Question 1

Which of the following statements is true regarding venous thromboembolism (VTE)and pulmonary embolus (PE)?

Accepted Answer

A)  PE should be suspected in any patient who has unexplained cardiorespiratory complaints and risk factors for VTE. 
B)  Bradycardia and hyperventilation are classic symptoms of PE. 
C)  Dyspnea, chest pain, and hemoptysis occur in nearly all patients with PE. 
D)  Most critically ill patients are at low risk for VTE and PE and do not require prophylaxis. 
A)  PE should be suspected in any patient who has unexplained cardiorespiratory complaints and risk factors for VTE. 
B)  Bradycardia and hyperventilation are classic symptoms of PE. 
C)  Dyspnea, chest pain, and hemoptysis occur in nearly all patients with PE. 
D)  Most critically ill patients are at low risk for VTE and PE and do not require prophylaxis. A

Question 2

Which of the following treatments may be used to dissolve a thrombus that is lodged in the pulmonary artery?

Accepted Answer

A)  Aspirin 
B)  Embolectomy 
C)  Heparin 
D)  Thrombolytics 
A)  Aspirin 
B)  Embolectomy 
C)  Heparin 
D)  Thrombolytics D

Question 3

The nurse calculates the PaO2/FiO2 ratio for the following values: PaO2 is 78 mm Hg; FiO2 is 0.6 (60%).

Accepted Answer

A)  46.8; meets criteria for ARDS 
B)  130; meets criteria for ARDS 
C)  468; normal lung function 
D)  Not enough data to compute the ratio 
A)  46.8; meets criteria for ARDS 
B)  130; meets criteria for ARDS 
C)  468; normal lung function 
D)  Not enough data to compute the ratio B

Question 4

The nurse is assessing a patient.Which assessment would cue the nurse to the potential of acute respiratory distress syndrome (ARDS)?

Accepted Answer

A)  Increased oxygen saturation via pulse oximetry 
B)  Increased peak inspiratory pressure on the ventilator 
C)  Normal chest radiograph with enlarged cardiac structures 
D)  PaO2/FiO2 ratio > 300 
A)  Increased oxygen saturation via pulse oximetry 
B)  Increased peak inspiratory pressure on the ventilator 
C)  Normal chest radiograph with enlarged cardiac structures 
D)  PaO2/FiO2 ratio > 300

Question 5

During rounds,the physician alerts the team that proning is being considered for a patient with acute respiratory distress syndrome.The nurse understands that proning is:

Accepted Answer

A)  an optional treatment if the PaO2/FiO2 ratio is less 100. 
B)  less of a risk for skin breakdown because the patient is face down. 
C)  possible with minimal help from co-workers. 
D)  used to provide continuous lateral rotational turning. 
A)  an optional treatment if the PaO2/FiO2 ratio is less 100. 
B)  less of a risk for skin breakdown because the patient is face down. 
C)  possible with minimal help from co-workers. 
D)  used to provide continuous lateral rotational turning.

Question 6

The nurse is caring for a mechanically ventilated patient.The nurse understands that strategies to prevent ventilator-associated pneumonia include which of the following? (Select all that apply.)

Accepted Answer

A)  Drain condensate from the ventilator tubing away from the patient. 
B)  Elevate the head of the bed 30 to 45 degrees. 
C)  Instill normal saline as part of the suctioning procedure. 
D)  Perform regular oral care with chlorhexidine. 
A)  Drain condensate from the ventilator tubing away from the patient. 
B)  Elevate the head of the bed 30 to 45 degrees. 
C)  Instill normal saline as part of the suctioning procedure. 
D)  Perform regular oral care with chlorhexidine.

Question 7

When fluid is present in the alveoli:

Accepted Answer

A)  alveoli collapse and atelectasis occurs. 
B)  diffusion of oxygen and carbon dioxide is impaired. 
C)  hypoventilation occurs. 
D)  the patient is in heart failure. 
A)  alveoli collapse and atelectasis occurs. 
B)  diffusion of oxygen and carbon dioxide is impaired. 
C)  hypoventilation occurs. 
D)  the patient is in heart failure.

Question 8

The nurse is caring for a patient with acute respiratory distress syndrome who is hypoxemic despite mechanical ventilation.The physician orders a nontraditional ventilator mode as part of treatment.Despite sedation and analgesia,the patient remains restless and appears to be in discomfort.The nurse informs the physician of this assessment and anticipates an order for:

Accepted Answer

A)  continuous lateral rotation therapy. 
B)  guided imagery. 
C)  neuromuscular blockade. 
D)  prone positioning. 
A)  continuous lateral rotation therapy. 
B)  guided imagery. 
C)  neuromuscular blockade. 
D)  prone positioning.

Question 9

The nurse is caring for a patient in acute respiratory failure and understands that the patient should be positioned: (Select all that apply.)

Accepted Answer

A)  high Fowler's. 
B)  side lying with head of bed elevated. 
C)  sitting in a chair. 
D)  supine with the bed flat. 
A)  high Fowler's. 
B)  side lying with head of bed elevated. 
C)  sitting in a chair. 
D)  supine with the bed flat.

Question 10

Which of the following statements is true regarding oral care for the prevention of ventilator-associated pneumonia (VAP)? (Select all that apply.)

Accepted Answer

A)  Tooth brushing is performed every 2 hours for the greatest effect. 
B)  Implementing a comprehensive oral care program is an intervention for preventing VAP. 
C)  Oral care protocols should include oral suctioning and brushing teeth. 
D)  Protocols that include chlorhexidine gluconate have been effective in preventing VAP. 
A)  Tooth brushing is performed every 2 hours for the greatest effect. 
B)  Implementing a comprehensive oral care program is an intervention for preventing VAP. 
C)  Oral care protocols should include oral suctioning and brushing teeth. 
D)  Protocols that include chlorhexidine gluconate have been effective in preventing VAP.

Question 11

The nurse is discharging a patient home following treatment for community-acquired pneumonia.As part of the discharge teaching,the nurse instructs:

Accepted Answer

A)  "If you get the pneumococcal vaccine, you'll never get pneumonia again." 
B)  "It is important for you to get an annual influenza shot to reduce your risk of pneumonia." 
C)  "Stay away from cold, drafty places because that increases your risk of pneumonia when you get home." 
D)  "Since you have been treated for pneumonia, you now have immunity from getting it in the future." 
A)  "If you get the pneumococcal vaccine, you'll never get pneumonia again." 
B)  "It is important for you to get an annual influenza shot to reduce your risk of pneumonia." 
C)  "Stay away from cold, drafty places because that increases your risk of pneumonia when you get home." 
D)  "Since you have been treated for pneumonia, you now have immunity from getting it in the future."

Question 12

A patient at high risk for pulmonary embolism is receiving Lovenox.The nurse explains to the patient:

Accepted Answer

A)  "I'm going to contact the pharmacist to see if you can take this medication by mouth." 
B)  "This injection is being given to prevent blood clots from forming." 
C)  "This medication will dissolve any blood clots you might get." 
D)  "You should not be receiving this medication. I will contact the physician to get it stopped." 
A)  "I'm going to contact the pharmacist to see if you can take this medication by mouth." 
B)  "This injection is being given to prevent blood clots from forming." 
C)  "This medication will dissolve any blood clots you might get." 
D)  "You should not be receiving this medication. I will contact the physician to get it stopped."

Question 13

The nurse is concerned that a patient is at increased risk of developing a pulmonary embolus and develops a plan of care for prevention to include which of the following?

Accepted Answer

A)  Antiseptic oral care 
B)  Bed rest with head of bed elevated 
C)  Coughing and deep breathing 
D)  Mobility 
A)  Antiseptic oral care 
B)  Bed rest with head of bed elevated 
C)  Coughing and deep breathing 
D)  Mobility

Question 14

The nurse is caring for a patient who is being turned prone as part of treatment for acute respiratory distress syndrome.The nurse understands that the priority nursing concern for this patient is which of the following?

Accepted Answer

A)  Management and protection of the airway 
B)  Prevention of gastric aspiration 
C)  Prevention of skin breakdown and nerve damage 
D)  Psychological support to patient and family 
A)  Management and protection of the airway 
B)  Prevention of gastric aspiration 
C)  Prevention of skin breakdown and nerve damage 
D)  Psychological support to patient and family

Question 15

The etiology of noncardiogenic pulmonary edema in acute respiratory distress syndrome (ARDS)is related to damage to the:

Accepted Answer

A)  alveolar-capillary membrane. 
B)  left ventricle. 
C)  mainstem bronchus. 
D)  trachea. 
A)  alveolar-capillary membrane. 
B)  left ventricle. 
C)  mainstem bronchus. 
D)  trachea.

Question 16

The nurse is caring for a patient with acute respiratory failure and identifies "Risk for Ineffective Airway Clearance" as a nursing diagnosis.A nursing intervention relevant to this diagnosis is:

Accepted Answer

A)  Elevate head of bed to 30 degrees. 
B)  Obtain order for venous thromboembolism prophylaxis. 
C)  Provide adequate sedation. 
D)  Reposition patient every 2 hours. 
A)  Elevate head of bed to 30 degrees. 
B)  Obtain order for venous thromboembolism prophylaxis. 
C)  Provide adequate sedation. 
D)  Reposition patient every 2 hours.

Question 17

A definitive diagnosis of pulmonary embolism can be made by:

Accepted Answer

A)  arterial blood gas (ABG) analysis. 
B)  chest x-ray examination. 
C)  pulmonary angiogram. 
D)  ventilation-perfusion scanning. 
A)  arterial blood gas (ABG) analysis. 
B)  chest x-ray examination. 
C)  pulmonary angiogram. 
D)  ventilation-perfusion scanning.

Question 18

The basic underlying pathophysiology of acute respiratory distress syndrome results from:

Accepted Answer

A)  a decrease in the number of white blood cells available. 
B)  damage to the right mainstem bronchus. 
C)  damage to the type II pneumocytes, which produce surfactant. 
D)  decreased capillary permeability. 
A)  a decrease in the number of white blood cells available. 
B)  damage to the right mainstem bronchus. 
C)  damage to the type II pneumocytes, which produce surfactant. 
D)  decreased capillary permeability.

Question 19

Identify diagnostic criteria for ARDS.(Select all that apply.)

Accepted Answer

A)  Bilateral infiltrates on chest x-ray study 
B)  Decreased cardiac output 
C)  PaO2/ FiO2 ratio of less than 200 
D)  Pulmonary artery occlusion pressure (PAOP) of more than 18 mm Hg 
A)  Bilateral infiltrates on chest x-ray study 
B)  Decreased cardiac output 
C)  PaO2/ FiO2 ratio of less than 200 
D)  Pulmonary artery occlusion pressure (PAOP) of more than 18 mm Hg

Question 20

The nurse is caring for a patient with cystic fibrosis (CF)and understands that treatment consists of which of the following? (Select all that apply.)

Accepted Answer

A)  Airway clearance therapies 
B)  Antibiotic therapy 
C)  Nutritional support 
D)  Tracheostomy 
A)  Airway clearance therapies 
B)  Antibiotic therapy 
C)  Nutritional support 
D)  Tracheostomy

Which of the following statements is true regarding venous thromboembolism (VTE)and pulmonary embolus (PE)?

Which of the following treatments may be used to dissolve a thrombus that is lodged in the pulmonary artery?

The nurse calculates the PaO₂/FiO₂ ratio for the following values: PaO₂ is 78 mm Hg; FiO₂ is 0.6 (60%).

The nurse is assessing a patient.Which assessment would cue the nurse to the potential of acute respiratory distress syndrome (ARDS)?

During rounds,the physician alerts the team that proning is being considered for a patient with acute respiratory distress syndrome.The nurse understands that proning is:

The nurse is caring for a mechanically ventilated patient.The nurse understands that strategies to prevent ventilator-associated pneumonia include which of the following? (Select all that apply.)

When fluid is present in the alveoli:

The nurse is caring for a patient in acute respiratory failure and understands that the patient should be positioned: (Select all that apply.)

Which of the following statements is true regarding oral care for the prevention of ventilator-associated pneumonia (VAP)? (Select all that apply.)

The nurse is discharging a patient home following treatment for community-acquired pneumonia.As part of the discharge teaching,the nurse instructs:

A patient at high risk for pulmonary embolism is receiving Lovenox.The nurse explains to the patient:

The nurse is concerned that a patient is at increased risk of developing a pulmonary embolus and develops a plan of care for prevention to include which of the following?

The nurse is caring for a patient who is being turned prone as part of treatment for acute respiratory distress syndrome.The nurse understands that the priority nursing concern for this patient is which of the following?

The etiology of noncardiogenic pulmonary edema in acute respiratory distress syndrome (ARDS)is related to damage to the:

The nurse is caring for a patient with acute respiratory failure and identifies "Risk for Ineffective Airway Clearance" as a nursing diagnosis.A nursing intervention relevant to this diagnosis is:

A definitive diagnosis of pulmonary embolism can be made by:

The basic underlying pathophysiology of acute respiratory distress syndrome results from:

Identify diagnostic criteria for ARDS.(Select all that apply.)

The nurse is caring for a patient with cystic fibrosis (CF)and understands that treatment consists of which of the following? (Select all that apply.)

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 in the Critical Care Unit

Comfort and Sedation

Nutritional Support

Dysrhythmia Interpretation and Management

Hemodynamic Monitoring

Ventilatory Assistance

Rapid Response Teams and Code Management

Shock, sepsis, and Multiple Organ Dysfunction Syndrome

Cardiovascular Alterations

Nervous System Alterations

Acute Kidney Injury

Hematological and Immune Disorders

Gastrointestinal Alterations

Endocrine Alterations

Trauma and Surgical Management

Burns

Solid Organ Transplantation

Filters

Exam 14: Acute Respiratory Failure

Which of the following statements is true regarding venous thromboembolism (VTE)and pulmonary embolus (PE)?

Which of the following treatments may be used to dissolve a thrombus that is lodged in the pulmonary artery?

The nurse calculates the PaO2/FiO2 ratio for the following values: PaO2 is 78 mm Hg; FiO2 is 0.6 (60%).

The nurse is assessing a patient.Which assessment would cue the nurse to the potential of acute respiratory distress syndrome (ARDS)?

During rounds,the physician alerts the team that proning is being considered for a patient with acute respiratory distress syndrome.The nurse understands that proning is:

The nurse is caring for a mechanically ventilated patient.The nurse understands that strategies to prevent ventilator-associated pneumonia include which of the following? (Select all that apply.)

When fluid is present in the alveoli:

The nurse is caring for a patient in acute respiratory failure and understands that the patient should be positioned: (Select all that apply.)

Which of the following statements is true regarding oral care for the prevention of ventilator-associated pneumonia (VAP)? (Select all that apply.)

The nurse is discharging a patient home following treatment for community-acquired pneumonia.As part of the discharge teaching,the nurse instructs:

A patient at high risk for pulmonary embolism is receiving Lovenox.The nurse explains to the patient:

The nurse is concerned that a patient is at increased risk of developing a pulmonary embolus and develops a plan of care for prevention to include which of the following?

The nurse is caring for a patient who is being turned prone as part of treatment for acute respiratory distress syndrome.The nurse understands that the priority nursing concern for this patient is which of the following?

The etiology of noncardiogenic pulmonary edema in acute respiratory distress syndrome (ARDS)is related to damage to the:

The nurse is caring for a patient with acute respiratory failure and identifies "Risk for Ineffective Airway Clearance" as a nursing diagnosis.A nursing intervention relevant to this diagnosis is:

A definitive diagnosis of pulmonary embolism can be made by:

The basic underlying pathophysiology of acute respiratory distress syndrome results from:

Identify diagnostic criteria for ARDS.(Select all that apply.)

The nurse is caring for a patient with cystic fibrosis (CF)and understands that treatment consists of which of the following? (Select all that apply.)

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 in the Critical Care Unit

Comfort and Sedation

Nutritional Support

Dysrhythmia Interpretation and Management

Hemodynamic Monitoring

Ventilatory Assistance

Rapid Response Teams and Code Management

Shock, sepsis, and Multiple Organ Dysfunction Syndrome

Cardiovascular Alterations

Nervous System Alterations

Acute Kidney Injury

Hematological and Immune Disorders

Gastrointestinal Alterations

Endocrine Alterations

Trauma and Surgical Management

Burns

Solid Organ Transplantation

Filters

The nurse calculates the PaO₂/FiO₂ ratio for the following values: PaO₂ is 78 mm Hg; FiO₂ is 0.6 (60%).