tension (PaO₂ < 80 mm Hg) or O₂
saturation < 90% on pulse oximetry. (Rationale:
threshold for supplemental O₂ and escalation.)
Hypercapnia definition - ....ANSWER ....✔✔ Elevated
arterial CO₂ (PaCO₂ > 45 mm Hg). (Rationale: indicates
hypoventilation or respiratory failure needing
ventilatory support.)
Acute respiratory failure - ....ANSWER ....✔✔
Inability of the respiratory system to maintain adequate
gas exchange (PaO₂ < 60 mm Hg or PaCO₂ > 50 mm
,2|Page
Hg with pH < 7.30). (Rationale: defines need for urgent
intervention or mechanical ventilation.)
ARDS (acute respiratory distress syndrome) -
....ANSWER ....✔✔ Noncardiogenic pulmonary
edema, severe hypoxemia refractory to O₂, bilateral
infiltrates on CXR; often after systemic
inflammation/injury. (Rationale: needs lung-protective
ventilation and treat underlying cause.)
Primary nursing priorities in respiratory distress -
....ANSWER ....✔✔ Maintain airway, provide O₂,
monitor vitals/ABGs, call for advanced support.
(Rationale: prevents hypoxic injury and guides
interventions.)
Inhalation injury signs - ....ANSWER ....✔✔ Facial
burns, singed nasal hair, carbonaceous sputum,
hoarseness, stridor. (Rationale: predict airway edema →
early intubation sometimes required.)
Indications for early intubation in burns/inhalation -
....ANSWER ....✔✔ Stridor, hoarseness, increasing
work of breathing, upper airway edema signs.
,3|Page
(Rationale: edema can progress rapidly making
intubation difficult later.)
Pulse oximetry limitations - ....ANSWER ....✔✔ Falsely
normal in CO poisoning, poor perfusion, dark nail polish.
(Rationale: ABG and clinical correlation often needed.)
ABG use - ....ANSWER ....✔✔ Assess PaO₂, PaCO₂,
pH, HCO₃⁻ to guide oxygenation/ventilation
management. (Rationale: objective measurement of gas
exchange and acid-base status.)
Oxygen delivery devices — nasal cannula - ....ANSWER
....✔✔ Low-flow O₂ 1-6 L/min; useful for mild
hypoxemia. (Rationale: low FiO₂ increments, comfortable
for patients.)
Simple face mask - ....ANSWER ....✔✔ 5-10 L/min
provides higher O₂ than nasal cannula. (Rationale: used
when cannula insufficient.)
Nonrebreather mask - ....ANSWER ....✔✔ 10-15
L/min, high FiO₂ approaching 60-100% with reservoir.
, 4|Page
(Rationale: for severe hypoxemia emergently before
intubation.)
High-flow nasal cannula (HFNC) - ....ANSWER ....✔✔
Delivers warmed, humidified O₂ at high flow with
variable FiO₂ and some positive airway pressure.
(Rationale: useful for hypoxemic respiratory failure, may
avoid intubation.)
CPAP/BiPAP - ....ANSWER ....✔✔ Noninvasive
positive pressure ventilation to improve
oxygenation/ventilation; CPAP for oxygenation, BiPAP
for ventilatory support. (Rationale: supports alveolar
recruitment, reduces work of breathing.)
Indications/contraindications for NIPPV - ....ANSWER
....✔✔ Good for COPD exacerbation/CHF with
respiratory distress; contraindicated if unable to protect
airway, massive secretions, facial trauma. (Rationale:
requires patient cooperation & intact airway reflexes.)
Ventilator complications — VAP (ventilator-associated
pneumonia) - ....ANSWER ....✔✔ Pneumonia occurring
>48 hrs after intubation. (Rationale: prevention bundles
reduce incidence.)
