ICU practice questions
A 56-year-old man with acute respiratory distress syndrome (ARDS) is on positive pressure
ventilation (PPV). The patient's cardiac index is 1.4 L/minute and pulmonary artery wedge
pressure is 8 mm Hg. What order by the physician is important for the nurse to question?
~Initiate a dobutamine (Dobutrex) infusion at 3 mcg/kg/minute.
~Administer one unit of packed red blood cells over the next 2 hours.
~Change the maintenance intravenous (IV) rate from 75 to 125 mL/hr.
~Increase positive end-expiratory pressure (PEEP) from 10 to 15 cm H2 O. - correct
answer-D
A 68-year-old male patient diagnosed with sepsis is orally intubated on mechanical
ventilation. Which action is most important for the nurse to take?
~Use the open-suctioning technique.
~Administer morphine for discomfort.
~Limit noise and cluster care activities.
~Elevate the head of the bed 30 degrees. - correct answer-~Elevate the head of the bed 30
degrees.
A 72-year-old woman with aspiration pneumonia develops severe respiratory distress. Which
diagnostic finding would indicate to the nurse that the patient has developed acute
respiratory distress syndrome (ARDS)?
~PaO2 of 42 mm Hg on 80% FIO2
~PaO2 of 64 mm Hg on 24% FIO2
~PaCO2 of 31 mm Hg and pH 7.51
~PaCO2 of 70 mm Hg and pH 7.29 - correct answer-A
A patient is in acute respiratory distress syndrome (ARDS) as a result of sepsis. Which
measure(s) would most likely be implemented to maintain cardiac output?
~Administer crystalloid fluids or colloid solutions.
~Position the patient in the Trendelenburg position.
~Place the patient on fluid restriction and administer diuretics.
~Perform chest physiotherapy and assist with staged coughing - correct answer-A
Arterial blood gas results are reported to the nurse for a 68-year-old patient admitted with
pneumonia: pH 7.31, PaCO2 49 mm Hg, HCO3 26 mEq/L, and PaO2 52 mm Hg. What
order from a physician should the nurse prioritize?
~Increase fluid intake to 2500 mL per 24 hours.
~Instruct the patient to breathe into a paper bag.
~Initiate oxygen at 2 L/min by nasal cannula.
~Perform chest physical therapy four times per day. - correct answer-C
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