Priorities in Critical Care Nursing, 6th Edition by Linda D.
Priorities in Critical Care Nursing, 6th Edition by Linda D.
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Chapter 15: Pulmonary Disorders
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | hypoxemic normocapnia. |
| b. | hypoxemic hypocapnia. |
| c. | hypoxemic hypercapnia. |
| d. | hypoxemia. |
ANS: C
Acute respiratory failure can be classified as hypoxemic normocapnic respiratory failure (type I) or hypoxemic hypercapnic respiratory failure (type II), depending on the patient’s arterial blood gas levels.
DIF: Cognitive Level: Comprehension REF: 283
OBJ: Nursing Process: Analysis TOP: Pulmonary Disorders
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
| a. | direct exposure to other patients who are infected. |
| b. | poor hand-washing technique by personnel. |
| c. | aspiration of sputum and saliva. |
| d. | accumulation of secretions in the lungs of immobilized patients. |
ANS: B
Personnel- and procedure-related factors include cross-contamination by hands, exposure to infected personnel, antibiotic therapy, and use of histamine blockers and antacids.
DIF: Cognitive Level: Comprehension REF: 294
OBJ: Nursing Process: Analysis TOP: Pulmonary Disorders
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
| a. | Alveolar hypoventilation |
| b. | Dead space ventilation |
| c. | Intrapulmonary shunting |
| d. | Ventilation/perfusion mismatching |
ANS: C
Hypoxemia is the result of impaired gas exchange and is the hallmark of acute respiratory failure. Hypercapnia may be present, depending on the underlying cause of the problem. The main causes of hypoxemia are alveolar hypoventilation, ventilation/perfusion (V/Q) mismatching, and intrapulmonary shunting. Intrapulmonary shunting occurs when blood passes through a portion of a lung that is not ventilated.
DIF: Cognitive Level: Comprehension REF: 285
OBJ: Nursing Process: Assessment TOP: Pulmonary Disorders
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
| a. | Aminophylline or theophylline |
| b. | Acetylcysteine or iodinated glycerol |
| c. | Guaifenesin or dextromethorphan |
| d. | Ipratropium or albuterol |
ANS: D
Medications to facilitate dilatation of the airways may also be of benefit in the treatment of the patient with acute respiratory failure. Bronchodilators, such as b2 agonists and anticholinergic agents, aid in smooth muscle relaxation and are of particular benefit to patients with airflow limitations.
DIF: Cognitive Level: Application REF: 286
OBJ: Nursing Process: Implementation TOP: Pulmonary Disorders
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
| a. | neuromuscular paralysis. |
| b. | switching modes of mechanical ventilation. |
| c. | continuous infusion of opioid medication. |
| d. | deep sedation or general anesthesia. |
ANS: A
In some patients, sedation does not decrease spontaneous respiratory efforts enough to allow adequate ventilation. Neuromuscular paralysis may be necessary to facilitate optimal ventilation. Paralysis also may be necessary to decrease oxygen consumption in the severely compromised patient.
DIF: Cognitive Level: Application REF: 286
OBJ: Nursing Process: Implementation TOP: Pulmonary Disorders
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
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