ARDS and Mechanical Ventilation Test Bank
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1. When the nurse is explaining respi- ANS: C
ratory failure to the patient's family,
what is the most accurate descrip-
tion to use?
a. The absence of ventilation.
b. Any episode in which part of the
airway is obstructed.
c. Inadequate gas exchange to meet
the needs of the body.
d. An episode of acute hypoxemia
caused by a pulmonary dysfunction.
2. Which diagnostic test will provide the ANS: C
nurse with the most specific informa- Arterial blood gas (ABG) analysis is most useful in this
tion to evaluate the effectiveness of setting because ventilatory failure causes problems
interventions for a patient with ven- with CO2 retention, and ABGs give information about
tilatory failure? the PaCO2 and pH. The other tests may also be done
a. Chest x-ray to help in assessing oxygenation or determining the
b. O2 saturation cause of the patient's ventilatory failure.
c. Arterial blood gas analysis
d. Central venous pressure monitor-
ing
3. While caring for a patient who has ANS: B
been admitted with a pulmonary em- Increasing O2 flowrate will usually improve O2 satura-
bolism, the nurse notes a change tion in patients with ventilation-perfusion mismatch,
in the patient's oxygen saturation as occurs with pulmonary embolism. Because the
(SpO2) from 94% to 88%. Which ac- problem is with perfusion, actions that improve venti-
tion should the nurse take? lation, such as deep breathing and coughing, sitting
a. Suction the patient's oropharynx. upright, and suctioning, are not likely to improve oxy-
b. Increase the prescribed O2 genation.
flowrate.
, ARDS and Mechanical Ventilation Test Bank
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c. Teach the patient to cough and
deep breathe.
d. Help the patient to sit in a more
upright position.
4. A patient with respiratory failure has ANS: B
a respiratory rate of 6 breaths/min The patient's lethargy, low respiratory rate, and SpO2
and an oxygen saturation (SpO2) indicate the need for mechanical ventilation with ven-
of 78%. The patient is increasingly tilator-controlled respiratory rate. Giving high-flow
lethargic. Which intervention will the O2 will not be helpful because the patient's respira-
nurse anticipate? tory rate is so low. Insertion of a mini-tracheostomy
a. Administration of 100% O2 by will promote removal of secretions, but it will not
non-rebreather mask improve the patient's respiratory rate or oxygenation.
b. Endotracheal intubation and posi- CPAP requires that the patient initiate an adequate
tive pressure ventilation respiratory rate to allow adequate gas exchange.
c. Insertion of a mini-tracheostomy
with frequent suctioning
d. Initiation of continuous positive
pressure ventilation (CPAP)
5. The oxygen saturation (SpO2) for a ANS: B
patient with left lower lobe pneumo- The patient's assessment indicates that assisted
nia is 90%. The patient has wheezes coughing is needed to help remove secretions, which
and a weak cough effort. Which ac- will improve oxygenation. A 4-hour rest period at this
tion should the nurse take? time may allow the O2 saturation to drop further.
a. Position the patient on the left Humidification will not be helpful unless the secre-
side. tions can be mobilized. Positioning on the left side
b. Assist the patient with staged may cause a further decrease in oxygen saturation
coughing. because perfusion will be directed more toward the
c. Place a humidifier in the patient's more poorly ventilated lung.
room.
, ARDS and Mechanical Ventilation Test Bank
Study online at https://quizlet.com/_8uxlhy
d. Schedule a 4-hour rest period for
the patient.
6. A nurse is caring for a patient with ANS: A
right lower lobe pneumonia who is The patient should be positioned with the "good"
obese. Which position will provide lung in the dependent position to improve the match
the best gas exchange? between ventilation and perfusion. The obese pa-
a. On the left side tient's abdomen will limit respiratory excursion when
b. On the right side sitting in the high-Fowler's or tripod positions.
c. In the tripod position
d. In the high-Fowler's position
7. When admitting a patient with pos- ANS: A
sible respiratory failure and a high Increasing somnolence will decrease the patient's
PaCO2, which assessment informa- respiratory rate and further increase the PaCO2 and
tion should be immediately reported respiratory failure. Rapid action is needed to prevent
to the health care provider? respiratory arrest. An SpO2 of 90%, weakness, and
a. The patient appears somnolent. elevated blood pressure all require ongoing moni-
b. The patient reports feeling weak. toring but are not indicators of possible impending
c. The patient's blood pressure is respiratory arrest.
164/98.
d. The patient's oxygen saturation is
90%.
8. A patient with acute respiratory dis- ANS: A
tress syndrome (ARDS) and acute Gentamicin, which is one of the aminoglycoside an-
kidney injury has several drugs pre- tibiotics, is potentially nephrotoxic, and the nurse
scribed. Which drug should the should clarify the drug and dosage with the health
nurse discuss with the health care care provider before administration. The other drugs
provider before giving? are appropriate for the patient with ARDS.
a. Gentamicin 60 mg IV
b. Pantoprazole (Protonix) 40 mg IV
, ARDS and Mechanical Ventilation Test Bank
Study online at https://quizlet.com/_8uxlhy
c. Sucralfate (Carafate) 1 gram per
NG tube
d. Methylprednisolone (Solu-Medrol)
60 mg IV
9. A patient develops increasing dys- ANS: D
pnea and hypoxemia 2 days after Pulmonary artery wedge pressures are normal in the
heart surgery. What patient with ARDS because the fluid in the alveoli is
procedure should the nurse antic- caused by increased permeability of the alveolar-cap-
ipate assisting with to determine illary membrane rather than by the backup of fluid
whether the patient has acute from the lungs (as occurs in cardiogenic pulmonary
respiratory distress syndrome edema). The other tests will not help in differentiating
(ARDS) or pulmonary edema caused cardiogenic from noncardiogenic pulmonary edema.
by heart failure?
a. Obtaining a ventilation-perfusion
scan
b. Drawing blood for arterial blood
gases
c. Positioning the patient for a chest
x-ray
d. Insertion of a pulmonary artery
catheter
10. A nurse is caring for a patient with ANS: B
ARDS who is being treated with me- The subcutaneous emphysema indicates barotrau-
chanical ventilation and high levels ma caused by positive pressure ventilation and
of positive end-expiratory pressure PEEP. Bradycardia, hypoxemia, and bronchial breath
(PEEP). Which assessment finding by sounds are all concerns and will need to be ad-
the nurse indicates that the PEEP dressed, but they are not specific indications that
may need to be reduced? PEEP should be reduced.
a. The patient's PaO2 is 50 mm Hg
and the SaO2 is 88%.
Study online at https://quizlet.com/_8uxlhy
1. When the nurse is explaining respi- ANS: C
ratory failure to the patient's family,
what is the most accurate descrip-
tion to use?
a. The absence of ventilation.
b. Any episode in which part of the
airway is obstructed.
c. Inadequate gas exchange to meet
the needs of the body.
d. An episode of acute hypoxemia
caused by a pulmonary dysfunction.
2. Which diagnostic test will provide the ANS: C
nurse with the most specific informa- Arterial blood gas (ABG) analysis is most useful in this
tion to evaluate the effectiveness of setting because ventilatory failure causes problems
interventions for a patient with ven- with CO2 retention, and ABGs give information about
tilatory failure? the PaCO2 and pH. The other tests may also be done
a. Chest x-ray to help in assessing oxygenation or determining the
b. O2 saturation cause of the patient's ventilatory failure.
c. Arterial blood gas analysis
d. Central venous pressure monitor-
ing
3. While caring for a patient who has ANS: B
been admitted with a pulmonary em- Increasing O2 flowrate will usually improve O2 satura-
bolism, the nurse notes a change tion in patients with ventilation-perfusion mismatch,
in the patient's oxygen saturation as occurs with pulmonary embolism. Because the
(SpO2) from 94% to 88%. Which ac- problem is with perfusion, actions that improve venti-
tion should the nurse take? lation, such as deep breathing and coughing, sitting
a. Suction the patient's oropharynx. upright, and suctioning, are not likely to improve oxy-
b. Increase the prescribed O2 genation.
flowrate.
, ARDS and Mechanical Ventilation Test Bank
Study online at https://quizlet.com/_8uxlhy
c. Teach the patient to cough and
deep breathe.
d. Help the patient to sit in a more
upright position.
4. A patient with respiratory failure has ANS: B
a respiratory rate of 6 breaths/min The patient's lethargy, low respiratory rate, and SpO2
and an oxygen saturation (SpO2) indicate the need for mechanical ventilation with ven-
of 78%. The patient is increasingly tilator-controlled respiratory rate. Giving high-flow
lethargic. Which intervention will the O2 will not be helpful because the patient's respira-
nurse anticipate? tory rate is so low. Insertion of a mini-tracheostomy
a. Administration of 100% O2 by will promote removal of secretions, but it will not
non-rebreather mask improve the patient's respiratory rate or oxygenation.
b. Endotracheal intubation and posi- CPAP requires that the patient initiate an adequate
tive pressure ventilation respiratory rate to allow adequate gas exchange.
c. Insertion of a mini-tracheostomy
with frequent suctioning
d. Initiation of continuous positive
pressure ventilation (CPAP)
5. The oxygen saturation (SpO2) for a ANS: B
patient with left lower lobe pneumo- The patient's assessment indicates that assisted
nia is 90%. The patient has wheezes coughing is needed to help remove secretions, which
and a weak cough effort. Which ac- will improve oxygenation. A 4-hour rest period at this
tion should the nurse take? time may allow the O2 saturation to drop further.
a. Position the patient on the left Humidification will not be helpful unless the secre-
side. tions can be mobilized. Positioning on the left side
b. Assist the patient with staged may cause a further decrease in oxygen saturation
coughing. because perfusion will be directed more toward the
c. Place a humidifier in the patient's more poorly ventilated lung.
room.
, ARDS and Mechanical Ventilation Test Bank
Study online at https://quizlet.com/_8uxlhy
d. Schedule a 4-hour rest period for
the patient.
6. A nurse is caring for a patient with ANS: A
right lower lobe pneumonia who is The patient should be positioned with the "good"
obese. Which position will provide lung in the dependent position to improve the match
the best gas exchange? between ventilation and perfusion. The obese pa-
a. On the left side tient's abdomen will limit respiratory excursion when
b. On the right side sitting in the high-Fowler's or tripod positions.
c. In the tripod position
d. In the high-Fowler's position
7. When admitting a patient with pos- ANS: A
sible respiratory failure and a high Increasing somnolence will decrease the patient's
PaCO2, which assessment informa- respiratory rate and further increase the PaCO2 and
tion should be immediately reported respiratory failure. Rapid action is needed to prevent
to the health care provider? respiratory arrest. An SpO2 of 90%, weakness, and
a. The patient appears somnolent. elevated blood pressure all require ongoing moni-
b. The patient reports feeling weak. toring but are not indicators of possible impending
c. The patient's blood pressure is respiratory arrest.
164/98.
d. The patient's oxygen saturation is
90%.
8. A patient with acute respiratory dis- ANS: A
tress syndrome (ARDS) and acute Gentamicin, which is one of the aminoglycoside an-
kidney injury has several drugs pre- tibiotics, is potentially nephrotoxic, and the nurse
scribed. Which drug should the should clarify the drug and dosage with the health
nurse discuss with the health care care provider before administration. The other drugs
provider before giving? are appropriate for the patient with ARDS.
a. Gentamicin 60 mg IV
b. Pantoprazole (Protonix) 40 mg IV
, ARDS and Mechanical Ventilation Test Bank
Study online at https://quizlet.com/_8uxlhy
c. Sucralfate (Carafate) 1 gram per
NG tube
d. Methylprednisolone (Solu-Medrol)
60 mg IV
9. A patient develops increasing dys- ANS: D
pnea and hypoxemia 2 days after Pulmonary artery wedge pressures are normal in the
heart surgery. What patient with ARDS because the fluid in the alveoli is
procedure should the nurse antic- caused by increased permeability of the alveolar-cap-
ipate assisting with to determine illary membrane rather than by the backup of fluid
whether the patient has acute from the lungs (as occurs in cardiogenic pulmonary
respiratory distress syndrome edema). The other tests will not help in differentiating
(ARDS) or pulmonary edema caused cardiogenic from noncardiogenic pulmonary edema.
by heart failure?
a. Obtaining a ventilation-perfusion
scan
b. Drawing blood for arterial blood
gases
c. Positioning the patient for a chest
x-ray
d. Insertion of a pulmonary artery
catheter
10. A nurse is caring for a patient with ANS: B
ARDS who is being treated with me- The subcutaneous emphysema indicates barotrau-
chanical ventilation and high levels ma caused by positive pressure ventilation and
of positive end-expiratory pressure PEEP. Bradycardia, hypoxemia, and bronchial breath
(PEEP). Which assessment finding by sounds are all concerns and will need to be ad-
the nurse indicates that the PEEP dressed, but they are not specific indications that
may need to be reduced? PEEP should be reduced.
a. The patient's PaO2 is 50 mm Hg
and the SaO2 is 88%.
