NUR 417– Exam 2 Complete Bundle | 2025-2026 Practice
Questions with Correct Answers, Study Notes, and Detailed
Rationales Covering All Major Nursing Topics/NURS 417 Exam
2||Already Graded A+
The nurse is caring for a patient who has required prolonged
mechanical ventilation and has the following arterial blood gas
results: pH 7.48, PaO2 85 mm Hg, PaCO2 32 mm Hg, and HCO3 25
mmol/L. Which of the following interpretations would the nurse
document?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis - Answer-d
The nurse is caring for a patient with an uncuffed tracheostomy tube
who coughs violently during suctioning and dislodges the
tracheostomy tube. Which of the following actions should the nurse
take first?
a. Insert the obturator and attempt to reinsert the tracheostomy tube.
b. Position the patient in an upright position with the neck extended.
c. Assess the patient's oxygen saturation and notify the health care
provider.
d. Ventilate the patient with a manual bag until the health care
provider arrives. - Answer-A
Which of the following actions should the nurse do to inflate the cuff
of an endotracheal tube
(ET) when the patient is on mechanical ventilation?
a. Inflate the cuff until the pilot balloon is firm.
b. Inflate the cuff with a minimum of 10 mL of air.
pg. 1
,c. Inject air into the cuff until a manometer shows 15 mm Hg
pressure.
d. Inject air into the cuff until a slight leak is heard only at peak
inflation. - Answer-ANS: D
The minimal occluding volume technique involves injecting air into
the cuff until an air leak is present only at peak inflation. The volume
to inflate the cuff varies with the ET and the patient's size. Cuff
pressure should be maintained at 20-25 mm Hg. An accurate
assessment of cuff pressure cannot be obtained by palpating the pilot
balloon.
Which of the following information obtained by the nurse when
caring for a patient receiving
mechanical ventilation indicates the need for suctioning?
a. The respiratory rate is 32 breaths/minute.
b. The pulse oximeter shows a SpO2 of 93%.
c. The patient has not been suctioned for the last 6 hours.
d. The lungs have occasional audible expiratory wheezes. -ANS: A
The increase in respiratory rate indicates that the patient may have
decreased airway clearance and requires suctioning. Suctioning is
done when patient assessment data indicate that it is needed, not on a
scheduled basis. Occasional expiratory wheezes do not indicate poor
airway clearance, and suctioning the patient may induce
bronchospasm and increase wheezing. An SpO2 of 93% is acceptable
and does not suggest that immediate suctioning is needed.
The nurse notes thick, white respiratory secretions from a patient who
is receiving mechanical ventilation. Which of the following
interventions will be most effective in resolving thisproblem?
a. Suction the patient every hour.
b. Reposition the patient every 2 hours.
pg. 2
,c. Add additional water to the patient's enteral feedings.
d. Instil 5 mL of sterile saline into the endotracheal tube (ET) before
suctioning. - Answer-ANS: C
Because the patient's secretions are thick, better hydration is
indicated. Suctioning every hour without any specific evidence for the
need will increase the incidence of mucosal trauma and would not
address the aetiology of the ineffective airway clearance. Instillation
of saline does not liquefy secretions and may decrease the SpO2.
Repositioning the patient is appropriate but will not decrease the
thickness of secretions.
4 hours after mechanical ventilation is initiated for a patient with
chronic obstructive pulmonary disease (COPD), the patient's arterial
blood gas (ABG) results include a pH of7.50, PaO2 of 80 mm Hg,
PaCO2 of 29 mm Hg, and HCO3- of 23 mmol/L. The nurse will
anticipate the need to do which of the following actions based upon
these findings?
a. Increase the FIO2.
b. Decrease the respiratory rate.
c. Increase the tidal volume (VT).
d. Leave the ventilator at the current settings. -ANS: B
The patient's PaCO2 and pH indicate respiratory alkalosis caused by
too high a respiratory rate. The PaO2 is appropriate for a patient with
COPD, increasing the tidal volume would further lower the PaCO2,
and the PaCO2 and pH indicate a need to make the ventilator changes.
The nurse is weaning a patient who has chronic obstructive
pulmonary disease (COPD) from
mechanical ventilation. Which of the following patient assessments
indicates that the weaning
protocol should be discontinued?
pg. 3
, a. The patient heart rate is 98 beats/minute.
b. The patient's oxygen saturation is 93%.
c. The patient respiratory rate is 32 breaths/minute.
d. The patient's spontaneous tidal volume is 500 mL. -ANS: C
Tachypnoea is a sign that the patient's work of breathing is too high to
allow weaning to proceed. The patient's heart rate is within normal
limits, although the nurse should continue to monitor it. An oxygen
saturation of 93% is acceptable for a patient with COPD. A
spontaneous tidal volume of 500 mL is within the acceptable range.
When the ventilator alarm sounds, the nurse finds the patient lying in
bed holding the endotracheal tube (ET). Which of the following
actions should the nurse take first?
a. Offer reassurance to the patient.
b. Activate the hospital's rapid response team.
c. Call the health care provider to reinsert the tube.
d. Manually ventilate the patient with 100% oxygen-ANS: D
The nurse should ensure maximal patient oxygenation by manually
ventilating with a bag valve-mask system. Offering reassurance to the
patient, notifying the health care provider about the need to reinsert
the tube, and activating the rapid response team also are appropriate
after the nurse has stabilized the patient's oxygenation.
The charge nurse is mentoring a new RN staff member providing care
to a patient receiving mechanical ventilation. Which of the following
actions by the new RN indicates the need for more education?
a. The RN turns the FIO2 up to 100% before suctioning.
b. The RN secures a bite block in place using adhesive tape.
c. The RN positions the patient with the head of bed at 10 degrees.
d. The RN asks for assistance to turn the patient to the prone position.
- Answer-C
pg. 4
Questions with Correct Answers, Study Notes, and Detailed
Rationales Covering All Major Nursing Topics/NURS 417 Exam
2||Already Graded A+
The nurse is caring for a patient who has required prolonged
mechanical ventilation and has the following arterial blood gas
results: pH 7.48, PaO2 85 mm Hg, PaCO2 32 mm Hg, and HCO3 25
mmol/L. Which of the following interpretations would the nurse
document?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis - Answer-d
The nurse is caring for a patient with an uncuffed tracheostomy tube
who coughs violently during suctioning and dislodges the
tracheostomy tube. Which of the following actions should the nurse
take first?
a. Insert the obturator and attempt to reinsert the tracheostomy tube.
b. Position the patient in an upright position with the neck extended.
c. Assess the patient's oxygen saturation and notify the health care
provider.
d. Ventilate the patient with a manual bag until the health care
provider arrives. - Answer-A
Which of the following actions should the nurse do to inflate the cuff
of an endotracheal tube
(ET) when the patient is on mechanical ventilation?
a. Inflate the cuff until the pilot balloon is firm.
b. Inflate the cuff with a minimum of 10 mL of air.
pg. 1
,c. Inject air into the cuff until a manometer shows 15 mm Hg
pressure.
d. Inject air into the cuff until a slight leak is heard only at peak
inflation. - Answer-ANS: D
The minimal occluding volume technique involves injecting air into
the cuff until an air leak is present only at peak inflation. The volume
to inflate the cuff varies with the ET and the patient's size. Cuff
pressure should be maintained at 20-25 mm Hg. An accurate
assessment of cuff pressure cannot be obtained by palpating the pilot
balloon.
Which of the following information obtained by the nurse when
caring for a patient receiving
mechanical ventilation indicates the need for suctioning?
a. The respiratory rate is 32 breaths/minute.
b. The pulse oximeter shows a SpO2 of 93%.
c. The patient has not been suctioned for the last 6 hours.
d. The lungs have occasional audible expiratory wheezes. -ANS: A
The increase in respiratory rate indicates that the patient may have
decreased airway clearance and requires suctioning. Suctioning is
done when patient assessment data indicate that it is needed, not on a
scheduled basis. Occasional expiratory wheezes do not indicate poor
airway clearance, and suctioning the patient may induce
bronchospasm and increase wheezing. An SpO2 of 93% is acceptable
and does not suggest that immediate suctioning is needed.
The nurse notes thick, white respiratory secretions from a patient who
is receiving mechanical ventilation. Which of the following
interventions will be most effective in resolving thisproblem?
a. Suction the patient every hour.
b. Reposition the patient every 2 hours.
pg. 2
,c. Add additional water to the patient's enteral feedings.
d. Instil 5 mL of sterile saline into the endotracheal tube (ET) before
suctioning. - Answer-ANS: C
Because the patient's secretions are thick, better hydration is
indicated. Suctioning every hour without any specific evidence for the
need will increase the incidence of mucosal trauma and would not
address the aetiology of the ineffective airway clearance. Instillation
of saline does not liquefy secretions and may decrease the SpO2.
Repositioning the patient is appropriate but will not decrease the
thickness of secretions.
4 hours after mechanical ventilation is initiated for a patient with
chronic obstructive pulmonary disease (COPD), the patient's arterial
blood gas (ABG) results include a pH of7.50, PaO2 of 80 mm Hg,
PaCO2 of 29 mm Hg, and HCO3- of 23 mmol/L. The nurse will
anticipate the need to do which of the following actions based upon
these findings?
a. Increase the FIO2.
b. Decrease the respiratory rate.
c. Increase the tidal volume (VT).
d. Leave the ventilator at the current settings. -ANS: B
The patient's PaCO2 and pH indicate respiratory alkalosis caused by
too high a respiratory rate. The PaO2 is appropriate for a patient with
COPD, increasing the tidal volume would further lower the PaCO2,
and the PaCO2 and pH indicate a need to make the ventilator changes.
The nurse is weaning a patient who has chronic obstructive
pulmonary disease (COPD) from
mechanical ventilation. Which of the following patient assessments
indicates that the weaning
protocol should be discontinued?
pg. 3
, a. The patient heart rate is 98 beats/minute.
b. The patient's oxygen saturation is 93%.
c. The patient respiratory rate is 32 breaths/minute.
d. The patient's spontaneous tidal volume is 500 mL. -ANS: C
Tachypnoea is a sign that the patient's work of breathing is too high to
allow weaning to proceed. The patient's heart rate is within normal
limits, although the nurse should continue to monitor it. An oxygen
saturation of 93% is acceptable for a patient with COPD. A
spontaneous tidal volume of 500 mL is within the acceptable range.
When the ventilator alarm sounds, the nurse finds the patient lying in
bed holding the endotracheal tube (ET). Which of the following
actions should the nurse take first?
a. Offer reassurance to the patient.
b. Activate the hospital's rapid response team.
c. Call the health care provider to reinsert the tube.
d. Manually ventilate the patient with 100% oxygen-ANS: D
The nurse should ensure maximal patient oxygenation by manually
ventilating with a bag valve-mask system. Offering reassurance to the
patient, notifying the health care provider about the need to reinsert
the tube, and activating the rapid response team also are appropriate
after the nurse has stabilized the patient's oxygenation.
The charge nurse is mentoring a new RN staff member providing care
to a patient receiving mechanical ventilation. Which of the following
actions by the new RN indicates the need for more education?
a. The RN turns the FIO2 up to 100% before suctioning.
b. The RN secures a bite block in place using adhesive tape.
c. The RN positions the patient with the head of bed at 10 degrees.
d. The RN asks for assistance to turn the patient to the prone position.
- Answer-C
pg. 4
