Critical Care exam 1: respiratory
Practice questions with answers
a
The normal range for PaCO2 is 35-45. This patient is experiencing a superimposed respiratory
alkalosis likely due to hyperventilation. The nurse should report the PaCO2 to the physician. -
ANS ✔✔1) A nurse is caring for a patient with ARDS. The nurse views the ABG. What value
should the nurse report to the physician?
pH: 7.35
PaCO2: 26mmhg
PaO2:95
HCO3: 22
a) PaCO2
b)pH
c)HCO3
d)PaO2
a, c, d
Decreased atelectasis", "Mobilization of secretions" and "Decreased pleural pressure" are
correct. Prone positioning, or placing the patient face down with the head turned to the side,
helps with pulmonary function in the patient diagnosed with ARDS. When the patient is placed
in a prone position, the heart and diaphragm are not pressing against the lungs, which means
that pleural pressure is reduced. When there is less pressure exerted on the lungs, atelectasis
,decreases. Studies have shown that many patients in the prone position have increased lung
secretions, which improves oxygenation.
-"Reduced need for endotracheal intubation" is incorrect. The prone position has not been
shown to decrease the likelihood of intubation.
-"Increased response to corticosteroid therapy" is incorrect because positioning does not
change the body's response to steroid therapy. - ANS ✔✔2) A nurse must position the patient
prone after his diagnosis of acute respiratory distress syndrome (ARDS). Which of the following
is a benefit of using this position? Select all that apply.
A)Decreased atelectasis
B)Reduced need for endotracheal intubation
c)Mobilization of secretions
d)Decreased pleural pressure
e)Increased response to corticosteroid therapy
c - ANS ✔✔3) A 25-year-old patient in the ICU is being treated for acute respiratory distress
syndrome (ARDS). The patient is on a ventilator and requires 80 percent FiO2. Which
information would the nurse most likely need to report about the patient to the respiratory
therapist working with her?
a)The patient needs endotracheal suctioning
b)The patient needs more oxygen because of his saturation
c)The patient needs an arterial blood gas drawn
d)The patient needs a hemoglobin level drawn
a,b,c
impaired mental status", "Insulin resistance" and "Seizures" are correct. Re-feeding syndrome
can occur as a response to nutrient reintroduction after a period of starvation. When an
, extremely malnourished patient receives TPN, the body has to adjust to receiving nutrients
again, which can cause shifts in electrolytes in the body. These shifts in electrolytes can result in
sudden and often fatal complications. Signs and symptoms of re-feeding syndrome include
confusion and impaired mental status, insulin resistance, seizures, coma and death.
-"Persistent weight loss" is incorrect because by the time a patient develops re-feeding
syndrome, the onset of symptoms is so sudden that weight loss cannot be measured as part of
the syndrome.
-"Constipation" is incorrect, as it is not a symptom of refeeding syndrome. - ANS ✔✔4) A patient
who has recovered from ARDS in the ICU is now malnourished and has lost a significant amount
of weight. The physician orders TPN to add nutrition for the patient, who then develops re-
feeding syndrome. Which of the following signs or symptoms would the nurse expect to see
with re-feeding syndrome? Select all that apply.
a. Impaired mental status
b. Insulin resistance
c. Seizures
d. Persistent weight loss
e. Constipation
b, d
Respiratory diseases can cause such compromise that the patient will suffer symptoms;
however, there are certain clinical indicators that can clarify whether the patient is actually in
respiratory failure. Clinical indicators of respiratory failure include pulse oximetry of less than
91% on room air, PaO2 level less than 60 mmHg, and a pCO2 level of over 50 mmHg. - ANS
✔✔5) A nurse is caring for a patient with ARDS. Which of the following clinical indicators would
signify that this client is in respiratory failure? Select all that apply.
a. Pulse oximetry of 94% on room air
b. A PaO2 level below 60 mmHg
c. An ABG pH level of 7.35
Practice questions with answers
a
The normal range for PaCO2 is 35-45. This patient is experiencing a superimposed respiratory
alkalosis likely due to hyperventilation. The nurse should report the PaCO2 to the physician. -
ANS ✔✔1) A nurse is caring for a patient with ARDS. The nurse views the ABG. What value
should the nurse report to the physician?
pH: 7.35
PaCO2: 26mmhg
PaO2:95
HCO3: 22
a) PaCO2
b)pH
c)HCO3
d)PaO2
a, c, d
Decreased atelectasis", "Mobilization of secretions" and "Decreased pleural pressure" are
correct. Prone positioning, or placing the patient face down with the head turned to the side,
helps with pulmonary function in the patient diagnosed with ARDS. When the patient is placed
in a prone position, the heart and diaphragm are not pressing against the lungs, which means
that pleural pressure is reduced. When there is less pressure exerted on the lungs, atelectasis
,decreases. Studies have shown that many patients in the prone position have increased lung
secretions, which improves oxygenation.
-"Reduced need for endotracheal intubation" is incorrect. The prone position has not been
shown to decrease the likelihood of intubation.
-"Increased response to corticosteroid therapy" is incorrect because positioning does not
change the body's response to steroid therapy. - ANS ✔✔2) A nurse must position the patient
prone after his diagnosis of acute respiratory distress syndrome (ARDS). Which of the following
is a benefit of using this position? Select all that apply.
A)Decreased atelectasis
B)Reduced need for endotracheal intubation
c)Mobilization of secretions
d)Decreased pleural pressure
e)Increased response to corticosteroid therapy
c - ANS ✔✔3) A 25-year-old patient in the ICU is being treated for acute respiratory distress
syndrome (ARDS). The patient is on a ventilator and requires 80 percent FiO2. Which
information would the nurse most likely need to report about the patient to the respiratory
therapist working with her?
a)The patient needs endotracheal suctioning
b)The patient needs more oxygen because of his saturation
c)The patient needs an arterial blood gas drawn
d)The patient needs a hemoglobin level drawn
a,b,c
impaired mental status", "Insulin resistance" and "Seizures" are correct. Re-feeding syndrome
can occur as a response to nutrient reintroduction after a period of starvation. When an
, extremely malnourished patient receives TPN, the body has to adjust to receiving nutrients
again, which can cause shifts in electrolytes in the body. These shifts in electrolytes can result in
sudden and often fatal complications. Signs and symptoms of re-feeding syndrome include
confusion and impaired mental status, insulin resistance, seizures, coma and death.
-"Persistent weight loss" is incorrect because by the time a patient develops re-feeding
syndrome, the onset of symptoms is so sudden that weight loss cannot be measured as part of
the syndrome.
-"Constipation" is incorrect, as it is not a symptom of refeeding syndrome. - ANS ✔✔4) A patient
who has recovered from ARDS in the ICU is now malnourished and has lost a significant amount
of weight. The physician orders TPN to add nutrition for the patient, who then develops re-
feeding syndrome. Which of the following signs or symptoms would the nurse expect to see
with re-feeding syndrome? Select all that apply.
a. Impaired mental status
b. Insulin resistance
c. Seizures
d. Persistent weight loss
e. Constipation
b, d
Respiratory diseases can cause such compromise that the patient will suffer symptoms;
however, there are certain clinical indicators that can clarify whether the patient is actually in
respiratory failure. Clinical indicators of respiratory failure include pulse oximetry of less than
91% on room air, PaO2 level less than 60 mmHg, and a pCO2 level of over 50 mmHg. - ANS
✔✔5) A nurse is caring for a patient with ARDS. Which of the following clinical indicators would
signify that this client is in respiratory failure? Select all that apply.
a. Pulse oximetry of 94% on room air
b. A PaO2 level below 60 mmHg
c. An ABG pH level of 7.35
