CRITICAL CARE EXAM 1: RESPIRATORY PRACTICE
QUESTIONS| TOP SCORES MADE SIMPLE | TRUSTED
TEST SOLUTIONS!
QUALITY CONTENT YOU CAN RELY ON!
1) A nurse is caring for a patient with ARDS. The nurse views the ABG. What value should
the nurse report to the physician?
pH: 7.35
PaCO2: 26mmhg
PaO2:95
HCO3: 22
a) PaCO2
b)pH
c)HCO3
d)PaO2 Answer: a
The normal range for PaCO2 is 35-45. This patient is experiencing a superimposed
respiratory alkalosis likely due to hyperventilation. The nurse should report the PaCO2 to
the physician.
2) A nurse must position the patient prone after his diagnosis of acute respiratory distress
syndrome (ARDS). Which of the following is a benefit of using this position? Select all that
apply.
A)Decreased atelectasis
B)Reduced need for endotracheal intubation
c)Mobilization of secretions
d)Decreased pleural pressure
e)Increased response to corticosteroid therapy Answer: a, c, d
Decreased atelectasis", "Mobilization of secretions" and "Decreased pleural pressure" are
correct. Prone positioning, or placing the patient face down with the head turned to the
side, helps with pulmonary function in the patient diagnosed with ARDS. When the patient
is placed in a prone position, the heart and diaphragm are not pressing against the lungs,
1
APPHIA - Crafted with Care and Precision for Academic Excellence.
,which means that pleural pressure is reduced. When there is less pressure exerted on the
lungs, atelectasis decreases. Studies have shown that many patients in the prone position
have increased lung secretions, which improves oxygenation.
-"Reduced need for endotracheal intubation" is incorrect. The prone position has not been
shown to decrease the likelihood of intubation.
-"Increased response to corticosteroid therapy" is incorrect because positioning does not
change the body's response to steroid therapy.
3) A 25-year-old patient in the ICU is being treated for acute respiratory distress syndrome
(ARDS). The patient is on a ventilator and requires 80 percent FiO2. Which information
would the nurse most likely need to report about the patient to the respiratory therapist
working with her?
a)The patient needs endotracheal suctioning
b)The patient needs more oxygen because of his saturation
c)The patient needs an arterial blood gas drawn
d)The patient needs a hemoglobin level drawn Answer: c
4) A patient who has recovered from ARDS in the ICU is now malnourished and has lost a
significant amount of weight. The physician orders TPN to add nutrition for the patient, who
then develops re-feeding syndrome. Which of the following signs or symptoms would the
nurse expect to see with re-feeding syndrome? Select all that apply.
a. Impaired mental status
b. Insulin resistance
c. Seizures
d. Persistent weight loss
e. Constipation Answer: a,b,c
impaired mental status", "Insulin resistance" and "Seizures" are correct. Re-feeding
syndrome can occur as a response to nutrient reintroduction after a period of starvation.
When an extremely malnourished patient receives TPN, the body has to adjust to receiving
nutrients again, which can cause shifts in electrolytes in the body. These shifts in
electrolytes can result in sudden and often fatal complications. Signs and symptoms of re-
2
APPHIA - Crafted with Care and Precision for Academic Excellence.
, feeding syndrome include confusion and impaired mental status, insulin resistance,
seizures, coma and death.
-"Persistent weight loss" is incorrect because by the time a patient develops re-feeding
syndrome, the onset of symptoms is so sudden that weight loss cannot be measured as
part of the syndrome.
-"Constipation" is incorrect, as it is not a symptom of refeeding syndrome.
5) A nurse is caring for a patient with ARDS. Which of the following clinical indicators would
signify that this client is in respiratory failure? Select all that apply.
a. Pulse oximetry of 94% on room air
b. A PaO2 level below 60 mmHg
c. An ABG pH level of 7.35
d. A pCO2 level over 50 mmHg
e. A respiratory rate of over 16/minute Answer: b, d
Respiratory diseases can cause such compromise that the patient will suffer symptoms;
however, there are certain clinical indicators that can clarify whether the patient is actually
in respiratory failure. Clinical indicators of respiratory failure include pulse oximetry of less
than 91% on room air, PaO2 level less than 60 mmHg, and a pCO2 level of over 50 mmHg.
6) A nurse is caring for a patient who is in respiratory distress because of ARDS. Which of
the following nursing diagnoses would most likely be associated with this condition?
a. Ineffective thermoregulation
b. Impaired urinary elimination
c. Ineffective tissue perfusion
d. Disturbed personal identity Answer: c
7) A nurse walks into a client who is in respiratory distress. The client has a tracheal
deviation to the right side. The nurse knows to prepare for which of the following emergent
procedures?
a. Chest tube insertion on the left side.
b. Chest tube insertion on the right side.
c. Intubation
3
APPHIA - Crafted with Care and Precision for Academic Excellence.
QUESTIONS| TOP SCORES MADE SIMPLE | TRUSTED
TEST SOLUTIONS!
QUALITY CONTENT YOU CAN RELY ON!
1) A nurse is caring for a patient with ARDS. The nurse views the ABG. What value should
the nurse report to the physician?
pH: 7.35
PaCO2: 26mmhg
PaO2:95
HCO3: 22
a) PaCO2
b)pH
c)HCO3
d)PaO2 Answer: a
The normal range for PaCO2 is 35-45. This patient is experiencing a superimposed
respiratory alkalosis likely due to hyperventilation. The nurse should report the PaCO2 to
the physician.
2) A nurse must position the patient prone after his diagnosis of acute respiratory distress
syndrome (ARDS). Which of the following is a benefit of using this position? Select all that
apply.
A)Decreased atelectasis
B)Reduced need for endotracheal intubation
c)Mobilization of secretions
d)Decreased pleural pressure
e)Increased response to corticosteroid therapy Answer: a, c, d
Decreased atelectasis", "Mobilization of secretions" and "Decreased pleural pressure" are
correct. Prone positioning, or placing the patient face down with the head turned to the
side, helps with pulmonary function in the patient diagnosed with ARDS. When the patient
is placed in a prone position, the heart and diaphragm are not pressing against the lungs,
1
APPHIA - Crafted with Care and Precision for Academic Excellence.
,which means that pleural pressure is reduced. When there is less pressure exerted on the
lungs, atelectasis decreases. Studies have shown that many patients in the prone position
have increased lung secretions, which improves oxygenation.
-"Reduced need for endotracheal intubation" is incorrect. The prone position has not been
shown to decrease the likelihood of intubation.
-"Increased response to corticosteroid therapy" is incorrect because positioning does not
change the body's response to steroid therapy.
3) A 25-year-old patient in the ICU is being treated for acute respiratory distress syndrome
(ARDS). The patient is on a ventilator and requires 80 percent FiO2. Which information
would the nurse most likely need to report about the patient to the respiratory therapist
working with her?
a)The patient needs endotracheal suctioning
b)The patient needs more oxygen because of his saturation
c)The patient needs an arterial blood gas drawn
d)The patient needs a hemoglobin level drawn Answer: c
4) A patient who has recovered from ARDS in the ICU is now malnourished and has lost a
significant amount of weight. The physician orders TPN to add nutrition for the patient, who
then develops re-feeding syndrome. Which of the following signs or symptoms would the
nurse expect to see with re-feeding syndrome? Select all that apply.
a. Impaired mental status
b. Insulin resistance
c. Seizures
d. Persistent weight loss
e. Constipation Answer: a,b,c
impaired mental status", "Insulin resistance" and "Seizures" are correct. Re-feeding
syndrome can occur as a response to nutrient reintroduction after a period of starvation.
When an extremely malnourished patient receives TPN, the body has to adjust to receiving
nutrients again, which can cause shifts in electrolytes in the body. These shifts in
electrolytes can result in sudden and often fatal complications. Signs and symptoms of re-
2
APPHIA - Crafted with Care and Precision for Academic Excellence.
, feeding syndrome include confusion and impaired mental status, insulin resistance,
seizures, coma and death.
-"Persistent weight loss" is incorrect because by the time a patient develops re-feeding
syndrome, the onset of symptoms is so sudden that weight loss cannot be measured as
part of the syndrome.
-"Constipation" is incorrect, as it is not a symptom of refeeding syndrome.
5) A nurse is caring for a patient with ARDS. Which of the following clinical indicators would
signify that this client is in respiratory failure? Select all that apply.
a. Pulse oximetry of 94% on room air
b. A PaO2 level below 60 mmHg
c. An ABG pH level of 7.35
d. A pCO2 level over 50 mmHg
e. A respiratory rate of over 16/minute Answer: b, d
Respiratory diseases can cause such compromise that the patient will suffer symptoms;
however, there are certain clinical indicators that can clarify whether the patient is actually
in respiratory failure. Clinical indicators of respiratory failure include pulse oximetry of less
than 91% on room air, PaO2 level less than 60 mmHg, and a pCO2 level of over 50 mmHg.
6) A nurse is caring for a patient who is in respiratory distress because of ARDS. Which of
the following nursing diagnoses would most likely be associated with this condition?
a. Ineffective thermoregulation
b. Impaired urinary elimination
c. Ineffective tissue perfusion
d. Disturbed personal identity Answer: c
7) A nurse walks into a client who is in respiratory distress. The client has a tracheal
deviation to the right side. The nurse knows to prepare for which of the following emergent
procedures?
a. Chest tube insertion on the left side.
b. Chest tube insertion on the right side.
c. Intubation
3
APPHIA - Crafted with Care and Precision for Academic Excellence.
