440 Exam 1 - Questions

Acute respiratory acidosis is defined clinically as A. PaCO2 greater than 50 mmHg and pH less than 7.30 B. PaO2 less than 60 mmHg C. PaCO2 greater than 45 mmHg and pH less than 7.35 D. PaO2 less than 80 mmHg

A. PaCO2 greater than 50 mmHg and pH less than 7.30

The atypical presentation of urinary tract infection often seen in the older adult patient includes which symptoms? (Select all that apply.) A. abdominal pain B. incontinence C. nausea and vomiting D. high fever E. confusion

A. abdominal pain B. incontinence C. nausea and vomiting E. confusion

Supportive equipment when a person has an artificial airway in place includes which of the following? (Select all that apply.) A. at least one oxygen source B. suctioning equipment C. manual resuscitation bag and mask D. a backup ventilator in the room

A. at least one oxygen source B. suctioning equipment C. manual resuscitation bag and mask

A nurse is watching the cardiac monitor, and a client's rhythm suddenly changes. There are no p waves; instead, there are fibrillatory waves before each QRS complex. How should the nurse correctly interpret the client's heart rhythm? A. atrial fibrillation B. sinus tachycardia C. ventricular fibrillation D. ventricular tachycardia

A. atrial fibrillation

To treat the nursing diagnosis Sleep Pattern Disturbance while managing the care of a mechanically ventilated patient, what would be the best nursing action? A. cluster activities B. administer sedatives C. administer neuromuscular blocking agents D. space activities evenly throughout the 24-hour day

A. cluster activities

Which age-related change in urinary system function should the nurse anticipate in the older adult? A. decreased glomerular filtration rate B. increased size of nephrons C. decreased ureter lumen size D. increased creatinine clearance

A. decreased glomerular filtration rate

When caring for the older patient, which intervention(s) should be a nursing priority for prevention of airway clearance and gas exchange complications? A. deep breathing and coughing exercises B. high fluid intake C. monitoring of respiratory rate and depth D. assessing for adventitious breath sounds

A. deep breathing and coughing exercises

The most common early clinical manifestations of ARDS that the nurse may observe are A. dyspnea and tachypnea B. cyanosis and apprehension C. hypotension and tachycardia D. respiratory distress and frothy sputum

A. dyspnea and tachypnea

When caring for the older patient, which common nursing intervention is most likely to result in skin breakdown? A. elevating head of bed 30 degrees B. turning every 2 hours C. using support surfaces D. moisturizing sacral skin

A. elevating head of bed 30 degrees

If Vt is set too low on the ventilator, what will it cause? A. hypoventilation B. pneumothorax C. hypoxemia D. hypocapnia

A. hypoventilation

The purpose of adding PEEP to positive pressure ventilation is to A. increase functional residual capacity and improve oxygenation B. increase FIO2 in an attempt to wean the patient and avoid O2 toxicity C. determine if the patient is in synchrony with the ventilator or needs to be paralyzed D. determine if the patient is able to be weaned and avoid the risk of pneumomediastinum

A. increase functional residual capacity and improve oxygenation

What does an increasing PIP most commonly indicate? A. increasing airway resistance and/or decreasing lung compliance B. decreasing airway resistance and/or decreasing lung compliance C. increasing airway resistance and increasing lung compliance D. decreasing airway resistance and decreasing lung compliance

A. increasing airway resistance and/or decreasing lung compliance

The lungs act as an acid-base buffer by A. increasing respiratory rate and depth when CO2 levels in the blood are high, reducing acid load B. increasing respiratory rate and depth when CO2 levels in the blood are low, reducing acid load C. decreasing respiratory rate and depth when CO2 levels in the blood are high, reducing acid load D. decreasing respiratory rate and depth when CO2 levels in the blood are low, increasing acid load

A. increasing respiratory rate and depth when CO2 levels in the blood are high, reducing acid load

What are some risk factors for the development of sepsis in older patients? (Select all that apply.) A. institutionalization B. pressure ulcers C. altered mental status D. indwelling urinary catheters E. female gender

A. institutionalization B. pressure ulcers D. indwelling urinary catheters

The older patient may not develop a fever as an early sign of infection due to which factor? A. lower basal temperature B. hyperthyroidism C. elevated humoral immune function D. increased circulating T-lymphocytes

A. lower basal temperature

The term __________ weaning is used to refer to weaning by intermittently removing the patient form the ventilator for increasing periods of time. A. manual B. ventilator C. SIMV D. pressure support ventilation

A. manual

In an emergency situation, what is the most common entry route for airway access? A. oral intubation B. nasal intubation C. tracheostomy D. oropharyngeal airway

A. oral intubation

Pressure-cycled ventilation uses which of the following as a constant? A. pressure B. time C. volume D. flow rate

A. pressure

The term permissive hypercapnia refers to which therapeutic strategy? A. reducing peak airway pressures by allowing some increase in PaCO2 B. controlling PaCO2 level at 45 to 50 mmHg C. enhancing gas exchange by allowing some increase in PaCO2 D. controlling PaO2 level by allowing hypercapnia

A. reducing peak airway pressures by allowing some increase in PaCO2

When admitting a patient in possible respiratory failure with a high PaCO2, which assessment information will be of most concern to the nurse? A. the patient is somnolent B. the patient's SpO2 is 90% C. the patient complains of weakness D. the patient's blood pressure is 162/94

A. the patient is somnolent

The older patient is more susceptible to skin breakdown for which reasons? (Select all that apply.) A. thinning of the skin B. increased subcutaneous tissue C. lower body fat content D. flattening of capillary beds E. loss of elasticity

A. thinning of the skin D. flattening of capillary beds E. loss of elasticity

What are the appropriate nursing interventions for the patient with delirium in the ICU (select all that apply)? A. use clocks and calendars to maintain orientation B. encourage round-the-clock presence of caregivers at the bedside C. sedate the patient with appropriate drugs to protect the patient from harmful behaviors D. silence all alarms, reduce overhead paging, and avoid conversations around the patient E. identify physiologic factors that may be contributing to the patient's confusion and irritability

A. use clocks and calendars to maintain orientation C. sedate the patient with appropriate drugs to protect the patient from harmful behaviors E. identify physiologic factors that may be contributing to the patient's confusion and irritability

Positive pressure ventilation (PPV) alters the relationship of ventilation to perfusion in what way? A. ventilation increases in nondependent lung areas B. ventilation increases in the small airways C. perfusion increases in the nondependent lung areas D. perfusion increases near the large airways

A. ventilation increases in nondependent lung areas

In mechanically ventilated older patients, weaning is often more difficult for which major reason? (Select all that apply.) A. weak respiratory muscle function B. confused mental state C. altered respiratory mechanics D. changes in hemodynamics E. reduced patient coping skills

A. weak respiratory muscle function C. altered respiratory mechanics

When gathering a nursing history on an older patient, what information from the patient would indicate an increased risk for peptic ulcer disease? A. "I have been under intense stress lately" B. "I take nonsteroidal anti-inflammatory drugs daily" C. "I stopped taking my calcium supplement because it was difficult to swallow" D. "I drink about four cups of coffee each day"

B. "I take nonsteroidal anti-inflammatory drugs daily"

According to the ARDS consensus criteria, a diagnosis of ARDS requires a P/F ratio of less than __________ mmHg. A. 175 B. 200 C. 225 D. 300

B. 200

About what percentage of older adults were living in institutional settings in 2009 A. 2% B. 4% C. 8% D. 10%

B. 4%

A P wave on an ECG represents an impulse arising at the A. SA node and repolarizing the atria B. SA node and depolarizing the atria C. AV node and depolarizing the atria D. AV node and spreading to the bundle of His

B. SA node and depolarizing the atria

Positive pressure ventilators adjust the tidal volume by doing what? A. adjusting the amount of negative airflow B. adjusting the amount of positive airflow C. altering the amount of negative pressure applied D. altering the amount of positive pressure applied

B. adjusting the amount of positive airflow

Traditional weaning criteria most effectively predict readiness in patients who fit what description? A. are elderly B. are relatively healthy C. have chronic pulmonary disease D. require prolonged mechanical ventilation

B. are relatively healthy

The hemodynamic changes the nurse expects to find after successful initiation of intraaortic balloon pump therapy in a patient with cardiogenic shock include (select all that apply) A. decreased SV B. decreased SVR C. decreased PAWP D. increased diastolic BP E. decreased myocardial oxygen consumption

B. decreased SVR C. decreased PAWP D. increased diastolic BP E. decreased myocardial oxygen consumption

A 68-year-old patient has been admitted to the coronary care unit after an inferior myocardial infarction. Age-related changes in myocardial pumping ability may be evidenced by A. increased contractility B. decreased contractility C. decreased left ventricle afterload D. increased cardiac output

B. decreased contractility

PPV affects the cardiovascular system by doing what? A. increasing cardiac output B. decreasing venous return to the heart C. increasing arterial blood pressure D. increasing venous return to the heart

B. decreasing venous return to the heart

The atypical presentation of some older patients experiencing acute myocardial ischemia/infarction may include which manifestations? (Select all that apply.) A. hypothermia B. falls C. flu-like syndromes D. higher than usual elevations of creatine kinase E. acute confusion

B. falls C. flu-like syndromes E. acute confusion

Which atypical signs of infection may be present in older patients? (Select all that apply.) A. metabolic alkalosis B. functional decline C. altered mental status D. recent history of falls E. unexplained hypo- or hyperglycemia

B. functional decline C. altered mental status D. recent history of falls E. unexplained hypo- or hyperglycemia

How does gastrointestinal bleeding secondary to mechanical ventilation most frequently manifest itself? A. grossly bloody stools B. guaiac-positive stools C. grossly bloody nasogastric drainage D. guaiac-negative nasogastric drainage

B. guaiac-positive stools

Barotrauma is associated with which ventilator setting? A. assist control mode B. high tidal volumes C. low FiO2 D. rapid respiratory rates

B. high tidal volumes

The term cycle as it applies to mechanical ventilation refers to the mechanism by which what occurs? A. the ventilator turns on and off B. inspiration ceases and expiration starts C. the concentration of oxygen is controlled D. the rate of airflow is maintained

B. inspiration ceases and expiration starts

Which of the following actions are necessary to obtain an accurate hemodynamic reading? (Select all that apply.) A. place the client in high-Fowler's position, with the head of the bed elevated no more than 30 degrees. B. level the transducer to phlebostatic axis C. zero transducer to room air D. record readings E. compare readings to physical assessment

B. level the transducer to phlebostatic axis C. zero transducer to room air D. record readings E. compare readings to physical assessment

The term pulmonary shunt refers to what condition? A. movement of air directly from one alveolus to another B. normal pulmonary capillary perfusion, reduced alveolar ventilation C. an opening between the pulmonary artery and the heart D. normal alveolar ventilation, reduced pulmonary capillary perfusion

B. normal pulmonary capillary perfusion, reduced alveolar ventilation

A low V/Q exists when what occurs? A. ventilation is in excess of perfusion B. perfusion is in excess of ventilation C. blood is shunted away from the alveoli D. there is an obstruction in the pulmonary capillaries

B. perfusion is in excess of ventilation

In what manner are the vast majority of patients requiring mechanical ventilation weaned? A. rapidly, with difficulty B. rapidly, without difficulty C. slowly, with difficulty D. slowly, without difficulty

B. rapidly, without difficulty

Which patient teaching points should the nurse include when providing discharge instructions to a patient with a new permanent pacemaker and the caregiver (select all that apply)? A. avoid or limit air travel B. take and record a daily pulse rate C. obtain and wear a Medic Alert ID or bracelet at all times D. avoid microwave ovens because they interfere with pacemaker functions

B. take and record a daily pulse rate C. obtain and wear a Medic Alert ID or bracelet at all times

Age-related pulmonary changes that may affect this patient include A. increased tidal volumes B. weakening of intercostal muscles and the diaphragm C. improved cough reflex D. decreased sensation of the glottis

B. weakening of intercostal muscles and the diaphragm

When caring for a patient who developed acute respiratory distress syndrome (ARDS) as a result of a urinary tract infection (UTI), the nurse is asked by the patient's family how a urinary tract infection could cause lung damage. Which response by the nurse is appropriate? A. "the infection spread through the circulation from the urinary tract to the lungs" B. "the urinary tract infection produced toxins that damaged the lungs" C. "the infection caused generalized inflammation that damaged the lungs" D. "the fever associated with the infection led to scar tissue formation in the lungs"

C. "the infection caused generalized inflammation that damaged the lungs"

A patient with an acid-base imbalance has an altered potassium level. The nurse recognizes that the potassium level is altered because: A. potassium is returned to extracellular fluid when metabolic acidosis is corrected B. hyperkalemia causes an alkalosis that results in potassium being shifted into the cells C. acidosis causes hydrogen ions in the blood to be exchanged for potassium from the cells D. in alkalosis, potassium is shifted into extracellular fluid to bind excessive bicarbonate

C. acidosis causes hydrogen ions in the blood to be exchanged for potassium from the cells

What is the primary reason that airway patency becomes compromised in the mechanically ventilated patient? A. ineffective cough to clear mucus B. oversedation C. airway obstruction D. dehydration

C. airway obstruction

The critical care nurse recognizes that an ideal plan for caregiver involvement includes A. a caregiver at the bedside at all times B. allowing caregivers at the bedside at preset, brief intervals C. an individually devised plan to involve caregivers with care and comfort measures D. restriction of visiting in the ICU because the environment is overwhelming to caregivers

C. an individually devised plan to involve caregivers with care and comfort measures

Which manifestation is an indication for suctioning? A. low airway pressure alarm B. low respiratory rate C. cough and high peak airway pressure D. normal oxygenation

C. cough and high peak airway pressure

Dehydration and hyponatremia in the older adult are often associated with which physiologic alteration in the kidneys? A. altered neural controls B. changes in the urethral sphincter C. declining renal tubule function D. increased concentration of urine

C. declining renal tubule function

Changes in cardiac output resulting from positive pressure ventilation are associated with which manifestation? A. increased arterial blood pressure B. increased urinary output C. decreased arterial blood pressure D. decreased pulse rate

C. decreased arterial blood pressure

When assessing the cardiovascular system of a 79-year-old patient, you might expect to find A. a narrowed pulse pressure B. diminished carotid artery pulses C. difficulty in isolating the apical pulse D. an increased heart rate in response to stress

C. difficulty in isolating the apical pulse

Maintenance of fluid balance in the patient with ARDS involves A. hydration using colloids B. administration of surfactant C. fluid restriction and diuretics as necessary D. keeping the hemoglobin at levels above 9 g/dL

C. fluid restriction and diuretics as necessary

The nurse understands that age-related changes in the thyroid gland increase the risk for development of which thyroid-related problem in the older patient? A. hyperthyroidism B. thyrotoxic storm C. hypothyroidism D. elevated basal metabolic rate

C. hypothyroidism

As a general statement, it would be correct to say that older adults have which characteristic? A. pretty much alike B. less likely to need to visit the ER C. increasingly diverse D. unlikely to have chronic diseases

C. increasingly diverse

Which question would be asked during the initial patient screening criteria for weaning eligibility? A. is the urinary output greater than 620 mL/24 hr B. is the prealbumin 10 mg/dL or greater C. is the patient's clinical condition improving D. have drugs been discontinued that decrease the respiratory drive

C. is the patient's clinical condition improving

The nurse is reviewing an EKG rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 second, and the QRS complexes measure 0.06 second. The overall heart rate is 64 bpm. Which of the following would be a correct interpretation based on these characteristics? A. sinus bradycardia B. sick sinus syndrome C. normal sinus rhythm D. first-degree heart block

C. normal sinus rhythm

Patients receiving mechanical ventilation are at increased risk of developing a nosocomial pulmonary infection for what reason? A. the lower airway is defenseless B. macrophage activity has been bypassed C. normal upper airway defenses are bypassed D. normal pulmonary mechanics have been altered

C. normal upper airway defenses are bypassed

A patient admitted with ACS has continuous ECG monitoring. An examination of the rhythm strip reveals the following characteristics: atrial rate 74 beats/min and regular; ventricular rate 62 beats/min and irregular; P wave normal shape; PR interval lengthens progressively until a P wave is not conducted; QRS normal shape. The priority nursing intervention would be to A. perform synchronized cardioversion B. administer epinephrine 1 mg IV push C. observe for symptoms of hypotension or angina D. apply transcutaneous pacemaker pads on the patient

C. observe for symptoms of hypotension or angina

Which musculoskeletal condition is most prevalent among older adults? A. gout B. rheumatoid arthritis C. osteoarthritis D. fractures

C. osteoarthritis

To establish hemodynamic monitoring for a patient, the nurse zeros the A. cardiac output monitoring system to the level of the left ventricle B. pressure monitoring system to eh level of the catheter tip located in the patient C. pressure monitoring system to the level of the atrium, identified as the phlebostatic axis D. pressure monitoring system to the level of the atrium, identified as the midclavicular line

C. pressure monitoring system to the level of the atrium, identified as the phlebostatic axis

Which condition is the most common indirect predisposing disorder of ARDS? A. gastric aspiration B. severe trauma C. sepsis D. pneumonia

C. sepsis

The nurse monitors the patient with positive pressure mechanical ventilation for A. paralytic ileus because pressure on the abdominal contents affects bowel motility B. diuresis and sodium depletion because of increased release of atrial natriuretic peptide C. signs of cardiovascular insufficiency because pressure in the chest impedes venous return D. respiratory acidosis in a patient with COPD because of alveolar hyperventilation and increased PaO2 levels

C. signs of cardiovascular insufficiency because pressure in the chest impedes venous return

The nurse is monitoring the ECG of a patient admitted with ACS. Which ECG characteristics would be most suggestive of myocardial ischemia? A. sinus rhythm with a pathologic Q wave B. sinus rhythm with an elevated ST segment C. sinus rhythm with a depressed ST segment D. sinus rhythm with premature atrial contractions

C. sinus rhythm with a depressed ST segment

Which intervention is most likely to prevent or limit barotrauma in the patient with ARDS who is mechanically ventilated A. decreasing PEEP B. increasing the tidal volume C. use of permissive hypercapnia D. use of positive pressure ventilation

C. use of permissive hypercapnia

The nursing management of a patient with an artificial airway includes A. maintaining ET tube cuff pressure at 30 cm H2O B. routine suctioning of the tube at least every 2 hours C. observing for cardiac dysrhythmias during suctioning D. preventing tube dislodgment by limiting mouth care to lubrication of the lips

CC. observing for cardiac dysrhythmias during suctioning

A nurse is teaching an older patient about the signs and symptoms of a myocardial infarction. Which statement by the patient would indicate that the teaching was effective? A. "the pain in my chest may last a long time" B. "I will feel like I have an elephant sitting on the center of my chest" C. "the chest pain will be sharp and over the center of my chest" D. "the pain may not be severe and may not be in my chest"

D. "the pain may not be severe and may not be in my chest"

What can a low minute ventilation (Ve) cause? A. acute metabolic alkalosis B. acute respiratory alkalosis C. acute metabolic acidosis D. acute respiratory acidosis

D. acute respiratory acidosis

Which statement is true about securing the artificial airway? A. the inflated cuff provides sufficient securing B. the airway is generally sutured in place C. a nasotracheal tube does not require securing D. artificial airways are optimally secured using a commercial tube holder

D. artificial airways are optimally secured using a commercial tube holder

The ECG monitor of a patient in the cardiac care unit after an MI indicates ventricular bigeminy with a rate of 50 beats/min. The nurse would anticipate A. performing defibrillation B. treating with IV amiodarone C. inserting a temporary transvenous pacemaker D. assessing the patient's response to the dysrhytmia

D. assessing the patient's response to the dysrhytmia

A client is having frequent premature ventricular contractions. A nurse would place priority on assessment of which of the following? A. sensation of palpitations B. causative factors, such as caffeine C. precipitating factors, such as infection D. blood pressure and oxygen saturation

D. blood pressure and oxygen saturation

Volume-cycled ventilation differs from pressure-cycled ventilation because it does what? A. adjusts volume as pulmonary pressure changes B. increases airflow as compliance increases C. decreases airflow as airway resistance decreases D. can adjust pressure to changes in lung compliance

D. can adjust pressure to changes in lung compliance

The majority of difficult-to-wean patients have which condition? A. pneumonia B. congestive heart failure C. acute respiratory distress syndrome D. chronic pulmonary disease

D. chronic pulmonary disease

SIMV weaning primarily is a(n) __________ exercise for the respiratory muscles. A. supportive B. resistance C. strengthening D. endurance

D. endurance

Certification in critical care nursing (CCRN) by the American Association of Critical-Care Nurses indicates that the nurse A. is an advanced practice nurse who cares for acutely and critically ill patients B. may practice independently to provide symptom management for the critically ill C. has earned a master's degree in the field of advanced acute and critical care nursing D. has practiced in critical care and successfully completed a test of critical care knowledge

D. has practiced in critical care and successfully completed a test of critical care knowledge

A patient has the following arterial blood gas (ABG) results: pH 7.48, PaO2 86, PaCO2 44, HCO3 29. When assessing the patient, the nurse would expect the patient to experience: A. warm, flushed skin B. respiratory rate of 36 C. blood pressure of 94/52 D. hypertonic muscles with cramping

D. hypertonic muscles with cramping

The pulmonary edema of ARDS differs from the pulmonary edema of HF in which way? A. in HF, PAWP is less than 18 B. in HF, bronchoalveolar lavage (BAL) fluid is protein rich C. in ARDS, heart enlargement is typically noted D. in ARDS, BAL fluid contains inflammatory cells

D. in ARDS, BAL fluid contains inflammatory cells

Which assessment finding in a patient receiving PPV should make the nurse suspect pulmonary barotrauma/volutrauma? A. onset of increased lethargy B. increase in arterial blood pressure C. increase in breath sounds over a lung field D. increased cough with high-pressure alarm triggering

D. increased cough with high-pressure alarm triggering

The pulmonary edema associated with ARDS is caused by which condition? A. capillary microembolism B. left ventricular failure C. loss of surfactant D. injured alveolar-capillary membrane

D. injured alveolar-capillary membrane

After prolonged cardiopulmonary bypass, a patient develops increasing shortness of breath and hypoxemia. To determine whether the patient has acute respiratory distress syndrome (ARDS) or pulmonary edema caused by left ventricular failure, the nurse will anticipate assisting with A. positioning the patient for a chest radiograph B. drawing blood for arterial blood gases C. obtaining a ventilation-perfusion scan D. inserting a pulmonary artery catheter

D. inserting a pulmonary artery catheter

Which statement correctly describes the primary purpose of CLRT? A. it prevents pneumonia B. it saves manual turning time C. it prevents decubitus ulcers D. it prevents reduced stasis of fluid and gas

D. it prevents reduced stasis of fluid and gas

Why is the risk of pulmonary infections higher in the older patient? A. increased lung elasticity B. increased alveolar surface area C. decreased chest anteroposterior (AP) diameter D. loss of pulmonary epithelial cells

D. loss of pulmonary epithelial cells

The term acute ventilatory failure refers to the inability of the lungs to do what? A. expand B. diffuse gases C. exchange oxygen and carbon dioxide D. maintain adequate alveolar ventilation

D. maintain adequate alveolar ventilation

The oxygen delivery system chosen for the patient in acute respiratory failure should: A. always be a low-flow device, such as a nasal cannula B. correct the PaO2 to a normal level as quickly as possible C. administer positive pressure ventilation to prevent CO2 narcosis D. maintain the PaO2 at greater than or equal to 60 mmHg at the lowest O2 concentration

D. maintain the PaO2 at greater than or equal to 60 mmHg at the lowest O2 concentration

PEEP affects the alveoli by doing what? A. increasing alveolar fluid B. decreasing their relative size C. sealing off nonfunctioning units D. maintaining them open at end expiration

D. maintaining them open at end expiration

The nurse prepares a patient for synchronized cardioversion knowing that cardioversion differs from defibrillation in that A. defibrillation requires a lower dose of electrical energy B. cardioversion is indicated to treat atrial bradydysrhytmias C. defibrillation is synchronized to deliver a shock during the QRS complex D. patients should be sedated if cardioversion is done on a non-emergency basis

D. patients should be sedated if cardioversion is done on a non-emergency basis

In the US, what is the fastest growing age group (by decade) A. people over 55 B. people over 65 C. people over 75 D. people over 85

D. people over 85

The nurse is aware that in the older adult high-acuity patient, altered gastric pH increases the risk of which complication? A. gastric ulcers B. hepatitis C. gastric cancer D. pneumonia

D. pneumonia

A client is in sinus bradycardia with a heart rate of 45 beats/min, complains of dizziness, and has a BP of 82/60 mmHg. Which of the following should the nurse anticipate will be prescribed? A. defibrillate the client B. administer digoxin (Lanoxin) C. continue to monitor the client D. prepare for transcutaneous pacing

D. prepare for transcutaneous pacing

When planning care for a patient on a mechanical ventilator, the nurse understands that the application of positive end expiratory pressure (PEEP) to the ventilator settings has which of the following therapeutic results? A. increased fraction of inspired oxygen concentration (FIO2) administration B. increased inflation of the lung C. prevention of barotrauma to the lung tissue D. prevention of alveolar collapse during expiration

D. prevention of alveolar collapse during expiration

A patient has the following arterial blood gas results: pH 7.52; PaCO2 30; HCO3 24. The nurse determines that these results indicate A. metabolic acidosis B. metabolic alkalosis C. respiratory acidosis D. respiratory alkalosis

D. respiratory alkalosis

A mechanically ventilated patient who is malnourished is at high risk for failure to wean for what reason? A. impaired gas exchange B. decreased cardiac output C. increased airway resistance D. respiratory muscle weakness

D. respiratory muscle weakness

In the adult, an inflated ET tube cuff is necessary for mechanical ventilation primarily because it does what? A. prevents stomach contents from getting into the lungs B. seals off the nasopharynx from the oropharynx C. prevents air from getting into the stomach D. seals off the lower airway from the upper airway

D. seals off the lower airway from the upper airway

The nurse is caring for a patient who was hospitalized two days earlier with aspiration pneumonia. Which assessment information is most important to communicate to the health care provider? A. the patient has a cough that is productive of blood-tinged sputum B. the patient has scattered crackles throughout the posterior lung bases C. the patient's temperature is 101.5° F after two days of IV antibiotic therapy D. the patient's SpO2 has dropped to 90%, although the O2 flow rate has been increased

D. the patient's SpO2 has dropped to 90%, although the O2 flow rate has been increased

The ventilator low exhaled volume alarm will trigger when what occurs? A. the patient is coughing B. there is water int eh tubing C. the patient is biting the ET tube D. there is a leak in the system

D. there is a leak in the system

pH 7.18 PaCO2 38 PaO2 70 HCO3 15 What is this?

Metabolic acidosis

pH 7.28 PaCO2 28 PaO2 70 HCO3- 18 What is this?

Metabolic acidosis

pH 7.58 PaCO2 35 PaO2 75 HCO3 50 What is this?

Metabolic alkalosis

pH 7.60 PaCO2 30 PaO2 60 HCO3 22 What is this?

Respiratory alkalosis