LATEST NR 325 ADULT HEALTH II:
ADVANCED RESPIRATORY LIFE SUPPORT
EXAM| COMPLETE QUESTION BANK WITH
CORRECT ANSWERS WITH RATIONALES
1. A 65-year-old patient presents with acute
respiratory distress, using accessory muscles, and is
unable to speak in full sentences. The patient's
oxygen saturation is 85% on a non-rebreather mask.
What is the most appropriate immediate intervention?
A) Administer a bronchodilator nebulizer
B) Prepare for immediate endotracheal intubation
C) Apply continuous positive airway pressure (CPAP)
D) Administer intravenous corticosteroids
Answer: B
Rationale: This patient is in acute respiratory failure
with severe distress and hypoxia. Immediate
intubation is indicated to secure the airway and
provide mechanical ventilation.
2. A patient is being mechanically ventilated. The
ventilator alarms with a high-pressure alarm. Which
of the following is the most likely cause?
,A) Patient disconnection from the ventilator
B) Kinking of the ventilator tubing
C) Endotracheal tube cuff leak
D) Accidental extubation
Answer: B
Rationale: A high-pressure alarm typically indicates
increased airway resistance or obstruction, such as
kinking of the tubing, secretions, or a patient biting
the tube.
3. A patient is on mechanical ventilation with the
following settings: tidal volume 500 mL, respiratory
rate 12 breaths/min, FiO2 40%, PEEP 5 cm H2O. The
patient's arterial blood gas (ABG) shows a PaCO2 of
55 mmHg and a pH of 7.28. What is the most
appropriate adjustment?
A) Increase the tidal volume
B) Increase the respiratory rate
C) Increase the FiO2
D) Increase the PEEP
Answer: B
Rationale: The ABG shows respiratory acidosis
(elevated PaCO2 and low pH). Increasing the
,respiratory rate will increase minute ventilation and
help eliminate CO2.
4. A patient is 24 hours post-operative following a
total hip replacement and suddenly develops acute
shortness of breath, chest pain, and hypoxia. The
patient's D-dimer is elevated. What is the most
appropriate diagnostic test?
A) Chest X-ray
B) CT pulmonary angiogram
C) Ventilation-perfusion (V/Q) scan
D) Pulmonary function test
Answer: B
Rationale: Acute onset of dyspnea, chest pain, and
hypoxia with elevated D-dimer is concerning for
pulmonary embolism. CT pulmonary angiogram is the
gold standard for diagnosis.
5. A patient with a history of COPD presents with an
acute exacerbation. The patient is confused,
tachycardic, and has a respiratory rate of 30
breaths/min. The ABG shows a pH of 7.25, PaCO2 of
60 mmHg, and PaO2 of 55 mmHg. What is the most
appropriate intervention?
, A) Administer high-flow oxygen via non-rebreather
mask
B) Prepare for non-invasive positive pressure
ventilation (NIPPV)
C) Administer intravenous corticosteroids
D) Administer a bronchodilator nebulizer
Answer: B
Rationale: This patient has acute respiratory failure
with hypercapnia. Non-invasive positive pressure
ventilation (NIPPV) such as BiPAP is indicated to
support ventilation and reduce work of breathing.
6. A patient is intubated and on mechanical
ventilation. The patient's SpO2 drops from 94% to
86%. The ventilator low-pressure alarm sounds. What
is the most appropriate initial action?
A) Assess the patient's breath sounds and check the
ventilator tubing
B) Increase the FiO2
C) Administer a bronchodilator
D) Suction the endotracheal tube
Answer: A
Rationale: A low-pressure alarm suggests a
disconnection or leak in the ventilator circuit. The
ADVANCED RESPIRATORY LIFE SUPPORT
EXAM| COMPLETE QUESTION BANK WITH
CORRECT ANSWERS WITH RATIONALES
1. A 65-year-old patient presents with acute
respiratory distress, using accessory muscles, and is
unable to speak in full sentences. The patient's
oxygen saturation is 85% on a non-rebreather mask.
What is the most appropriate immediate intervention?
A) Administer a bronchodilator nebulizer
B) Prepare for immediate endotracheal intubation
C) Apply continuous positive airway pressure (CPAP)
D) Administer intravenous corticosteroids
Answer: B
Rationale: This patient is in acute respiratory failure
with severe distress and hypoxia. Immediate
intubation is indicated to secure the airway and
provide mechanical ventilation.
2. A patient is being mechanically ventilated. The
ventilator alarms with a high-pressure alarm. Which
of the following is the most likely cause?
,A) Patient disconnection from the ventilator
B) Kinking of the ventilator tubing
C) Endotracheal tube cuff leak
D) Accidental extubation
Answer: B
Rationale: A high-pressure alarm typically indicates
increased airway resistance or obstruction, such as
kinking of the tubing, secretions, or a patient biting
the tube.
3. A patient is on mechanical ventilation with the
following settings: tidal volume 500 mL, respiratory
rate 12 breaths/min, FiO2 40%, PEEP 5 cm H2O. The
patient's arterial blood gas (ABG) shows a PaCO2 of
55 mmHg and a pH of 7.28. What is the most
appropriate adjustment?
A) Increase the tidal volume
B) Increase the respiratory rate
C) Increase the FiO2
D) Increase the PEEP
Answer: B
Rationale: The ABG shows respiratory acidosis
(elevated PaCO2 and low pH). Increasing the
,respiratory rate will increase minute ventilation and
help eliminate CO2.
4. A patient is 24 hours post-operative following a
total hip replacement and suddenly develops acute
shortness of breath, chest pain, and hypoxia. The
patient's D-dimer is elevated. What is the most
appropriate diagnostic test?
A) Chest X-ray
B) CT pulmonary angiogram
C) Ventilation-perfusion (V/Q) scan
D) Pulmonary function test
Answer: B
Rationale: Acute onset of dyspnea, chest pain, and
hypoxia with elevated D-dimer is concerning for
pulmonary embolism. CT pulmonary angiogram is the
gold standard for diagnosis.
5. A patient with a history of COPD presents with an
acute exacerbation. The patient is confused,
tachycardic, and has a respiratory rate of 30
breaths/min. The ABG shows a pH of 7.25, PaCO2 of
60 mmHg, and PaO2 of 55 mmHg. What is the most
appropriate intervention?
, A) Administer high-flow oxygen via non-rebreather
mask
B) Prepare for non-invasive positive pressure
ventilation (NIPPV)
C) Administer intravenous corticosteroids
D) Administer a bronchodilator nebulizer
Answer: B
Rationale: This patient has acute respiratory failure
with hypercapnia. Non-invasive positive pressure
ventilation (NIPPV) such as BiPAP is indicated to
support ventilation and reduce work of breathing.
6. A patient is intubated and on mechanical
ventilation. The patient's SpO2 drops from 94% to
86%. The ventilator low-pressure alarm sounds. What
is the most appropriate initial action?
A) Assess the patient's breath sounds and check the
ventilator tubing
B) Increase the FiO2
C) Administer a bronchodilator
D) Suction the endotracheal tube
Answer: A
Rationale: A low-pressure alarm suggests a
disconnection or leak in the ventilator circuit. The
