MECHANICAL VENTILATION (NCLEX)
FINAL TEST 2026 QUESTIONS WITH
CORRECT ANSWERS GRADED A+
◍ A patient on Bilevel Positive Airway Pressure (BiPAP) repeatedly removes
the mask. What is the nurse's priority?.
Answer: Assess tolerance and consider alternative interfaces or sedation. —
Noninvasive Positive Pressure Ventilation (NIPPV) requires a tight‑fitting
mask and patient cooperation.
◍ A chest x‑ray shows the Endotracheal Tube (ETT) tip at the carina. What is
the correct action?.
Answer: Withdraw the Endotracheal Tube (ETT) to 2-6 cm above the
carina. — Target position per document.
◍ A patient with head trauma is placed on Positive Pressure Ventilation
(PPV). What nursing action helps prevent increased intracranial pressure?.
Answer: Elevate the head of the bed and maintain alignment. — PPV
impairs venous drainage → ↑ intracranial pressure.
◍ A nurse uses suction pressure of 180 mmHg. What is the risk?.
Answer: Mucosal damage. — Suction pressure must be <120 mmHg.
◍ The nurse obtains the vital signs for a patient admitted 2 days ago with
gram-negative sepsis: temperature 101.2° F, blood pressure 90/56 mm Hg,
pulse 92, respirations 34. Which action should the nurse take next?a.
Administer the scheduled IV antibiotic.b. Give the PRN acetaminophen
(Tylenol) 650 mg.c. Obtain oxygen saturation using pulse oximetry.d.
Notify the health care provider of the patient's vital signs..
Answer: ANS: CThe patient's increased respiratory rate in combination with
the admission diagnosis of gram-negative sepsis indicates that acute
, respiratory distress syndrome (ARDS) may be developing. The nurse should
check for hypoxemia, a hallmark of ARDS. The health care provider should
be notified after further assessment of the patient. Administration of the
scheduled antibiotic and administration of Tylenol also will be done, but
they are not the highest priority for a patient who may be developing
ARDS.DIF: Cognitive Level: Application REF: 1758 | 1760 TOP: Nursing
Process: Implementation MSC: NCLEX: Physiological Integrity
◍ A patient with obstructive sleep apnea is placed on Continuous Positive
Airway Pressure (CPAP). What complication must the nurse monitor for in
a patient with myocardial compromise?.
Answer: Increased work of breathing. — The document states Continuous
Positive Airway Pressure (CPAP) increases work of breathing and must be
used cautiously in cardiac patients.
◍ A patient with severe hypoxia and respiratory muscle fatigue is
deteriorating. What intervention is indicated?.
Answer: Endotracheal intubation and mechanical ventilation. — Indications
include apnea, acute respiratory failure, severe hypoxia, and respiratory
muscle fatigue.
◍ After receiving change-of-shift report, which patient will the nurse assess
first?a. A patient with cystic fibrosis who has thick, green-colored sputumb.
A patient with pneumonia who has coarse crackles in both lung basesc. A
patient with emphysema who has an oxygen saturation of 91% to 92%d. A
patient with septicemia who has intercostal and suprasternal retractions.
Answer: ANS: DThis patient's history of septicemia and labored breathing
suggest the onset of ARDS, which will require rapid interventions such as
administration of oxygen and use of positive pressure ventilation. The other
patients also should be assessed as quickly as possible, but their assessment
data are typical of their disease processes and do not suggest deterioration in
their status.DIF: Cognitive Level: Analysis REF: 1758-1760 OBJ: Special
Questions: Multiple Patients TOP: Nursing Process: Assessment MSC:
NCLEX: Safe and Effective Care Environment
, ◍ . To evaluate the effectiveness of prescribed therapies for a patient with
ventilatory failure, which diagnostic test will be most useful to the nurse?a.
Chest x-raysb. Pulse oximetryc. Arterial blood gas (ABG) analysisd.
Pulmonary artery pressure monitoring.
Answer: ANS: CABG analysis is most useful in this setting because
ventilatory failure causes problems with CO2 retention, and ABGs provide
information about the PaCO2 and pH. The other tests also may be done to
help in assessing oxygenation or determining the cause of the patient's
ventilatory failure.DIF: Cognitive Level: Application REF: 1752-1754 TOP:
Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
◍ A patient is receiving enteral feeding while ventilated. Why is this
preferred?.
Answer: Supports gut integrity and reduces infection risk. — Listed as
preferred route.
◍ A patient develops increasing dyspnea and hypoxemia 2 days after having
cardiac surgery. To determine whether the patient has acute respiratory
distress syndrome (ARDS) or pulmonary edema caused by left ventricular
failure, the nurse will anticipate assisting witha. inserting a pulmonary artery
catheter.b. obtaining a ventilation-perfusion scan.c. drawing blood for
arterial blood gases.d. positioning the patient for a chest radiograph..
Answer: ANS: APulmonary artery wedge pressures are normal in the patient
with ARDS because the fluid in the alveoli is caused by increased
permeability of the alveolar-capillary membrane rather than by the backup
of fluid from the lungs (as occurs in cardiogenic pulmonary edema). The
other tests will not help in differentiating cardiogenic from noncardiogenic
pulmonary edema.DIF: Cognitive Level: Application REF: 1753-1754 TOP:
Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
◍ A patient with acute respiratory distress syndrome (ARDS) who is intubated
and receiving mechanical ventilation develops a pneumothorax. Which
action will the nurse anticipate taking?a. Lower the positive end-expiratory
pressure (PEEP).b. Increase the fraction of inspired oxygen (FIO2).c.
FINAL TEST 2026 QUESTIONS WITH
CORRECT ANSWERS GRADED A+
◍ A patient on Bilevel Positive Airway Pressure (BiPAP) repeatedly removes
the mask. What is the nurse's priority?.
Answer: Assess tolerance and consider alternative interfaces or sedation. —
Noninvasive Positive Pressure Ventilation (NIPPV) requires a tight‑fitting
mask and patient cooperation.
◍ A chest x‑ray shows the Endotracheal Tube (ETT) tip at the carina. What is
the correct action?.
Answer: Withdraw the Endotracheal Tube (ETT) to 2-6 cm above the
carina. — Target position per document.
◍ A patient with head trauma is placed on Positive Pressure Ventilation
(PPV). What nursing action helps prevent increased intracranial pressure?.
Answer: Elevate the head of the bed and maintain alignment. — PPV
impairs venous drainage → ↑ intracranial pressure.
◍ A nurse uses suction pressure of 180 mmHg. What is the risk?.
Answer: Mucosal damage. — Suction pressure must be <120 mmHg.
◍ The nurse obtains the vital signs for a patient admitted 2 days ago with
gram-negative sepsis: temperature 101.2° F, blood pressure 90/56 mm Hg,
pulse 92, respirations 34. Which action should the nurse take next?a.
Administer the scheduled IV antibiotic.b. Give the PRN acetaminophen
(Tylenol) 650 mg.c. Obtain oxygen saturation using pulse oximetry.d.
Notify the health care provider of the patient's vital signs..
Answer: ANS: CThe patient's increased respiratory rate in combination with
the admission diagnosis of gram-negative sepsis indicates that acute
, respiratory distress syndrome (ARDS) may be developing. The nurse should
check for hypoxemia, a hallmark of ARDS. The health care provider should
be notified after further assessment of the patient. Administration of the
scheduled antibiotic and administration of Tylenol also will be done, but
they are not the highest priority for a patient who may be developing
ARDS.DIF: Cognitive Level: Application REF: 1758 | 1760 TOP: Nursing
Process: Implementation MSC: NCLEX: Physiological Integrity
◍ A patient with obstructive sleep apnea is placed on Continuous Positive
Airway Pressure (CPAP). What complication must the nurse monitor for in
a patient with myocardial compromise?.
Answer: Increased work of breathing. — The document states Continuous
Positive Airway Pressure (CPAP) increases work of breathing and must be
used cautiously in cardiac patients.
◍ A patient with severe hypoxia and respiratory muscle fatigue is
deteriorating. What intervention is indicated?.
Answer: Endotracheal intubation and mechanical ventilation. — Indications
include apnea, acute respiratory failure, severe hypoxia, and respiratory
muscle fatigue.
◍ After receiving change-of-shift report, which patient will the nurse assess
first?a. A patient with cystic fibrosis who has thick, green-colored sputumb.
A patient with pneumonia who has coarse crackles in both lung basesc. A
patient with emphysema who has an oxygen saturation of 91% to 92%d. A
patient with septicemia who has intercostal and suprasternal retractions.
Answer: ANS: DThis patient's history of septicemia and labored breathing
suggest the onset of ARDS, which will require rapid interventions such as
administration of oxygen and use of positive pressure ventilation. The other
patients also should be assessed as quickly as possible, but their assessment
data are typical of their disease processes and do not suggest deterioration in
their status.DIF: Cognitive Level: Analysis REF: 1758-1760 OBJ: Special
Questions: Multiple Patients TOP: Nursing Process: Assessment MSC:
NCLEX: Safe and Effective Care Environment
, ◍ . To evaluate the effectiveness of prescribed therapies for a patient with
ventilatory failure, which diagnostic test will be most useful to the nurse?a.
Chest x-raysb. Pulse oximetryc. Arterial blood gas (ABG) analysisd.
Pulmonary artery pressure monitoring.
Answer: ANS: CABG analysis is most useful in this setting because
ventilatory failure causes problems with CO2 retention, and ABGs provide
information about the PaCO2 and pH. The other tests also may be done to
help in assessing oxygenation or determining the cause of the patient's
ventilatory failure.DIF: Cognitive Level: Application REF: 1752-1754 TOP:
Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
◍ A patient is receiving enteral feeding while ventilated. Why is this
preferred?.
Answer: Supports gut integrity and reduces infection risk. — Listed as
preferred route.
◍ A patient develops increasing dyspnea and hypoxemia 2 days after having
cardiac surgery. To determine whether the patient has acute respiratory
distress syndrome (ARDS) or pulmonary edema caused by left ventricular
failure, the nurse will anticipate assisting witha. inserting a pulmonary artery
catheter.b. obtaining a ventilation-perfusion scan.c. drawing blood for
arterial blood gases.d. positioning the patient for a chest radiograph..
Answer: ANS: APulmonary artery wedge pressures are normal in the patient
with ARDS because the fluid in the alveoli is caused by increased
permeability of the alveolar-capillary membrane rather than by the backup
of fluid from the lungs (as occurs in cardiogenic pulmonary edema). The
other tests will not help in differentiating cardiogenic from noncardiogenic
pulmonary edema.DIF: Cognitive Level: Application REF: 1753-1754 TOP:
Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
◍ A patient with acute respiratory distress syndrome (ARDS) who is intubated
and receiving mechanical ventilation develops a pneumothorax. Which
action will the nurse anticipate taking?a. Lower the positive end-expiratory
pressure (PEEP).b. Increase the fraction of inspired oxygen (FIO2).c.
