Chapter 15: Acute Respiratory Failure

Chapter 15: Acute Respiratory Failure

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse is caring for a patient with acute respiratory failure and identifies “Risk for Ineffective Airway Clearance” as a nursing diagnosis. A nursing intervention relevant to this diagnosis is to

a.	elevate the head of the bed to 30 degrees.
b.	obtain an order for venous thromboembolism prophylaxis.
c.	provide adequate sedation.
d.	reposition the patient every 2 hours.

 

 

ANS:   D

Repositioning the patient will facilitate mobilization of secretions. Elevating the head of bed is an intervention to prevent infection. Venous thromboembolism prophylaxis is ordered to prevent complications of immobility. Sedation is an intervention to manage anxiety, and administration of sedatives increases the risk for retained secretions.

 

DIF:    Cognitive Level: Analyze/Analysis   REF:    p. 396 Nursing Care Plan

OBJ:    Formulate a plan of care for the patient with acute respiratory failure.

TOP:    Nursing Process Step: Intervention

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

2. The patient with acute respiratory distress syndrome (ARDS) would exhibit which of the following symptoms?

a.	Decreasing PaO2 levels despite increased FiO2 administration
b.	Elevated alveolar surfactant levels
c.	Increased lung compliance with increased FiO2 administration
d.	Respiratory acidosis associated with hyperventilation

 

 

ANS:   A

Patients with ARDS often have hypoxemia refractory to treatment. Surfactant levels are often diminished in ARDS. Compliance decreases in ARDS. In early ARDS, hyperventilation may occur along with respiratory alkalosis.

 

DIF:    Cognitive Level: Understand/Comprehension                      REF:    pp. 298-299

OBJ:    Describe the pathophysiology of ARF.

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

3. The nurse assesses a patient who is admitted for an overdose of sedatives. The nurse expects to find which acid-base alteration?

a.	Hyperventilation and respiratory acidosis
b.	Hypoventilation and respiratory acidosis
c.	Hypoventilation and respiratory alkalosis
d.	Respiratory acidosis and normal oxygen levels

 

 

ANS:   B

Hypoventilation is common after overdose and results in impaired elimination of carbon dioxide and respiratory acidosis. The overdose depresses the respiratory drive, which results in hypoventilation, not hyperventilation. Hypoxemia is expected secondary to depressed respirations.

 

DIF:    Cognitive Level: Analyze/Analysis   REF:    p. 390 | p. 392

OBJ:    Describe the pathophysiology of ARF.

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

4. Intrapulmonary shunting refers to

a.	alveoli that are not perfused.
b.	blood that is shunted from the left side of the heart to the right and causes heart failure.
c.	blood that is shunted from the right side of the heart to the left without oxygenation.
d.	shunting of blood supply to only one lung.

 

 

ANS:   C

Shunting refers to blood that is not oxygenated in the lungs.

 

DIF:    Cognitive Level: Understand/Comprehension                      REF:    pp. 390-391

OBJ:    Describe the pathophysiology of ARF.

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity