ARDS 1
A client with ARDS is receiving high levels of oxygen via mechanical ventilation. Which complication should the nurse monitor for?
A. Pneumothorax
B. Respiratory acidosis
C. Pulmonary embolism
D. Atelectasis
Answer: A
Rationale: High airway pressures and PEEP can lead to barotrauma, such as pneumothorax
The nurse is suctioning a client with ARDS who is on mechanical ventilation. Which precaution is most important to prevent desaturation?
A. Limit suctioning time to no more than 15 seconds
B. Use sterile technique
C. Administer a sedative prior to suctioning
D. Avoid suctioning unless there is visible mucus
Answer: A
Rationale: Limiting suctioning time prevents hypoxemia, especially in clients already compromised by ARDS.
Which client is most at risk for developing ARDS?
A. A 34-year-old with newly diagnosed asthma
B. A 72-year-old with a hip fracture
C. A 45-year-old with pancreatitis and sepsis
D. A 60-year-old with chronic heart failure
Answer: C
Rationale: ARDS is often triggered by systemic inflammation such as sepsis or pancreatitis.
A nurse is caring for a client with sleep apnea. Which intervention best reduces cardiovascular risks associated with the condition?
A. Encourage smoking cessation
B. Promote CPAP compliance
C. Administer a beta-blocker
D. Encourage caffeine reduction
Answer: B
Rationale: CPAP improves oxygenation during sleep, reducing hypoxia-related strain on the cardiovascular system
Which diagnostic test best confirms the diagnosis of obstructive sleep apnea?
A. Chest x-ray
B. Serum bicarbonate levels
C. Overnight polysomnography
D. Spirometry
Answer: C
Rationale: Polysomnography is the gold standard diagnostic test for sleep apnea.
What is the hallmark finding that differentiates ARDS from cardiogenic pulmonary edema?
A. Pink frothy sputum
B. Bilateral crackles
C. Decreased PaO2 despite increased FiO2
D. Elevated BNP levels
Answer: C
Rationale: In ARDS, hypoxemia is refractory to oxygen therapy due to alveolar-capillary damage. Elevated BNP suggests cardiac origin.
A client is intubated and placed on mechanical ventilation for ARDS. Which sign requires immediate intervention?
A. SpO2 of 92% on 40% FiO2
B. High-pressure ventilator alarm
C. End-tidal CO2 of 35 mmHg
D. Patient coughing during suctioning
Answer: B
Rationale: A high-pressure alarm may indicate obstruction, kinked tubing, or worsening lung compliance and needs immediate assessment.
Which nursing action is appropriate when preparing a client for prone positioning in ARDS?
A. Encourage client to deep breathe during the turn
B. Administer sedation as prescribed
C. Place in Trendelenburg position before turning
D. Avoid using pillows or supports
Answer: B
Rationale: Sedation is typically required for prone positioning in mechanically ventilated clients to minimize distress and facilitate oxygenation.
A nurse is assessing a postoperative client for signs of obstructive sleep apnea. Which finding is most indicative?
A. Inspiratory wheezes
B. Oxygen saturation dropping below 90% during sleep
C. Productive cough during the night
D. Cheyne-Stokes respirations
Answer: B
Rationale: Sleep apnea often presents as intermittent desaturations during sleep, often accompanied by loud snoring or gasping.
Which medication should be used with caution in clients with obstructive sleep apnea?
A. Acetaminophen
B. Albuterol
C. Lorazepam
D. Lisinopril
Answer: C
Rationale: Benzodiazepines can cause respiratory depression and worsen airway collapse in sleep apnea.
In a client with ARDS, which ventilator setting adjustment is aimed at preventing barotrauma?
A. Increasing tidal volume
B. Using low tidal volume ventilation
C. Increasing PEEP aggressively
D. Reducing respiratory rate
Answer: B
Rationale: Low tidal volume ventilation (lung-protective strategy) reduces the risk of overdistension and barotrauma.
What is usually the first sign of MODS?
A. Decreased urine output
B. Hypotension
C. Edema
D. Bradycardia
Answer: A
Rationale: Decreased urine output is one of the first signs of MODS because the kidneys are highly sensitive to changes in perfusion and oxygenation
Which dietary instruction is most appropriate for a client newly diagnosed with obstructive sleep apnea?
A. Increase carbohydrate intake before bedtime
B. Limit fluids after dinner to prevent nocturia
C. Consume a protein-rich snack before sleep
D. Avoid alcohol and sedatives in the evening
Answer: D
Rationale: Alcohol and sedatives relax throat muscles, worsening airway obstruction during sleep.
A nurse is evaluating the effectiveness of CPAP in a client with sleep apnea. Which finding indicates treatment success?
A. Decreased nocturia
B. Increased blood pressure
C. Daytime drowsiness
D. Improved morning headaches
Answer: D
Rationale: Improved morning headaches and energy levels suggest improved oxygenation and sleep quality from CPAP use
A client receiving high PEEP on the ventilator becomes hypotensive. What is the most likely cause?
A. Bradycardia
B. Decreased venous return
C. Hyperkalemia
D. Oxygen toxicity
Answer: B
Rationale: High PEEP increases intrathoracic pressure, reducing venous return and potentially causing hypotension.
Name nursing interventions that are cruical in order to avoid ventilator-associated pneumonia in a patient with ARDS?
A. Oral care
B. Marinating proper hygiene
C. Putting the patient in prone position
D. Increasing the vent settings
Answer: A and B
Rationale: Oral care is important because it helps remove/prevent bacteria in the mouth. Good hygiene is important because it also helps prevent the transmission of bacteria
Which of the following ABG results would the nurse expect in a client with severe ARDS?
A. pH 7.45, PaCO2 35, HCO3 24
B. pH 7.30, PaCO2 60, HCO3 25
C. pH 7.50, PaCO2 30, HCO3 18
D. pH 7.38, PaCO2 40, HCO3 24
Answer: B
Rationale: Severe ARDS causes hypoventilation, leading to respiratory acidosis (low pH, high PaCO2).
Which of the following is NOT an example of a direct insult resulting in ARDS?
A. Pneumonia
B. Aspiration
C. Smoke inhalation
D. Multiple blood transfusions
Answer: D
Rationale: Multiple blood transfusions does not direct affect the lungs in the same way as pneumonia, aspiration, and smoke inhalation do