Question 1

The nurse is assessing the exhaled tidal volume (EVT)in a mechanically ventilated patient.The rationale for this assessment is to

Accepted Answer

A)  assess for tension pneumothorax. 
B)  assess the level of positive end-expiratory pressure. 
C)  compare the tidal volume delivered with the tidal volume prescribed. 
D)  determine the patient's work of breathing. 
A)  assess for tension pneumothorax. 
B)  assess the level of positive end-expiratory pressure. 
C)  compare the tidal volume delivered with the tidal volume prescribed. 
D)  determine the patient's work of breathing.

Question 2

A patient is having difficulty weaning from mechanical ventilation.The nurse assesses the patient for which potential cause of this difficult weaning?

Accepted Answer

A)  Cardiac output of 6 L/min. 
B)  Hemoglobin of 8 g/dL. 
C)  Negative sputum culture and sensitivity. 
D)  White blood cell count of 8000. 
A)  Cardiac output of 6 L/min. 
B)  Hemoglobin of 8 g/dL. 
C)  Negative sputum culture and sensitivity. 
D)  White blood cell count of 8000.

Question 3

Pulse oximetry measures

Accepted Answer

A)  arterial blood gases. 
B)  hemoglobin values. 
C)  oxygen consumption. 
D)  oxygen saturation. 
A)  arterial blood gases. 
B)  hemoglobin values. 
C)  oxygen consumption. 
D)  oxygen saturation.

Question 4

A PaCO2 of 48 mm Hg is associated with

Accepted Answer

A)  hyperventilation. 
B)  hypoventilation. 
C)  increased absorption of O2. 
D)  increased excretion of HCO3. 
A)  hyperventilation. 
B)  hypoventilation. 
C)  increased absorption of O2. 
D)  increased excretion of HCO3.

Question 5

The nurse notes that the patient's arterial blood gas levels indicate hypoxemia.The patient is not intubated and has a respiratory rate of 22 breaths/min.The nurse's first intervention to relieve hypoxemia is to:

Accepted Answer

A)  call the provider for an emergency intubation procedure. 
B)  obtain an order for bilevel positive airway pressure (BiPAP). 
C)  notify the provider of values and obtain a prescription for oxygen. 
D)  suction secretions from the oropharynx. 
A)  call the provider for an emergency intubation procedure. 
B)  obtain an order for bilevel positive airway pressure (BiPAP). 
C)  notify the provider of values and obtain a prescription for oxygen. 
D)  suction secretions from the oropharynx.

Question 6

A patient has coronary artery bypass graft surgery and is transported to the surgical intensive care unit at noon and is placed on mechanical ventilation.Interpret the initial arterial blood gas levels
PH: 7.31
PaCO2: 48 mm Hg
Bicarbonate: 22 mEq/L
PaO2: 115 mm Hg
O2 saturation: 99%

Accepted Answer

A)  Normal arterial blood gas levels with a high oxygen level 
B)  Partly compensated respiratory acidosis; normal oxygen 
C)  Uncompensated metabolic acidosis with high oxygen levels 
D)  Uncompensated respiratory acidosis; hyperoxygenated 
A)  Normal arterial blood gas levels with a high oxygen level 
B)  Partly compensated respiratory acidosis; normal oxygen 
C)  Uncompensated metabolic acidosis with high oxygen levels 
D)  Uncompensated respiratory acidosis; hyperoxygenated

Question 7

A mode of pressure-targeted ventilation that provides positive pressure to decrease the workload of spontaneous breathing through the endotracheal tube is

Accepted Answer

A)  continuous positive airway pressure. 
B)  positive end-expiratory pressure. 
C)  pressure support ventilation. 
D)  T-piece adapter. 
A)  continuous positive airway pressure. 
B)  positive end-expiratory pressure. 
C)  pressure support ventilation. 
D)  T-piece adapter.

Question 8

The provider orders the following mechanical ventilation settings for a patient who weighs 75 kg.The patient's spontaneous respiratory rate is 22 breaths/min.Which arterial blood gas abnormality may occur if the patient continues to be tachypneic at these ventilator settings?
Settings:
Tidal volume: 600 mL (8 mL per kg)
FiO2: 0.5
Respiratory rate: 14 breaths/min
Mode assist/control
Positive end-expiratory pressure: 10 cm H2O

Accepted Answer

A)  Metabolic acidosis 
B)  Metabolic alkalosis 
C)  Respiratory acidosis 
D)  Respiratory alkalosis 
A)  Metabolic acidosis 
B)  Metabolic alkalosis 
C)  Respiratory acidosis 
D)  Respiratory alkalosis

Question 9

Current guidelines recommend the oral route for endotracheal intubation.The rationale for this recommendation is that nasotracheal intubation is associated with a greater risk for

Accepted Answer

A)  basilar skull fracture. 
B)  cervical hyperextension. 
C)  impaired ability to "mouth" words. 
D)  sinusitis and infection. 
A)  basilar skull fracture. 
B)  cervical hyperextension. 
C)  impaired ability to "mouth" words. 
D)  sinusitis and infection.

Question 10

A patient presents to the emergency department demonstrating agitation and complaining of numbness and tingling in his fingers.His arterial blood gas levels reveal the following: pH 7.51,PaCO2 25,HCO3 25.The nurse interprets these blood gas values as:

Accepted Answer

A)  compensated metabolic alkalosis. 
B)  normal values. 
C)  uncompensated respiratory acidosis. 
D)  uncompensated respiratory alkalosis. 
A)  compensated metabolic alkalosis. 
B)  normal values. 
C)  uncompensated respiratory acidosis. 
D)  uncompensated respiratory alkalosis.

Question 11

Positive end-expiratory pressure (PEEP)is a mode of ventilatory assistance that produces the following condition:

Accepted Answer

A)  Each time the patient initiates a breath, the ventilator delivers a full preset tidal volume. 
B)  For each spontaneous breath taken by the patient, the tidal volume is determined by the patient's ability to generate negative pressure. 
C)  The patient must have a respiratory drive, or no breaths will be delivered. 
D)  There is pressure remaining in the lungs at the end of expiration that is measured in cm H2O. 
A)  Each time the patient initiates a breath, the ventilator delivers a full preset tidal volume. 
B)  For each spontaneous breath taken by the patient, the tidal volume is determined by the patient's ability to generate negative pressure. 
C)  The patient must have a respiratory drive, or no breaths will be delivered. 
D)  There is pressure remaining in the lungs at the end of expiration that is measured in cm H2O.

Question 12

A patient is admitted to the cardiac surgical intensive care unit after cardiac surgery with the following arterial blood gas (ABG)levels.What action by the nurse is best?
PH: 7.4
PaCO2: 40 mm Hg
Bicarbonate: 24 mEq/L
PaO2: 95 mm Hg
O2 saturation: 97%
Respirations: 20 breaths/min

Accepted Answer

A)  Call the provider to request rapid intubation. 
B)  Document the findings and continue to monitor. 
C)  Request that another set of ABGs be drawn and run. 
D)  Correlate the patient's O2 saturation with the ABGs. 
A)  Call the provider to request rapid intubation. 
B)  Document the findings and continue to monitor. 
C)  Request that another set of ABGs be drawn and run. 
D)  Correlate the patient's O2 saturation with the ABGs.

Question 13

The nurse is caring for a patient whose ventilator settings include 15 cm H2O of positive end-expiratory pressure (PEEP).What complication does the nurse assess the patient for?

Accepted Answer

A)  Fluid overload secondary to decreased venous return 
B)  High cardiac index secondary to more efficient ventricular function 
C)  Hypoxemia secondary to prolonged positive pressure at expiration 
D)  Low cardiac output secondary to increased intrathoracic pressure 
A)  Fluid overload secondary to decreased venous return 
B)  High cardiac index secondary to more efficient ventricular function 
C)  Hypoxemia secondary to prolonged positive pressure at expiration 
D)  Low cardiac output secondary to increased intrathoracic pressure

Question 14

Which of the following devices is best suited to deliver 65% oxygen to a patient who is spontaneously breathing?

Accepted Answer

A)  Face mask with non-rebreathing reservoir 
B)  Low-flow nasal cannula 
C)  Simple face mask 
D)  Venturi mask 
A)  Face mask with non-rebreathing reservoir 
B)  Low-flow nasal cannula 
C)  Simple face mask 
D)  Venturi mask

Question 15

The nurse is caring for a patient who is mechanically ventilated.As part of the nursing care,the nurse understands that

Accepted Answer

A)  communication with intubated patients is often difficult. 
B)  controlled ventilation is the preferred mode for most patients. 
C)  patients with chronic obstructive pulmonary disease wean easily from mechanical ventilation. 
D)  wrist restraints are applied to all patients to avoid self-extubation. 
A)  communication with intubated patients is often difficult. 
B)  controlled ventilation is the preferred mode for most patients. 
C)  patients with chronic obstructive pulmonary disease wean easily from mechanical ventilation. 
D)  wrist restraints are applied to all patients to avoid self-extubation.

Question 16

When assessing the patient for hypoxemia,the nurse recognizes that an early sign of the effect of hypoxemia on the cardiovascular system is

Accepted Answer

A)  heart block. 
B)  restlessness. 
C)  tachycardia. 
D)  tachypnea. 
A)  heart block. 
B)  restlessness. 
C)  tachycardia. 
D)  tachypnea.

The nurse is assessing the exhaled tidal volume (EV_T)in a mechanically ventilated patient.The rationale for this assessment is to

A patient is having difficulty weaning from mechanical ventilation.The nurse assesses the patient for which potential cause of this difficult weaning?

Pulse oximetry measures

A PaCO₂of 48 mm Hg is associated with

The nurse notes that the patient's arterial blood gas levels indicate hypoxemia.The patient is not intubated and has a respiratory rate of 22 breaths/min.The nurse's first intervention to relieve hypoxemia is to:

A patient has coronary artery bypass graft surgery and is transported to the surgical intensive care unit at noon and is placed on mechanical ventilation.Interpret the initial arterial blood gas levels PH: 7.31 PaCO₂: 48 mm Hg Bicarbonate: 22 mEq/L PaO₂: 115 mm Hg O₂ saturation: 99%

A mode of pressure-targeted ventilation that provides positive pressure to decrease the workload of spontaneous breathing through the endotracheal tube is

Current guidelines recommend the oral route for endotracheal intubation.The rationale for this recommendation is that nasotracheal intubation is associated with a greater risk for

A patient presents to the emergency department demonstrating agitation and complaining of numbness and tingling in his fingers.His arterial blood gas levels reveal the following: pH 7.51,PaCO₂ 25,HCO₃ 25.The nurse interprets these blood gas values as:

Positive end-expiratory pressure (PEEP)is a mode of ventilatory assistance that produces the following condition:

A patient is admitted to the cardiac surgical intensive care unit after cardiac surgery with the following arterial blood gas (ABG)levels.What action by the nurse is best? PH: 7.4 PaCO₂: 40 mm Hg Bicarbonate: 24 mEq/L PaO₂: 95 mm Hg O₂ saturation: 97% Respirations: 20 breaths/min

The nurse is caring for a patient whose ventilator settings include 15 cm H₂O of positive end-expiratory pressure (PEEP).What complication does the nurse assess the patient for?

Which of the following devices is best suited to deliver 65% oxygen to a patient who is spontaneously breathing?

The nurse is caring for a patient who is mechanically ventilated.As part of the nursing care,the nurse understands that

When assessing the patient for hypoxemia,the nurse recognizes that an early sign of the effect of hypoxemia on the cardiovascular system is

Overview of Critical Care Nursing

Patient and Family Response to the Critical Care Experience

Ethical and Legal Issues in Critical Care Nursing

End-of-Life Care and Palliative Care in Critical Care Settings

Comfort and Sedation

Nutritional Support

Dysrhythmia Interpretation and Management

Hemodynamic Monitoring

Rapid Response Teams and Code Management

Organ Donation

Shock,Sepsis,and Multiple Organ Dysfunction Syndrome

Cardiovascular Alterations

Nervous System Alterations

Acute Respiratory Failure

Acute Kidney Injury

Hematological and Immune Disorders

Gastrointestinal Alterations

Endocrine Alterations

Trauma and Surgical Management

Burns

Filters

Exam 9: Ventilatory Assistance

The nurse is assessing the exhaled tidal volume (EVT)in a mechanically ventilated patient.The rationale for this assessment is to

A patient is having difficulty weaning from mechanical ventilation.The nurse assesses the patient for which potential cause of this difficult weaning?

Pulse oximetry measures

A PaCO2 of 48 mm Hg is associated with

The nurse notes that the patient's arterial blood gas levels indicate hypoxemia.The patient is not intubated and has a respiratory rate of 22 breaths/min.The nurse's first intervention to relieve hypoxemia is to:

A patient has coronary artery bypass graft surgery and is transported to the surgical intensive care unit at noon and is placed on mechanical ventilation.Interpret the initial arterial blood gas levels PH: 7.31 PaCO2: 48 mm Hg Bicarbonate: 22 mEq/L PaO2: 115 mm Hg O2 saturation: 99%

A mode of pressure-targeted ventilation that provides positive pressure to decrease the workload of spontaneous breathing through the endotracheal tube is

Current guidelines recommend the oral route for endotracheal intubation.The rationale for this recommendation is that nasotracheal intubation is associated with a greater risk for

A patient presents to the emergency department demonstrating agitation and complaining of numbness and tingling in his fingers.His arterial blood gas levels reveal the following: pH 7.51,PaCO2 25,HCO3 25.The nurse interprets these blood gas values as:

Positive end-expiratory pressure (PEEP)is a mode of ventilatory assistance that produces the following condition:

A patient is admitted to the cardiac surgical intensive care unit after cardiac surgery with the following arterial blood gas (ABG)levels.What action by the nurse is best? PH: 7.4 PaCO2: 40 mm Hg Bicarbonate: 24 mEq/L PaO2: 95 mm Hg O2 saturation: 97% Respirations: 20 breaths/min

The nurse is caring for a patient whose ventilator settings include 15 cm H2O of positive end-expiratory pressure (PEEP).What complication does the nurse assess the patient for?

Which of the following devices is best suited to deliver 65% oxygen to a patient who is spontaneously breathing?

The nurse is caring for a patient who is mechanically ventilated.As part of the nursing care,the nurse understands that

When assessing the patient for hypoxemia,the nurse recognizes that an early sign of the effect of hypoxemia on the cardiovascular system is

Overview of Critical Care Nursing

Patient and Family Response to the Critical Care Experience

Ethical and Legal Issues in Critical Care Nursing

End-of-Life Care and Palliative Care in Critical Care Settings

Comfort and Sedation

Nutritional Support

Dysrhythmia Interpretation and Management

Hemodynamic Monitoring

Rapid Response Teams and Code Management

Organ Donation

Shock,Sepsis,and Multiple Organ Dysfunction Syndrome

Cardiovascular Alterations

Nervous System Alterations

Acute Respiratory Failure

Acute Kidney Injury

Hematological and Immune Disorders

Gastrointestinal Alterations

Endocrine Alterations

Trauma and Surgical Management

Burns

Filters

The nurse is assessing the exhaled tidal volume (EV_T)in a mechanically ventilated patient.The rationale for this assessment is to

A PaCO₂of 48 mm Hg is associated with

A patient has coronary artery bypass graft surgery and is transported to the surgical intensive care unit at noon and is placed on mechanical ventilation.Interpret the initial arterial blood gas levels PH: 7.31 PaCO₂: 48 mm Hg Bicarbonate: 22 mEq/L PaO₂: 115 mm Hg O₂ saturation: 99%

A patient presents to the emergency department demonstrating agitation and complaining of numbness and tingling in his fingers.His arterial blood gas levels reveal the following: pH 7.51,PaCO₂ 25,HCO₃ 25.The nurse interprets these blood gas values as:

A patient is admitted to the cardiac surgical intensive care unit after cardiac surgery with the following arterial blood gas (ABG)levels.What action by the nurse is best? PH: 7.4 PaCO₂: 40 mm Hg Bicarbonate: 24 mEq/L PaO₂: 95 mm Hg O₂ saturation: 97% Respirations: 20 breaths/min

The nurse is caring for a patient whose ventilator settings include 15 cm H₂O of positive end-expiratory pressure (PEEP).What complication does the nurse assess the patient for?