Question 1

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.

Question 2

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 3

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 4

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 5

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 6

A patient's endotracheal tube is not secured tightly.The respiratory care practitioner assists the nurse in taping the tube.After the tube is retaped,the nurse auscultates the patient's lungs and notes that the breath sounds over the left lung fields are absent.The nurse suspects that

Accepted Answer

A)  the endotracheal tube is in the right mainstem bronchus. 
B)  the patient has a left pneumothorax. 
C)  the patient has aspirated secretions during the procedure. 
D)  the stethoscope earpiece is clogged with wax. 
A)  the endotracheal tube is in the right mainstem bronchus. 
B)  the patient has a left pneumothorax. 
C)  the patient has aspirated secretions during the procedure. 
D)  the stethoscope earpiece is clogged with wax.

Question 7

The nurse is assisting with endotracheal intubation of the patient and recognizes that the procedure will be done in what order: _______________,_______________,_______________,_______________,_______________?
A) assess balloon on endotracheal tube for symmetry and leaks
B) assess lung fields for bilateral expansion
C) inflate balloon of endotracheal tube
D) insert endotracheal tube with laryngoscope and blade
E) suction oropharynx

Accepted Answer

A,E,D,C,B
Intubation is done systematica

Question 8

A patient is admitted to the cardiac surgical intensive care unit after cardiac surgery.Four hours after admission to the surgical intensive care unit at 4 PM,the patient has stable vital signs and normal arterial blood gases (ABGs),and is placed on a T-piece for ventilatory weaning.The following information pertains to the 1900 assessment.  
What interdisciplinary staff member does the nurse notify to assist in the care of this patient while preparing to give this patient diuretics?

Accepted Answer

A)  Respiratory therapist to adjust ventilator 
B)  Social worker to notify family 
C)  Phlebotomy to obtain another set of blood gasses 
D)  Nursing assistant to help reposition the patient 
A)  Respiratory therapist to adjust ventilator 
B)  Social worker to notify family 
C)  Phlebotomy to obtain another set of blood gasses 
D)  Nursing assistant to help reposition the patient

Question 9

One of the early signs of hypoxemia on the nervous system is

Accepted Answer

A)  cyanosis. 
B)  restlessness. 
C)  agitation. 
D)  tachypnea. 
A)  cyanosis. 
B)  restlessness. 
C)  agitation. 
D)  tachypnea.

Question 10

A patient is being mechanically ventilated in the synchronized intermittent mandatory ventilation mode at a rate of 4 breaths/min.His spontaneous respirations are 12 breaths/min.He receives a dose of morphine sulfate,and his spontaneous respirations decrease to 4 breaths/min.Which acid-base disturbance will likely occur?

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 11

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 12

The nurse is caring for a mechanically ventilated patient.The providers are considering performing a tracheostomy because the patient is having difficulty weaning from mechanical ventilation.Related to tracheostomy,the nurse understands which of the following?

Accepted Answer

A)  Patient outcomes are better if the tracheostomy is done within a week of intubation. 
B)  Percutaneous tracheostomy can be done safely at the bedside by the respiratory therapist. 
C)  Procedures performed in the operating room are associated with fewer complications. 
D)  The greatest risk after a percutaneous tracheostomy is accidental decannulation. 
A)  Patient outcomes are better if the tracheostomy is done within a week of intubation. 
B)  Percutaneous tracheostomy can be done safely at the bedside by the respiratory therapist. 
C)  Procedures performed in the operating room are associated with fewer complications. 
D)  The greatest risk after a percutaneous tracheostomy is accidental decannulation.

Question 13

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 14

A patient's ventilator settings are adjusted to treat hypoxemia.The fraction of inspired oxygen is increased from 0.6 to 0.7,and the positive end-expiratory pressure is increased from 10 to 15 cm H2O.Shortly after these adjustments,the nurse notes that the patient's blood pressure drops from 120/76 mm Hg to 90/60 mm Hg.What is the most likely cause of this decrease in blood pressure?

Accepted Answer

A)  Decrease in cardiac output 
B)  Hypovolemia 
C)  Increase in venous return 
D)  Oxygen toxicity 
A)  Decrease in cardiac output 
B)  Hypovolemia 
C)  Increase in venous return 
D)  Oxygen toxicity

Question 15

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 16

The nurse is caring for a mechanically ventilated patient and is charting outside the patient's room when the ventilator alarm sounds.What is the priority order for the nurse to complete these actions: _______________,_______________,_______________,_______________?
A) check quickly for possible causes of the alarm that can be fixed
B) after troubleshooting, connect back to mechanical ventilator and reassess patient
C) go to patient's bedside
D) manually ventilate the patient while getting a respiratory therapist

Accepted Answer

C,A,D,B
The nurse must quickly assess th

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

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%

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

Pulse oximetry measures

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

A patient's endotracheal tube is not secured tightly.The respiratory care practitioner assists the nurse in taping the tube.After the tube is retaped,the nurse auscultates the patient's lungs and notes that the breath sounds over the left lung fields are absent.The nurse suspects that

One of the early signs of hypoxemia on the nervous system is

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 mechanically ventilated patient.The providers are considering performing a tracheostomy because the patient is having difficulty weaning from mechanical ventilation.Related to tracheostomy,the nurse understands which of the following?

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

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:

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

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

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%

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

Pulse oximetry measures

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

A patient's endotracheal tube is not secured tightly.The respiratory care practitioner assists the nurse in taping the tube.After the tube is retaped,the nurse auscultates the patient's lungs and notes that the breath sounds over the left lung fields are absent.The nurse suspects that

One of the early signs of hypoxemia on the nervous system is

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 mechanically ventilated patient.The providers are considering performing a tracheostomy because the patient is having difficulty weaning from mechanical ventilation.Related to tracheostomy,the nurse understands which of the following?

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

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:

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

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 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

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: