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1. The nursing management of a patient with an artificial airway includes
a. maintaining ET tube cuff pressure at 35 cm H2O.
b. routine suctioning of the tube at least every 2 hours.
c. observing for cardiac dysrhythmias during suctioning.
d. preventing tube dislodgment by limiting mouth care to lubrication of the
lips
- ANSWER C. observing for cardiac dysrhythmias during suctioning.
2. A nurse is caring for a patient who is orally intubated and receiving
mechanical ventilation. To decrease the risk for ventilator-associated
pneumonia, which action will the nurse include in the plan of care?
A. Limit the use of positive end-expiratory pressure.
B. Elevate head of bed to 30 to 45 degrees.
C. Suction the endotracheal tube every 2 to 4 hours.
D. Give enteral feedings at no more than 10 mL/hr.
- ANSWER B; Elevation of the head decreases the risk for aspiration
3. After receiving change-of-shift report on a medical unit, which patient would
the nurse assess first?
a. A patient with septicemia who has intercostal and suprasternal retractions
b. A patient with pneumonia who has crackles bilaterally in the lung bases
,c. A patient with cystic fibrosis who has thick, green-colored sputum
d. A patient with emphysema who has an oxygen saturation of 90% to 92%
- ANSWER A; This patient's history of septicemia and labored breathing
suggest the onset of ARDS, which will require rapid interventions such as
administration of O2 and use of positive-pressure ventilation
4. Which signs and symptoms distinguish hypoxemic from hypercapnic respiratory
failure? (select all that apply)
a. Cyanosis
b. Tachypnea
c. Morning headache
d. Paradoxical breathing
e. Use of pursed-lip breathing
- ANSWER A, B, D
5. Which diagnostic test would provide the nurse with the most specific
information to evaluate the effectiveness of interventions for a patient with
ventilatory failure?
a. Chest x-ray
b. O2 saturation
c. Arterial blood gases
d. Central venous pressure
- ANSWER C
6. A patient who is experiencing an acute asthma attack is admitted to the
emergency department. Which assessment would the nurse complete first?
A. Measure forced expiratory volume (FEV) flow rate
B. Ask about inhaled corticosteroid use
C. Listen to the patient’s breath sounds
,D. Determine when the dyspnea started.
- ANSWER C; Assessment of the patient's breath sounds will help determine
how effectively the patient is ventilating and whether rapid intubation may be
necessary
7. The emergency department nurse is evaluating the outcomes for a patient who
has received treatment during an asthma attack. Which assessment finding is
the best indicator that the therapy has been effective?
a. Respiratory rate is 16 breaths/min.
b. O2 saturation is >90%.
c. Accessory muscle use has decreased.
d. No wheezes are audible.
- ANSWER B
8. Which statement by the nurse to the patient's caregiver about the purpose of
positive end-expiratory pressure (PEEP) is accurate?
a. "PEEP will push more air into the lungs during inhalation."
b. "PEEP allows the breathing machine to deliver 100% O2 to the lungs."
c. "PEEP prevents the lung air sacs from collapsing during exhalation."
d. "PEEP will prevent lung damage while the patient is on the ventilator."
- ANSWER C
9. The purpose of adding PEEP to positive pressure ventilation is to
a. increase functional residual capacity and improve oxygenation.
b. increase FIO2 to try to help wean the patient and avoid O2 toxicity.
c. determine if the patient can be weaned and avoid pneumomediastinum.
d. determine if the patient is in synchrony with the ventilator or needs to be
paralyzed.
- ANSWER A
, 10. Which intervention is most likely to prevent or limit volutrauma in the patient
with ARDS who is mechanically ventilated?
a. Increasing PEEP
b. Increasing the inspiratory flow rate
c. Use of low tidal volume ventilation
d. Suctioning the patient via endotracheal tube hourly
- ANSWER C
11. Which action would the nurse take to verify the correct placement of an oral
endotracheal tube (ET) immediately after insertion and before securing the tube?
A. Auscultate for bilateral breath sounds.
B. Observe for symmetrical chest movement.
C. Obtain a portable chest x-ray.
D. Use an end-tidal CO2 monitor.
- ANSWER D
12. Which of the following diseases is not commonly classified under obstructive
lung disease?
Chronic Obstructive Pulmonary Disease (COPD)
Asthma
Bronchiectasis
Pulmonary Fibrosis
- ANSWER Pulmonary Fibrosis
13. The respiratory therapist in the ICU is called to assess a patient with ARDS. The
patient is SOB. The x-ray shows "white" chest radiograph and the PAO2 is 60 mm
Hg on an FiO2 of 100%. Which of the following is indicated?
Shunting
Alveolar hyperventilation
Decreased CO2
Perfusion impairment
- ANSWER Shunting