Oxygenation vs Ventilation
Which conditions are associated with oxygenation failure? (Select all that apply)
A. Pneumonia
B. Pulmonary embolism
C. Drug overdose
D. ARDS
E. Spinal cord injury
Answer: A, B, D
Rationale: Oxygenation failure = gas exchange problem (pneumonia, ARDS, PE). CNS/spinal issues cause ventilatory failure.
Which are EARLY signs of respiratory failure? (Select all that apply)
A. Restlessness
B. Tachycardia
C. Cyanosis
D. Tachypnea
E. Confusion
Answer: A, B, D
Rationale:
Early: restlessness, tachycardia, tachypnea. Late: Cyanosis/confusion.
Which interventions improve oxygenation? (select all that apply):
A. high Fowler's position
B. oxygen therapy
C. supine positioning
D. incentive spirometry
E. fluid retention
Answer: A, B, D
Rationale: Positioning + O2 + lung expansion improve oxygenation.
Which best describes CPAP?
A. Two pressure levels
B. Continuous pressure
C. Invasive ventilation
D. Removes CO2
Answer: B
Rationale: CPAP = constant pressure.
Asthma is characterized by:
A. Infection
B. Chronic inflammation
C. Fluid overload
D. Cardiac dysfunction
Answer: B
Rationale: Chronic airway inflammation
A patient has PaCO2 55 mmHg. This finding indicates:
A. Hypoxemia
B. Oxygenation failure
C. Ventilatory failure
D. Metabolic alkalosis
Answer: C
Rationale: Elevated CO₂ = inability to ventilate (remove CO2).
A patient becomes confused and lethargic. what should the nurse do FIRST?
A. Document findings
B. Apply restraints
C. Assess oxygenation
D. Administer sedatives
Answer: C
Rationale: Late hypoxia
priority is airway/oxygen assessment.
A patient presents with dyspnea. What is the FIRST intervention?
A. Chest x-ray
B. Oxygen administration
C. IV fluids
D. Antibiotics
Answer: B
Rationale: Always prioritize oxygenation first
Which are characteristics of BiPAP? (Select all that apply)
A. Two pressure levels
B. Helps remove CO2
C. Continuous pressure only
D. Noninvasive
E. Improves ventilation
Answer: A, B, D, E
Rationale: BiPAP supports ventilation with dual pressures.
Which are symptoms of asthma? (Select all that apply)
A. Wheezing
B. Chest tightness
C. Dyspnea
D. Bradycardia
E. Cough
Answer: A, B, C, E
Rationale: Classic asthma symptoms
Which findings are consistent with hypercapnic respiratory failure? (Select all that apply)
A. PaCO2 >45 mmHg
B. pH <7.35
C. PaO2 >80 mmHg
D. Respiratory acidosis
E. Increased ventilation
Answer: A, B, D
Rationale: Hypercapnia = high CO2 + acidosis.
Which findings indicate LATE respiratory failure? (Select all that apply)
A. Cyanosis
B. Restlessness
C. Confusion
D. Lethargy
E. Air hunger
Answer: A, C, D
Rationale:
early= restless
emergent= air hunger
Which interventions help mobilize the patient's secretions? (Select all that apply)
A. Hydration
B. Incentive spirometry
C. Ambulation
D. Sedation
E. Chest physiotherapy
Answer: A, B, C, E
Rationale: These promote airway clearance; sedation worsens it.
Which patient would benefit MOST from CPAP?
A. COPD with CO2 retention
B. Sleep apnea
C. Neuromuscular failure
D. Drug overdose
Answer: B
Rationale: CPAP keeps airways open in sleep apnea patients.
What is the FIRST-line treatment in asthma exacerbation?
A. Steroids
B. Bronchodilators
C. Antibiotics
D. Diuretics
Answer: B
Rationale: Bronchodilators open airways first.
extra credit: what do you do 2nd?
Which patient is MOST at risk for ventilatory failure?
A. Pneumonia
B. COPD exacerbation with CO2 retention
C. Pulmonary embolism
D. ARDS
Answer: B
Rationale: COPD → CO2 trapping → ventilatory failure.
A restless patient on BiPAP becomes more agitated. What is the priority action?
A. Administer Ativan
B. Remove mask
C. Assess respiratory status
D. Apply restraints
Answer: C
Rationale: Restlessness = worsening hypoxia and fear causes agitation. Sedation worsens the respiratory depression.
A patient on BiPAP requires FiO2 of 90% and is declining. What should the nurse anticipate?
A. Discharge
B. CPAP
C. Intubation
D. Decrease oxygen
Answer: C
Rationale: Max support failing → mechanical ventilation will be needed.
Which indicate failure of noninvasive ventilation? (Select all that apply)
A. Increasing restlessness
B. Rising CO2 levels
C. Improved oxygenation
D. Fatigue
E. Decreased RR
Answer: A, B, D
Rationale: These show worsening respiratory status.
Which indicate status asthmaticus? (Select all that apply)
A. No response to inhalers
B. Severe dyspnea
C. Stable breathing
D. Continuous symptoms
E. Mild wheezing
Answer: A, B, D
Rationale: Life-threatening, unresponsive asthma
which conditions impair ventilation due to neuromuscular causes? (select all that apply):
A. Guillain-Barré syndrome
B. Myasthenia gravis
C. Asthma
D. Spinal cord injury
E. Pneumonia
Answer: A, B, D
Rationale: Neuromuscular disorders impair diaphragm → CO2 retention.
Which findings suggest impending respiratory arrest? (Select all that apply)
A. Lethargy
B. Cyanosis
C. Decreased respiratory effort
D. Stable vital signs
E. Confusion
Answer: A, B, C, E
Rationale: These are late, severe signs and will need immediate escalation of care
Which are priority nursing actions for respiratory failure? (Select all that apply)
A. Frequent assessments
B. Communication with RT/provider
C. Ignore restlessness
D. Provide oral care
E. Support and reassurance
Answer: A, B, D, E
Rationale: Monitoring + collaboration + comfort are critical.
What are indications for intubation? (Select all that apply)
A. Failure of BiPAP
B. Severe hypoxia
C. Respiratory arrest
D. Mild dyspnea
E. Exhaustion
Answer: A, B, C, E
Rationale: These indicate inability to maintain airway/ventilation.
Which complications can occur with severe asthma? (Select all that apply)
A. Pneumothorax
B. Respiratory arrest
C. Cor pulmonale
D. Hypertension
E. PE
Answer: A, B, C
Rationale: Severe asthma → lung rupture, arrest, right heart failure.