NUR 265 Exam 2 Study Guide 2026 | Advanced
Med-Surg Units 4–6 | Mechanical Ventilation,
ARDS, Endocrine, DKA & HHS | Galen College
of Nursing
NUR 265 Exam 2 Study Guide 2026 | Advanced Med-Surg Units 4–6 |
Mechanical Ventilation, ARDS, Endocrine, DKA & HHS | Galen College of Nursing
SECTION 1: Mechanical Ventilation
1. A nurse is caring for a client receiving mechanical ventilation. Which of the
following modes delivers a preset tidal volume at a preset rate, regardless of the
client's spontaneous efforts?
A) Assist-control (AC) ventilation
B) Synchronized intermittent mandatory ventilation (SIMV)
C) Pressure support ventilation (PSV)
D) Continuous positive airway pressure (CPAP)
Correct Answer: A
Rationale: Assist-control (AC) ventilation delivers a preset tidal volume at a preset
rate. If the client initiates a breath, the ventilator delivers the preset tidal volume.
SIMV delivers a preset number of breaths but allows spontaneous breaths
between. PSV augments spontaneous breaths. CPAP provides continuous positive
pressure but does not deliver preset breaths.
,2. A student is studying the rotation of the ventilator's tidal volume in a client
with acute respiratory distress syndrome (ARDS). Which of the following tidal
volumes is recommended for lung-protective ventilation?
A) 4-6 mL/kg of predicted body weight
B) 8-10 mL/kg of predicted body weight
C) 10-12 mL/kg of predicted body weight
D) 12-15 mL/kg of predicted body weight
Correct Answer: A
Rationale: The rotation of the ventilator's tidal volume in ARDS: lung-protective
ventilation uses a tidal volume of 4-6 mL/kg of predicted body weight to prevent
ventilator-induced lung injury (VILI). Higher tidal volumes can cause barotrauma
and volutrauma.
3. A nurse is assessing a client receiving mechanical ventilation. Which of the
following findings indicates the need for suctioning?
A) Increased peak airway pressure
B) Decreased peak airway pressure
C) Improved oxygen saturation
D) Decreased respiratory rate
Correct Answer: A
Rationale: Increased peak airway pressure indicates secretions in the airway and
the need for suctioning. Decreased peak airway pressure, improved oxygen
saturation, and decreased respiratory rate do not indicate the need for suctioning.
4. A student is studying the rotation of the alarm on a mechanical ventilator. The
high-pressure alarm sounds. Which of the following is the most likely cause?
A) Disconnection of the ventilator circuit
B) Increased airway secretions
,C) Leak in the ventilator circuit
D) Decreased tidal volume
Correct Answer: B
Rationale: The rotation of the alarm on a mechanical ventilator: the high-pressure
alarm sounds when there is increased resistance to airflow, such as increased
airway secretions, coughing, or biting the endotracheal tube. Disconnection and
leaks cause low-pressure alarms.
5. A nurse is caring for a client receiving mechanical ventilation. Which of the
following indicates the client is ready for weaning?
A) Vital capacity of 10 mL/kg
B) Vital capacity of 15 mL/kg
C) Negative inspiratory force of -20 cm H₂O
D) Positive inspiratory force of +20 cm H₂O
Correct Answer: B
Rationale: A vital capacity of 15 mL/kg indicates the client has adequate
respiratory muscle strength for weaning. A vital capacity of 10 mL/kg is
insufficient. Negative inspiratory force should be at least -20 to -30 cm H₂O (more
negative indicates stronger effort).
6. A student is studying the rotation of the endotracheal tube in a client
receiving mechanical ventilation. Which of the following indicates tube
displacement?
A) Increased oxygen saturation
B) Decreased breath sounds on one side
C) Improved tidal volume
D) Decreased peak airway pressure
Correct Answer: B
Rationale: The rotation of the endotracheal tube in a client receiving mechanical
, ventilation: decreased breath sounds on one side indicates tube displacement
(e.g., right mainstem bronchus intubation). Increased oxygen saturation, improved
tidal volume, and decreased peak airway pressure do not indicate displacement.
7. A nurse is assessing a client receiving mechanical ventilation. Which of the
following findings indicates ventilator-associated pneumonia (VAP)?
A) Fever and purulent secretions
B) Decreased temperature
C) Improved oxygen saturation
D) Decreased white blood cell count
Correct Answer: A
Rationale: Fever and purulent secretions indicate ventilator-associated
pneumonia (VAP). Decreased temperature, improved oxygen saturation, and
decreased white blood cell count do not suggest VAP.
8. A student is studying the rotation of the oxygen concentration in a client
receiving mechanical ventilation. Which of the following is the goal of oxygen
therapy?
A) Maintain PaO₂ above 60 mmHg
B) Maintain PaO₂ above 100 mmHg
C) Maintain PaO₂ above 40 mmHg
D) Maintain PaO₂ above 80 mmHg
Correct Answer: A
Rationale: The rotation of the oxygen concentration in a client receiving
mechanical ventilation: the goal is to maintain PaO₂ above 60 mmHg to ensure
adequate tissue oxygenation. PaO₂ above 100 mmHg may cause oxygen toxicity.
PaO₂ above 40 mmHg is below normal.
Med-Surg Units 4–6 | Mechanical Ventilation,
ARDS, Endocrine, DKA & HHS | Galen College
of Nursing
NUR 265 Exam 2 Study Guide 2026 | Advanced Med-Surg Units 4–6 |
Mechanical Ventilation, ARDS, Endocrine, DKA & HHS | Galen College of Nursing
SECTION 1: Mechanical Ventilation
1. A nurse is caring for a client receiving mechanical ventilation. Which of the
following modes delivers a preset tidal volume at a preset rate, regardless of the
client's spontaneous efforts?
A) Assist-control (AC) ventilation
B) Synchronized intermittent mandatory ventilation (SIMV)
C) Pressure support ventilation (PSV)
D) Continuous positive airway pressure (CPAP)
Correct Answer: A
Rationale: Assist-control (AC) ventilation delivers a preset tidal volume at a preset
rate. If the client initiates a breath, the ventilator delivers the preset tidal volume.
SIMV delivers a preset number of breaths but allows spontaneous breaths
between. PSV augments spontaneous breaths. CPAP provides continuous positive
pressure but does not deliver preset breaths.
,2. A student is studying the rotation of the ventilator's tidal volume in a client
with acute respiratory distress syndrome (ARDS). Which of the following tidal
volumes is recommended for lung-protective ventilation?
A) 4-6 mL/kg of predicted body weight
B) 8-10 mL/kg of predicted body weight
C) 10-12 mL/kg of predicted body weight
D) 12-15 mL/kg of predicted body weight
Correct Answer: A
Rationale: The rotation of the ventilator's tidal volume in ARDS: lung-protective
ventilation uses a tidal volume of 4-6 mL/kg of predicted body weight to prevent
ventilator-induced lung injury (VILI). Higher tidal volumes can cause barotrauma
and volutrauma.
3. A nurse is assessing a client receiving mechanical ventilation. Which of the
following findings indicates the need for suctioning?
A) Increased peak airway pressure
B) Decreased peak airway pressure
C) Improved oxygen saturation
D) Decreased respiratory rate
Correct Answer: A
Rationale: Increased peak airway pressure indicates secretions in the airway and
the need for suctioning. Decreased peak airway pressure, improved oxygen
saturation, and decreased respiratory rate do not indicate the need for suctioning.
4. A student is studying the rotation of the alarm on a mechanical ventilator. The
high-pressure alarm sounds. Which of the following is the most likely cause?
A) Disconnection of the ventilator circuit
B) Increased airway secretions
,C) Leak in the ventilator circuit
D) Decreased tidal volume
Correct Answer: B
Rationale: The rotation of the alarm on a mechanical ventilator: the high-pressure
alarm sounds when there is increased resistance to airflow, such as increased
airway secretions, coughing, or biting the endotracheal tube. Disconnection and
leaks cause low-pressure alarms.
5. A nurse is caring for a client receiving mechanical ventilation. Which of the
following indicates the client is ready for weaning?
A) Vital capacity of 10 mL/kg
B) Vital capacity of 15 mL/kg
C) Negative inspiratory force of -20 cm H₂O
D) Positive inspiratory force of +20 cm H₂O
Correct Answer: B
Rationale: A vital capacity of 15 mL/kg indicates the client has adequate
respiratory muscle strength for weaning. A vital capacity of 10 mL/kg is
insufficient. Negative inspiratory force should be at least -20 to -30 cm H₂O (more
negative indicates stronger effort).
6. A student is studying the rotation of the endotracheal tube in a client
receiving mechanical ventilation. Which of the following indicates tube
displacement?
A) Increased oxygen saturation
B) Decreased breath sounds on one side
C) Improved tidal volume
D) Decreased peak airway pressure
Correct Answer: B
Rationale: The rotation of the endotracheal tube in a client receiving mechanical
, ventilation: decreased breath sounds on one side indicates tube displacement
(e.g., right mainstem bronchus intubation). Increased oxygen saturation, improved
tidal volume, and decreased peak airway pressure do not indicate displacement.
7. A nurse is assessing a client receiving mechanical ventilation. Which of the
following findings indicates ventilator-associated pneumonia (VAP)?
A) Fever and purulent secretions
B) Decreased temperature
C) Improved oxygen saturation
D) Decreased white blood cell count
Correct Answer: A
Rationale: Fever and purulent secretions indicate ventilator-associated
pneumonia (VAP). Decreased temperature, improved oxygen saturation, and
decreased white blood cell count do not suggest VAP.
8. A student is studying the rotation of the oxygen concentration in a client
receiving mechanical ventilation. Which of the following is the goal of oxygen
therapy?
A) Maintain PaO₂ above 60 mmHg
B) Maintain PaO₂ above 100 mmHg
C) Maintain PaO₂ above 40 mmHg
D) Maintain PaO₂ above 80 mmHg
Correct Answer: A
Rationale: The rotation of the oxygen concentration in a client receiving
mechanical ventilation: the goal is to maintain PaO₂ above 60 mmHg to ensure
adequate tissue oxygenation. PaO₂ above 100 mmHg may cause oxygen toxicity.
PaO₂ above 40 mmHg is below normal.
