N432 Exam 1 Davis Edge

N432 EXAM 1 DAVIS EDGE


Thebnchargebnnursebnisbnrevisingbnthebnventilatedbnpatientsbninbnthebnintensivebncarebnunitbnforbntheirb
nriskbnofbndevelopingbnacutebnrespiratorybndistressbnsyndromebn(ARDS).bnWhichbnpatientsbnshouldbnbeb
nmostbncloselybnmonitoredbnforbnsymptoms?bnSelectbnallbnthatbnapply.bn-bnanswers--
*bn88bnyearbnoldbnwithbnaspirationbnpneumoniabnafterbnabnstrokebn(aspirationbnisbnabnhighbnriskbnforbnA
RDSbndevelopment)

*bn19bnyearbnoldbninvolvedbninbnabnmulti-
carbnaccidentbn(severebntraumabnsuchbnasbnabncarbnaccidentbnisbnabnriskbnfactorbnforbnARDS)

*bn45bnyearbnoldbnwhobnhadbnabnfive-
vesselbncoronarybnbypassbngraftbnsurgerybn(thosebnwhobnhavebnbeenbnonbncardiopulmonarybnbypassbna
rebnatbnrisk)

xbn54bnyearbnoldbnwithbnabncolostomybnfrombndiverticulitisbn(abdominalbnsurgeriesbnarebnnotbnhigherbnr
isk,bnunlessbninbnthebnpresencebnofbnsepsis)

*bn62bnyearbnoldbnwithbnabnleftbnlobebnremovalbnfrombnlungbncancerbn(abnpneumonectomybnisbnabnriskb
nfactor)




Thebnnursebnisbncaringbnforbnabnpatientbnwithbnanbnincreasedbnriskbnforbndevelopingbnacutebnrespirator
ybndistressbnsyndromebn(ARDS).bnCalculatebnthebnARDSbnratiobnifbnthebnpatient'sbnPaO2bnisbn70bnonbnan
bnFiO2bnofbn60%.bnRoundbntobnthebnnearestbnwholebnnumber.bnEnterbnnumeralbnonly.

Answer

CorrectbnAnswer:bn117

Rationale:bnTobncalculatebnthebnARDSbnratio,bndividebnthebnPaO2bnbybnthebnpercentbnofbnFiO2.bn70/0.60
bn=bn116.6bn=bn117bn-bnanswers--tobncalculatebnthebnARDSbnratio,bn70/0.60bn=bn117




Thebnnursebnisbncaringbnforbnabnpatientbnwithbnacutebnrespiratorybndistressbnsyndromebnwithbnabnseveri
tybnratiobnofbn101bnonbnpositivebnend-
expiratorybnpressurebn(PEEP).bnWhatbncategorybnofbnseveritybnisbnthisbnpatient?bn-bnanswers--
moderate.




xbnMild

, Rationale:bnThisbnisbnabnseveritybnratiobnofbn200-
300bnonbnventilatorbnsettingsbnthatbnincludebnpositivebnend-
expiratorybnpressurebn(PEEP)bnorbncontinuousbnpositivebnairwaybnpressurebn(CPAP).

*bnModerate

Rationale:bnThisbnisbnabnseveritybnratiobnofbn100-200bnonbnventilatorbnsettingsbnthatbnincludebnPEEP.

xbnProgressive

Rationale:bnThisbnisbnnotbnabnseveritybnratiobnoption.

xbnSevere

Rationale:bnThisbnisbnabnseveritybnratiobnofbnlessbnthanbn100bnonbnventilatorbnsettingsbnthatbnincludebnP
EEP.

TestbnTaking



Duringbnthebnearlybnstagesbnofbnacutebnrespiratorybndistressbnsyndromebn(ARDS),bnthebnnursebnshouldb
nmonitorbnforbnwhichbnarterialbnbloodbngasbnchange?bn-bnanswers--respiratorybnalkalosis




arterialbnbloodbngasesbninitiallybnrevealbnabnrespiratorybnalkalosisbnduebntobnthebntachypnea



Thebnnursebnisbnreviewingbnthebnchestbnx-
raybnreportbnofbnabnventilatedbnpatientbnrequiringbnanbnFiO2bnofbn70%.bnWhichbnfindingbnisbnmostbncon
cerning?bn-bnanswers--bilateralbninfiltrates



duringbnthebnearlybnphasesbnofbnacutebnrespiratorybndistressbnsyndromebn(ARDS),bnserialbnchestbnx-
raybncanbnbebnusedbntobnidentifybnthebnbilateralbninfiltratesbnthatbnarebnthebnhallmarkbnsignbnofbnthisbn
diseasebnprocess



Thebnnursebnisbncaringbnforbnabnpatientbnwithbnacutebnrespiratorybndistressbnsyndromebn(ARDS)bnwhose
bnconditionbnisbndeteriorating.bnWhatbnventilatorybnoptionsbnmaybnbebnconsideredbntobnimprovebnrefra
ctorybnhypoxemia?bnSelectbnallbnthatbnapply.bn-bnanswers--
*bnreducebnthebntidalbnvolumebn(thebnmostbncommonbnisbnconventionalbnventilationbnusingbnreducedbn
tidalbnvolumesbnandbnpositivebnend-
expiratorybnpressurebn(PEEP).bnThisbnallowsbnthebnalveolibntobnopenbnandbnremainbnopenbnwhilebnatbnt
hebnsamebntimebnkeepingbnpeakbnairwaybnpressurebnlow.



xbnincreasebnthebnPEEP