Question 1

A patient presents to the emergency department complaining of sudden onset of increased weakness and tingling of the lower extremities that has progressed to the upper arms. The patient is diagnosed with Guillain-Barré syndrome. The patient's respiratory rate is 8; blood pressure is 86/48. The patient is being prepared for intubation. What would the nurse anticipate the blood gases to reveal?

Accepted Answer

The patient is likely experiencing respiratory acidosis due to hypoventilation, which would result in elevated PaCO₂.

Question 2

A patient has just been diagnosed with acute respiratory distress syndrome ARDS). The nurse is aware that both acute lung injury ALI) and ARDS patients often require which priority intervention?

Accepted Answer

Both ALI and ARDS patients often experience severe respiratory distress requiring mechanical ventilation to support oxygenation and ventilation. Choice B (preparation of a living will) and C (hydration with ice chips) are not the priority interventions for ALI/ARDS patients. Choice D (frequent suctioning) may be necessary but it is not the priority intervention.

Question 3

A patient was admitted 3 days ago with a myocardial infarction MI) and has developed pulmonary edema. How would the nurse explain this condition to the patient and family?

Accepted Answer

Pulmonary edema is a condition where there is an accumulation of fluid in the lungs due to increased pressure in the pulmonary system. This increased pressure is often caused by a cardiac event, such as a myocardial infarction, where the heart muscle is unable to efficiently pump blood through the body, causing fluid to back up into the lungs.

Question 4

Which interventions should the nurse plan to help reduce a patient's risk of developing ventilator-associated pneumonia? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of Which interventions should the nurse plan to...

Question 5

A patient who is being mechanically ventilated also has a pleural chest tube. The nurse becomes concerned that the chest tube is not functioning correctly. Which actions should the nurse take? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The nurse should look for tidaling in the chest tube and in the diagnostic fluid chamber to assess the functioning of the chest tube. Tidaling is the movement of fluid back and forth in response to changes in intrathoracic pressure during inspiration and expiration, indicating that the chest tube is functioning correctly. The nurse should not clamp the chest tube, disconnect the suction source, or increase the suction without further assessment and orders from the healthcare provider.

Question 6

Which patient should the nurse assess first?

Accepted Answer

A patient with a chest tube complaining of difficulty breathing indicates a potential respiratory compromise and may require immediate intervention.

Question 7

A patient presents with PaO₂of 54 mmHg and an arterial oxygen saturation of 80%. The nurse assesses for which most likely cause of this type of acute respiratory failure?

Accepted Answer

The patient's low oxygen saturation and high PaCO2 (54 mmHg) suggest hypoventilation due to a problem with gas exchange. Pneumothorax is a likely cause, as it can result in decreased lung expansion and impaired gas exchange. Cervical spinal cord injury, obesity, and oversedation may also cause respiratory failure, but they would likely present with different patterns of gas exchange abnormalities.

Question 8

Arterial blood gases reveal that a patient's PaO₂ is 84% on room air. The patient's FaO₂/FiO₂ ratio is ______.

Accepted Answer

The answer of Arterial blood gases reveal that a patient's...

Question 9

The health care team plans to begin weaning a patient diagnosed with sepsis from the mechanical ventilator. The nurse would review the medical record to assess for achievement of which criteria? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of The health care team plans to begin...

Question 10

A patient who was in a motor vehicle accident 1 day ago has been diagnosed with lung contusions. The patient develops increasing respiratory distress. The nurse recognizes that which factor will differentiate a diagnosis of acute lung injury ALI) from a diagnosis of acute respiratory distress syndrome ARDS)?

Accepted Answer

ARDS and ALI are primarily differentiated by the severity of hypoxemia, with ARDS presenting more severe hypoxemia compared to ALI.

Question 11

The nurse is concerned that an intubated patient is experiencing a cuff leak. Which assessment data would support the nurse's concern? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of The nurse is concerned that an intubated...

Question 12

A patient who has cardiogenic pulmonary edema is receiving intravenous dopamine at a rate of 195 mcg/min. The patient weighs 65 kg. The nurse would increase surveillance for tachycardia and dysrhythmias if the dopamine rate must be increased to a rate greater than ________ mcg/min.

Accepted Answer

The answer of A patient who has cardiogenic pulmonary edema...

Question 13

A patient who is septic is restless and agitated. The chest X-ray results indicate bilateral patchy infiltrates. As the patient's condition continues to deteriorate, which finding would raise the nurse's concern that the patient is developing ARDS?

Accepted Answer

Refractory hypoxemia is a hallmark sign of acute respiratory distress syndromes (ARDS). It refers to severely decreased oxygen levels in the blood that do not respond to oxygen therapy. The other options, such as hypertension and hyperventilation, may be present in sepsis but are not specific to ARDS. Decreasing HCO₃ may also be present in sepsis but does not necessarily indicate the development of ARDS.

Question 14

The nurse is giving a report to the oncoming ICU shift for the most recent admission. The nurse indicates the patient is hypotensive, has an S₃ heart sound, has crackles, has pink frothy sputum, and the skin is diaphoretic and cool. The oncoming shift recognizes which differences between cardiogenic pulmonary edema CPE) and noncardiogenic pulmonary edema NCPE)?

Accepted Answer

The patient in the report has signs consistent with cardiogenic pulmonary edema (CPE), including hypotension, an S3 heart sound (S₃), crackles, and pink frothy sputum. Additionally, the skin is diaphoretic and cool, which can also be seen in CPE. Noncardiogenic pulmonary edema (NCPE) can present with different signs, such as hypertension, bounding pulses, and JVD, which are not present in this case. The presence of cool and diaphoretic skin is a notable difference between CPE and NCPE.

Question 15

A student is accompanying the nurse today. A newly admitted ICU patient with a diagnosis of pulmonary edema has an elevated jugular vein distension JVD) and an S₃. Based on these assessment findings, the nurse indicates to the student that this is which type of pulmonary edema?

Accepted Answer

The elevated jugular vein distension (JVD) suggests a problem with the heart, specifically the right side of the heart, which can cause blood to back up into the veins. This is commonly seen in cardiogenic pulmonary edema. The S₃ is not a recognizable medical abbreviation, so it does not provide any additional information for the diagnosis of pulmonary edema type.

Quiz 28: Caring for the Patient With Complex Respiratory Disorders

A patient has just been diagnosed with acute respiratory distress syndrome ARDS) . The nurse is aware that both acute lung injury ALI) and ARDS patients often require which priority intervention?

A patient was admitted 3 days ago with a myocardial infarction MI) and has developed pulmonary edema. How would the nurse explain this condition to the patient and family?

Which interventions should the nurse plan to help reduce a patient's risk of developing ventilator-associated pneumonia? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.

Which patient should the nurse assess first?

A patient presents with PaO₂of 54 mmHg and an arterial oxygen saturation of 80%. The nurse assesses for which most likely cause of this type of acute respiratory failure?

Arterial blood gases reveal that a patient's PaO₂ is 84% on room air. The patient's FaO₂/FiO₂ ratio is ______.

The nurse is concerned that an intubated patient is experiencing a cuff leak. Which assessment data would support the nurse's concern? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.

A patient who has cardiogenic pulmonary edema is receiving intravenous dopamine at a rate of 195 mcg/min. The patient weighs 65 kg. The nurse would increase surveillance for tachycardia and dysrhythmias if the dopamine rate must be increased to a rate greater than ________ mcg/min.

A patient who is septic is restless and agitated. The chest X-ray results indicate bilateral patchy infiltrates. As the patient's condition continues to deteriorate, which finding would raise the nurse's concern that the patient is developing ARDS?

A student is accompanying the nurse today. A newly admitted ICU patient with a diagnosis of pulmonary edema has an elevated jugular vein distension JVD) and an S₃. Based on these assessment findings, the nurse indicates to the student that this is which type of pulmonary edema?

Quiz 28: Caring for the Patient With Complex Respiratory Disorders

A patient has just been diagnosed with acute respiratory distress syndrome ARDS) . The nurse is aware that both acute lung injury ALI) and ARDS patients often require which priority intervention?

A patient was admitted 3 days ago with a myocardial infarction MI) and has developed pulmonary edema. How would the nurse explain this condition to the patient and family?

Which interventions should the nurse plan to help reduce a patient's risk of developing ventilator-associated pneumonia? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.

Which patient should the nurse assess first?

A patient presents with PaO2 of 54 mmHg and an arterial oxygen saturation of 80%. The nurse assesses for which most likely cause of this type of acute respiratory failure?

Arterial blood gases reveal that a patient's PaO2 is 84% on room air. The patient's FaO2/FiO2 ratio is ______.

The nurse is concerned that an intubated patient is experiencing a cuff leak. Which assessment data would support the nurse's concern? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.

A patient who has cardiogenic pulmonary edema is receiving intravenous dopamine at a rate of 195 mcg/min. The patient weighs 65 kg. The nurse would increase surveillance for tachycardia and dysrhythmias if the dopamine rate must be increased to a rate greater than ________ mcg/min.

A patient who is septic is restless and agitated. The chest X-ray results indicate bilateral patchy infiltrates. As the patient's condition continues to deteriorate, which finding would raise the nurse's concern that the patient is developing ARDS?

A student is accompanying the nurse today. A newly admitted ICU patient with a diagnosis of pulmonary edema has an elevated jugular vein distension JVD) and an S3. Based on these assessment findings, the nurse indicates to the student that this is which type of pulmonary edema?

A patient presents with PaO₂of 54 mmHg and an arterial oxygen saturation of 80%. The nurse assesses for which most likely cause of this type of acute respiratory failure?

Arterial blood gases reveal that a patient's PaO₂ is 84% on room air. The patient's FaO₂/FiO₂ ratio is ______.

A student is accompanying the nurse today. A newly admitted ICU patient with a diagnosis of pulmonary edema has an elevated jugular vein distension JVD) and an S₃. Based on these assessment findings, the nurse indicates to the student that this is which type of pulmonary edema?