NUR 4090 EXAM 1 | COMPREHENSIVE STUDY GUIDE, NCLEX-STYLE PRACTICE
QUESTIONS AND ANSWERS 2026/2027
Resp Failure - correct answer ✔✔-Gas exchange that is not adequate to maintain ABGs
-PaO2 less than 50
and or PaCO2 greater than 50
Types of Acute Resp Failure - correct answer ✔✔1. Hypercapnic Hypoxemic- Low O2 and
elevated PCO2
2. Hypoxemic- O2 less than 50% despite supplemental oxygen
Acute Resp Failure S/S - correct answer ✔✔-impaired oxygenation
-restlessness
-fatigue
-headache
-dyspnea
-air hunger
-tachycardic
-inc BP.
As hypoxemia progresses confusion, lethargy, tachycardia, tachypnea, central cyanosis,
diaphoresis, respiratory arrest
Acute Resp Failure NM - correct answer ✔✔-Assist with intubation and maintain mechanical
ventilation.
-Pts are in ICU.
-Assess respiratory status by monitoring the level of responsiveness, abg, pulse ox and vitals
,Compliance - correct answer ✔✔-Stretch ability of the lungs
-Very compliant lungs are easy to ventilate and take only a small amt of pressure to deliver
volume. Example is emphysema
Non compliant - correct answer ✔✔-Lungs are stiff and hard to ventilate. Take an inc amt of
pressure to deliver a volume of gas
Example: ARDS and pneumonia
ARDS - correct answer ✔✔A rapid occuring (less than 72 hours from precipitating event)
progressive form of hypoxemic resp failure which occurs in those who have sustained a severe
physiological insult pulmonary or non pulmonary in origin
Non Pulmonary causes of ARDS - correct answer ✔✔-Burns: over great percentage of body
-sepsis
-drug overdose
-trauma
-pancreatitis: blisters form on pancreas and when they break enters bloodstream and goes to
lungs
-ecamplsia
-hypo or hyperthermia
-blood transfusion greater than 3 units
-DIC
-CABG surgery
-Shock
Pulmonary causes of ARDS - correct answer ✔✔-Pneumonia
-Inhalation injuries: smoke (firemen) or chemical
-aspiration: gastric content, near drowning
, -pneumonitis
Patho of ARDS - correct answer ✔✔-damage to alveolar capillary membrane
-interstitial edema
-alveolar edema or pulm edema
-loss of surfactant
ARDS Phase 1 - correct answer ✔✔Acute Exudative Phase
-Can last up to a week
-Injury to alveoli capillary endothelial and epithelial cells
-Proteinaceous flooding and dec gas exchange
-Fluid inactivates surfactant production
ARDS Phase 2 - correct answer ✔✔Proliferative Phase
-Lasts up to 3 weeks or longer
-Resolution of acute phase and initial repair or lung
-Pt may recover or move to next phase
ARDS Phase 3 - correct answer ✔✔Fibrotic Phase
-Normal lung tissue replaced by fibrotic tissue
-Leads to vascular occlusion and Pulmonary HTN
-Pt becomes vent dependent and death in common in this phase
ARDS S/S - correct answer ✔✔-Dyspnea and tachypnea (1st S/S)
-Inc resp distress
-Intercostal/ suprasternal retractions
QUESTIONS AND ANSWERS 2026/2027
Resp Failure - correct answer ✔✔-Gas exchange that is not adequate to maintain ABGs
-PaO2 less than 50
and or PaCO2 greater than 50
Types of Acute Resp Failure - correct answer ✔✔1. Hypercapnic Hypoxemic- Low O2 and
elevated PCO2
2. Hypoxemic- O2 less than 50% despite supplemental oxygen
Acute Resp Failure S/S - correct answer ✔✔-impaired oxygenation
-restlessness
-fatigue
-headache
-dyspnea
-air hunger
-tachycardic
-inc BP.
As hypoxemia progresses confusion, lethargy, tachycardia, tachypnea, central cyanosis,
diaphoresis, respiratory arrest
Acute Resp Failure NM - correct answer ✔✔-Assist with intubation and maintain mechanical
ventilation.
-Pts are in ICU.
-Assess respiratory status by monitoring the level of responsiveness, abg, pulse ox and vitals
,Compliance - correct answer ✔✔-Stretch ability of the lungs
-Very compliant lungs are easy to ventilate and take only a small amt of pressure to deliver
volume. Example is emphysema
Non compliant - correct answer ✔✔-Lungs are stiff and hard to ventilate. Take an inc amt of
pressure to deliver a volume of gas
Example: ARDS and pneumonia
ARDS - correct answer ✔✔A rapid occuring (less than 72 hours from precipitating event)
progressive form of hypoxemic resp failure which occurs in those who have sustained a severe
physiological insult pulmonary or non pulmonary in origin
Non Pulmonary causes of ARDS - correct answer ✔✔-Burns: over great percentage of body
-sepsis
-drug overdose
-trauma
-pancreatitis: blisters form on pancreas and when they break enters bloodstream and goes to
lungs
-ecamplsia
-hypo or hyperthermia
-blood transfusion greater than 3 units
-DIC
-CABG surgery
-Shock
Pulmonary causes of ARDS - correct answer ✔✔-Pneumonia
-Inhalation injuries: smoke (firemen) or chemical
-aspiration: gastric content, near drowning
, -pneumonitis
Patho of ARDS - correct answer ✔✔-damage to alveolar capillary membrane
-interstitial edema
-alveolar edema or pulm edema
-loss of surfactant
ARDS Phase 1 - correct answer ✔✔Acute Exudative Phase
-Can last up to a week
-Injury to alveoli capillary endothelial and epithelial cells
-Proteinaceous flooding and dec gas exchange
-Fluid inactivates surfactant production
ARDS Phase 2 - correct answer ✔✔Proliferative Phase
-Lasts up to 3 weeks or longer
-Resolution of acute phase and initial repair or lung
-Pt may recover or move to next phase
ARDS Phase 3 - correct answer ✔✔Fibrotic Phase
-Normal lung tissue replaced by fibrotic tissue
-Leads to vascular occlusion and Pulmonary HTN
-Pt becomes vent dependent and death in common in this phase
ARDS S/S - correct answer ✔✔-Dyspnea and tachypnea (1st S/S)
-Inc resp distress
-Intercostal/ suprasternal retractions
