NSG 4330 Final 2025/2026 Exam
Questions Marking Scheme New Update
| A+ Rated
Respiratory failure types - 🧠 ANSWER ✔✔one or both gas exchanging
functions are inadequate
hypoxemic - oxygenation failure (PaO2 <60)
hypercapnic - ventilation failure (PaCO2 >45/pH <7.35)
both can be acute or chronic
Acute respiratory failure s/s - 🧠 ANSWER ✔✔early s/s - *change in mental
status, restless*, tachycardia, tachypnea
progressive s/s - agitation - coma, tachycardia - arrhythmias, hyper -
hypotension, dyspnea, accessory muscle use
late s/s - coma, cyanosis, hypotension, seizures, *decreased O2 sat*
ARF management - 🧠 ANSWER ✔✔O2 therapy
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PRIVACY STATEMENT. ALL RIGHTS RESERVED
,Secretion clearance - hydration, HOB elevated, humidified O2, suctioning,
deep breathing, IS, coughing
artificial airway to keep tongue from obstructing
PPV (BiPAP, CPAP)
Meds - bronchodilators, steroids, diuretics, abx, benzos, analgesics
BiPAP vs CPAP - 🧠 ANSWER ✔✔BiPAP - pressure delivered at different
levels during inhalation and exhalation (higher in, lower out)
CPAP - continuous level of pressure for inhale/exhale
Contraindications to NIPPV - 🧠 ANSWER ✔✔apnea, decr LOC, ++
secretions, high O2 req, facial trauma
ARDS etiology - 🧠 ANSWER ✔✔mainly d/t pneumonia but also: sepsis,
aspiration, trauma
ARDS - 🧠 ANSWER ✔✔life threatening RF; acute, diffuse, inflammatory
lung injury
incr alveolar cap permeability = pulmonary edema
COPYRIGHT©BLAIRALISTERNEWTON 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
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PRIVACY STATEMENT. ALL RIGHTS RESERVED
,s/s - *rapid onset of severe dyspnea*, *hypoxemia does not respond to
supp O2*, tachypnea, retractions, crackles, rhonchi, decr LOC, tachycardia,
hypotension, cyanosis
tx - supportive; usually combo of: intubation/ventilation, meds, prone
positioning, permissive hypercapnia
PEEP - 🧠 ANSWER ✔✔positive end expiratory pressure
keeps airways open at end of breath to prevent collapse/promote
oxygenation
ARDS drug therapy - 🧠 ANSWER ✔✔similar to RF
abx
diuretics
sedation
*fluids* - controversial
ARDS nsg interventions - 🧠 ANSWER ✔✔close monitoring
freq ABGs
monitor hgb
cough or suction if pt cannot
COPYRIGHT©BLAIRALISTERNEWTON 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
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PRIVACY STATEMENT. ALL RIGHTS RESERVED
, *watch for s/s of cardiac compromise and low BP*
analgesia/sedation as needed
hand hygiene
*mouth care* to prev VAP
metabolic acidosis - 🧠 ANSWER ✔✔low ph, low bicarb
too much acid in body (CKD/kidney failure)
body making too much, not removing enough, body cannot balance
s/s - long/deep breaths, tachycardia, weakness, headache, n/v
metabolic alkalosis - 🧠 ANSWER ✔✔high ph, high bicarb
causes - prolonged vomiting, hypovolemia, diuretics, hypokalemia
s/s - confusion, tremors, dizziness, spasms, n/v, numbness/tingling
respiratory acidosis - 🧠 ANSWER ✔✔low ph, high CO2
lungs cannot remove enough CO2
causes - asthma, lung injury, substance use
s/s - anxiety, confusion, cyanosis, SOB, wheezing
respiratory alkalosis - 🧠 ANSWER ✔✔high pH, low CO2
COPYRIGHT©BLAIRALISTERNEWTON 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
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PRIVACY STATEMENT. ALL RIGHTS RESERVED
Questions Marking Scheme New Update
| A+ Rated
Respiratory failure types - 🧠 ANSWER ✔✔one or both gas exchanging
functions are inadequate
hypoxemic - oxygenation failure (PaO2 <60)
hypercapnic - ventilation failure (PaCO2 >45/pH <7.35)
both can be acute or chronic
Acute respiratory failure s/s - 🧠 ANSWER ✔✔early s/s - *change in mental
status, restless*, tachycardia, tachypnea
progressive s/s - agitation - coma, tachycardia - arrhythmias, hyper -
hypotension, dyspnea, accessory muscle use
late s/s - coma, cyanosis, hypotension, seizures, *decreased O2 sat*
ARF management - 🧠 ANSWER ✔✔O2 therapy
COPYRIGHT©BLAIRALISTERNEWTON 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
1
PRIVACY STATEMENT. ALL RIGHTS RESERVED
,Secretion clearance - hydration, HOB elevated, humidified O2, suctioning,
deep breathing, IS, coughing
artificial airway to keep tongue from obstructing
PPV (BiPAP, CPAP)
Meds - bronchodilators, steroids, diuretics, abx, benzos, analgesics
BiPAP vs CPAP - 🧠 ANSWER ✔✔BiPAP - pressure delivered at different
levels during inhalation and exhalation (higher in, lower out)
CPAP - continuous level of pressure for inhale/exhale
Contraindications to NIPPV - 🧠 ANSWER ✔✔apnea, decr LOC, ++
secretions, high O2 req, facial trauma
ARDS etiology - 🧠 ANSWER ✔✔mainly d/t pneumonia but also: sepsis,
aspiration, trauma
ARDS - 🧠 ANSWER ✔✔life threatening RF; acute, diffuse, inflammatory
lung injury
incr alveolar cap permeability = pulmonary edema
COPYRIGHT©BLAIRALISTERNEWTON 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
2
PRIVACY STATEMENT. ALL RIGHTS RESERVED
,s/s - *rapid onset of severe dyspnea*, *hypoxemia does not respond to
supp O2*, tachypnea, retractions, crackles, rhonchi, decr LOC, tachycardia,
hypotension, cyanosis
tx - supportive; usually combo of: intubation/ventilation, meds, prone
positioning, permissive hypercapnia
PEEP - 🧠 ANSWER ✔✔positive end expiratory pressure
keeps airways open at end of breath to prevent collapse/promote
oxygenation
ARDS drug therapy - 🧠 ANSWER ✔✔similar to RF
abx
diuretics
sedation
*fluids* - controversial
ARDS nsg interventions - 🧠 ANSWER ✔✔close monitoring
freq ABGs
monitor hgb
cough or suction if pt cannot
COPYRIGHT©BLAIRALISTERNEWTON 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
3
PRIVACY STATEMENT. ALL RIGHTS RESERVED
, *watch for s/s of cardiac compromise and low BP*
analgesia/sedation as needed
hand hygiene
*mouth care* to prev VAP
metabolic acidosis - 🧠 ANSWER ✔✔low ph, low bicarb
too much acid in body (CKD/kidney failure)
body making too much, not removing enough, body cannot balance
s/s - long/deep breaths, tachycardia, weakness, headache, n/v
metabolic alkalosis - 🧠 ANSWER ✔✔high ph, high bicarb
causes - prolonged vomiting, hypovolemia, diuretics, hypokalemia
s/s - confusion, tremors, dizziness, spasms, n/v, numbness/tingling
respiratory acidosis - 🧠 ANSWER ✔✔low ph, high CO2
lungs cannot remove enough CO2
causes - asthma, lung injury, substance use
s/s - anxiety, confusion, cyanosis, SOB, wheezing
respiratory alkalosis - 🧠 ANSWER ✔✔high pH, low CO2
COPYRIGHT©BLAIRALISTERNEWTON 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
4
PRIVACY STATEMENT. ALL RIGHTS RESERVED
