LS1 Week 4 Chapter 21 Respiratory Care Modalities

Which type of oxygen includes the administration of oxygen at pressure greater than atomspheric pressure? a. Hyperbaric b. Transtracheal c. Low flow system d. High flow system

a. Hyperbaric

Which oxygen administration device has the advantage of providing a high oxygen concentration? a. Catheter b. Nonrebreathing mask c. Face tent d. Venturi mask

b. Nonrebreathing mask

Arterial blood gases should be obtained how often after intiating continous mechanical ventilation? a. 25 minutes b. 15 minutes c. 20 minutes d. 10 minutes

c. 20 minutes

Constant bubbling in the water seal of a chest drainage system indicates which problem? a. Air leak b. Increased drainage c. Tension pneumothorax d. Tidaling

a. Air leakW

Which is the most reliable and accurate method for delivering precise concentration of oxygen through noninvasive means? a. Ventruri Mask b. Partial-rebreathing mask c. Nasal Cannula d. T-piece

a. Venturi Mask

The nurse is assigned to care for a client with a chest tube. The nurse should endsure that which item is kept at the client's bedside? a. An incentive spirometer b. A set of hemostats c. An Ambu bag d. A bottle of sterile water

d. A bottle of sterile water

Which is a correct endotracheal tube cuff pressure? a. 16 mm Hg b. 19 mm Hg c. 22 mm Hg d. 13 mm Hg

a. 16 mm Hg

The nurse is caring for a client who is scheduled for a lobectomy. Following the procedure, the nurse will plan care based on the client a. requiring a mechanical ventilation following surgery b. returning from surgery with no drainage tubes c. requiring sedation until the chest tube(s) are removed d. returning to the nursing unit with two chest tubes

d. returning to the nursing unit with two chest tubes

The nurse is caring for a client in the ICU who required emergent endotracheal (ET) intubation with mechanical ventilation. The nurse receives an order to obtain arterial blood gases (ABGs) after the procedure. The nurse recognizes that ABGs should be obtained how long after mechanical ventilation is initiated? a. 20 minutes b. 10 minutes c. 25 minutes d. 15 minutes

a. 20 minutes

The nurse is caring for a client in the ICU who is receiving mechanical ventilation. Which nursing measure is implemented in an effort to reduce the client's risk of developing ventilator-associatied pneumonia (VAP)? a. Cleaning the client's mouth with chlorhexidine daily b. Maintaining the client in a high Fowler's position c. Turning and repositioning the client every 4 hours d. Ensuring that the client remains sedated while intubated

a. Cleaning the client's mouth with chlorhexidine daily

Which statments would be considered appropriate intervention for a client with an endotracheal tube? Select all that applay a. Humidified oxygen should always be introducded through the tube b. Routine cuff deflation is recommended c. Suctioning the oropharynx prn is not recommend d. Cuff pressures should be checked every 6 to 8 hours e. The cuff is deflated before the tube is removed

a. Humidified oxygen should always be introducded through the tube d. Cuff pressures should be checked every 6 to 8 hours e. The cuff is deflated before the tube is removed

Which oxygen administration device has the advantage of providing a high oxygen concentration? a. Nonrebreathing Mask b. Face Tent c. Venturi Mask d. Catheter

a. Nonrebreathing Mask explanation: Nonrebreathing mask provides high concentration but fits poorly. A venturi Mask provides low level of supplement oxygen. A catheter is an inexpensive device that provides a variable fraction of inspired oxygen and may cause gastric distention. A face tent provides a fairly accurate fraction of inspired oxygen but is bulky and uncomfortable. It would not be the choice to provide a high oxygen concentration.

The nurse is preparing to perform tracheostomy care for a client with a newly inserted tracheostomy tube. Which action, if preformed by the nurse, indicates the need for further review of the procedure? a. Places a clean tracheostomy ties then removes soiled ties after the new ties are in place b. Cleans the wound and the plate with a sterile cotton tip mositened with hydrogen peroxide c. Puts on clean gloves; removes and discards the solid dressing in a biohazard container d. Dries and resinsert the inner cannula or replaces it with a new disposable inner cannula

a. Places a clean tracheostomy ties then removes soiled ties after the new ties are in place

Which type of ventilator has a preset volume of air to be delivered with each inspiration? a. Volume-controlled b. Time-Cycled c. Pressure-cycled d. Negative-cycled

a. Volume-controlled

In general, chest drainage tubes are not used for the patient undergoing a. pneumonectomy b. wedge resection c. segmentectomy d. lobectomy

a. pneumonectomy explanation: Usually no drains are used for a client undergoing pneumonectomy because the accumaliation of fluid in the empty hemothorax prevent mediastinal shift. With lobectomy, two chest tubes are usually inserted for drainage, the upper tube for air and lower tube for fluid. With wedge resection, the pleural cavity is usually drained because of the possiblity an air or blood leak. With segmentectomy, drains are usually used because of the possiblity of an air or blood leak.

The nurse is preparing to perform chest physiotherapy (CPT) on a client. Which statement by the client tells the nurse that the procedure is contraindicated. a. "I received my pain medication 10 minutes ago, let's do my CPT now" b. "I just finished eating lunch, I'm ready for my CPT now" c. I have been coughing all morning and am barely bringing up anything" d. "I just changed into my running suit; we can do my CPT now"

b. "I just finished eating lunch, I'm ready for my CPT now"

When performing endotracheal suctioning, the nurse applies suctioning while withdrawing and gently rotating the catheter 360 degree for how long? a. 20 to 25 seconds b. 10 to 15 seconds c. 30 to 35 seconds d. 0 to 5 seconds

b. 10 to 15 seconds explanation: In general, the nurse should apply suction no longer than 10 to 15 seconds. Applying suction for 20 to 25 or 30 to 35 seconds is hazardous and may result in the development of hypoxia, which can lead to dysrhythmias, and ultimately, cardiac arrest. Applying suction for 0 to 5 seconds would provide to little time for effective suction secretion.

Which range of water pressure within the endotracheal tube cuff is believed to prevent both injury and aspiration? a. 10-15 mm Hg b. 15-20 mm Hg c. 30-35 mm Hg d. 0-5 mm Hg

b. 15 to 20 mm Hg explanation: Usually the pressure is maintained at <25 cm water pressure to prevent injury and at >20 cm water pressure to prevent aspiration. High cuff pressure can cause tracheal bleeding, ischema, and pressure necrosis, where as low cuff pressure can increase the risk of aspiration pneumonia. A wather pressue of 0 to 5 or 10 to 15 cm would indicate that the cuff is underinflated. A water pressure of 30 to 35 cm would indicate the cuff is overinflated.

Which is an adverse reaction that would require the process of weaning from a ventilator to be terminated? a. Heart rate <100 bpm b. Vital capacity of 12 mL/kg c. Blood pressure increase of 20 mm Hg d. PaO2 60 mmHg with an FiO2 <40%

c. Blood pressure increase of 20 mm Hg

The nurse is caring for a client following a thoracotomy. Which findings requires immediate intervention by the nurse? a. Moderate amounts of colorless sputum b. Heart rate, 112 bpm c. Chest tube drainage, 190 mL/hr d. Pain of 5 on a 1 to 10 scale

c. Chest tube drainage, 190 mL/hr

Which finding would indicate a decrease in pressure with mechanical ventilation? a. Kinked tubing b. Decrease in lung compliance c. Increase in complaince d. Plugged airway tube

c. Increase in complaince

Which ventilator mode provides a combination of mechanically assisted breaths and spontaneous breaths? a. Assist control b Synchronized intermittent mandatory ventilation (SIMV) c. Intermittent mandatory ventilation (IMV) d. Pressure Support

c. Intermittent mandatory ventilation (IMV)

The nurse is preparing to assist the health care provider to remove a client's chest tube. Which intruction will the nurse correctly give to the client? a. "Do not move during the removal of the chest tube because moving will make it more painful? b. While the chest tube is being removed, raise your arms above your head" c. "Exhale forcefully while the chest tube is being removed" d. "When the tube is being removed, take a deep breath, exhale, and bear down.

d. "When the tube is being removed, take a deep breath, exhale, and bear down.

Which ventilator mode provides full ventilatory support by delivering a preset tidal volume and respiratory rate? a. Pressure support b. IMV c. SIMV d. Assist control

d. Assist control

The nurse has instructed a client on how to perform pursed-lip breathing. The nurse recognizes the purpose of this type of breathing is to accomplish which result? a. Promote more effeicient and controlled ventilation and to decrease the work of breathing b. Promote the client's ability to take in oxygen c. Promote the strengthening of the client's diaphragm d. Improve oxygen transport; induce a slow, deep breathing pattern; and assist the client to control breathing

d. Improve oxygen transport; induce a slow, deep breathing pattern; and assist the client to control breathing

The nurse is caring for a client with an endotracheal tube (ET). Which nursing intervention is contraidicated? a. Checking the cuff pressure every 6 to 8 hours b. Ensuring that humdified oxygen is always introduced through the tube c. Deflating the cuff before removing the tube d. Routinely deflating the cuff

d. Routinely deflating the cuff

A client is being mechanically ventiated in the ICU. The ventilator alarms begin to sound. The nurse should complete which action first? a. Notify the respiratory therapist. b. Manually ventilate the client. c. Reposition the endotracheal tube d. Troubleshoot to identify the malfuction.

d. Troubleshoot to identify the malfuction.

Which is a potential complication of a low pressure in the endotracheal tube cuff? a. Tracheal bleeding b. Pressure necrosis c. Tracheal ischemia d. Aspiration pneumonia

d. aspiration pneumonia