Question 1

In assessing a patient,the nurse understands that an early sign of hypoxemia is:

Accepted Answer

A)  clubbing of nail beds 
B)  cyanosis 
C)  hypotension 
D)  restlessness 
A)  clubbing of nail beds 
B)  cyanosis 
C)  hypotension 
D)  restlessness

Question 2

The patient with acute respiratory distress syndrome (ARDS)would exhibit which of the following symptoms?

Accepted Answer

A)  Decreasing PaO2 levels despite increased FiO2 administration 
B)  Elevated alveolar surfactant levels 
C)  Increased lung compliance with increased FiO2 administration 
D)  Respiratory acidosis associated with hyperventilation 
A)  Decreasing PaO2 levels despite increased FiO2 administration 
B)  Elevated alveolar surfactant levels 
C)  Increased lung compliance with increased FiO2 administration 
D)  Respiratory acidosis associated with hyperventilation

Question 3

The nurse is caring for a postoperative patient with chronic obstructive pulmonary disease ( COPD ).Which assessment would be a cue to the patient developing postoperative pneumonia?

Accepted Answer

A)  Bradycardia 
B)  Change in sputum characteristics 
C)  Hypoventilation and respiratory acidosis 
D)  Pursed-lip breathing 
A)  Bradycardia 
B)  Change in sputum characteristics 
C)  Hypoventilation and respiratory acidosis 
D)  Pursed-lip breathing

Question 4

The nurse is discharging a patient with asthma.As part of the discharge instruction,the nurse instructs the patient to prevent exacerbation by:

Accepted Answer

A)  obtaining an appointment for follow-up pulmonary function studies 1 week after discharge. 
B)  limiting activity until patient is able to climb two flights of stairs. 
C)  taking all asthma medications as prescribed. 
D)  taking medications on a "prn" basis according to symptoms. 
A)  obtaining an appointment for follow-up pulmonary function studies 1 week after discharge. 
B)  limiting activity until patient is able to climb two flights of stairs. 
C)  taking all asthma medications as prescribed. 
D)  taking medications on a "prn" basis according to symptoms.

Question 5

The nurse is caring for a patient with a diagnosis of pulmonary embolism.The nurse understands that the most common cause of a pulmonary embolus is:

Accepted Answer

A)  amniotic fluid embolus. 
B)  deep vein thrombosis from lower extremities. 
C)  fat embolus from a long bone fracture. 
D)  vegetation that dislodges from an infected central venous catheter. 
A)  amniotic fluid embolus. 
B)  deep vein thrombosis from lower extremities. 
C)  fat embolus from a long bone fracture. 
D)  vegetation that dislodges from an infected central venous catheter.

Question 6

On the following picture of the alveolar-capillary membrane,select the image that demonstrates shunting.

Accepted Answer

A)

B) 
  
C) 
  
D) 
  
E) 
  
A)

B) 
  
C) 
  
D) 
  
E)

Question 7

Which of the following are physiological effects of positive end-expiratory pressure (PEEP)used in the treatment of ARDS? (Select all that apply.)

Accepted Answer

A)  Increase functional residual capacity 
B)  Prevent collapse of unstable alveoli 
C)  Improve arterial oxygenation 
D)  Open collapsed alveoli 
E)  None of above 
A)  Increase functional residual capacity 
B)  Prevent collapse of unstable alveoli 
C)  Improve arterial oxygenation 
D)  Open collapsed alveoli 
E)  None of above

Question 8

Which of the following acid-base disturbances commonly occurs with the hyperventilation and impaired gas exchange seen in severe exacerbation of asthma?

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

A patient presents to the emergency department in acute respiratory failure secondary to community-acquired pneumonia.The patient has a history of chronic obstructive pulmonary disease.The nurse anticipates which treatment to facilitate ventilation?

Accepted Answer

A)  Emergency tracheostomy and mechanical ventilation 
B)  Mechanical ventilation via an endotracheal tube 
C)  Noninvasive positive-pressure ventilation (NPPV) 
D)  Oxygen at 100% via bag-valve-mask device 
A)  Emergency tracheostomy and mechanical ventilation 
B)  Mechanical ventilation via an endotracheal tube 
C)  Noninvasive positive-pressure ventilation (NPPV) 
D)  Oxygen at 100% via bag-valve-mask device

Question 10

Intrapulmonary shunting refers to:

Accepted Answer

A)  alveoli that are not perfused. 
B)  blood that is shunted from the left side of the heart to the right and causes heart failure. 
C)  blood that is shunted from the right side of the heart to the left without oxygenation. 
D)  shunting of blood supply to only one lung. 
A)  alveoli that are not perfused. 
B)  blood that is shunted from the left side of the heart to the right and causes heart failure. 
C)  blood that is shunted from the right side of the heart to the left without oxygenation. 
D)  shunting of blood supply to only one lung.

Question 11

Which of the following are components of the Institute for Healthcare Improvement's (IHI's)ventilator bundle? (Select all that apply.)

Accepted Answer

A)  Interrupt sedation each day to assess readiness to extubate. 
B)  Maintain head of bed at least 30 degrees elevation. 
C)  Provide deep vein thrombosis prophylaxis. 
D)  Provide prophylaxis for peptic ulcer disease. 
E)  Swab the mouth with foam swabs every 2 hours. 
A)  Interrupt sedation each day to assess readiness to extubate. 
B)  Maintain head of bed at least 30 degrees elevation. 
C)  Provide deep vein thrombosis prophylaxis. 
D)  Provide prophylaxis for peptic ulcer disease. 
E)  Swab the mouth with foam swabs every 2 hours.

Question 12

Select the strategies for preventing deep vein thrombosis (DVT)and pulmonary embolus (PE).(Select all that apply.)

Accepted Answer

A)  Graduated compression stockings 
B)  Heparin or low-molecular weight heparin for patients at risk 
C)  Sequential compression devices 
D)  Strict bed rest 
A)  Graduated compression stockings 
B)  Heparin or low-molecular weight heparin for patients at risk 
C)  Sequential compression devices 
D)  Strict bed rest

Question 13

The nurse is assessing a patient with acute respiratory distress syndrome.An expected assessment is:

Accepted Answer

A)  cardiac output of 10 L/min and low systemic vascular resistance. 
B)  PAOP of 10 mm Hg and PaO2 of 55. 
C)  PAOP of 20 mm Hg and cardiac output of 3 L/min. 
D)  PAOP of 5 mm Hg and high systemic vascular resistance. 
A)  cardiac output of 10 L/min and low systemic vascular resistance. 
B)  PAOP of 10 mm Hg and PaO2 of 55. 
C)  PAOP of 20 mm Hg and cardiac output of 3 L/min. 
D)  PAOP of 5 mm Hg and high systemic vascular resistance.

Question 14

A strategy for preventing thromboembolism in patients at risk who cannot take anticoagulants is:

Accepted Answer

A)  administration of two aspirin tablets every 4 hours. 
B)  infusion of thrombolytics. 
C)  insertion of a vena cava filter. 
D)  subcutaneous heparin administration every 12 hours. 
A)  administration of two aspirin tablets every 4 hours. 
B)  infusion of thrombolytics. 
C)  insertion of a vena cava filter. 
D)  subcutaneous heparin administration every 12 hours.

Question 15

An acute exacerbation of asthma is treated with which of the following?

Accepted Answer

A)  Corticosteroids and theophylline by mouth 
B)  Inhaled bronchodilators and intravenous corticosteroids 
C)  Prone positioning or continuous lateral rotation 
D)  Sedation and inhaled bronchodilators 
A)  Corticosteroids and theophylline by mouth 
B)  Inhaled bronchodilators and intravenous corticosteroids 
C)  Prone positioning or continuous lateral rotation 
D)  Sedation and inhaled bronchodilators

Question 16

The nurse assesses a patient who is admitted for an overdose of sedatives.The nurse expects to find which acid-base alteration?

Accepted Answer

A)  Hyperventilation and respiratory acidosis 
B)  Hypoventilation and respiratory acidosis 
C)  Hypoventilation and respiratory alkalosis 
D)  Respiratory acidosis and normal oxygen levels 
A)  Hyperventilation and respiratory acidosis 
B)  Hypoventilation and respiratory acidosis 
C)  Hypoventilation and respiratory alkalosis 
D)  Respiratory acidosis and normal oxygen levels

In assessing a patient,the nurse understands that an early sign of hypoxemia is:

The patient with acute respiratory distress syndrome (ARDS)would exhibit which of the following symptoms?

The nurse is caring for a postoperative patient with chronic obstructive pulmonary disease ( COPD ).Which assessment would be a cue to the patient developing postoperative pneumonia?

The nurse is discharging a patient with asthma.As part of the discharge instruction,the nurse instructs the patient to prevent exacerbation by:

The nurse is caring for a patient with a diagnosis of pulmonary embolism.The nurse understands that the most common cause of a pulmonary embolus is:

On the following picture of the alveolar-capillary membrane,select the image that demonstrates shunting.

Which of the following are physiological effects of positive end-expiratory pressure (PEEP)used in the treatment of ARDS? (Select all that apply.)

Which of the following acid-base disturbances commonly occurs with the hyperventilation and impaired gas exchange seen in severe exacerbation of asthma?

A patient presents to the emergency department in acute respiratory failure secondary to community-acquired pneumonia.The patient has a history of chronic obstructive pulmonary disease.The nurse anticipates which treatment to facilitate ventilation?

Intrapulmonary shunting refers to:

Which of the following are components of the Institute for Healthcare Improvement's (IHI's)ventilator bundle? (Select all that apply.)

Select the strategies for preventing deep vein thrombosis (DVT)and pulmonary embolus (PE).(Select all that apply.)

The nurse is assessing a patient with acute respiratory distress syndrome.An expected assessment is:

A strategy for preventing thromboembolism in patients at risk who cannot take anticoagulants is:

An acute exacerbation of asthma is treated with which of the following?

The nurse assesses a patient who is admitted for an overdose of sedatives.The nurse expects to find which acid-base alteration?

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

In assessing a patient,the nurse understands that an early sign of hypoxemia is:

The patient with acute respiratory distress syndrome (ARDS)would exhibit which of the following symptoms?

The nurse is caring for a postoperative patient with chronic obstructive pulmonary disease ( COPD ).Which assessment would be a cue to the patient developing postoperative pneumonia?

The nurse is discharging a patient with asthma.As part of the discharge instruction,the nurse instructs the patient to prevent exacerbation by:

The nurse is caring for a patient with a diagnosis of pulmonary embolism.The nurse understands that the most common cause of a pulmonary embolus is:

On the following picture of the alveolar-capillary membrane,select the image that demonstrates shunting.

Which of the following are physiological effects of positive end-expiratory pressure (PEEP)used in the treatment of ARDS? (Select all that apply.)

Which of the following acid-base disturbances commonly occurs with the hyperventilation and impaired gas exchange seen in severe exacerbation of asthma?

A patient presents to the emergency department in acute respiratory failure secondary to community-acquired pneumonia.The patient has a history of chronic obstructive pulmonary disease.The nurse anticipates which treatment to facilitate ventilation?

Intrapulmonary shunting refers to:

Which of the following are components of the Institute for Healthcare Improvement's (IHI's)ventilator bundle? (Select all that apply.)

Select the strategies for preventing deep vein thrombosis (DVT)and pulmonary embolus (PE).(Select all that apply.)

The nurse is assessing a patient with acute respiratory distress syndrome.An expected assessment is:

A strategy for preventing thromboembolism in patients at risk who cannot take anticoagulants is:

An acute exacerbation of asthma is treated with which of the following?

The nurse assesses a patient who is admitted for an overdose of sedatives.The nurse expects to find which acid-base alteration?

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