NURS 401
NURS 401 Exam 4 Questions and Answers 2026
Bronchial asthma
the bronchiole is obstructed on expiration, particularly by muscle spasm, edema of
the mucosa and thick secretions
Pulmonary Embolus
collection of particulate matter-solids, liquids, air, (blood clot, infectious mass,
emphyema, air embolism) that enters venous circulation and lodges in pulmonary
vessels, usually occurs when a blood clot from a VTE in leg or pelvic vein breaks
off and travels through the vena cava into the right side of the heart
VTE
blood clot in the extremities, calf pain
ex. clot at the end of the picc line
PE s/s
decreased gas exchange, not perfusing, tissue hypoxia, infarction, dyspnea, SOB,
tachypnea, tachycardia, pleuritic chest pain, dry cough, hemoptysis, distended
neck veins, syncope, cyanosis, systemic hypotension, abnormal heart sounds,
abnormal ECG, low grade fever, petechiae, flu-like symptom, pt feels like they
are going to die, work of breathing is bad
Petechiae
worry! can indicate infection
Risk factors for PE
Prolonged immobilization
Central venous catheters
Surgery
Obesity
Advancing age
Conditions that increase blood clotting (Afib)
NURS 401
,NURS 401
History of thromboembolism
Birth control
Assessment of PE
ultrasound, d-dimer (elevated with PE, won't tell you if you have a PE), CT, PE
chest study to check for PE, CPR DOES NOTHING!
Lab assessment for PE
ABGs (vented pts), PaO2-FiO2 ratio falls, pulse ox, chest xray (doesn't show PE),
special CT does, ultrasound, d-dimer (elevated with PE, won't tell you if you have
a PE), PE chest study to check for PE, CPR DOES NOTHING!
ETCO2 vs Pulse ox
ETCO2 is immediate while pulse ox is 60 seconds behind
Normal ETCO2
35-45 (ventilation), like a tombstone
-if COPD/Asthma: sharp fins
Normal pulse ox
keep about 94% (oxygenation)
Nonsurgical management of PE
oxygen therapy (nasal cannula, mask), continuous cardiac monitor, obtain adequate
venous access (2 largebore IVs), continuous monitoring of pulse ox (ETCO2
monitoring), drug therapy (anticoagulants, fibrinolytics-assess for bleeding)
Interventions for fibrinolytic therapy for PE
assess for bleeding every 2 hrs, examine all stool, urine, drainage, vomit for blood,
test for occult blood, measure abdominal girth every 8hr for bleeding in the
abdominal cavity, monitor lab values (INR, hemoglobin, CBC, urinalysis),
embolectomy, inferior vena cava filtration, ASSESS LOC (first thing to go)
You can lose how much blood before there is a change in vs
1/3 of your blood
NURS 401
, NURS 401
Acute respiratory failure
ABG values:
Pao2 (ABG) <60 mm Hg
Sao2 <90%; or Paco2 >50 mm Hg with pH <7.30, pCO2 >45 (resp. acidosis),
Patient is always hypoxemic, ventilation and oxygenation failure, hypoventilation
(losing blood), occurs in pts with abnormal lungs (chronic bronchitis, emphysema,
asthma attack), diseased bronchioles and alveoli cause oxygenation failure,
increased work of breathing, resp. muscles unable to function effectively
Ventilatory failure
problem in O2 intake, High PCO2 + low pH (acidosis), caused from COPD, PE,
asthma, narcotics, neuromuscular disorders, strokes, increased ICP, oxygen will
not help, physical problem of lungs or chest wall, defect in resp. control center in
brain, poor function of resp. muscles (esp. diaphragm)
Oxygenation failure
ventilation normal, decreased lung perfusion, low SaO2 (pulse ox), can have
abnormal hemoglobin, gas exchange problem, caused from PE, pneumonia, high
altitudes, ARDS, insufficient oxygenation of pulmonary blood at alveolar level,
right to left shunting of blood, v/q mismatch
Hypoxia
pulse ox
Hypoxemia
deficient amount of oxygen in the blood
Dyspnea interventions
-Oxygen therapy
-Position of comfort
-Relaxation, diversion, guided imagery
-Energy-conserving measures
-Drugs
Acute respiratory distress syndrome (ARDS)
NURS 401
NURS 401 Exam 4 Questions and Answers 2026
Bronchial asthma
the bronchiole is obstructed on expiration, particularly by muscle spasm, edema of
the mucosa and thick secretions
Pulmonary Embolus
collection of particulate matter-solids, liquids, air, (blood clot, infectious mass,
emphyema, air embolism) that enters venous circulation and lodges in pulmonary
vessels, usually occurs when a blood clot from a VTE in leg or pelvic vein breaks
off and travels through the vena cava into the right side of the heart
VTE
blood clot in the extremities, calf pain
ex. clot at the end of the picc line
PE s/s
decreased gas exchange, not perfusing, tissue hypoxia, infarction, dyspnea, SOB,
tachypnea, tachycardia, pleuritic chest pain, dry cough, hemoptysis, distended
neck veins, syncope, cyanosis, systemic hypotension, abnormal heart sounds,
abnormal ECG, low grade fever, petechiae, flu-like symptom, pt feels like they
are going to die, work of breathing is bad
Petechiae
worry! can indicate infection
Risk factors for PE
Prolonged immobilization
Central venous catheters
Surgery
Obesity
Advancing age
Conditions that increase blood clotting (Afib)
NURS 401
,NURS 401
History of thromboembolism
Birth control
Assessment of PE
ultrasound, d-dimer (elevated with PE, won't tell you if you have a PE), CT, PE
chest study to check for PE, CPR DOES NOTHING!
Lab assessment for PE
ABGs (vented pts), PaO2-FiO2 ratio falls, pulse ox, chest xray (doesn't show PE),
special CT does, ultrasound, d-dimer (elevated with PE, won't tell you if you have
a PE), PE chest study to check for PE, CPR DOES NOTHING!
ETCO2 vs Pulse ox
ETCO2 is immediate while pulse ox is 60 seconds behind
Normal ETCO2
35-45 (ventilation), like a tombstone
-if COPD/Asthma: sharp fins
Normal pulse ox
keep about 94% (oxygenation)
Nonsurgical management of PE
oxygen therapy (nasal cannula, mask), continuous cardiac monitor, obtain adequate
venous access (2 largebore IVs), continuous monitoring of pulse ox (ETCO2
monitoring), drug therapy (anticoagulants, fibrinolytics-assess for bleeding)
Interventions for fibrinolytic therapy for PE
assess for bleeding every 2 hrs, examine all stool, urine, drainage, vomit for blood,
test for occult blood, measure abdominal girth every 8hr for bleeding in the
abdominal cavity, monitor lab values (INR, hemoglobin, CBC, urinalysis),
embolectomy, inferior vena cava filtration, ASSESS LOC (first thing to go)
You can lose how much blood before there is a change in vs
1/3 of your blood
NURS 401
, NURS 401
Acute respiratory failure
ABG values:
Pao2 (ABG) <60 mm Hg
Sao2 <90%; or Paco2 >50 mm Hg with pH <7.30, pCO2 >45 (resp. acidosis),
Patient is always hypoxemic, ventilation and oxygenation failure, hypoventilation
(losing blood), occurs in pts with abnormal lungs (chronic bronchitis, emphysema,
asthma attack), diseased bronchioles and alveoli cause oxygenation failure,
increased work of breathing, resp. muscles unable to function effectively
Ventilatory failure
problem in O2 intake, High PCO2 + low pH (acidosis), caused from COPD, PE,
asthma, narcotics, neuromuscular disorders, strokes, increased ICP, oxygen will
not help, physical problem of lungs or chest wall, defect in resp. control center in
brain, poor function of resp. muscles (esp. diaphragm)
Oxygenation failure
ventilation normal, decreased lung perfusion, low SaO2 (pulse ox), can have
abnormal hemoglobin, gas exchange problem, caused from PE, pneumonia, high
altitudes, ARDS, insufficient oxygenation of pulmonary blood at alveolar level,
right to left shunting of blood, v/q mismatch
Hypoxia
pulse ox
Hypoxemia
deficient amount of oxygen in the blood
Dyspnea interventions
-Oxygen therapy
-Position of comfort
-Relaxation, diversion, guided imagery
-Energy-conserving measures
-Drugs
Acute respiratory distress syndrome (ARDS)
NURS 401
