Acute Respiratory Failure
Which arterial blood gas pH results would the nurse most commonly note with chronic respiratory insufficiency?
a. pH within normal limits
b. pH above normal range
c. pH below normal range
d. Variable pH
a. pH within normal limits
Which condition is the most common indirect predisposing disorder of ARDS?
a. Gastric aspiration
b. Severe trauma
c. Sepsis
d. Pneumonia
d. Pneumonia
Which type of embolism manifests as dyspnea, tachycardia, neurological symptoms and petechiae?
a. Venous air
b. Amniotic
c. Thrombus
d. Fat
d. Fat
A patient with chest trauma has sustained a hemothorax, and preparations are made for chest tube placement. The chest tube will be inserted at which location?
a. Anteriorly at level of second intercostal space
b. Midaxillary at level of fifth or sixth intercostal space
c. Posterior-laterally at the second intercostal space
d. Anteriorly at the fifth or sixth intercostal space
b. Midaxillary at level of fifth or sixth intercostal space
Evaluation of the effectiveness of interventions to resolve a problme with breathing pattern and ventilation is best measured by which desired patient outcome?
a. Usual mental status
b. Normal or improved lung sounds
c. Absent accessory muscle use
d. Normal respiratory rate, depth, and rhythm
d. Normal respiratory rate, depth, and rhythm
Failure to oxygenate refers to which primary problem?
a. Ventilation
b. Hypoxemia
c. Arterial pH
d. Carbon dioxide
b. Hypoxemia
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
What is the most common predisposing factor for development of thromboembolism?
a. Immobility
b. Postsurgery status
c. Malignancy
d. Coronary artery disease
a. Immobility
Internal origin problems that may require chest tube insertion include which types of injury? (SATA)
a. Barotrauma
b. Penetrating chest trauma
c. Procedural rupture of visceral pleura
d. Chest contusion
e. Bleb rupture
a. Barotrauma
c. Procedural rupture of visceral pleura
e. Bleb rupture
A patient with right-sided pneumonia has impaired oxygenation and ventilation. Which position may enhance oxygenation?
a. Any position of comfort
b. Supine
c. Side-lying on the unaffected side
d. Side-lying on the affected side
c. Side-lying on the unaffected side
The primary problem associated with failure to ventilate is which condition?
a. Alveolar hypoventilation
b. Capillary hypoperfusion
c. Alveolar hyperventilation
d. Capillary hyperperfusion
a. Alveolar hypoventilation
Permissive hypercapnia is contraindicated in which patient population?
a. Those with unstable intracranial pressure
b. Those requiring mechanical ventilation
c. Those whose ARDS is related to traumatic injury
d. Those who are over age 45 years
a. Those with unstable intracranial pressure
What is a common sign or symptom of PE?
a. Rhonchi
b. Pneumothorax
c. Dyspnea
d. Bradycarida
c. Dyspnea
Pneumothorax is characterized by which common clinical findings? (SATA)
a. Tachypnea
b. Bradycardia
c. Respiratory acidosis
d. Shortness of breath
e. Decreased PaO2
a. Tachypnea
d. Shortness of breath
e. Decreased PaO2
Which assessments would suggest impaired oxygenation and ventilation? (SATA)
a. Confusion
b. Increased lethargy
c. Decreased restlessness
d. Increased PaO2
e. Decreased PaCO2
a. Confusion
b. Increased lethargy
c. Decreased restlessness
What is the result of increased metabolic damage?
a. Decreased oxygen consumption
b. Decreased CO2 production
c. Increased oxygen consumption
d. Increased CO2 consumption
c. Increased oxygen consumption
Which statement correctly describes the primary purpose of CLRT?
a. It prevents pneumonia
b. It saves manual turning time
c. It prevent decubitus ulcers
d. It prevents reduced stasis of fluid and gas
d. It prevents reduced stasis of fluid and gas
What is the major initial treatment for PE?
a. Thromboembolytic therapy
b. Surgical embolectomy
c. Oxygen therapy
d. Anticoagulant therapy
d. Anticoagulant therapy
What is the purpose of the water-seal chamber in a three-chamber chest drainage system?
a. Facilitate drainage from the chest tube
b. Preventing airflow back into the patient
c. Facilitate control of level of negative suction
d. Prevent fluid from draining into the suction chamber
b. Preventing airflow back into the patient
Which nursing intervention would assist in maintaining effective clearance of airway secretions?
a. Restricting fluids to 1 L/day
b. Coughing and deep breathing every 1-2 hrs
c. Minimizing use of opioid analgesics
d. Restricting activities
b. Coughing and deep breathing every 1-2 hrs