NURS 6202 CHAPTER 67 ACUTE RESPIRATORY
FAILURE AND ARDS QUESTIONS AND ANSWERS |
STUDY GUIDE & PRACTICE TEST 2026/2027
1 of 32
Definition
b. Augmented coughing is done by applying pressure on the
abdominal muscles at the beginning of expiration. This type of
coughing helps increase abdominal pressure and expiratory flow to
assist the cough to remove secretions in the patient who is exhausted.
An oral airway is used only if there is a possibility that the tongue will
obstruct the airway. Huff coughing prevents the glottis from closing
during the cough and works well for patients with chronic obstructive
pulmonary disease (COPD) to clear central airways. Slow pursed lip
breathing allows more time for expiration and prevents small
bronchioles from collapsing.
Give this one a go later!
,Patient-Centered Care: A patient has a PaO2 of 50 mm Hg and a PaCO2 of 42 mm
Hg because of an intrapulmonary shunt. Which therapy should the nurse expect the
patient to respond to best?
a. Positive pressure ventilation
b. Oxygen administration at a fractional inspired oxygen concentration (FIO2) of
100%
c. Applying O2 per nasal cannula at 1 to 3 L/min
Pa
d tielenatr-iC
. C enatierw
ng ready C
seacre
re: tA
iop
nastw
ieintht w
coituhgahm
inagsasinvde shuecm
tiotnhinograx and pneumothorax
has absent breath sounds in the right lung. To promote improved V/Q matching,
how should the nurse position the patient?
a. On the left side
b. On the right side
c. In a reclining chair bed
d. Supine with the head of the bed elevated
Patient-Centered Care: A patient in hypercapnic respiratory failure has a
nursing diagnosis of impaired airway clearance caused by increasing
exhaustion. What is an appropriate nursing intervention for this patient?
a. Inserting an oral airway
b. Performing augmented coughing
c. Teaching the patient huff coughing
d. Teaching the patient slow pursed-lip breathing
Patient-Centered Care: The patient with a history of heart failure and acute
respiratory failure has thick secretions that she is having difficulty coughing up.
Which intervention would best help mobilize her secretions?
a. Give more IV fluid.
b. Perform postural drainage.
c. Provide O2 by aerosol mask.
d. Suction nasopharyngeal airways.
Don't know?
2 of 32
,Term
Which physiologic mechanism of hypoxemia occurs with pulmonary
fibrosis?
a. Anatomic shunt
b. Diffusion limitation
c. Intrapulmonary shunt
d. V/Q mismatch ratio of less than 1
Give this one a go later!
a. Refractory hypoxemia, hypoxemia that does not respond to increasing
concentrations of oxygenation by any route, is a hallmark of ARDS and is always
present. Bronchial breath sounds may be associated with the progression of ARDS.
PaCO2 levels may be normal until the patient is no longer able to compensate in
response to the hypoxemia. Pulmonary artery wedge pressure (PAWP) that is
normally increased in cardiogenic pulmonary edema is normal in the pulmonary
edema of ARDS.
b. Early signs of ARDS are insidious and difficult to detect, but the nurse should be
alert for any early signs of hypoxemia, such as dyspnea, tachypnea, cough, and
restlessness in patients at risk for ARDS. Later, tachycardia, diaphoresis, mental
status changes, cyanosis, and pallor may be present. Abnormal findings on physical
examination or diagnostic studies, such as worsened lung sounds and respiratory
distress, respiratory alkalosis, or decreasing PaO2, are usually indications that ARDS
has progressed beyond the initial stages.
b. Diffusion limitation in pulmonary fibrosis is caused by thickened alveolar-
capillary interface, which slows gas transport. Anatomic shunt is often
congenital. Blood passes through an anatomic channel in the heart and
bypasses the lungs. An intrapulmonary shunt occurs when blood flows
through the pulmonary capillaries, but gas exchange does not occur as with
, ARDS. In V/Q mismatch the amount of air (ventilation) is not matched to the
amount of blood flow (perfusion).
a. Because the brain is very sensitive to a decrease in oxygen delivery, restlessness,
confusion, agitation, and combative behavior are early signs of hypoxemia, for
which the nurse should be alert. Mild hypertension is also an early sign,
accompanied by tachycardia. Central cyanosis is an unreliable, late sign of
hypoxemia. Dysrhythmias also occur later.
Don't know?
3 of 32
Term
When the V/Q lung scan results show a mismatch ratio that is greater
than 1, which condition should be suspected?
a. Pain
b. Atelectasis
c. Pulmonary embolus
d. Ventricular septal defect
Give this one a go later!
b. There is often a dramatic decrease in BP with decreased preload (CVP) and
cardiac
output (CO). PEEP increases intrathoracic and intrapulmonic pressures and reduces
blood return to both the right and left sides of the heart. Increased PaO2 is an
expected
effect of PEEP.
FAILURE AND ARDS QUESTIONS AND ANSWERS |
STUDY GUIDE & PRACTICE TEST 2026/2027
1 of 32
Definition
b. Augmented coughing is done by applying pressure on the
abdominal muscles at the beginning of expiration. This type of
coughing helps increase abdominal pressure and expiratory flow to
assist the cough to remove secretions in the patient who is exhausted.
An oral airway is used only if there is a possibility that the tongue will
obstruct the airway. Huff coughing prevents the glottis from closing
during the cough and works well for patients with chronic obstructive
pulmonary disease (COPD) to clear central airways. Slow pursed lip
breathing allows more time for expiration and prevents small
bronchioles from collapsing.
Give this one a go later!
,Patient-Centered Care: A patient has a PaO2 of 50 mm Hg and a PaCO2 of 42 mm
Hg because of an intrapulmonary shunt. Which therapy should the nurse expect the
patient to respond to best?
a. Positive pressure ventilation
b. Oxygen administration at a fractional inspired oxygen concentration (FIO2) of
100%
c. Applying O2 per nasal cannula at 1 to 3 L/min
Pa
d tielenatr-iC
. C enatierw
ng ready C
seacre
re: tA
iop
nastw
ieintht w
coituhgahm
inagsasinvde shuecm
tiotnhinograx and pneumothorax
has absent breath sounds in the right lung. To promote improved V/Q matching,
how should the nurse position the patient?
a. On the left side
b. On the right side
c. In a reclining chair bed
d. Supine with the head of the bed elevated
Patient-Centered Care: A patient in hypercapnic respiratory failure has a
nursing diagnosis of impaired airway clearance caused by increasing
exhaustion. What is an appropriate nursing intervention for this patient?
a. Inserting an oral airway
b. Performing augmented coughing
c. Teaching the patient huff coughing
d. Teaching the patient slow pursed-lip breathing
Patient-Centered Care: The patient with a history of heart failure and acute
respiratory failure has thick secretions that she is having difficulty coughing up.
Which intervention would best help mobilize her secretions?
a. Give more IV fluid.
b. Perform postural drainage.
c. Provide O2 by aerosol mask.
d. Suction nasopharyngeal airways.
Don't know?
2 of 32
,Term
Which physiologic mechanism of hypoxemia occurs with pulmonary
fibrosis?
a. Anatomic shunt
b. Diffusion limitation
c. Intrapulmonary shunt
d. V/Q mismatch ratio of less than 1
Give this one a go later!
a. Refractory hypoxemia, hypoxemia that does not respond to increasing
concentrations of oxygenation by any route, is a hallmark of ARDS and is always
present. Bronchial breath sounds may be associated with the progression of ARDS.
PaCO2 levels may be normal until the patient is no longer able to compensate in
response to the hypoxemia. Pulmonary artery wedge pressure (PAWP) that is
normally increased in cardiogenic pulmonary edema is normal in the pulmonary
edema of ARDS.
b. Early signs of ARDS are insidious and difficult to detect, but the nurse should be
alert for any early signs of hypoxemia, such as dyspnea, tachypnea, cough, and
restlessness in patients at risk for ARDS. Later, tachycardia, diaphoresis, mental
status changes, cyanosis, and pallor may be present. Abnormal findings on physical
examination or diagnostic studies, such as worsened lung sounds and respiratory
distress, respiratory alkalosis, or decreasing PaO2, are usually indications that ARDS
has progressed beyond the initial stages.
b. Diffusion limitation in pulmonary fibrosis is caused by thickened alveolar-
capillary interface, which slows gas transport. Anatomic shunt is often
congenital. Blood passes through an anatomic channel in the heart and
bypasses the lungs. An intrapulmonary shunt occurs when blood flows
through the pulmonary capillaries, but gas exchange does not occur as with
, ARDS. In V/Q mismatch the amount of air (ventilation) is not matched to the
amount of blood flow (perfusion).
a. Because the brain is very sensitive to a decrease in oxygen delivery, restlessness,
confusion, agitation, and combative behavior are early signs of hypoxemia, for
which the nurse should be alert. Mild hypertension is also an early sign,
accompanied by tachycardia. Central cyanosis is an unreliable, late sign of
hypoxemia. Dysrhythmias also occur later.
Don't know?
3 of 32
Term
When the V/Q lung scan results show a mismatch ratio that is greater
than 1, which condition should be suspected?
a. Pain
b. Atelectasis
c. Pulmonary embolus
d. Ventricular septal defect
Give this one a go later!
b. There is often a dramatic decrease in BP with decreased preload (CVP) and
cardiac
output (CO). PEEP increases intrathoracic and intrapulmonic pressures and reduces
blood return to both the right and left sides of the heart. Increased PaO2 is an
expected
effect of PEEP.
