Examl 2:l NSG223/l NSGl 223l (NEWl 2025/l
2026l Update)l Medical-Surgicall Nursingl IIl
Review|l Questionsl &l Answers|l Gradel A|l
100%l Correctl (Verifiedl Solutions)-l
Herzing
QUESTION
Whatl doesl ARDSl initiallyl resemble?
Answer:
Severel pulmonaryl edema
QUESTION
Acutel phasel ofl ARDSl clinicall manifestations
Answer:
Rapidl onsetl ofl dyspneal thatl occursl 72l hrsl afterl precipitatingl eventl
-Arteriall hypoxemial thatl doesn'tl improvel withl supplementall O2
-x-rayl willl lookl likel congestivel pulmonaryl edemal (bilaterall infiltrates)
QUESTION
Howl doesl ARDSl progress?
Answer:
Thel acutel lungl injuryl thenl progressesl tol fibrosingl alveolitisl withl persistent,l severel
hypoxemia.
-Increasedl alveolarl deadl space
-decreasedl pulmonaryl compliance
QUESTION
,Whenl isl ptl thoughtl tol bel inl recoveryl phasel ofl ARDS?
Answer:
ifl thel hypoxemial graduallyl resolves,l thel chestl x-rayl improves,l andl thel lungsl becomel
morel compliant.
QUESTION
Nursingl assessmentl forl mechanicall ventilation
Answer:
-identifyl waysl ventilatorl mightl bel makingl patientl anxious
examples:l tubel blockagel byl kinkingl orl retainedl secretions,l otherl acutel respiratoryl
problemsl (e.g.,l pneumothoraxl andl pain),l al suddenl decreasel inl thel oxygenl level,l thel
levell ofl dyspnea,l orl ventilatorl malfunction
-sedationl mightl help
QUESTION
Whatl isl PEEP?
Answer:
helpsl increasel functionall residuall capacityl andl reversel alveolarl collapsel byl keepingl thel
alveolil open,l resultingl inl improvedl arteriall oxygenationl andl al reductionl inl thel severityl
ofl thel V./Q.l imbalance.
QUESTION
O2l levelsl withl PEEP
Answer:
Byl usingl PEEP,l al lowerl FiO2l mayl bel required.l Thel goall isl al PaO2l greaterl thanl 60l
mml Hgl orl anl oxygenl saturationl levell ofl greaterl thanl 90%l atl thel lowestl possiblel FiO2.
QUESTION
Nursingl Managementl forl ARDS
Answer:
,-Monitorl labsl (O2)
-makel surel patientl rests
-helpl patientl repositionl (pronel isl bestl position
-Relievel ptl anxiety
-frequentl assessmentl ofl ptl status
QUESTION
Medicationsl tol maintainl PEEP
Answer:
Sedativesl (ativan,l Versed,l Precedex,l propofol,l andl barbituates)
Neuromuscularl blockingl agentsl ifl sedativesl don'tl help
QUESTION
Neuromuscularl blockingl agents
Answer:
temporarilyl paralyzesl thel patientl
Withl paralysis,l thel patientl appearsl tol bel unconscious;l losesl motorl function;l andl cannotl
breathe,l talk,l orl blinkl independently.l However,l thel patientl retainsl sensationl andl isl
awakel andl ablel tol hear.
-needl tol educatel ptl thatl thisl isl temporary
QUESTION
examplesl ofl neuromuscularl blockingl agents
Answer:
pancuroniuml (Pavulon),l vecuroniuml (Norcuron),l atracuriuml (Tracrium),l andl rocuroniuml
(Zemuron)
QUESTION
Considerationsl withl neuromuscularl blockingl agents
Answer:
-Educationl forl ptl andl family
, -eyel carel (ptl can'tl blink)
-makel surel ventilatorl isl notl disconnectedl (respiratoryl musclesl becomel paralyzedl asl well)
-analgesicsl mustl bel administeredl withl thesel meds
-predisposel thel patientl tol venousl thromboembolisml (VTE),l musclel atrophy,l footl drop,l
pepticl ulcerl disease,l andl skinl breakdown
QUESTION
purposedl ofl inhaledl nitricl oxide
Answer:
mayl helpl tol reducel V./Q.l mismatchl andl improvel oxygenation
QUESTION
Whatl medicationsl canl bel prescribedl forl hypovolemial withl ARDS?
Answer:
Inotropicl orl vasopressorl agents
QUESTION
Whatl medicationsl mayl bel usedl tol improvel patient-ventilatorl synchronizationl andl helpl tol
decreasel severel hypoxemia?
Answer:
Neuromuscularl blockingl agents,l sedatives,l andl analgesics
QUESTION
Sedativesl thatl mayl bel prescribedl withl ARDS?
Answer:
Sedativesl thatl mayl bel usedl arel lorazepaml (Ativan),l midazolaml (Versed),l propofoll
(Diprivan),l opioids,l andl short-actingl barbiturates
QUESTION
Howl isl thel acid-basel balancel maintained?
2026l Update)l Medical-Surgicall Nursingl IIl
Review|l Questionsl &l Answers|l Gradel A|l
100%l Correctl (Verifiedl Solutions)-l
Herzing
QUESTION
Whatl doesl ARDSl initiallyl resemble?
Answer:
Severel pulmonaryl edema
QUESTION
Acutel phasel ofl ARDSl clinicall manifestations
Answer:
Rapidl onsetl ofl dyspneal thatl occursl 72l hrsl afterl precipitatingl eventl
-Arteriall hypoxemial thatl doesn'tl improvel withl supplementall O2
-x-rayl willl lookl likel congestivel pulmonaryl edemal (bilaterall infiltrates)
QUESTION
Howl doesl ARDSl progress?
Answer:
Thel acutel lungl injuryl thenl progressesl tol fibrosingl alveolitisl withl persistent,l severel
hypoxemia.
-Increasedl alveolarl deadl space
-decreasedl pulmonaryl compliance
QUESTION
,Whenl isl ptl thoughtl tol bel inl recoveryl phasel ofl ARDS?
Answer:
ifl thel hypoxemial graduallyl resolves,l thel chestl x-rayl improves,l andl thel lungsl becomel
morel compliant.
QUESTION
Nursingl assessmentl forl mechanicall ventilation
Answer:
-identifyl waysl ventilatorl mightl bel makingl patientl anxious
examples:l tubel blockagel byl kinkingl orl retainedl secretions,l otherl acutel respiratoryl
problemsl (e.g.,l pneumothoraxl andl pain),l al suddenl decreasel inl thel oxygenl level,l thel
levell ofl dyspnea,l orl ventilatorl malfunction
-sedationl mightl help
QUESTION
Whatl isl PEEP?
Answer:
helpsl increasel functionall residuall capacityl andl reversel alveolarl collapsel byl keepingl thel
alveolil open,l resultingl inl improvedl arteriall oxygenationl andl al reductionl inl thel severityl
ofl thel V./Q.l imbalance.
QUESTION
O2l levelsl withl PEEP
Answer:
Byl usingl PEEP,l al lowerl FiO2l mayl bel required.l Thel goall isl al PaO2l greaterl thanl 60l
mml Hgl orl anl oxygenl saturationl levell ofl greaterl thanl 90%l atl thel lowestl possiblel FiO2.
QUESTION
Nursingl Managementl forl ARDS
Answer:
,-Monitorl labsl (O2)
-makel surel patientl rests
-helpl patientl repositionl (pronel isl bestl position
-Relievel ptl anxiety
-frequentl assessmentl ofl ptl status
QUESTION
Medicationsl tol maintainl PEEP
Answer:
Sedativesl (ativan,l Versed,l Precedex,l propofol,l andl barbituates)
Neuromuscularl blockingl agentsl ifl sedativesl don'tl help
QUESTION
Neuromuscularl blockingl agents
Answer:
temporarilyl paralyzesl thel patientl
Withl paralysis,l thel patientl appearsl tol bel unconscious;l losesl motorl function;l andl cannotl
breathe,l talk,l orl blinkl independently.l However,l thel patientl retainsl sensationl andl isl
awakel andl ablel tol hear.
-needl tol educatel ptl thatl thisl isl temporary
QUESTION
examplesl ofl neuromuscularl blockingl agents
Answer:
pancuroniuml (Pavulon),l vecuroniuml (Norcuron),l atracuriuml (Tracrium),l andl rocuroniuml
(Zemuron)
QUESTION
Considerationsl withl neuromuscularl blockingl agents
Answer:
-Educationl forl ptl andl family
, -eyel carel (ptl can'tl blink)
-makel surel ventilatorl isl notl disconnectedl (respiratoryl musclesl becomel paralyzedl asl well)
-analgesicsl mustl bel administeredl withl thesel meds
-predisposel thel patientl tol venousl thromboembolisml (VTE),l musclel atrophy,l footl drop,l
pepticl ulcerl disease,l andl skinl breakdown
QUESTION
purposedl ofl inhaledl nitricl oxide
Answer:
mayl helpl tol reducel V./Q.l mismatchl andl improvel oxygenation
QUESTION
Whatl medicationsl canl bel prescribedl forl hypovolemial withl ARDS?
Answer:
Inotropicl orl vasopressorl agents
QUESTION
Whatl medicationsl mayl bel usedl tol improvel patient-ventilatorl synchronizationl andl helpl tol
decreasel severel hypoxemia?
Answer:
Neuromuscularl blockingl agents,l sedatives,l andl analgesics
QUESTION
Sedativesl thatl mayl bel prescribedl withl ARDS?
Answer:
Sedativesl thatl mayl bel usedl arel lorazepaml (Ativan),l midazolaml (Versed),l propofoll
(Diprivan),l opioids,l andl short-actingl barbiturates
QUESTION
Howl isl thel acid-basel balancel maintained?
