Question 1

The nurse suspects the possible onset of ARDS in a susceptible patient who develops which of the following symptoms?

Accepted Answer

The symptoms of dyspnea, restlessness, and mild hypoxemia are some of the earliest signs of ARDS. Tachypnea and hypertension with elevated PaO2/FiO2, diffuse crackles and rhonchi, and cough with blood-tinged sputum and respiratory alkalosis may also occur in ARDS, but they are usually seen at a later stage of the disease.

Question 2

The nurse anticipates the possibility of hypercapnic respiratory failure when the patient has which of the following problems?

Accepted Answer

Chest trauma and multiple rib fractures can lead to hypoventilation due to pain and mechanical restriction, causing CO2 retention and hypercapnic respiratory failure.

Question 3

A patient is brought to the emergency department unconscious following a barbiturate overdose.The nurse recognizes that the patient is at risk for which of the following conditions?

Accepted Answer

Barbiturates can depress the central nervous system and may cause respiratory depression, leading to ventilatory failure and hypercapnic respiratory failure.

Question 4

A patient in acute respiratory failure as a complication of COPD has a PaCO₂of 65 mm Hg;adventitious lung sounds,especially in the right lung;and marked fatigue with an ineffective cough.To promote gas exchange in the patient,what should the nurse do?

Accepted Answer

The patient is showing signs of respiratory distress and ineffective cough, which indicates that respiratory secretions are present and need to be removed to improve gas exchange. The nurse should assist the patient with augmented coughing, which involves instructing the patient to take a deep breath and cough forcefully to help remove secretions. This technique helps to promote gas exchange and decrease the risk of complications such as pneumonia. Humidification may also be beneficial, but it is not the priority intervention in this case. Positioning the patient on the right side with the head of the bed elevated may help to improve gas exchange by allowing better air flow to the left lung, but it does not address the issue of respiratory secretions. Scheduling assessments and treatments to allow rest periods is important, but it does not directly address the patient's respiratory distress.

Question 5

The nurse would assess pulse oximetry in which of the following patients?

Accepted Answer

The answer of The nurse would assess pulse oximetry in...

Question 6

Following a coronary artery bypass graft performed with cardiopulmonary bypass,a patient develops pulmonary edema.The nurse anticipates that differentiation between ARDS and pulmonary edema of cardiogenic origin will be made by which of the following diagnostic tests?

Accepted Answer

Pulmonary artery wedge pressures (PAWPs) help differentiate between ARDS and pulmonary edema of cardiogenic origin by measuring the pressure in the pulmonary capillaries. ARDS typically has lower pressures while cardiogenic pulmonary edema results in elevated pressure readings. The other diagnostic tests may provide helpful information but are not as specific for differentiating between the two conditions.

Question 7

When caring for a patient with pulmonary fibrosis,the nurse understands that the patient is at risk for hypoxemic respiratory failure as a result of which of the following conditions?

Accepted Answer

Pulmonary fibrosis causes thickening of the alveoli, which can lead to reduced oxygen transfer into the blood. This can ultimately lead to hypoxemic respiratory failure. Choices A, B, and D do not directly relate to the pathophysiology of pulmonary fibrosis.

Question 8

Which of the following findings indicates to the nurse that a patient with acute respiratory distress who has no history of chronic lung disease is in acute respiratory failure?

Accepted Answer

A PaO2 of 45 mm Hg indicates severe hypoxemia, which is a hallmark of acute respiratory failure.

Question 9

To evaluate both oxygenation and ventilation in a patient with acute respiratory failure,the nurse uses the findings revealed with which of the following monitoring methods?

Accepted Answer

Arterial blood gas (ABG) analysis is the most accurate method for evaluating both oxygenation and ventilation in a patient with acute respiratory failure. It provides information about the levels of oxygen, carbon dioxide, and pH in arterial blood, allowing the healthcare provider to determine the severity of respiratory failure and adjust treatment accordingly. Chest X-ray films can provide information about lung structure but do not provide information about gas exchange. Pulse oximetry only measures oxygen saturation and does not provide information about carbon dioxide levels or pH. Hemodynamic monitoring assesses cardiac output, blood pressure, and fluid status but does not evaluate oxygenation or ventilation.

Question 10

A patient with severe chronic lung disease is hospitalized in respiratory distress.When monitoring the patient,which nursing assessment will be of most concern?

Accepted Answer

A decrease in respiratory rate from 30 breaths/min to 10 breaths/min is a sign of respiratory failure and is the most concerning assessment finding. This indicates that the patient is not ventilating adequately and requires urgent intervention. Bibasilar lung crackles and sitting in the tripod position are common in patients with chronic lung disease and may not necessarily indicate an acute deterioration. An oxygen saturation of 91% is low but can be managed with supplemental oxygen therapy.

Question 11

A patient with hypercapnic respiratory failure is lethargic and has the following vital signs: blood pressure 84/50 mm Hg,pulse 120 beats/min,respiration 8 breaths/min,and SpO₂ of 89%.Which collaborative intervention will the nurse anticipate?

Accepted Answer

The patient is showing signs of severe respiratory distress and altered mental status due to hypercapnic respiratory failure, indicated by a low respiratory rate and low oxygen saturation. Endotracheal intubation with mechanical ventilation is the most appropriate intervention to ensure the patient's airway is protected and to assist with adequate ventilation and oxygenation.

Question 12

A patient is diagnosed with a large pulmonary embolism.In explaining to the patient what has happened to cause respiratory failure,what does the nurse understand is the mechanism involved?

Accepted Answer

A large pulmonary embolism can cause ventilation-perfusion (V/Q) mismatch because the blood flow to certain areas of the lungs may be decreased due to the obstruction, while ventilation continues to occur normally. This leads to shunting, where blood is perfusing large areas of underventilated alveoli, ultimately causing respiratory failure.

Question 13

While performing an admission assessment of a patient in hypercapnic respiratory failure due to COPD,what symptoms would the nurse expect the patient to report?

Accepted Answer

A morning headache and dyspnea are common symptoms in patients with hypercapnic respiratory failure due to COPD, as elevated CO2 levels can cause headaches, and dyspnea is a typical symptom of COPD.

Question 14

When caring for a patient who developed ARDS as a result of a gram-negative urinary infection that became systemic,the nurse is asked by the patient's family how a urinary tract infection could cause lung damage.What is the best response to the family members?

Accepted Answer

Serious infections, such as a gram-negative urinary infection, can cause the body's inflammatory and immune systems to react abnormally with lung tissue. This can lead to the development of acute respiratory distress syndrome (ARDS) which is characterized by lung damage and difficulty breathing. In ARDS, the lungs become inflamed, and fluid accumulates in the air sacs, making it difficult for oxygen to pass from the lungs into the bloodstream.

Question 15

To improve V/Q match and facilitate secretion removal in the patient with left lower lobe pneumonia,how should the nurse position the patient?

Accepted Answer

Positioning the patient on the right side allows the healthier lung (in this case, the right lung) to be in a more dependent position, which improves ventilation-perfusion (V/Q) matching by directing more blood flow to the better-ventilated lung areas. This position also facilitates the removal of secretions from the affected left lower lobe by using gravity.

Question 16

Which assessment finding would the nurse expect in a patient with hypoxemia?

Accepted Answer

Hypoxemia often leads to increased respiratory effort, which can result in prolonged expiration as the body attempts to expel more carbon dioxide and increase oxygen intake.

Question 17

A patient admitted 2 days ago with gram-negative sepsis has the following assessment data: temperature 38.3°C,blood pressure 90/56 mm Hg,pulse 92 beats/min,respiration 34 breaths/min.Which action should the nurse take first?

Accepted Answer

The patient's vital signs indicate a potential deterioration in their condition, specifically with regards to hypotension and tachypnea. The nurse should prioritize notifying the physician to ensure prompt intervention and assessment. Options A and C are appropriate interventions, but they should not take precedence over addressing the patient's current unstable condition. Option B is insufficient as it does not address the need for intervention.

Question 18

Which of the following is a predisposing factor for the development of acute respiratory failure?

Accepted Answer

The answer of Which of the following is a predisposing...

Question 19

Which of the following areas has the highest regional ventilation-perfusion ratio?

Accepted Answer

The apex of the lung has a higher ventilation-perfusion ratio compared to the base of the lung due to the effects of gravity. Ventilation (air flow) is higher at the apex due to the decreased weight of the upper chest and better ventilation in upright humans. Perfusion (blood flow) however is equal, so the net V/Q ratio for the apex is higher.

Question 20

While caring for a patient with a pulmonary embolism,the nurse notes a change in the patient's arterial oxygen saturation by pulse oximetry (SpO₂)from 94% to 88%.The nurse recognizes that management of this patient's hypoxemia usually requires which of the following treatments?

Accepted Answer

The drop in SpO2 from 94% to 88% indicates hypoxemia, which can be managed by administration of supplemental oxygen. Positive pressure ventilation may be needed in severe cases, but it is not the first-line treatment for hypoxemia caused by pulmonary embolism. Drugs that relieve bronchospasm and removal of respiratory secretions are not indicated for the management of hypoxemia in a patient with pulmonary embolism.

Quiz 70: Nursing Management: Respiratory Failure and Acute Respiratory Distress Syndrome

The nurse suspects the possible onset of ARDS in a susceptible patient who develops which of the following symptoms?

The nurse anticipates the possibility of hypercapnic respiratory failure when the patient has which of the following problems?

A patient is brought to the emergency department unconscious following a barbiturate overdose.The nurse recognizes that the patient is at risk for which of the following conditions?

A patient in acute respiratory failure as a complication of COPD has a PaCO₂of 65 mm Hg;adventitious lung sounds,especially in the right lung;and marked fatigue with an ineffective cough.To promote gas exchange in the patient,what should the nurse do?

The nurse would assess pulse oximetry in which of the following patients?

Following a coronary artery bypass graft performed with cardiopulmonary bypass,a patient develops pulmonary edema.The nurse anticipates that differentiation between ARDS and pulmonary edema of cardiogenic origin will be made by which of the following diagnostic tests?

When caring for a patient with pulmonary fibrosis,the nurse understands that the patient is at risk for hypoxemic respiratory failure as a result of which of the following conditions?

Which of the following findings indicates to the nurse that a patient with acute respiratory distress who has no history of chronic lung disease is in acute respiratory failure?

To evaluate both oxygenation and ventilation in a patient with acute respiratory failure,the nurse uses the findings revealed with which of the following monitoring methods?

A patient with severe chronic lung disease is hospitalized in respiratory distress.When monitoring the patient,which nursing assessment will be of most concern?

A patient with hypercapnic respiratory failure is lethargic and has the following vital signs: blood pressure 84/50 mm Hg,pulse 120 beats/min,respiration 8 breaths/min,and SpO₂ of 89%.Which collaborative intervention will the nurse anticipate?

A patient is diagnosed with a large pulmonary embolism.In explaining to the patient what has happened to cause respiratory failure,what does the nurse understand is the mechanism involved?

While performing an admission assessment of a patient in hypercapnic respiratory failure due to COPD,what symptoms would the nurse expect the patient to report?

When caring for a patient who developed ARDS as a result of a gram-negative urinary infection that became systemic,the nurse is asked by the patient's family how a urinary tract infection could cause lung damage.What is the best response to the family members?

To improve V/Q match and facilitate secretion removal in the patient with left lower lobe pneumonia,how should the nurse position the patient?

Which assessment finding would the nurse expect in a patient with hypoxemia?

A patient admitted 2 days ago with gram-negative sepsis has the following assessment data: temperature 38.3°C,blood pressure 90/56 mm Hg,pulse 92 beats/min,respiration 34 breaths/min.Which action should the nurse take first?

Which of the following is a predisposing factor for the development of acute respiratory failure?

Which of the following areas has the highest regional ventilation-perfusion ratio?

While caring for a patient with a pulmonary embolism,the nurse notes a change in the patient's arterial oxygen saturation by pulse oximetry (SpO₂) from 94% to 88%.The nurse recognizes that management of this patient's hypoxemia usually requires which of the following treatments?

Quiz 70: Nursing Management: Respiratory Failure and Acute Respiratory Distress Syndrome

The nurse suspects the possible onset of ARDS in a susceptible patient who develops which of the following symptoms?

The nurse anticipates the possibility of hypercapnic respiratory failure when the patient has which of the following problems?

A patient is brought to the emergency department unconscious following a barbiturate overdose.The nurse recognizes that the patient is at risk for which of the following conditions?

A patient in acute respiratory failure as a complication of COPD has a PaCO2 of 65 mm Hg;adventitious lung sounds,especially in the right lung;and marked fatigue with an ineffective cough.To promote gas exchange in the patient,what should the nurse do?

The nurse would assess pulse oximetry in which of the following patients?

Following a coronary artery bypass graft performed with cardiopulmonary bypass,a patient develops pulmonary edema.The nurse anticipates that differentiation between ARDS and pulmonary edema of cardiogenic origin will be made by which of the following diagnostic tests?

When caring for a patient with pulmonary fibrosis,the nurse understands that the patient is at risk for hypoxemic respiratory failure as a result of which of the following conditions?

Which of the following findings indicates to the nurse that a patient with acute respiratory distress who has no history of chronic lung disease is in acute respiratory failure?

To evaluate both oxygenation and ventilation in a patient with acute respiratory failure,the nurse uses the findings revealed with which of the following monitoring methods?

A patient with severe chronic lung disease is hospitalized in respiratory distress.When monitoring the patient,which nursing assessment will be of most concern?

A patient with hypercapnic respiratory failure is lethargic and has the following vital signs: blood pressure 84/50 mm Hg,pulse 120 beats/min,respiration 8 breaths/min,and SpO2 of 89%.Which collaborative intervention will the nurse anticipate?

A patient is diagnosed with a large pulmonary embolism.In explaining to the patient what has happened to cause respiratory failure,what does the nurse understand is the mechanism involved?

While performing an admission assessment of a patient in hypercapnic respiratory failure due to COPD,what symptoms would the nurse expect the patient to report?

When caring for a patient who developed ARDS as a result of a gram-negative urinary infection that became systemic,the nurse is asked by the patient's family how a urinary tract infection could cause lung damage.What is the best response to the family members?

To improve V/Q match and facilitate secretion removal in the patient with left lower lobe pneumonia,how should the nurse position the patient?

Which assessment finding would the nurse expect in a patient with hypoxemia?

A patient admitted 2 days ago with gram-negative sepsis has the following assessment data: temperature 38.3°C,blood pressure 90/56 mm Hg,pulse 92 beats/min,respiration 34 breaths/min.Which action should the nurse take first?

Which of the following is a predisposing factor for the development of acute respiratory failure?

Which of the following areas has the highest regional ventilation-perfusion ratio?

While caring for a patient with a pulmonary embolism,the nurse notes a change in the patient's arterial oxygen saturation by pulse oximetry (SpO2) from 94% to 88%.The nurse recognizes that management of this patient's hypoxemia usually requires which of the following treatments?

A patient in acute respiratory failure as a complication of COPD has a PaCO₂of 65 mm Hg;adventitious lung sounds,especially in the right lung;and marked fatigue with an ineffective cough.To promote gas exchange in the patient,what should the nurse do?

A patient with hypercapnic respiratory failure is lethargic and has the following vital signs: blood pressure 84/50 mm Hg,pulse 120 beats/min,respiration 8 breaths/min,and SpO₂ of 89%.Which collaborative intervention will the nurse anticipate?

While caring for a patient with a pulmonary embolism,the nurse notes a change in the patient's arterial oxygen saturation by pulse oximetry (SpO₂) from 94% to 88%.The nurse recognizes that management of this patient's hypoxemia usually requires which of the following treatments?