Deck 20: Respiratory Failure

Question 1

The nurse would expect to observe which characteristics in a patient with type II respiratory failure?

A) Hypoxemia without hypercapnia
B) Hypoxemia with hypercapnia
C) Hypoxemia with hypocapnia
D) Hyperventilation

Answer 1

Hypoxemia with hypercapnia

Question 2

Which arterial blood gas values does the nurse anticipate in a patient with acute type II respiratory failure?

A) Increased PaO₂
B) Decreased PaCO₂
C) Acidic pH
D) Increased bicarbonate levels

Answer 2

Acidic pH

Question 3

What response should the nurse give a nursing student who asks why a patient with respiratory failure is being placed in the prone position?

A) "The prone position reduces ventilation-perfusion matching."
B) "The prone position reduces functional residual capacity."
C) "The prone position reduces V-Q matching."
D) "The prone position improves oxygenation."

Answer 3

"The prone position improves oxygenation."

Question 4

When planning care to improve oxygenation for a patient with respiratory failure, the nursing plan includes turning and positioning the patient regularly. What rationale does the nurse give for this intervention?

A) Turning reduces lung expansion.
B) Turning maximizes the use of all lung zones.
C) Turning reduces ventilation-perfusion matching.
D) Turning reduces the work of breathing.

Question 5

Which statement by a patient with respiratory failure indicates that more teaching is needed about use of the incentive spirometer, which promotes deep breathing?

A) "The incentive spirometer helps me take deep breaths."
B) "The incentive spirometer helps to open the alveoli in my lungs."
C) "The incentive spirometer helps my lungs exchange oxygen and carbon dioxide more effectively."
D) "The incentive spirometer improves retention of carbon dioxide."

Question 6

Which measure should the nurse include in the care plan to loosen thick secretions in the patient with respiratory failure?

A) Incentive spirometry
B) Supplemental oxygen via face mask
C) Chest percussion and vibration
D) Pursed lip breathing

Question 7

When planning care for a patient in the exudative phase of acute respiratory distress syndrome (ARDS), which concept should the nurse keep in mind?

A) Microvascular endothelial damage only has occurred.
B) Alveolar epithelial damage only has occurred.
C) Both microvascular endothelial and alveolar epithelial damage have occurred.
D) The alveolar-capillary membrane is still intact.

Question 8

The nurse in intensive care is caring for a patient who is developing ARDS secondary to infection. When the patient develops hypoxemia, which intervention does the nurse anticipate?

A) Intubation with mechanical ventilation
B) Oxygen delivery via nasal cannula
C) Oxygen delivery via Venturi mask
D) Administration of surfactant

Question 9

When caring for an intubated patient on mechanical ventilation using positive end-expiratory pressure (PEEP), the nurse continually assesses for which potential complication?

A) Lung injury due to barotraumas
B) Pulmonary emboli
C) Cor pulmonale
D) Pulmonary edema

Question 10

The nurse explains to the parents of a premature newborn that infant respiratory distress syndrome is caused by:

A) infection.
B) deficiency of surfactant.
C) inflammation.
D) trauma during birth.

Question 11

How should the nurse respond when the parent of a child with infant respiratory distress syndrome asks the nurse why surfactant is important?

A) "Surfactant helps to keep the alveoli in the lungs expanded."
B) "Surfactant stimulates the newborn to breath."
C) "Surfactant protects the alveolar-capillary membranes from leaks."
D) "Surfactant reduces inflammation in the lungs."

Question 12

When assessing the newborn, which finding should alert the nurse to a potential complication?

A) A loud cry
B) Respiratory rate of 40 breaths/minute
C) Nasal flaring
D) Acrocyanosis

Question 13

When assessing a newborn with infant respiratory distress syndrome, who is receiving surfactant therapy, which finding should alert the nurse of a complication of this medication?

A) Pulmonary edema
B) Development of a new heart murmur
C) Bleeding into the lungs
D) Decreased urinary output

Question 14

The nurse should keep which concept in mind when providing care to a patient with cardiogenic pulmonary edema?

A) Increased left ventricular pressure is reflected back to the pulmonary capillary bed.
B) This condition is caused by decreased oncotic pressure due to anemia.
C) Capillary endothelial injury makes the capillaries leaky.
D) Lymphatic blockage prevents drainage of interstitial fluid.

Question 15

Which manifestation would the nurse expect to find in the cardiac assessment of a patient with pulmonary edema?

A) Accentuated pulmonic component of S2
B) S4
C) Accentuated S1
D) Diminished S1

Question 16

When assessing the patient with pulmonary edema, which pulmonary capillary wedge pressure does the nurse anticipate?

A) <10 mmHg
B) 10-14 mmHg
C) 14-18 mmHg
D) > 18 mmHg

Question 17

When planning care for the patient with end-stage COPD, the nurse takes into consideration that the patient is at high risk for:

A) type I respiratory failure.
B) type II respiratory failure.
C) Pulmonary edema.
D) ARDS.

Question 18

Which cardiac complication does the nurse anticipate in the patient with advanced COPD?

A) Cor pulmonale
B) Left-sided heart failure
C) Pericarditis
D) Hypertension

Question 19

When assessing a patient with advanced COPD, which sputum characteristic indicates an acute exacerbation?

A) Thin, dark-colored
B) Thin, clear-colored
C) Thick, dark-colored
D) Frothy sputum

Question 20

The nurse teaches a patient with advanced COPD to use pursed lip breathing. Which statement indicates that the patient understands the rationale for this type of breathing?

A) "This will help me breathe in more oxygen."
B) "This will help keep my small airways open."
C) "This will help me use my accessory muscles for breathing."
D) "This will help me cough up more sputum."