FIRST PUBLISH OCTOBER 2024
Critical Care exam 1: respiratory Practice
questions with correct answers
1) A nurse is caring for a patient with ARDS. The nurse views the ABG. What value should the nurse
report to the physician?
pH: 7.35
PaCO2: 26mmhg
PaO2:95
HCO3: 22
a) PaCO2
b)pH
c)HCO3
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d)PaO2 - ANSWER✔✔-a
The normal range for PaCO2 is 35-45. This patient is experiencing a superimposed respiratory alkalosis
likely due to hyperventilation. The nurse should report the PaCO2 to the physician.
2) A nurse must position the patient prone after his diagnosis of acute respiratory distress syndrome
(ARDS). Which of the following is a benefit of using this position? Select all that apply.
A)Decreased atelectasis
B)Reduced need for endotracheal intubation
c)Mobilization of secretions
d)Decreased pleural pressure
e)Increased response to corticosteroid therapy - ANSWER✔✔-a, c, d
Decreased atelectasis", "Mobilization of secretions" and "Decreased pleural pressure" are correct. Prone
positioning, or placing the patient face down with the head turned to the side, helps with pulmonary
function in the patient diagnosed with ARDS. When the patient is placed in a prone position, the heart
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and diaphragm are not pressing against the lungs, which means that pleural pressure is reduced. When
there is less pressure exerted on the lungs, atelectasis decreases. Studies have shown that many patients
in the prone position have increased lung secretions, which improves oxygenation.
-"Reduced need for endotracheal intubation" is incorrect. The prone position has not been shown to
decrease the likelihood of intubation.
-"Increased response to corticosteroid therapy" is incorrect because positioning does not change the
body's response to steroid therapy.
3) A 25-year-old patient in the ICU is being treated for acute respiratory distress syndrome (ARDS). The
patient is on a ventilator and requires 80 percent FiO2. Which information would the nurse most likely
need to report about the patient to the respiratory therapist working with her?
a)The patient needs endotracheal suctioning
b)The patient needs more oxygen because of his saturation
c)The patient needs an arterial blood gas drawn
d)The patient needs a hemoglobin level drawn - ANSWER✔✔-c
4) A patient who has recovered from ARDS in the ICU is now malnourished and has lost a significant
amount of weight. The physician orders TPN to add nutrition for the patient, who then develops re-
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feeding syndrome. Which of the following signs or symptoms would the nurse expect to see with re-
feeding syndrome? Select all that apply.
a. Impaired mental status
b. Insulin resistance
c. Seizures
d. Persistent weight loss
e. Constipation - ANSWER✔✔-a,b,c
impaired mental status", "Insulin resistance" and "Seizures" are correct. Re-feeding syndrome can occur
as a response to nutrient reintroduction after a period of starvation. When an extremely malnourished
patient receives TPN, the body has to adjust to receiving nutrients again, which can cause shifts in
electrolytes in the body. These shifts in electrolytes can result in sudden and often fatal complications.
Signs and symptoms of re-feeding syndrome include confusion and impaired mental status, insulin
resistance, seizures, coma and death.
-"Persistent weight loss" is incorrect because by the time a patient develops re-feeding syndrome, the
onset of symptoms is so sudden that weight loss cannot be measured as part of the syndrome.
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