ARDS- NCLEX (questions n answers)
graded A+
1. It will be most important for the nurse to check pulse oximetry for which of
these patients?
a. A patient with emphysema and a respiratory rate of 16
b. A patient with massive obesity who is refusing to get out of bed
c. A patient with pneumonia who has just been admitted to the unit
d. A patient who has just received morphine sulfate for postoperative pain -
correct answer ✔✔C
Rationale: Hypoxemia and hypoxemic respiratory failure are caused by disorders
that interfere with the transfer of oxygen into the blood, such as pneumonia. The
other listed disorders are more likely to cause problems with hypercapnia because
of ventilatory failure.
2. The nurse will monitor for clinical manifestations of hypercapnia when a patient
in the emergency department has
a. chest trauma and multiple rib fractures.
b. carbon monoxide poisoning after a house fire.
c. left-sided ventricular failure and acute pulmonary edema.
d. tachypnea and acute respiratory distress syndrome (ARDS). - correct answer
✔✔A
Rationale: Hypercapnia is caused by poor ventilatory effort, which occurs in chest
trauma when rib fractures (or flail chest) decrease lung ventilation. Carbon
monoxide poisoning, acute pulmonary edema, and ARDS are more commonly
associated with hypoxemia.
, 3. When a patient is diagnosed with pulmonary fibrosis, the nurse will teach the
patient about the risk for poor oxygenation because of
a. too-rapid movement of blood flow through the pulmonary blood vessels.
b. incomplete filling of the alveoli with air because of reduced respiratory ability.
c. decreased transfer of oxygen into the blood because of thickening of the alveoli.
d. mismatch between lung ventilation and blood flow through the blood vessels of
the lung. - correct answer ✔✔C
Rationale: Pulmonary fibrosis causes the alveolar-capillary interface to become
thicker, which increases the amount of time it takes for gas to diffuse across the
membrane. Too-rapid pulmonary blood flow is another cause of shunt but does
not describe the pathology of pulmonary fibrosis. Decrease in alveolar ventilation
will cause hypercapnia. Ventilation and perfusion are matched in pulmonary
fibrosis; the problem is with diffusion.
4. A patient is diagnosed with a large pulmonary embolism. When explaining to
the patient what has happened to cause respiratory failure, which information will
the nurse include?
a. "Oxygen transfer into your blood is slow because of thick membranes between
the small air sacs and the lung circulation."
b. "Thick secretions in your small airways are blocking air from moving into the
small air sacs in your lungs."
c. "Large areas of your lungs are getting good blood flow but are not receiving
enough air to fill the small air sacs."
d. "Blood flow though some areas of your lungs is decreased even though you are
taking adequate breaths." - correct answer ✔✔D
Rationale: A pulmonary embolus limits blood flow but does not affect ventilation,
leading to a ventilation-perfusion mismatch. The response beginning, "Oxygen
graded A+
1. It will be most important for the nurse to check pulse oximetry for which of
these patients?
a. A patient with emphysema and a respiratory rate of 16
b. A patient with massive obesity who is refusing to get out of bed
c. A patient with pneumonia who has just been admitted to the unit
d. A patient who has just received morphine sulfate for postoperative pain -
correct answer ✔✔C
Rationale: Hypoxemia and hypoxemic respiratory failure are caused by disorders
that interfere with the transfer of oxygen into the blood, such as pneumonia. The
other listed disorders are more likely to cause problems with hypercapnia because
of ventilatory failure.
2. The nurse will monitor for clinical manifestations of hypercapnia when a patient
in the emergency department has
a. chest trauma and multiple rib fractures.
b. carbon monoxide poisoning after a house fire.
c. left-sided ventricular failure and acute pulmonary edema.
d. tachypnea and acute respiratory distress syndrome (ARDS). - correct answer
✔✔A
Rationale: Hypercapnia is caused by poor ventilatory effort, which occurs in chest
trauma when rib fractures (or flail chest) decrease lung ventilation. Carbon
monoxide poisoning, acute pulmonary edema, and ARDS are more commonly
associated with hypoxemia.
, 3. When a patient is diagnosed with pulmonary fibrosis, the nurse will teach the
patient about the risk for poor oxygenation because of
a. too-rapid movement of blood flow through the pulmonary blood vessels.
b. incomplete filling of the alveoli with air because of reduced respiratory ability.
c. decreased transfer of oxygen into the blood because of thickening of the alveoli.
d. mismatch between lung ventilation and blood flow through the blood vessels of
the lung. - correct answer ✔✔C
Rationale: Pulmonary fibrosis causes the alveolar-capillary interface to become
thicker, which increases the amount of time it takes for gas to diffuse across the
membrane. Too-rapid pulmonary blood flow is another cause of shunt but does
not describe the pathology of pulmonary fibrosis. Decrease in alveolar ventilation
will cause hypercapnia. Ventilation and perfusion are matched in pulmonary
fibrosis; the problem is with diffusion.
4. A patient is diagnosed with a large pulmonary embolism. When explaining to
the patient what has happened to cause respiratory failure, which information will
the nurse include?
a. "Oxygen transfer into your blood is slow because of thick membranes between
the small air sacs and the lung circulation."
b. "Thick secretions in your small airways are blocking air from moving into the
small air sacs in your lungs."
c. "Large areas of your lungs are getting good blood flow but are not receiving
enough air to fill the small air sacs."
d. "Blood flow though some areas of your lungs is decreased even though you are
taking adequate breaths." - correct answer ✔✔D
Rationale: A pulmonary embolus limits blood flow but does not affect ventilation,
leading to a ventilation-perfusion mismatch. The response beginning, "Oxygen
