NUR 265 Exam 2: (Latest 2026/2027 Update) Mechanical Ventilation,
Pulmonary Emergencies, Endocrine & Acid-Base Disorders | Q&A |
Grade A | 100% Correct (Verified Answers)
Complete Review: ET Tube Confirmation, Vent Modes, VAP Prevention, PE, Tension Pneumothorax, ARDS,
Pheochromocytoma, Addison's vs Cushing's, DKA & HHS
SUBJECT SOURCE FORMAT
Medical-Surgical Nursing / NUR 265 Galen Exam 2 Study Guide 2026/2027 Q&A Guide with Rationale
Q1
In what order should ET tube placement be confirmed?
CORRECT ANSWER
ETCO2 (20-40 mmHg) → chest symmetry → auscultate left/right/abdomen → chest X‑ray
RATIONALE
• ETCO2 is most immediate and reliable confirmation of tube placement in the trachea.
• Equal breath sounds bilaterally and absent breath sounds over the stomach.
• Final confirmation with chest X‑ray (tube above carina).
Q2
A patient is on a ventilator where the machine delivers a full set number of breaths regardless of the
patient's effort. This mode is called:
CORRECT ANSWER
Assist/Control (A/C) – vent does everything
RATIONALE
• A/C: machine delivers preset breaths even if patient tries to breathe faster; may cause hyperventilation.
• SIMV: patient initiates breaths, vent assists with preset breaths; allows respiratory muscle conditioning.
• PEEP: positive end‑expiratory pressure keeps alveoli open.
, Q3
A high‑pressure alarm sounds on the ventilator. What are possible causes?
CORRECT ANSWER
Blocked airway (mucus plug, kinked tube), coughing, tension pneumothorax, anxiety/pain, decreased lung
compliance (ARDS)
RATIONALE
• Always assess the patient first, not the monitor.
• High pressure = resistance to airflow (obstruction, bronchospasm, pneumothorax).
• Interventions: suction, reposition tube, sedate for anxiety/pain.
Q4
When is it acceptable to shut off a ventilator alarm?
CORRECT ANSWER
NEVER – alarms are safety features; silence only briefly after assessing patient
RATIONALE
• Alarms indicate disconnection, obstruction, or desaturation.
• If patient is in respiratory distress: call for help, disconnect vent, bag patient, then reassess.
• Nurse can only use SILENCE, RESTART, and 100% O2 buttons.
Q5
List evidence‑based interventions to prevent ventilator‑associated pneumonia (VAP).
CORRECT ANSWER
Remove water from circuits, HOB ≥30°, turn Q2h, suction, oral care Q2h, prevent aspiration, lip
moisturizer, percussion
RATIONALE
• Oral care with chlorhexidine reduces bacterial load.
• HOB elevation prevents microaspiration of gastric contents.
• Subglottic suctioning ET tubes also recommended.
Pulmonary Emergencies, Endocrine & Acid-Base Disorders | Q&A |
Grade A | 100% Correct (Verified Answers)
Complete Review: ET Tube Confirmation, Vent Modes, VAP Prevention, PE, Tension Pneumothorax, ARDS,
Pheochromocytoma, Addison's vs Cushing's, DKA & HHS
SUBJECT SOURCE FORMAT
Medical-Surgical Nursing / NUR 265 Galen Exam 2 Study Guide 2026/2027 Q&A Guide with Rationale
Q1
In what order should ET tube placement be confirmed?
CORRECT ANSWER
ETCO2 (20-40 mmHg) → chest symmetry → auscultate left/right/abdomen → chest X‑ray
RATIONALE
• ETCO2 is most immediate and reliable confirmation of tube placement in the trachea.
• Equal breath sounds bilaterally and absent breath sounds over the stomach.
• Final confirmation with chest X‑ray (tube above carina).
Q2
A patient is on a ventilator where the machine delivers a full set number of breaths regardless of the
patient's effort. This mode is called:
CORRECT ANSWER
Assist/Control (A/C) – vent does everything
RATIONALE
• A/C: machine delivers preset breaths even if patient tries to breathe faster; may cause hyperventilation.
• SIMV: patient initiates breaths, vent assists with preset breaths; allows respiratory muscle conditioning.
• PEEP: positive end‑expiratory pressure keeps alveoli open.
, Q3
A high‑pressure alarm sounds on the ventilator. What are possible causes?
CORRECT ANSWER
Blocked airway (mucus plug, kinked tube), coughing, tension pneumothorax, anxiety/pain, decreased lung
compliance (ARDS)
RATIONALE
• Always assess the patient first, not the monitor.
• High pressure = resistance to airflow (obstruction, bronchospasm, pneumothorax).
• Interventions: suction, reposition tube, sedate for anxiety/pain.
Q4
When is it acceptable to shut off a ventilator alarm?
CORRECT ANSWER
NEVER – alarms are safety features; silence only briefly after assessing patient
RATIONALE
• Alarms indicate disconnection, obstruction, or desaturation.
• If patient is in respiratory distress: call for help, disconnect vent, bag patient, then reassess.
• Nurse can only use SILENCE, RESTART, and 100% O2 buttons.
Q5
List evidence‑based interventions to prevent ventilator‑associated pneumonia (VAP).
CORRECT ANSWER
Remove water from circuits, HOB ≥30°, turn Q2h, suction, oral care Q2h, prevent aspiration, lip
moisturizer, percussion
RATIONALE
• Oral care with chlorhexidine reduces bacterial load.
• HOB elevation prevents microaspiration of gastric contents.
• Subglottic suctioning ET tubes also recommended.
