NUR2790/NUR 2790 Exam 2 V2 |
Professional Nursing III / PN3 Q&A
with Rationale | Rasmussen
University
1. A patient with ARDS is receiving mechanical ventilation. The nurse notes the patient has
refractory hypoxemia. What does this term imply?
A. Oxygen levels improve rapidly with increased FiO2.
B. The patient is experiencing respiratory alkalosis.
C. Oxygen levels stay low despite high concentrations of supplemental oxygen.
D. The patient has a high pulmonary capillary wedge pressure.
Correct Answer: C
Expert Explanation: Refractory hypoxemia is a defining characteristic of ARDS where the
PaO2 does not increase significantly with supplemental oxygen. This happens because the
alveoli are filled with fluid or collapsed, leading to a right-to-left shunt. Nurses must
monitor these patients closely as they often require high levels of PEEP to maintain
oxygenation.
2. A nurse is interpreting ABG results: pH 7.28, PaCO2 50, HCO3 24. What is the correct
interpretation?
A. Metabolic Acidosis
,B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Correct Answer: B
Expert Explanation: The pH is less than 7.35, indicating acidosis, and the PaCO2 is greater
than 45, which identifies the cause as respiratory. Because the HCO3 is within the normal
range of 22-26, there is no compensation occurring yet. This condition is frequently seen in
patients with hypoventilation or COPD exacerbations.
3. Which rhythm is characterized by a ‘sawtooth’ pattern on the EKG?
A. Atrial Flutter
B. Ventricular Tachycardia
C. Atrial Fibrillation
D. First-Degree AV Block
Correct Answer: A
Expert Explanation: Atrial flutter is recognized by rapid, regular atrial waves that
resemble the teeth of a saw. The ventricular rate depends on the conduction ratio through
the AV node. Management often includes rate control and possible synchronized
cardioversion if the patient is unstable.
, 4. The high-pressure alarm on a ventilator sounds. What is the priority nursing action?
A. Check for a disconnected tube.
B. Assess the patient and check for airway obstruction.
C. Silence the alarm and wait for it to reset.
D. Increase the oxygen concentration immediately.
Correct Answer: B
Expert Explanation: High-pressure alarms indicate that the ventilator is meeting
resistance when delivering a breath, which could be caused by secretions or biting the tube.
The nurse should first assess the patient’s respiratory status and breath sounds. If the
cause is not immediately fixable, the nurse must manually ventilate the patient with an
Ambu bag.
5. A patient is admitted with a suspected Pulmonary Embolism. Which diagnostic test is the
gold standard for confirmation?
A. Chest X-ray
B. D-dimer
C. Electrocardiogram
D. CT Pulmonary Angiography (CTPA)
Correct Answer: D
Professional Nursing III / PN3 Q&A
with Rationale | Rasmussen
University
1. A patient with ARDS is receiving mechanical ventilation. The nurse notes the patient has
refractory hypoxemia. What does this term imply?
A. Oxygen levels improve rapidly with increased FiO2.
B. The patient is experiencing respiratory alkalosis.
C. Oxygen levels stay low despite high concentrations of supplemental oxygen.
D. The patient has a high pulmonary capillary wedge pressure.
Correct Answer: C
Expert Explanation: Refractory hypoxemia is a defining characteristic of ARDS where the
PaO2 does not increase significantly with supplemental oxygen. This happens because the
alveoli are filled with fluid or collapsed, leading to a right-to-left shunt. Nurses must
monitor these patients closely as they often require high levels of PEEP to maintain
oxygenation.
2. A nurse is interpreting ABG results: pH 7.28, PaCO2 50, HCO3 24. What is the correct
interpretation?
A. Metabolic Acidosis
,B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Correct Answer: B
Expert Explanation: The pH is less than 7.35, indicating acidosis, and the PaCO2 is greater
than 45, which identifies the cause as respiratory. Because the HCO3 is within the normal
range of 22-26, there is no compensation occurring yet. This condition is frequently seen in
patients with hypoventilation or COPD exacerbations.
3. Which rhythm is characterized by a ‘sawtooth’ pattern on the EKG?
A. Atrial Flutter
B. Ventricular Tachycardia
C. Atrial Fibrillation
D. First-Degree AV Block
Correct Answer: A
Expert Explanation: Atrial flutter is recognized by rapid, regular atrial waves that
resemble the teeth of a saw. The ventricular rate depends on the conduction ratio through
the AV node. Management often includes rate control and possible synchronized
cardioversion if the patient is unstable.
, 4. The high-pressure alarm on a ventilator sounds. What is the priority nursing action?
A. Check for a disconnected tube.
B. Assess the patient and check for airway obstruction.
C. Silence the alarm and wait for it to reset.
D. Increase the oxygen concentration immediately.
Correct Answer: B
Expert Explanation: High-pressure alarms indicate that the ventilator is meeting
resistance when delivering a breath, which could be caused by secretions or biting the tube.
The nurse should first assess the patient’s respiratory status and breath sounds. If the
cause is not immediately fixable, the nurse must manually ventilate the patient with an
Ambu bag.
5. A patient is admitted with a suspected Pulmonary Embolism. Which diagnostic test is the
gold standard for confirmation?
A. Chest X-ray
B. D-dimer
C. Electrocardiogram
D. CT Pulmonary Angiography (CTPA)
Correct Answer: D
