Deck 20: Pulmonary Therapeutic Management

Question 1

What nursing interventions should be included in the nursing management of the patient receiving a neuromuscular blocking agent?

A) Withholding all sedation and narcotics
B) Protecting the patient from the environment
C) Keeping the patient supine
D) Speaking to the patient only when necessary

Answer 1

Protecting the patient from the environment

Question 2

To select the correct size of an oropharyngeal airway,the nurse should ensure the airway extends from which area to which area?

A) Tip of the nose to the ear lobe
B) Middle of the mouth to the ear lobe
C) Tip of the nose to the middle of the trachea
D) Corner of the mouth to the angle of the jaw

Answer 2

Corner of the mouth to the angle of the jaw

Question 3

Which oxygen delivery device is considered a low-flow system?

A) Nasal cannula
B) Simple face mask
C) Reservoir cannula
D) Air-entrainment nebulizer

Answer 3

Nasal cannula

Question 4

Which statement describes the assist-control mode of ventilation?

A) It delivers gas at preset volume, at a set rate, and in response to the patient's inspiratory efforts.
B) It delivers gas at a preset volume, allowing the patient to breathe spontaneously at his or her own volume.
C) It applies positive pressure during both ventilator breaths and spontaneous breaths.
D) It delivers gas at preset rate and tidal volume regardless of the patient's inspiratory efforts.

Question 5

Patient safety precautions when working with oxygen include which action?

A) Observing for signs of oxygen-associated hyperventilation
B) Ensuring the oxygen device is properly positioned
C) Removal of all oxygen devices when eating
D) Administration of oxygen at the nurse's discretion

Question 6

Which airway would be the most appropriate for a patient requiring intubation longer than 21 days?

A) Oropharyngeal airway
B) Esophageal obturator airway
C) Tracheostomy tube
D) Endotracheal intubation

Question 7

Which arterial blood gas (ABG)values would indicate a need for oxygen therapy?

A) PaO₂ of 80 mm Hg
B) PaCO₂ of 35 mm Hg
C) HCO₃¯ of 24 mEq
D) SaO₂ of 87%

Question 8

When assessing an intubated patient,the nurse notes normal breath sounds on the right side of the chest and absent breath sounds on the left side of the chest.What problem should the nurse suspect?

A) Right mainstem intubation
B) Left pneumothorax
C) Right hemothorax
D) Gastric intubation

Question 9

What nursing intervention can minimize the complications of suctioning?

A) Inserting the suction catheter no more than 5 inches
B) Premedicating the patient with atropine
C) Hyperoxygenating the patient with 100% oxygen
D) Increasing the suction to 150 mm Hg

Question 10

Which ventilator phase variable initiates the change from exhalation to inspiration?

A) Cycle
B) Trigger
C) Flow
D) Pressure

Question 11

Which statement best describes the effects of positive-pressure ventilation on cardiac output?

A) Positive-pressure ventilation increases intrathoracic pressure, which increases venous return and cardiac output.
B) Positive-pressure ventilation decreases venous return, which increases preload and cardiac output.
C) Positive-pressure ventilation increases venous return, which decreases preload and cardiac output.
D) Positive-pressure ventilation increases intrathoracic pressure, which decreases venous return and cardiac output.

Question 12

A patient with acute lung failure has been on a ventilator for 3 days and is being considered for weaning.When entering the room,the ventilator inoperative alarm sounds.What action should the nurse take FIRST?

A) Troubleshoot the ventilator until the problem is found.
B) Take the patient off the ventilator and manually ventilate.
C) Call the respiratory therapist for help.
D) Silence the ventilator alarms until the problem is resolved.

Question 13

Use of oxygen therapy in the patient who is hypercapnic may result in which situation?

A) Oxygen toxicity
B) Absorption atelectasis
C) Carbon dioxide retention
D) Pneumothorax

Question 14

Which oxygen administration device can deliver oxygen concentrations of 90%?

A) Nonrebreathing mask
B) Nasal cannula
C) Partial rebreathing mask
D) Simple mask

Question 15

A patient was admitted with acute lung failure.The patient has been on a ventilator for 3 days and is being considered for weaning.Which criteria would indicate that the patient is ready to be weaned?

A) FiO₂ greater than 50%
B) Rapid shallow breathing index less than 105
C) Minute ventilation greater than 10 L/min
D) Vital capacity/kg greater than or equal to 15 mL

Question 16

Which oxygen therapy device should is used in a patient requiring the delivery of a precise low FiO₂?

A) Simple mask
B) Nasal cannula
C) Air-entrainment mask
D) Partial rebreathing mask

Question 17

Which statement is correct concerning endotracheal tube cuff management?

A) The cuff should be deflated every hour to minimize pressure on the trachea.
B) A small leak should be heard on inspiration if the cuff has been inflated using the minimal leak technique.
C) Cuff pressures should be kept between 20 to 30 mm Hg to ensure an adequate seal.
D) Cuff pressure monitoring should be done once every 24 hours.

Question 18

A patient with acute lung failure has been on a ventilator for 3 days and is being considered for weaning.The ventilator high-pressure limit alarm keeps alarming.What would cause this problem?

A) A leak in the patient's endotracheal (ET) tube cuff
B) A kink in the ventilator tubing
C) The patient is disconnected from the ventilator
D) A faulty oxygen filter

Question 19

A patient was admitted to the critical care unit with acute respiratory failure.The patient has been on a ventilator for 3 days and is being considered for weaning.Which criteria would indicate that the patient is not tolerating weaning?

A) A decrease in heart rate from 92 to 80 beats/min
B) An SpO₂ of 92%
C) An increase in respiratory rate from 22 to 38 breaths/min
D) Spontaneous tidal volumes of 300 to 350 mL

Question 20

What is the preset positive pressure used to augment the patient's inspiratory effort known as?

A) Positive end-expiratory pressure (PEEP)
B) Continuous positive airway pressure (CPAP)
C) Pressure control ventilation (PCV)
D) Pressure support ventilation (PSV)

Question 21

Which medication can cause bronchospasms and should be administered with a bronchodilator?

A) Beta-2 agonist
B) Mucloytics
C) Anticholinergic agents
D) Xanthines

Question 22

Which interventions minimize the complications associated with suctioning an artificial airway?

A) Hyperoxygenate the patient prior to the start of the procedure
B) Hyperoxygenate the patient after each pass of the suction catheter
C) Limit the duration of each suction pass to 20 seconds
D) Instill 5 to 10 mL of normal saline to facilitate secretion removal
E) Use intermittent suction to avoid damaging tracheal tissue

Question 23

What is the therapeutic blood level for theophylline (Xanthines)?

A) 5 to 10 mg/dL
B) 10 to 20 mg/dL
C) 20 to 30 mg/dL
D) 35 to 45 mg/dL

Question 24

What is an indication for a pneumonectomy?

A) Peripheral granulomas
B) Bronchiectasis
C) Unilateral tuberculosis
D) Single lung abscess

Question 25

Which of the following are complications of endotracheal tubes?

A) Tracheoesophageal fistula
B) Cricoid abscess
C) Tracheal stenosis
D) Tube obstruction
E) Hemorrhage

Question 26

The Passy-Muir valve is contraindicated in which patient?

A) A patient who is trying to relearn normal breathing patterns
B) A patient who has minimal secretions
C) A patient with laryngeal or pharyngeal dysfunction
D) A patient who wants to speak while on the ventilator

Question 27

What are the clinical manifestations associated with oxygen toxicity?

A) Substernal chest pain that increases with deep breathing
B) Moist cough and tracheal irritation
C) Pleuritic pain occurring on inhalation, followed by dyspnea
D) Increasing CO₂
E) Sore throat and eye and ear discomfort

Question 28

Which statements regarding rotation therapies are accurate?

A) Continuous lateral rotation therapy (CLRT) can be effective for improving oxygenation if used for at least 18 hours/day.
B) Kinetic therapy can decrease the incidence of ventilator-acquired pneumonia in neurologic and postoperative patients.
C) Use of rotational therapy eliminates the need for other pressure ulcer prevention strategies.
D) CLRT helps avoid hemodynamic instability secondary to the continuous, gentle turning of the patient.
E) CLRT has minimal pulmonary benefits for critically ill patients.

Question 29

A patient was taken to surgery for a left lung resection.The patient returned to the unit 30 minutes ago.Upon completion of the assessment,the nurse notices that the chest tube has drained 150 mL of red fluid in the past 30 minutes.The nurse contacts the physician and suspects that the patient has developed what complication?

A) Pulmonary edema
B) Hemorrhage
C) Acute lung failure
D) Bronchopleural fistula

Question 30

Which route for endotracheal (ET)tube placement is usually used in an emergency intubation?

A) Orotracheal
B) Nasotracheal
C) Nasopharyngeal
D) Trachea