COMPLEX ADULT HEALTH EXAM 1 REVIEW
VERSION 2 2026 ACTUAL SCRIPT COMPLETE
QUESTIONS AND ANSWERS 100% CORRECT
◉ The nurse is caring for a patient with an endotracheal tube. The
nurse understands that endotracheal suctioning is needed to
facilitate removal of secretions and that the procedure
a. decreases intracranial pressure.
b. depresses the cough reflex.
c. is done as indicated by patient assessment.
d. is more effective if preceded by saline instillation. Answer: C
Suctioning is performed as indicated by patient assessment.
Suctioning is associated with increases in intracranial pressure;
therefore, it is important to hyperoxygenate the patient before
suctioning to reduce this complication.
◉ A patient is admitted to the progressive care unit with a diagnosis
of community-acquired pneumonia. The patient has a history of
chronic obstructive pulmonary disease and diabetes. A set of arterial
blood gases obtained on admission without supplemental oxygen
shows pH 7.35; PaCO2 55 mm Hg; bicarbonate 30 mEq/L; PaO2 65
mm Hg. These blood gases reflect:
a. hypoxemia and compensated metabolic alkalosis.
b. hypoxemia and compensated respiratory acidosis.
,c. normal oxygenation and partly compensated metabolic alkalosis.
d. normal oxygenation and uncompensated respiratory acidosis..
Answer: B
The PaO2 of 65 mm Hg is lower than normal range (80 to 100 mm
Hg), indicating hypoxemia. The high PaCO2 indicates respiratory
acidosis. The elevated bicarbonate indicates metabolic alkalosis.
Because the pH is normal, the underlying acid-base alteration is
compensated. Given the patient's history of chronic pulmonary
disease and a pH that is at the lower end of normal range, it can be
determined that this patient is hypoxemic with fully compensated
respiratory acidosis.
◉ A patient's status worsens and needs mechanical ventilation. The
pulmonologist wants the patient to receive 10 breaths/min from the
ventilator but wants to encourage the patient to breathe
spontaneously between the mechanical breaths at his own tidal
volume. This mode of ventilation is called
a. assist/control ventilation.
b. controlled ventilation.
c. intermittent mandatory ventilation.
d. positive end-expiratory pressure.. Answer: C
◉ 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
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.. Answer: A
The endotracheal tube can become dislodged during repositioning
and is likely to be in the right mainstem bronchus. It is important to
reassess breath sounds after the retaping procedure. A
pneumothorax would also result in diminished or absent breath
sounds; however, it is not associated with repositioning the
endotracheal tube. Aspiration may occur during the procedure but
would be manifested in changes in the chest x-ray or by hypoxemia,
for example.
◉ A mode of pressure-targeted ventilation that provides positive
pressure to decrease the workload of spontaneous breathing
through the endotracheal tube is
a. continuous positive airway pressure.
b. positive end-expiratory pressure.
c. pressure support ventilation.
d. T-piece adapter.. Answer: C
Pressure support (PS) is a mode of ventilation in which the patient's
spontaneous respiratory activity is augmented by the delivery of a
preset amount of inspiratory positive pressure
, ◉ The amount of effort needed to maintain a given level of
ventilation is termed
a. compliance.
b. resistance.
c. tidal volume.
d. work of breathing.. Answer: D
Work of breathing is the amount of effort needed to maintain a given
level of ventilation. Compliance is a measure of the distensibility, or
stretchability, of the lung and chest wall. Resistance refers to the
opposition to the flow of gases in the airways. Tidal volume is the
volume of air in a typical breath.
◉ Which of the following devices is best suited to deliver 65%
oxygen to a patient who is spontaneously breathing?
a. Face mask with non-rebreathing reservoir
b. Low-flow nasal cannula
c. Simple face mask
d. Venturi mask. Answer: A
Face masks with reservoirs (partial rebreathing and non-
rebreathing reservoir masks) provide oxygen concentration of 60%
or higher. The addition of the reservoir increases the amount of
oxygen available to the patient during inspiration and allows for the
delivery of concentrations of 35% to 60% (partial rebreather) or
VERSION 2 2026 ACTUAL SCRIPT COMPLETE
QUESTIONS AND ANSWERS 100% CORRECT
◉ The nurse is caring for a patient with an endotracheal tube. The
nurse understands that endotracheal suctioning is needed to
facilitate removal of secretions and that the procedure
a. decreases intracranial pressure.
b. depresses the cough reflex.
c. is done as indicated by patient assessment.
d. is more effective if preceded by saline instillation. Answer: C
Suctioning is performed as indicated by patient assessment.
Suctioning is associated with increases in intracranial pressure;
therefore, it is important to hyperoxygenate the patient before
suctioning to reduce this complication.
◉ A patient is admitted to the progressive care unit with a diagnosis
of community-acquired pneumonia. The patient has a history of
chronic obstructive pulmonary disease and diabetes. A set of arterial
blood gases obtained on admission without supplemental oxygen
shows pH 7.35; PaCO2 55 mm Hg; bicarbonate 30 mEq/L; PaO2 65
mm Hg. These blood gases reflect:
a. hypoxemia and compensated metabolic alkalosis.
b. hypoxemia and compensated respiratory acidosis.
,c. normal oxygenation and partly compensated metabolic alkalosis.
d. normal oxygenation and uncompensated respiratory acidosis..
Answer: B
The PaO2 of 65 mm Hg is lower than normal range (80 to 100 mm
Hg), indicating hypoxemia. The high PaCO2 indicates respiratory
acidosis. The elevated bicarbonate indicates metabolic alkalosis.
Because the pH is normal, the underlying acid-base alteration is
compensated. Given the patient's history of chronic pulmonary
disease and a pH that is at the lower end of normal range, it can be
determined that this patient is hypoxemic with fully compensated
respiratory acidosis.
◉ A patient's status worsens and needs mechanical ventilation. The
pulmonologist wants the patient to receive 10 breaths/min from the
ventilator but wants to encourage the patient to breathe
spontaneously between the mechanical breaths at his own tidal
volume. This mode of ventilation is called
a. assist/control ventilation.
b. controlled ventilation.
c. intermittent mandatory ventilation.
d. positive end-expiratory pressure.. Answer: C
◉ 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
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.. Answer: A
The endotracheal tube can become dislodged during repositioning
and is likely to be in the right mainstem bronchus. It is important to
reassess breath sounds after the retaping procedure. A
pneumothorax would also result in diminished or absent breath
sounds; however, it is not associated with repositioning the
endotracheal tube. Aspiration may occur during the procedure but
would be manifested in changes in the chest x-ray or by hypoxemia,
for example.
◉ A mode of pressure-targeted ventilation that provides positive
pressure to decrease the workload of spontaneous breathing
through the endotracheal tube is
a. continuous positive airway pressure.
b. positive end-expiratory pressure.
c. pressure support ventilation.
d. T-piece adapter.. Answer: C
Pressure support (PS) is a mode of ventilation in which the patient's
spontaneous respiratory activity is augmented by the delivery of a
preset amount of inspiratory positive pressure
, ◉ The amount of effort needed to maintain a given level of
ventilation is termed
a. compliance.
b. resistance.
c. tidal volume.
d. work of breathing.. Answer: D
Work of breathing is the amount of effort needed to maintain a given
level of ventilation. Compliance is a measure of the distensibility, or
stretchability, of the lung and chest wall. Resistance refers to the
opposition to the flow of gases in the airways. Tidal volume is the
volume of air in a typical breath.
◉ Which of the following devices is best suited to deliver 65%
oxygen to a patient who is spontaneously breathing?
a. Face mask with non-rebreathing reservoir
b. Low-flow nasal cannula
c. Simple face mask
d. Venturi mask. Answer: A
Face masks with reservoirs (partial rebreathing and non-
rebreathing reservoir masks) provide oxygen concentration of 60%
or higher. The addition of the reservoir increases the amount of
oxygen available to the patient during inspiration and allows for the
delivery of concentrations of 35% to 60% (partial rebreather) or
