Critical Care exam 1: respiratory
This Critical Care Exam 1: Respiratory Practice Questions focus heavily on advanced
topics like Acute Respiratory Distress Syndrome (ARDS), arterial blood gas (ABG) interpretation,
mechanical ventilation management, and life-threatening respiratory emergencies.
These structured, high-yield practice scenarios and rationales closely mimic the core 80-question
patterns found in this advanced ICU nursing exam bank
🫁 Acute Respiratory Distress Syndrome (ARDS) & Hypoxemia
• : Type II alveolar cells produce surfactant, which reduces surface tension and prevents
alveolar collapse. Damage to these cells leads to massive atelectasis and structural shunting.
Core ICU Respiratory Reference Metrics
Use these diagnostic parameters to evaluate critical respiratory failure cases on your exam:
Parameter Normal Range Critical Care Threshold / Indicator
< 60 mmHg (Hypoxemic Respiratory
\(PaO_{2}\) 75 – 100 mmHg
Failure)
> 50 mmHg (Hypercapnic Respiratory
\(PaCO_{2}\) 35 – 45 mmHg
Failure)
\(PaO_2/FiO_2\) Ratio > 400 < 300 (ARDS Indicator; < 100 is severe)
Negative Inspiratory Force -50 to -100 > -20 \(cmH_{2}O\) (Indicates poor
(NIF) \(cmH_{2}O\) weaning readiness)
1
, Quiz_________________?
:D
This client has the most severe hypoxia and respiratory alkalosis, indicated by low partial
pressure of arterial carbon dioxide (PaCO2) values on ABG analysis. -
ANSWER✅
The nurse is assessing arterial blood gases (ABGs). The client with which ABG reading
requires the nurse's immediate attention?
a. pH, 7.32; PaCO2, 55 mm Hg; PaO2, 70 mm Hg
b. pH, 7.45; PaCO2, 42 mm Hg; PaO2, 70 mm Hg
c. pH, 7.48; PaCO2, 38 mm Hg; PaO2, 60 mm Hg
d. pH, 7.55; PaCO2, 32 mm Hg; PaO2, 50 mm Hg
Quiz_________________?
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. -
ANSWER✅
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
2
, b)pH
c)HCO3
d)PaO2
Quiz_________________?
a
Tracheal deviation indicates a pneumothorax, the direction of the deviation indicates the
side the pneumothorax is on. If the trachea is deviating to the right, then the pneumo is on
the left. The treatment for this is a chest tube on the side of trhe deflated lung. -
ANSWER✅
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
d. Tracheostomy
Quiz_________________?
A
Airway and breathing are the top priority. The nurse would also need to monitor for
bleeding when administering fibrinolytic therapy, and would monitor the IV site as well.
Teaching the client is also a need, however. Oxygenation is the highest priority. -
ANSWER✅
It is determined that a client has a large pulmonary embolism (PE). Fibrinolytic therapy is
initiated. What is the nurse's priority action?
a. Monitor the client's oxygenation.
3
, b. Teach the client about potential side effects.
c. Monitor the IV insertion site.
d. Monitor for bleeding.
Quiz_________________?
A
If the client has the cuff on the endotracheal tube inflated, the cuff should prevent air from
going around the cuff and through the vocal cords. If the client can talk with the cuff inflated,
the cuff probably has a leak, causing it to become deflated and allowing air to pass through.
The risk is that the client will not receive the prescribed tidal volume. -
ANSWER✅
The nurse is caring for a client who is intubated with an endotracheal tube and on a
mechanical ventilator. The client is able to make sounds. What is the nurse's first action?
a. Check cuff inflation on the endotracheal tube.
b. Listen carefully to the client.
c. Call the health care provider.
d. Auscultate the lungs
Quiz_________________?
A
Increased intrathoracic pressure can inhibit blood return to the heart and cause decreased
cardiac output. This manifests with a drop in blood pressure. The pulse oximetry reading,
ABGs, and urinary output are all normal. -
ANSWER✅
The nurse is caring for a client who is receiving mechanical ventilation accompanied by
positive end-expiratory pressure (PEEP). What assessment findings require immediate
intervention?
a. Blood pressure drop from 110/90 mm Hg to 80/50 mm/Hg
b. Pulse oximetry value of 96%
4
This Critical Care Exam 1: Respiratory Practice Questions focus heavily on advanced
topics like Acute Respiratory Distress Syndrome (ARDS), arterial blood gas (ABG) interpretation,
mechanical ventilation management, and life-threatening respiratory emergencies.
These structured, high-yield practice scenarios and rationales closely mimic the core 80-question
patterns found in this advanced ICU nursing exam bank
🫁 Acute Respiratory Distress Syndrome (ARDS) & Hypoxemia
• : Type II alveolar cells produce surfactant, which reduces surface tension and prevents
alveolar collapse. Damage to these cells leads to massive atelectasis and structural shunting.
Core ICU Respiratory Reference Metrics
Use these diagnostic parameters to evaluate critical respiratory failure cases on your exam:
Parameter Normal Range Critical Care Threshold / Indicator
< 60 mmHg (Hypoxemic Respiratory
\(PaO_{2}\) 75 – 100 mmHg
Failure)
> 50 mmHg (Hypercapnic Respiratory
\(PaCO_{2}\) 35 – 45 mmHg
Failure)
\(PaO_2/FiO_2\) Ratio > 400 < 300 (ARDS Indicator; < 100 is severe)
Negative Inspiratory Force -50 to -100 > -20 \(cmH_{2}O\) (Indicates poor
(NIF) \(cmH_{2}O\) weaning readiness)
1
, Quiz_________________?
:D
This client has the most severe hypoxia and respiratory alkalosis, indicated by low partial
pressure of arterial carbon dioxide (PaCO2) values on ABG analysis. -
ANSWER✅
The nurse is assessing arterial blood gases (ABGs). The client with which ABG reading
requires the nurse's immediate attention?
a. pH, 7.32; PaCO2, 55 mm Hg; PaO2, 70 mm Hg
b. pH, 7.45; PaCO2, 42 mm Hg; PaO2, 70 mm Hg
c. pH, 7.48; PaCO2, 38 mm Hg; PaO2, 60 mm Hg
d. pH, 7.55; PaCO2, 32 mm Hg; PaO2, 50 mm Hg
Quiz_________________?
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. -
ANSWER✅
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
2
, b)pH
c)HCO3
d)PaO2
Quiz_________________?
a
Tracheal deviation indicates a pneumothorax, the direction of the deviation indicates the
side the pneumothorax is on. If the trachea is deviating to the right, then the pneumo is on
the left. The treatment for this is a chest tube on the side of trhe deflated lung. -
ANSWER✅
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
d. Tracheostomy
Quiz_________________?
A
Airway and breathing are the top priority. The nurse would also need to monitor for
bleeding when administering fibrinolytic therapy, and would monitor the IV site as well.
Teaching the client is also a need, however. Oxygenation is the highest priority. -
ANSWER✅
It is determined that a client has a large pulmonary embolism (PE). Fibrinolytic therapy is
initiated. What is the nurse's priority action?
a. Monitor the client's oxygenation.
3
, b. Teach the client about potential side effects.
c. Monitor the IV insertion site.
d. Monitor for bleeding.
Quiz_________________?
A
If the client has the cuff on the endotracheal tube inflated, the cuff should prevent air from
going around the cuff and through the vocal cords. If the client can talk with the cuff inflated,
the cuff probably has a leak, causing it to become deflated and allowing air to pass through.
The risk is that the client will not receive the prescribed tidal volume. -
ANSWER✅
The nurse is caring for a client who is intubated with an endotracheal tube and on a
mechanical ventilator. The client is able to make sounds. What is the nurse's first action?
a. Check cuff inflation on the endotracheal tube.
b. Listen carefully to the client.
c. Call the health care provider.
d. Auscultate the lungs
Quiz_________________?
A
Increased intrathoracic pressure can inhibit blood return to the heart and cause decreased
cardiac output. This manifests with a drop in blood pressure. The pulse oximetry reading,
ABGs, and urinary output are all normal. -
ANSWER✅
The nurse is caring for a client who is receiving mechanical ventilation accompanied by
positive end-expiratory pressure (PEEP). What assessment findings require immediate
intervention?
a. Blood pressure drop from 110/90 mm Hg to 80/50 mm/Hg
b. Pulse oximetry value of 96%
4
