CMSRN Respiratory and Pulmonary Care 2

Question 1

A patient on mechanical ventilation develops high peak airway pressures. What is the priority nursing assessment?

Accepted Answer

Assess for kinking of the ventilator tubing or ET tube

Answer

Check the IV site for infiltration

Answer

Increase the tidal volume

Answer

Decrease the FiO2

Question 2

Which position is best for a spontaneously breathing patient with unilateral pneumonia to improve oxygenation?

Accepted Answer

Good lung down (unaffected side dependent)

Answer

Supine with head of bed flat

Answer

Affected side down (dependent)

Answer

Prone position

Question 3

A patient with asthma is experiencing an acute exacerbation. What is the first-line medication the nurse should administer?

Accepted Answer

Short-acting beta-2 agonist (SABA)

Answer

Inhaled corticosteroid

Answer

Leukotriene receptor antagonist

Answer

Intravenous aminophylline

Question 4

The nurse is caring for a patient with a pleural effusion. Which intervention would the nurse anticipate assisting with to relieve symptoms?

Accepted Answer

Thoracentesis to drain fluid

Answer

Chest tube insertion for pneumothorax

Answer

Bronchoscopy for direct visualization

Answer

Pericardiocentesis

Question 5

A patient with pulmonary embolism (PE) is being treated with heparin infusion. Which lab value requires immediate dose adjustment?

Accepted Answer

aPTT of 120 seconds (therapeutic range 60–100 seconds)

Answer

Platelet count of 200,000/mm³

Answer

Hemoglobin of 10 g/dL

Answer

BUN of 18 mg/dL

Question 6

A patient with a tracheostomy has thick, tenacious secretions. Which independent nursing intervention is most appropriate?

Accepted Answer

Increase humidification of inspired air

Answer

Increase IV fluid rate without a physician order

Answer

Administer mucolytic medication

Answer

Perform postural drainage every 4 hours