ARDS NCLEX QUESTIONS AND ANSWERS GRADED A+
Which S&S distinguish hypoxemia from as quickly as possible
hypercapnic respiratory failure? SATA d. Base the selection on the patients condition
a. Cyanosis and amount of FIO2 needed - ANSWER -D
b. Tachypnea
c. Morning headache
d. Paradoxical breathing The most common early manifestations of ARDS
e. Use of pursed lip breathing - ANSWER - that the nurse may see are
A, B, D a. Dyspnea and tachypnea
A: Cynosis is a late sign of hypoxemia b. Cyanosis and apprehension
B: Tachypnea is a sign of hypoxemia c. Respiratory distress and frothy sputum
D: Paradoxical breathing is a late sign of d. Bradycardia and increased work of breathing -
hypoxmeia ANSWER -A
C & E are S&S of Hypercapnia
Interventions used in managing the patient with
A nurse is reviewing the health records of five ARDS includes
clients. Which of the following clients are at risk SATA
for developing ARDS? (SATA) a. IV injection of surfactant
a. A client who experienced a near drowning b. Aggressive IV fluid resuscitation
b. A client following coronary artery bypass graft c. Giving adequate analgesia and sedation
surgery d. Elevating the HOB 30-45 degrees when supine
c. A client who has a hemoglobin of 15.1 mg/dL e. Monitoring hemodynamic parameters and daily
d. A client who has dysphagia weights - ANSWER -C, D, E
E. A client who experienced acute drug toxicity - - keep pt dry
ANSWER -A: CORRECT - near drowning - IV injection - could cause bleeding
incident is at risk for developing ARDS due to
trauma to lungs and cerebral edema.
B: CORRECT - at risk for developing ARDS due WHich intervention is most likely to prevent or
to trauma to chest limit volutrauma in the pt with ARDS who is
C: NO - hemoglobin of 15.1 is within expected mechanically ventilated?
range. Client with low hemoglobin as at risk for a. Increasing PEEP
ARDS b. Increasing the inspiratory flow rate
D: CORRECT - difficulty swallowing and risk for c. Use of low tidal volume ventilation
aspiration d. Suctioning the patient via endotracheal tube
E: CORRECT - damage to central nervous hourly - ANSWER -C
system - pt with ARDS are ventilated with a low VT of 4-8
ml/Kg
- low VT ventilation has reduced mortality and
An important consideration in selecting an 02 risk for volutrauma
delivery device for the patient with acute
hypoxemic respiratory failure is to
a. Always start with noninvasive positive The nurse is assessing the respiratory status of a
pressure ventilation client who has suffered a fractured rib. The nurse
b. Apply a low flow device, such as a nasal should expect to note which finding?
cannula or face mask a. Slow, deep respirations
c. Be able to correct the PaO2 to a normal level b. Rapid, deep respirations
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, ARDS NCLEX QUESTIONS AND ANSWERS GRADED A+
c. Paradoxical respirations respiratory failure?
d. Pain, especially on inspiration - a. Diffusion limitation
ANSWER -D b. Intrapulmonary shunt
Typical signs and symptoms include pain and c. Alveolar hypoventilation
tenderness that is exacerbated by inspiration, d. Ventilation-perfusion mismatch -
shallow respirations, ANSWER -A
pt with pulmonary fibrosis has a thickened
alveolar-capillary interface that slows gas
A pt is in acute respiratory distress syndrome transport, so hypoxemia is more likely during
(ARDS) from sepsis. Which measure would be exercise than at rest. Intrapulmonary shunt
implemented to maintain cardiac output? occurs when alveoli fill with fluid (e.g., acute
a. Administer IV crystalloid fluids. respiratory distress syndrome, pneumonia).
b. Place the patient on a strict fluid restriction. Alveolar hypoventilation occurs when there is a
c. Position the patient in Trendelenburg position. generalized decrease in ventilation (e.g.,
d. Perform chest physiotherapy and assist with restrictive lung disease, central nervous system
staged coughing. - ANSWER -A diseases, neuromuscular diseases). Ventilation-
Low cardiac output may necessitate crystalloid perfusion mismatch occurs when the amount of
fluids in addition to lowering positive end- air does not match the amount of blood that the
expiratory pressure (PEEP) or giving inotropes. lung receives (e.g., chronic obstructive
The Trendelenburg position is not recommended pulmonary disease, pulmonary embolus).
to treat hypotension. Chest physiotherapy is
unlikely to relieve decreased cardiac output.
Fluid restriction would be an inappropriate The nurse is assessing a client with multiple
intervention. trauma who is at risk for developing acute
respiratory distress syndrome. The nurse should
assess for which earliest sign if ARDS?
A client with a chest injury has suffered flail a. Bilateral wheezes
chest. The nurse assesses the client for which b. Inspiratory crackles
most distinctive sign of flail chest? c. Intercostal retraction
a. Cyanosis d. Increased respiratory rate - ANSWER -D
b. Hypotension Increased respiratory rate is earliest sign of
c. Paradoxical chest movement ebt ARDS. Can begin from 1-96 hours after initial
d. Dyspnea, especially on expiration - insult to body. This is followed by increasing
ANSWER -C dyspnea, air hunger, retraction of accessory
Flail chest results from multiple rib fractures. This muscles, and cyanosis. Breath sounds may be
results in a 'floating' section of ribs. This section clear or consist of fine inspiratory crackles or
is unattached to rest of bony rib cage, and diffuse course crackles.
results in paradoxical chest movement. Force of
inspiration pulls fractured segment inwards, while
rest of body expands. Normal PAWP range - ANSWER -6-12
mmHg
The pt with pulmonary fibrosis has hypoxemia
during exercise but not at rest. To plan patient What is PAWP? - ANSWER -1. a
care, the nurse identifies the patient is measurement of pulmonary capillary pressure
experiencing which physiologic mechanism of 2. reflects left ventricular end-diastolic pressure
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Which S&S distinguish hypoxemia from as quickly as possible
hypercapnic respiratory failure? SATA d. Base the selection on the patients condition
a. Cyanosis and amount of FIO2 needed - ANSWER -D
b. Tachypnea
c. Morning headache
d. Paradoxical breathing The most common early manifestations of ARDS
e. Use of pursed lip breathing - ANSWER - that the nurse may see are
A, B, D a. Dyspnea and tachypnea
A: Cynosis is a late sign of hypoxemia b. Cyanosis and apprehension
B: Tachypnea is a sign of hypoxemia c. Respiratory distress and frothy sputum
D: Paradoxical breathing is a late sign of d. Bradycardia and increased work of breathing -
hypoxmeia ANSWER -A
C & E are S&S of Hypercapnia
Interventions used in managing the patient with
A nurse is reviewing the health records of five ARDS includes
clients. Which of the following clients are at risk SATA
for developing ARDS? (SATA) a. IV injection of surfactant
a. A client who experienced a near drowning b. Aggressive IV fluid resuscitation
b. A client following coronary artery bypass graft c. Giving adequate analgesia and sedation
surgery d. Elevating the HOB 30-45 degrees when supine
c. A client who has a hemoglobin of 15.1 mg/dL e. Monitoring hemodynamic parameters and daily
d. A client who has dysphagia weights - ANSWER -C, D, E
E. A client who experienced acute drug toxicity - - keep pt dry
ANSWER -A: CORRECT - near drowning - IV injection - could cause bleeding
incident is at risk for developing ARDS due to
trauma to lungs and cerebral edema.
B: CORRECT - at risk for developing ARDS due WHich intervention is most likely to prevent or
to trauma to chest limit volutrauma in the pt with ARDS who is
C: NO - hemoglobin of 15.1 is within expected mechanically ventilated?
range. Client with low hemoglobin as at risk for a. Increasing PEEP
ARDS b. Increasing the inspiratory flow rate
D: CORRECT - difficulty swallowing and risk for c. Use of low tidal volume ventilation
aspiration d. Suctioning the patient via endotracheal tube
E: CORRECT - damage to central nervous hourly - ANSWER -C
system - pt with ARDS are ventilated with a low VT of 4-8
ml/Kg
- low VT ventilation has reduced mortality and
An important consideration in selecting an 02 risk for volutrauma
delivery device for the patient with acute
hypoxemic respiratory failure is to
a. Always start with noninvasive positive The nurse is assessing the respiratory status of a
pressure ventilation client who has suffered a fractured rib. The nurse
b. Apply a low flow device, such as a nasal should expect to note which finding?
cannula or face mask a. Slow, deep respirations
c. Be able to correct the PaO2 to a normal level b. Rapid, deep respirations
1/7
, ARDS NCLEX QUESTIONS AND ANSWERS GRADED A+
c. Paradoxical respirations respiratory failure?
d. Pain, especially on inspiration - a. Diffusion limitation
ANSWER -D b. Intrapulmonary shunt
Typical signs and symptoms include pain and c. Alveolar hypoventilation
tenderness that is exacerbated by inspiration, d. Ventilation-perfusion mismatch -
shallow respirations, ANSWER -A
pt with pulmonary fibrosis has a thickened
alveolar-capillary interface that slows gas
A pt is in acute respiratory distress syndrome transport, so hypoxemia is more likely during
(ARDS) from sepsis. Which measure would be exercise than at rest. Intrapulmonary shunt
implemented to maintain cardiac output? occurs when alveoli fill with fluid (e.g., acute
a. Administer IV crystalloid fluids. respiratory distress syndrome, pneumonia).
b. Place the patient on a strict fluid restriction. Alveolar hypoventilation occurs when there is a
c. Position the patient in Trendelenburg position. generalized decrease in ventilation (e.g.,
d. Perform chest physiotherapy and assist with restrictive lung disease, central nervous system
staged coughing. - ANSWER -A diseases, neuromuscular diseases). Ventilation-
Low cardiac output may necessitate crystalloid perfusion mismatch occurs when the amount of
fluids in addition to lowering positive end- air does not match the amount of blood that the
expiratory pressure (PEEP) or giving inotropes. lung receives (e.g., chronic obstructive
The Trendelenburg position is not recommended pulmonary disease, pulmonary embolus).
to treat hypotension. Chest physiotherapy is
unlikely to relieve decreased cardiac output.
Fluid restriction would be an inappropriate The nurse is assessing a client with multiple
intervention. trauma who is at risk for developing acute
respiratory distress syndrome. The nurse should
assess for which earliest sign if ARDS?
A client with a chest injury has suffered flail a. Bilateral wheezes
chest. The nurse assesses the client for which b. Inspiratory crackles
most distinctive sign of flail chest? c. Intercostal retraction
a. Cyanosis d. Increased respiratory rate - ANSWER -D
b. Hypotension Increased respiratory rate is earliest sign of
c. Paradoxical chest movement ebt ARDS. Can begin from 1-96 hours after initial
d. Dyspnea, especially on expiration - insult to body. This is followed by increasing
ANSWER -C dyspnea, air hunger, retraction of accessory
Flail chest results from multiple rib fractures. This muscles, and cyanosis. Breath sounds may be
results in a 'floating' section of ribs. This section clear or consist of fine inspiratory crackles or
is unattached to rest of bony rib cage, and diffuse course crackles.
results in paradoxical chest movement. Force of
inspiration pulls fractured segment inwards, while
rest of body expands. Normal PAWP range - ANSWER -6-12
mmHg
The pt with pulmonary fibrosis has hypoxemia
during exercise but not at rest. To plan patient What is PAWP? - ANSWER -1. a
care, the nurse identifies the patient is measurement of pulmonary capillary pressure
experiencing which physiologic mechanism of 2. reflects left ventricular end-diastolic pressure
2/7
