Question 1

Aspiration can best be prevented by

Accepted Answer

A)  observing the amount given in the tube feeding. 
B)  assessing the patient's level of consciousness. 
C)  encouraging the patient to cough and to breathe deeply. 
D)  positioning a patient in a semirecumbent position. 
A)  observing the amount given in the tube feeding. 
B)  assessing the patient's level of consciousness. 
C)  encouraging the patient to cough and to breathe deeply. 
D)  positioning a patient in a semirecumbent position. D

Question 2

Which of the following findings confirms the diagnosis of a PE?

Accepted Answer

A)  Low-probability V/Q scan 
B)  Negative pulmonary angiogram 
C)  High-probability V/Q scan 
D)  Absence of vascular markings on the chest radiograph 
A)  Low-probability V/Q scan 
B)  Negative pulmonary angiogram 
C)  High-probability V/Q scan 
D)  Absence of vascular markings on the chest radiograph C

Question 3

Patients with left-sided pneumonia may benefit from placing them in which of the following positions?

Accepted Answer

A)  Reverse Trendelenburg 
B)  Supine 
C)  On the left side 
D)  On the right side 
A)  Reverse Trendelenburg 
B)  Supine 
C)  On the left side 
D)  On the right side D

Question 4

The major hemodynamic consequence of a massive pulmonary embolus is

Accepted Answer

A)  increased systemic vascular resistance leading to left heart failure. 
B)  pulmonary hypertension leading to right heart failure. 
C)  portal vein blockage leading to ascites. 
D)  embolism to the internal carotids leading to a stroke. 
A)  increased systemic vascular resistance leading to left heart failure. 
B)  pulmonary hypertension leading to right heart failure. 
C)  portal vein blockage leading to ascites. 
D)  embolism to the internal carotids leading to a stroke.

Question 5

Weaning methods that are used in combination with each other include

Accepted Answer

A)  SIMV with CPAP. 
B)  SIMV with PSV. 
C)  CPAP with PSV. 
D)  T-piece and PSV. 
E)  PEEP with CPAP. 
A)  SIMV with CPAP. 
B)  SIMV with PSV. 
C)  CPAP with PSV. 
D)  T-piece and PSV. 
E)  PEEP with CPAP.

Question 6

A patient was admitted to the critical care unit after a left pneumonectomy.The patient is receiving 40% oxygen via a simple facemask.The morning chest radiography study reveals right lower lobe pneumonia.After eating breakfast, the patient suddenly vomits and aspirates.Which test would the nurse expect the health care provider to order to identify the infectious pathogen?

Accepted Answer

A)  CBC with differential 
B)  Wound culture of surgical site 
C)  Sputum Gram stain and culture 
D)  Urine specimen 
A)  CBC with differential 
B)  Wound culture of surgical site 
C)  Sputum Gram stain and culture 
D)  Urine specimen

Question 7

A pneumothorax greater than 15% requires

Accepted Answer

A)  systemic antibiotics to treat the inflammatory response. 
B)  an occlusive dressing to equalize lung pressures. 
C)  interventions to evacuate the air from the pleural space and facilitate re-expansion of the collapsed lung. 
D)  mechanical ventilation to assist with re-expansion of the collapsed lung. 
A)  systemic antibiotics to treat the inflammatory response. 
B)  an occlusive dressing to equalize lung pressures. 
C)  interventions to evacuate the air from the pleural space and facilitate re-expansion of the collapsed lung. 
D)  mechanical ventilation to assist with re-expansion of the collapsed lung.

Question 8

A patient has been admitted to the critical care unit with the diagnosis of acute respiratory distress syndrome (ARDS).Arterial blood gasses (ABGs)revealed an elevated pH and decreased PaCO2.The patient is becoming fatigued, and the health care provider orders a repeat ABG.The nurse anticipates the following results

Accepted Answer

A)  elevated pH and decreased PaCO2 
B)  elevated pH and elevated PaCO2 
C)  decreased pH and decreased PaCO2 
D)  decreased pH and elevated PaCO2 
A)  elevated pH and decreased PaCO2 
B)  elevated pH and elevated PaCO2 
C)  decreased pH and decreased PaCO2 
D)  decreased pH and elevated PaCO2

Question 9

Which of the following therapeutic measures would be the most effective in treating hypoxemia in the presence of intrapulmonary shunting associated with ARDS?

Accepted Answer

A)  Sedating the patient to blunt noxious stimuli 
B)  Increasing the FiO2 on the ventilator 
C)  Administering positive-end expiratory pressure (PEEP) 
D)  Restricting fluids to 500 mL per shift 
A)  Sedating the patient to blunt noxious stimuli 
B)  Increasing the FiO2 on the ventilator 
C)  Administering positive-end expiratory pressure (PEEP) 
D)  Restricting fluids to 500 mL per shift

Question 10

Nursing management of the patient with acute lung failure includes which of the following interventions?

Accepted Answer

A)  Positioning the patient with the least affected side down 
B)  Providing adequate rest between treatments 
C)  Performing percussion and postural drainage every 4 hours 
D)  Controlling fever 
E)  Pharmaceutical medications to control anxiety 
A)  Positioning the patient with the least affected side down 
B)  Providing adequate rest between treatments 
C)  Performing percussion and postural drainage every 4 hours 
D)  Controlling fever 
E)  Pharmaceutical medications to control anxiety

Question 11

Which of the following diagnostic criteria is indicative of ARDS?

Accepted Answer

A)  Radiologic evidence of bibasilar atelectasis 
B)  PaO2/FiO2 ratio less than or equal to 200 mm Hg 
C)  Pulmonary artery wedge pressure greater than 18 mm Hg 
D)  Increased static and dynamic compliance 
A)  Radiologic evidence of bibasilar atelectasis 
B)  PaO2/FiO2 ratio less than or equal to 200 mm Hg 
C)  Pulmonary artery wedge pressure greater than 18 mm Hg 
D)  Increased static and dynamic compliance

Question 12

A patient was admitted to the critical care unit after a left pneumonectomy.The patient is receiving 40% oxygen via a simple facemask.The morning chest radiography study reveals right lower lobe pneumonia.After eating breakfast, the patient suddenly vomits and aspirates.The patient becomes agitated, has decreased level of consciousness, and has an inability to maintain saturation.The nurse expects the next action will include

Accepted Answer

A)  placing the patient on a mechanical ventilator. 
B)  change in antibiotics to control infection. 
C)  suctioning and repositioning. 
D)  administering a sedative to control anxiety. 
A)  placing the patient on a mechanical ventilator. 
B)  change in antibiotics to control infection. 
C)  suctioning and repositioning. 
D)  administering a sedative to control anxiety.

Question 13

Psychologic factors that may contribute to long-term mechanical ventilation dependence include

Accepted Answer

A)  fear. 
B)  delirium. 
C)  lack of confidence in the ability to breathe. 
D)  depression. 
E)  trust in the staff so the patient displays a lack of effort. 
A)  fear. 
B)  delirium. 
C)  lack of confidence in the ability to breathe. 
D)  depression. 
E)  trust in the staff so the patient displays a lack of effort.

Question 14

A patient was admitted to the critical care unit after a left pneumonectomy.The patient is receiving 40% oxygen via a simple facemask.The morning chest radiography study reveals right lower lobe pneumonia.After eating breakfast, the patient suddenly vomits and aspirates.The first action that should be taken after the patient's aspiration event is

Accepted Answer

A)  lavaging his airway with normal saline. 
B)  placing him on his back in a semi-Fowler position. 
C)  administering manual ventilations with a resuscitation bag. 
D)  suctioning his airway. 
A)  lavaging his airway with normal saline. 
B)  placing him on his back in a semi-Fowler position. 
C)  administering manual ventilations with a resuscitation bag. 
D)  suctioning his airway.

Question 15

Supplemental oxygen administration is usually effective in treating hypoxemia related to

Accepted Answer

A)  physiologic shunting. 
B)  dead space ventilation. 
C)  hypercapnia with a PaCO2 of 35 mm Hg. 
D)  ventilation/perfusion mismatching. 
A)  physiologic shunting. 
B)  dead space ventilation. 
C)  hypercapnia with a PaCO2 of 35 mm Hg. 
D)  ventilation/perfusion mismatching.

Question 16

The most common presenting signs and symptoms associated with PEs are

Accepted Answer

A)  tachycardia and tachypnea. 
B)  hemoptysis and evidence of deep vein thromboses. 
C)  apprehension and dyspnea. 
D)  right ventricular failure and fever 
A)  tachycardia and tachypnea. 
B)  hemoptysis and evidence of deep vein thromboses. 
C)  apprehension and dyspnea. 
D)  right ventricular failure and fever

Question 17

Depending on the patient's risk for the recurrence of PE, a patient may be placed on warfarin for

Accepted Answer

A)  1 to 3 months. 
B)  3 to 6 months. 
C)  3 to 12 months. 
D)  12 to 36 months. 
A)  1 to 3 months. 
B)  3 to 6 months. 
C)  3 to 12 months. 
D)  12 to 36 months.

Question 18

The two most common causes of hospital-acquired pneumonia in the United States are

Accepted Answer

A)  Staphylococcus aureus and Pseudomonas aeruginosa 
B)  Escherichia coli and Haemophilus influenzae 
C)  methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa 
D)  Klebsiella spp. and Enterobacter spp. 
A)  Staphylococcus aureus and Pseudomonas aeruginosa 
B)  Escherichia coli and Haemophilus influenzae 
C)  methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa 
D)  Klebsiella spp. and Enterobacter spp.

Question 19

Which of the following nursing interventions should be used to optimize oxygenation and ventilation in the patient with acute respiratory failure?

Accepted Answer

A)  Provide adequate rest and recovery time between procedures. 
B)  Position the patient with the good lung up. 
C)  Suction the patient every hour. 
D)  Avoid hyperventilating the patient. 
A)  Provide adequate rest and recovery time between procedures. 
B)  Position the patient with the good lung up. 
C)  Suction the patient every hour. 
D)  Avoid hyperventilating the patient.

Question 20

A patient was admitted to the critical care unit after a left pneumonectomy.The patient is receiving 40% oxygen via a simple facemask.The morning chest radiography study reveals right lower lobe pneumonia.After eating breakfast, the patient suddenly vomits and aspirates.The single most important measure to prevent the spread of infection between staff and patients is

Accepted Answer

A)  respiratory isolation. 
B)  hand washing. 
C)  use of PPE. 
D)  antibiotics. 
A)  respiratory isolation. 
B)  hand washing. 
C)  use of PPE. 
D)  antibiotics.

Exam 15: Pulmonary Disorders

Aspiration can best be prevented by

Which of the following findings confirms the diagnosis of a PE?

Patients with left-sided pneumonia may benefit from placing them in which of the following positions?

The major hemodynamic consequence of a massive pulmonary embolus is

Weaning methods that are used in combination with each other include

A pneumothorax greater than 15% requires

Which of the following therapeutic measures would be the most effective in treating hypoxemia in the presence of intrapulmonary shunting associated with ARDS?

Nursing management of the patient with acute lung failure includes which of the following interventions?

Which of the following diagnostic criteria is indicative of ARDS?

Psychologic factors that may contribute to long-term mechanical ventilation dependence include

Supplemental oxygen administration is usually effective in treating hypoxemia related to

The most common presenting signs and symptoms associated with PEs are

Depending on the patient's risk for the recurrence of PE, a patient may be placed on warfarin for

The two most common causes of hospital-acquired pneumonia in the United States are

Which of the following nursing interventions should be used to optimize oxygenation and ventilation in the patient with acute respiratory failure?

Caring for the Critically Ill Patient

Ethical and Legal Issues

Patient and Family Education

Psychosocial and Spiritual Alterations and Management

Sleep Alterations

Nutritional Alterations

Gerontological Alterations

Pain and Pain Management

Sedation, Agitation and Delirium Management

End of Life Care

Cardiovascular Clinical Assessment and Diagnostic Procedures

Cardiovascular Disorders

Cardiovascular Therapeutic Management

Pulmonary Clinical Assessment and Diagnostic Procedures

Pulmonary Therapeutic Management

Neurologic Clinical Assessment and Diagnostic Procedures

Neurologic Disorders and Therapeutic Management

Kidney Clinical Assessment and Diagnostic Procedures

Kidney Disorders and Therapeutic Management

Gastrointestinal Clinical Assessment and Diagnostic Procedures

Gastrointestinal Disorders and Therapeutic Management

Endocrine Clinical Assessment and Diagnostic Procedures

Endocrine Disorders and Therapeutic Management

Trauma

Shock, Sepsis, and Multiple Organ Dysfunction Syndrome

Hematologic Disorders and Oncologic Emergencies

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