NU455 exam 1 Questions and Answers Already Passed Latest Update 2025-2026
A patient in the ICU is mechanically ventilated. Which of the following interventions is most
important to prevent ventilator-associated pneumonia (VAP)?
A) Perform oropharyngeal suctioning every 2 hours.
B) Administer antibiotics prophylactically.
C) Elevate the head of the bed to 30-45 degrees.
D) Change the ventilator tubing every shift. - Answers C) Elevate the head of the bed to 30-45
degrees.
Rationale: Elevating the head of the bed helps reduce the risk of aspiration, which can contribute
to VAP.
A patient with acute respiratory distress syndrome (ARDS) is placed on mechanical ventilation.
What is the primary goal of ventilation in ARDS patients?
A) To maintain high oxygen levels at any cost.
B) To provide adequate oxygenation while minimizing lung injury.
C) To increase tidal volume to improve oxygenation.
D) To maintain normal carbon dioxide levels. - Answers B) To provide adequate oxygenation
while minimizing lung injury.
Rationale: In ARDS, protective lung strategies, such as low tidal volumes, are used to minimize
further lung injury while ensuring adequate oxygenation.
While assessing a patient's arterial blood gases (ABGs), the nurse notes the following results:
pH 7.29, PaCO2 50 mm Hg, HCO3 24 mEq/L. What condition does this patient most likely have?
A) Metabolic acidosis
B) Respiratory acidosis
C) Respiratory alkalosis
D) Metabolic alkalosis - Answers B) Respiratory acidosis
,Rationale: The low pH (7.29) and high PaCO2 (50 mm Hg) indicate respiratory acidosis, typically
caused by hypoventilation or impaired gas exchange.
A nurse is caring for a patient with a pulmonary embolism (PE). Which of the following is the
most common sign or symptom of PE?
A) Wheezing
B) Hemoptysis
C) Sudden onset of shortness of breath
D) Fever - Answers C) Sudden onset of shortness of breath
Rationale: The sudden onset of dyspnea is the most common symptom of a pulmonary
embolism, due to blockage of the pulmonary circulation.
A patient has a chest tube in place after a pneumothorax. The nurse observes continuous
bubbling in the water seal chamber. What is the most appropriate action?
A) Increase suction.
B) Clamp the chest tube.
C) Check for air leaks in the system.
D) Encourage the patient to cough and deep breathe. - Answers C) Check for air leaks in the
system.
Rationale: Continuous bubbling in the water seal chamber usually indicates an air leak in the
system that should be identified and resolved.
A patient is in acute respiratory failure with hypoxemia. Which of the following ABG results
would the nurse expect to see?
A) pH 7.40, PaO2 95 mm Hg, PaCO2 40 mm Hg
B) pH 7.35, PaO2 80 mm Hg, PaCO2 45 mm Hg
C) pH 7.25, PaO2 55 mm Hg, PaCO2 30 mm Hg
D) pH 7.50, PaO2 105 mm Hg, PaCO2 25 mm Hg - Answers C) pH 7.25, PaO2 55 mm Hg, PaCO2
30 mm Hg
, Rationale: These ABG results indicate hypoxemia (PaO2 < 60 mm Hg), with compensatory
hyperventilation, leading to a low PaCO2.
A patient with hypercarbia presents to the emergency department. What would the nurse expect
the ABG results to show?
A) Elevated pH, decreased PaCO2
B) Decreased pH, increased PaCO2
C) Decreased pH, decreased HCO3
D) Normal pH, normal PaCO2 - Answers B) Decreased pH, increased PaCO2
Rationale: Hypercarbia (increased PaCO2) leads to respiratory acidosis, characterized by a low
pH and elevated CO2 levels.
A patient is being treated for ARDS and has a PaO2 of 55 mm Hg despite receiving 100% oxygen.
Which of the following interventions is most likely to improve this patient's oxygenation?
A) Increase the respiratory rate.
B) Use prone positioning.
C) Increase the tidal volume.
D) Administer bronchodilators. - Answers B) Use prone positioning.
Rationale: Prone positioning improves oxygenation in ARDS patients by enhancing lung
expansion and gas exchange in previously collapsed alveoli
What is a priority nursing intervention for a patient with hypoxemia who is receiving oxygen
therapy?
A) Keep oxygen saturation above 90%.
B) Maintain the patient in a supine position.
C) Discontinue oxygen once the patient reports improvement.
D) Monitor for signs of oxygen toxicity if high-flow oxygen is used. - Answers D) Monitor for
signs of oxygen toxicity if high-flow oxygen is used.
A patient in the ICU is mechanically ventilated. Which of the following interventions is most
important to prevent ventilator-associated pneumonia (VAP)?
A) Perform oropharyngeal suctioning every 2 hours.
B) Administer antibiotics prophylactically.
C) Elevate the head of the bed to 30-45 degrees.
D) Change the ventilator tubing every shift. - Answers C) Elevate the head of the bed to 30-45
degrees.
Rationale: Elevating the head of the bed helps reduce the risk of aspiration, which can contribute
to VAP.
A patient with acute respiratory distress syndrome (ARDS) is placed on mechanical ventilation.
What is the primary goal of ventilation in ARDS patients?
A) To maintain high oxygen levels at any cost.
B) To provide adequate oxygenation while minimizing lung injury.
C) To increase tidal volume to improve oxygenation.
D) To maintain normal carbon dioxide levels. - Answers B) To provide adequate oxygenation
while minimizing lung injury.
Rationale: In ARDS, protective lung strategies, such as low tidal volumes, are used to minimize
further lung injury while ensuring adequate oxygenation.
While assessing a patient's arterial blood gases (ABGs), the nurse notes the following results:
pH 7.29, PaCO2 50 mm Hg, HCO3 24 mEq/L. What condition does this patient most likely have?
A) Metabolic acidosis
B) Respiratory acidosis
C) Respiratory alkalosis
D) Metabolic alkalosis - Answers B) Respiratory acidosis
,Rationale: The low pH (7.29) and high PaCO2 (50 mm Hg) indicate respiratory acidosis, typically
caused by hypoventilation or impaired gas exchange.
A nurse is caring for a patient with a pulmonary embolism (PE). Which of the following is the
most common sign or symptom of PE?
A) Wheezing
B) Hemoptysis
C) Sudden onset of shortness of breath
D) Fever - Answers C) Sudden onset of shortness of breath
Rationale: The sudden onset of dyspnea is the most common symptom of a pulmonary
embolism, due to blockage of the pulmonary circulation.
A patient has a chest tube in place after a pneumothorax. The nurse observes continuous
bubbling in the water seal chamber. What is the most appropriate action?
A) Increase suction.
B) Clamp the chest tube.
C) Check for air leaks in the system.
D) Encourage the patient to cough and deep breathe. - Answers C) Check for air leaks in the
system.
Rationale: Continuous bubbling in the water seal chamber usually indicates an air leak in the
system that should be identified and resolved.
A patient is in acute respiratory failure with hypoxemia. Which of the following ABG results
would the nurse expect to see?
A) pH 7.40, PaO2 95 mm Hg, PaCO2 40 mm Hg
B) pH 7.35, PaO2 80 mm Hg, PaCO2 45 mm Hg
C) pH 7.25, PaO2 55 mm Hg, PaCO2 30 mm Hg
D) pH 7.50, PaO2 105 mm Hg, PaCO2 25 mm Hg - Answers C) pH 7.25, PaO2 55 mm Hg, PaCO2
30 mm Hg
, Rationale: These ABG results indicate hypoxemia (PaO2 < 60 mm Hg), with compensatory
hyperventilation, leading to a low PaCO2.
A patient with hypercarbia presents to the emergency department. What would the nurse expect
the ABG results to show?
A) Elevated pH, decreased PaCO2
B) Decreased pH, increased PaCO2
C) Decreased pH, decreased HCO3
D) Normal pH, normal PaCO2 - Answers B) Decreased pH, increased PaCO2
Rationale: Hypercarbia (increased PaCO2) leads to respiratory acidosis, characterized by a low
pH and elevated CO2 levels.
A patient is being treated for ARDS and has a PaO2 of 55 mm Hg despite receiving 100% oxygen.
Which of the following interventions is most likely to improve this patient's oxygenation?
A) Increase the respiratory rate.
B) Use prone positioning.
C) Increase the tidal volume.
D) Administer bronchodilators. - Answers B) Use prone positioning.
Rationale: Prone positioning improves oxygenation in ARDS patients by enhancing lung
expansion and gas exchange in previously collapsed alveoli
What is a priority nursing intervention for a patient with hypoxemia who is receiving oxygen
therapy?
A) Keep oxygen saturation above 90%.
B) Maintain the patient in a supine position.
C) Discontinue oxygen once the patient reports improvement.
D) Monitor for signs of oxygen toxicity if high-flow oxygen is used. - Answers D) Monitor for
signs of oxygen toxicity if high-flow oxygen is used.
