Examl 2:l NRl 341/l NR341l (Latestl 2026/l
2027l Update)l Complexl Adultl Healthl
Review|l Q/Al |l Gradel A|l 100%l Correctl
(Verifiedl Answers)l -Chamberlain
Q:l True/False:l ifl thel nursel suspectsl thel ETl tubel isl inl thel esophagus,l pulll outl thel
tubel andl dol thel following...Bag-maskl ventilationl withl anl oropharyngeall orl
nasopharyngell orl both
Answer:
True,l alwaysl maintainl al highl indexl ofl suspicionl ofl esophageall intubation,l particularlyl ifl
thel intubationl wasl difficult.l Ifl inl doubt,l trustl yourl instincts!!!
Q:l Tracheostomyl Overview:
Answer:
-l Indications:l Long-terml mechanicall ventilation,l frequentl suctioning,l protectingl thel airway
Q:l Endotracheall Suctioning:
Answer:
-l Indicatedl byl assessmentl (PRN):l visiblel secretions,l coughing,l rhonchi,l highl pressurel onl
vent,l andl ventilatorl alarm
-l Conventionall versusl closedl suctioning
-l Procedures:l hyperl oxygenatedl throughoutl procedure,l avoidl normall salinel instillation
Q:l Ventilatorl Settings:
Answer:
-l Usesl positivel pressurel byl mechanicallyl fillingl thel lungsl withl O2l andl isl thel oppositel
ofl thel physiologyl ofl breathing
,-l Fractionl ofl Inspiredl Oxygenl (FiO2);l thel percentagel ofl inspiredl O2l thel ventilatorl isl
givingl thel patient?
-l FiO2l rangesl froml 0.21l (21%)l tol 1.0l (100%)l O2.l RAl =l 0.21l orl 21%l O2
-l Respiratoryl Ratel (RR)l thel numberl ofl breathsl tol bel deliveredl tol thel patientl perl minute
Q:l Positivel Endl Expiratoryl Pressurel (PEEP):
Answer:
-l Thel amountl ofl positivel pressurel (inl cmsl ofl H20)l appliedl tol thel airwaysl duringl
expiration;l PEEPl isl meantl tol holdl openl thel alveolil andl preventl airwayl collapsel
betweenl breaths
Q:l Positivel End-Expiratoryl Pressurel (PEEP)
Answer:
PEEP
,Q:l Alarmsl &l Troubleshooting:
Answer:
-l NEVERl shutl alarmsl off;l onlyl silence
-l Manuallyl ventilatel ifl unsurel ofl thel probleml untill al newl ventilatorl isl availablel forl use
-l Mostl ICUsl havel dedicatedl RTsl whol managel mechanicall ventl alongl withl nursel and/orl
physician
Q:l Typesl ofl Ventl Alarms:
Answer:
-l Highl Pressure:l Increasedl secretions,l wheezing,l bronchospasm,l causingl decreasedl
airway,l displacedl ETT.l Pt.l gag,l kinked,l biting
, -l Lowl Pressure:l Disconnectionl orl leakl inl ventilatorl orl patient'sl airwayl cuff;l patientl
stopsl breathing
Q:l Complicationsl ofl Mechanicall Ventilation:
Answer:
-l ETTl outl ofl position...rightl mainl steml bronchus,l dislodged
-l Unplannedl extubation...securingl important
-l Laryngeall /l Tracheall Injury...preventl excessivel headl movement
-l Damagel tol orall andl nasall mucosa
Q:l Barotrauma:
Answer:
-l Injuryl causedl byl pressurel tol enclosedl bodyl surfaces,l forl examplel froml tool muchl
pressurel inl thel lungs.l Eg.l Pneumothorax,l tensionl pneumothorax
-l Detect:l highl peakl airwayl pressuresl onl vent,l meanl airwayl pressure,l decreasedl breathl
sounds,l tracheall shift,l subcutaneousl crepitus,l andl hypoxemia
-l Treatl tensionl pneumothoraxl vial manuallyl ventilate,l needlel thoracostomy
Q:l Complicationsl ofl Mechanicall Ventilationl -l Infection:
Answer:
-l Normall protectivel mechanisml bypassedl byl ETTl tube;l ventilator-associatedl pneumonial
(VAP)
-l Ventilatorl bundle:l Headl ofl bedl atl 30l degrees,l awakenl dailyl andl assessl readinessl tol
wean,l stressl ulcerl prophylaxisl (eg.l pantoprazole),l DVTl prophylaxisl (enoxaparin,l
Sequentiall Compressionl Devices),l orall carel usingl chlorohexidinel inl somel bundles
Q:l Stoppingl thel Weaningl Process:
Answer:
-l RRl >l 35l orl <l 8l breaths/min
-l Lowl spontaneousl V1l <l 5mL/kg
2027l Update)l Complexl Adultl Healthl
Review|l Q/Al |l Gradel A|l 100%l Correctl
(Verifiedl Answers)l -Chamberlain
Q:l True/False:l ifl thel nursel suspectsl thel ETl tubel isl inl thel esophagus,l pulll outl thel
tubel andl dol thel following...Bag-maskl ventilationl withl anl oropharyngeall orl
nasopharyngell orl both
Answer:
True,l alwaysl maintainl al highl indexl ofl suspicionl ofl esophageall intubation,l particularlyl ifl
thel intubationl wasl difficult.l Ifl inl doubt,l trustl yourl instincts!!!
Q:l Tracheostomyl Overview:
Answer:
-l Indications:l Long-terml mechanicall ventilation,l frequentl suctioning,l protectingl thel airway
Q:l Endotracheall Suctioning:
Answer:
-l Indicatedl byl assessmentl (PRN):l visiblel secretions,l coughing,l rhonchi,l highl pressurel onl
vent,l andl ventilatorl alarm
-l Conventionall versusl closedl suctioning
-l Procedures:l hyperl oxygenatedl throughoutl procedure,l avoidl normall salinel instillation
Q:l Ventilatorl Settings:
Answer:
-l Usesl positivel pressurel byl mechanicallyl fillingl thel lungsl withl O2l andl isl thel oppositel
ofl thel physiologyl ofl breathing
,-l Fractionl ofl Inspiredl Oxygenl (FiO2);l thel percentagel ofl inspiredl O2l thel ventilatorl isl
givingl thel patient?
-l FiO2l rangesl froml 0.21l (21%)l tol 1.0l (100%)l O2.l RAl =l 0.21l orl 21%l O2
-l Respiratoryl Ratel (RR)l thel numberl ofl breathsl tol bel deliveredl tol thel patientl perl minute
Q:l Positivel Endl Expiratoryl Pressurel (PEEP):
Answer:
-l Thel amountl ofl positivel pressurel (inl cmsl ofl H20)l appliedl tol thel airwaysl duringl
expiration;l PEEPl isl meantl tol holdl openl thel alveolil andl preventl airwayl collapsel
betweenl breaths
Q:l Positivel End-Expiratoryl Pressurel (PEEP)
Answer:
PEEP
,Q:l Alarmsl &l Troubleshooting:
Answer:
-l NEVERl shutl alarmsl off;l onlyl silence
-l Manuallyl ventilatel ifl unsurel ofl thel probleml untill al newl ventilatorl isl availablel forl use
-l Mostl ICUsl havel dedicatedl RTsl whol managel mechanicall ventl alongl withl nursel and/orl
physician
Q:l Typesl ofl Ventl Alarms:
Answer:
-l Highl Pressure:l Increasedl secretions,l wheezing,l bronchospasm,l causingl decreasedl
airway,l displacedl ETT.l Pt.l gag,l kinked,l biting
, -l Lowl Pressure:l Disconnectionl orl leakl inl ventilatorl orl patient'sl airwayl cuff;l patientl
stopsl breathing
Q:l Complicationsl ofl Mechanicall Ventilation:
Answer:
-l ETTl outl ofl position...rightl mainl steml bronchus,l dislodged
-l Unplannedl extubation...securingl important
-l Laryngeall /l Tracheall Injury...preventl excessivel headl movement
-l Damagel tol orall andl nasall mucosa
Q:l Barotrauma:
Answer:
-l Injuryl causedl byl pressurel tol enclosedl bodyl surfaces,l forl examplel froml tool muchl
pressurel inl thel lungs.l Eg.l Pneumothorax,l tensionl pneumothorax
-l Detect:l highl peakl airwayl pressuresl onl vent,l meanl airwayl pressure,l decreasedl breathl
sounds,l tracheall shift,l subcutaneousl crepitus,l andl hypoxemia
-l Treatl tensionl pneumothoraxl vial manuallyl ventilate,l needlel thoracostomy
Q:l Complicationsl ofl Mechanicall Ventilationl -l Infection:
Answer:
-l Normall protectivel mechanisml bypassedl byl ETTl tube;l ventilator-associatedl pneumonial
(VAP)
-l Ventilatorl bundle:l Headl ofl bedl atl 30l degrees,l awakenl dailyl andl assessl readinessl tol
wean,l stressl ulcerl prophylaxisl (eg.l pantoprazole),l DVTl prophylaxisl (enoxaparin,l
Sequentiall Compressionl Devices),l orall carel usingl chlorohexidinel inl somel bundles
Q:l Stoppingl thel Weaningl Process:
Answer:
-l RRl >l 35l orl <l 8l breaths/min
-l Lowl spontaneousl V1l <l 5mL/kg
