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A finding indicating to the nurse that a 22-year-old patient
with respiratory distress is in acute respiratory failure in-
cludes a
a. shallow breathing pattern.
b. partial pressure of arterial oxygen(PaO2) of 45 mm Hg.
b. partial pressure of arterial oxygen(PaO2) of 45 mm Hg.
c. partial pressure of carbon dioxide in arterial gas
(PaCO2) of 34 mm Hg.
d. respiratory rate of 32/min.
A patient with hypercapnic respiratory failure has a respi-
ratory rate of 8 and an SpO2 of 89%. The patient is in-
creasingly lethargic. Which collaborative intervention will
the nurse anticipate?
a. Administration of 100% oxygen by non-rebreather
mask b. Endotracheal intubation and positive pressure ventila-
tion
b. Endotracheal intubation and positive pressure ventila-
tion
c. Insertion of a mini-tracheostomy with frequent suction-
ing
d. Initiation of bilevel positive pressure ventilation (BiPAP)
When admitting a patient in possible respiratory failure
with a highPaCO2, which assessment information will be
of most concern to the nurse? a
a. The patient is somnolent. (sleepy)
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b. The patient's SpO2 is 90%.
c. The patient complains of weakness.
d. The patient's blood pressure is162/94.
The nurse is caring for a patient who was hospitalized
2 days earlier with aspiration pneumonia. Which assess-
ment information is most important to communicate to
the healthcare provider?
a. The patient has a cough that is productive of
blood-tinged sputum.
d. The patient's SpO2 has dropped to 90%,although the
b. The patient has scattered crackles throughout the pos- O2 flow rate has been increased.
terior lung bases.
c. The patient's temperature is 101.5° F after 2 days of IV
antibiotic therapy.
d. The patient's SpO2 has dropped to 90%,although the
O2 flow rate has been increased.
When caring for a patient who developed acute respira-
tory distress syndrome (ARDS) as a result of a urinary tract
infection (UTI), the nurse is asked by the patient's family
how a urinary tract infection could cause lung damage.
Which response by the nurse is appropriate?
c. "The infection caused generalized inflammation that
a. "The infection spread through the circulation from the damaged the lungs."
urinary tract to the lungs."
b. "The urinary tract infection produced toxins that dam-
aged the lungs."
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c. "The infection caused generalized inflammation that
damaged the lungs."
d. "The fever associated with the infection led to scar tissue
formation in the lungs."
You're providing care to a patient who is being treated for
aspiration pneumonia. The patient is on a 100% non-re-
breather mask. Which finding below is a HALLMARK sign C. The patient's PaO2 remains at 45 mmHg.
and symptom that the patient is developing acute respi-
ratory distress syndrome (ARDS) A hallmark sign and symptom found in ARDS is refracto-
ry hypoxemia. This is where that although the patient is
A. The patient is experiencing bradypnea. receiving a high amount of oxygen (here a 100% non-re-
B. The patient is tired and confused. breather mask) the patient is STILL hypoxic.
C. The patient's PaO2 remains at 45 mmHg.
D. The patient's blood pressure is 180/96..
You're teaching a class on critical care concepts to a group
of new nurses. You're discussing the topic of acute res-
piratory distress syndrome (ARDS). At the beginning of
the lecture, you assess the new nurses understanding
about this condition. Which statement by a new nurse
The answer is D.
demonstrates he understands the condition?*
ARDS is a type of respiratory failure that occurs when the
A. "This condition develops because the exocrine glands
capillary membrane that surrounds the alveoli sac be-
start to work incorrectly leading to thick, copious mucous
comes damaged, which causes fluid to leak into the alveoli
to collect in the alveoli sacs."
sac. Option A describes cystic fibrosis, option B describes
B. "ARDS is a pulmonary disease that gradually causes
COPD, and option C describes a pneumothorax.
chronic obstruction of airflow from the lungs."
C. "Acute respiratory distress syndrome occurs due to the
collapsing of a lung because air has accumulated in the
pleural space."
D. "This condition develops because alveolar capillary
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membrane permeability has changed leading to fluid col-
lecting in the alveoli sacs."
C.
Which patient below is at MOST risk for developing ARDS
and has the worst prognosis? Sepsis is the MOST common cause of ARDS because of
A. A 52-year-old male patient with a pneumothorax. systemic inflammation experienced. This is also true if the
B. A 48-year-old male being treated for diabetic ketoaci- cause of the sepsis is a gram-negative bacterium (this also
dosis. makes the infection harder to treat...hence poor prog-
C. A 69-year-old female with sepsis caused by a nosis). With sepsis, the immune cells that are present
gram-negative bacterial infection. with the inflammation travel to the lungs and damage the
D. A 30-year-old female with cystic fibrosis. alveolar capillary membrane leading to fluid to leak in the
alveolar sacs.
A patient is on mechanical ventilation with PEEP (positive
The answer is B.
end-expiratory pressure). Which finding below indicates
the patient is developing a complication related to their Mechanical ventilation with PEEP can cause issues with
therapy and requires immediate treatment?*= intrathoracic pressure and decrease the cardiac output
(watch out for a low blood pressure) along with hyper-
A. HCO3 26 mmHg
inflation of the lungs (possible pneumothorax or subq
B. Blood pressure 70/45
emphysema which is air that escapes into the skin because
C. PaO2 80 mmHg
the lungs are leaking air).
D. PaCO2 38 mmHg
You're precepting a nursing student who is assisting you
care for a patient on mechanical ventilation with PEEP for
treatment of ARDS. The student asks you why the PEEP D. "This pressure setting helps open the alveoli sacs that
setting is at 10 mmHg. Your response is: are collapsed during exhalation."
A. "This pressure setting assists the patient with breathing This setting of PEEP (it can range between 10 to 20 mmHg
in and out and helps improve air flow." of water) and it helps to open the alveoli sacs that are
B. "This pressure setting will help prevent a decrease in collapsed, especially during exhalation.
cardiac output and hyperinflation of the lungs."
C. "This pressure setting helps prevent fluid from filling