Question 1

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. A,B,C,D

Question 2

Medical management of a patient with status asthmaticus that supports oxygenation and ventilation include

Accepted Answer

A)  oxygen therapy. 
B)  bronchodilators. 
C)  corticosteroids. 
D)  antibiotics. 
E)  intubation and mechanical ventilation. 
A)  oxygen therapy. 
B)  bronchodilators. 
C)  corticosteroids. 
D)  antibiotics. 
E)  intubation and mechanical ventilation. A,B,C,E

Question 3

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. A

Question 4

Which of the following conditions develops when air enters the pleural space from the lung on inhalation and cannot exit on exhalation?

Accepted Answer

A)  Tension pneumothorax 
B)  Sucking chest wound 
C)  Open pneumothorax 
D)  Pulmonary interstitial empyema 
A)  Tension pneumothorax 
B)  Sucking chest wound 
C)  Open pneumothorax 
D)  Pulmonary interstitial empyema

Question 5

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 6

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 7

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

Question 8

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 9

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 10

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 11

According to the National Association of Medical Direction of Respiratory Care Consensus Panel prolonged mechanical ventilation has been defined as

Accepted Answer

A)  "the need for >=30 consecutive days of mechanical ventilation for >=8 hours per day" 
B)  "the need for >=15 consecutive days of mechanical ventilation for >=12 hours per day" 
C)  "the need for >=21 consecutive days of mechanical ventilation for >=6 hours per day" 
D)  "the need for >=40 consecutive days of mechanical ventilation for >=4 hours per day" 
A)  "the need for >=30 consecutive days of mechanical ventilation for >=8 hours per day" 
B)  "the need for >=15 consecutive days of mechanical ventilation for >=12 hours per day" 
C)  "the need for >=21 consecutive days of mechanical ventilation for >=6 hours per day" 
D)  "the need for >=40 consecutive days of mechanical ventilation for >=4 hours per day"

Question 12

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

Question 13

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 up 
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 up 
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 14

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 15

A patient with acute respiratory failure may require a bronchodilator if which of the following occurs?

Accepted Answer

A)  Excessive secretions 
B)  Bronchospasms 
C)  Thick secretions 
D)  Fighting the ventilator 
A)  Excessive secretions 
B)  Bronchospasms 
C)  Thick secretions 
D)  Fighting the ventilator

Question 16

Which of the following causes of hypoxemia is the result of blood passing through unventilated portions of the lungs?

Accepted Answer

A)  Alveolar hypoventilation 
B)  Dead space ventilation 
C)  Intrapulmonary shunting 
D)  Drug overdose 
A)  Alveolar hypoventilation 
B)  Dead space ventilation 
C)  Intrapulmonary shunting 
D)  Drug overdose

Question 17

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 18

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 19

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.

Question 20

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.

Exam 20: Pulmonary Disorders

Weaning methods that are used in combination with each other include

Medical management of a patient with status asthmaticus that supports oxygenation and ventilation include

Which of the following conditions develops when air enters the pleural space from the lung on inhalation and cannot exit on exhalation?

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

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

The most common presenting signs and symptoms associated with PEs are

The major hemodynamic consequence of a massive pulmonary embolus is

According to the National Association of Medical Direction of Respiratory Care Consensus Panel prolonged mechanical ventilation has been defined as

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

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

A pneumothorax greater than 15% requires

A patient with acute respiratory failure may require a bronchodilator if which of the following occurs?

Which of the following causes of hypoxemia is the result of blood passing through unventilated portions of the lungs?

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

Supplemental oxygen administration is usually effective in treating hypoxemia related to

Aspiration can best be prevented by

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

Critical Care Nursing Practice

Ethical Issues

Legal Issues

Genetics and Genomics in Critical Care

Patient and Family Education

Psychosocial and Spiritual Alterations and Management

Sleep Alterations and Management

Nutrition Alterations and Management

Pain and Pain Management

Sedation,Agitation,Delirium: Assessment and Management

End-Of-Life Issues

Cardiovascular Anatomy and Physiology

Cardiovascular Clinical Assessment

Cardiovascular Diagnostic Procedures

Cardiovascular Disorders

Cardiovascular Therapeutic Management

Pulmonary Anatomy and Physiology

Pulmonary Clinical Assessment

Pulmonary Diagnostic Procedures

Pulmonary Therapeutic Management

Neurologic Anatomy and Physiology

Neurologic Clinical Assessment and Diagnostic Procedures

Neurologic Disorders and Therapeutic Management

Kidney Anatomy and Physiology

Kidney Clinical Assessment and Diagnostic Procedures

Kidney Disorders and Therapeutic Management

Gastrointestinal Anatomy and Physiology

Gastrointestinal Clinical Assessment and Diagnostic Procedures

Gastrointestinal Disorders and Therapeutic Management

Endocrine Anatomy and Physiology

Endocrine Clinical Assessment and Diagnostic Procedures

Endocrine Disorders and Therapeutic Management

Trauma

Shock,sepsis,and Multiple Organ Dysfunction Syndrome

Burns

Organ Donation and Transplantation

Hematologic Disorders and Oncologic Emergencies

The Obstetric Patient

The Pediatric Patient

The Older Adult Patient

The Perianesthesia Patient

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