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Nursing Priorities for Respiratory Care, Exams of Nursing

University of WestminsterNursing

Various nursing priorities and considerations for caring for patients with respiratory conditions, including thoracentesis, ards, copd exacerbations, respiratory failure, and post-bronchoscopy complications. It provides guidance on patient positioning, monitoring vital signs, managing equipment, recognizing signs of respiratory distress, and administering appropriate interventions. The information is relevant for nurses working in acute care settings, such as hospitals, who need to be able to identify and respond to respiratory emergencies and provide evidence-based nursing care to patients with a range of respiratory disorders.

Typology: Exams

2023/2024

Available from 10/14/2024

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AACN ECCO Pulmonary Part 1 exam
2024
What are the nursing priorities for patient care before, during, or after thoracentesis? -
ANS Position patient sitting on or lying...
Continually monitor...
Help attach tubes to chest drainage...
A nurse caring for a patient with ARDS on BiPAP observes rapid progression and
tachypnea with RR between 37 and 41. What intervention should the nurse anticipate? -
ANS Call emergency team for rapid intubation
For which purposes is EtCO2 monitoring indicated? - ANS WRONG
Determining accurate...
Monitoring patients recovering from general...
Measuring effectiveness of CPR
A patient has the following ABG results: pH 7.25, PaCO2 43, PaO2 80, SaO2 91%, and
HCO3- 18. What is the most likely underlying cause? - ANS Acute kidney injury
Which patient has an indication for oxygen therapy with a low-flow device? - ANS Who
is postoperative...
A patient with respiratory failure following cardiac surgery has crackles in bilateral
posterior lower lobes and is on 4 L/min NC. Which interventions will promote normal
respiratory function? - ANS Reduce anxiety...
Ensure early progressive mobility...
Administer bronchodilators...
A nurse monitoring a patient undergoing bedside bronchoscopy notes a decline in a
patient's oxygen saturation. Which should the nurse anticipate? - ANS Auscultate lung
sounds...
Provide supplemental O2...
Monitor EtCO2
The ABG test results for a patient with a spinal cord injury are pH 7.29, PaCO2 54, and
HCO3- 25. Which acid-base disorder is reflected? - ANS Respiratory acidosis
A patient with COPD on PEEP reports sudden chest pain. The nurse observes
tachycardia and shortness of breath. Which other conditions should the nurse
expected? - ANS Decreased PaCO2 levels...
Decreased chest excursion on one side...
Decreased SaO2 level
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AACN ECCO Pulmonary Part 1 exam

What are the nursing priorities for patient care before, during, or after thoracentesis? - ANS Position patient sitting on or lying... Continually monitor... Help attach tubes to chest drainage... A nurse caring for a patient with ARDS on BiPAP observes rapid progression and tachypnea with RR between 37 and 41. What intervention should the nurse anticipate? - ANS Call emergency team for rapid intubation For which purposes is EtCO2 monitoring indicated? - ANS WRONG Determining accurate... Monitoring patients recovering from general... Measuring effectiveness of CPR A patient has the following ABG results: pH 7.25, PaCO2 43, PaO2 80, SaO2 91%, and HCO3- 18. What is the most likely underlying cause? - ANS Acute kidney injury Which patient has an indication for oxygen therapy with a low-flow device? - ANS Who is postoperative... A patient with respiratory failure following cardiac surgery has crackles in bilateral posterior lower lobes and is on 4 L/min NC. Which interventions will promote normal respiratory function? - ANS Reduce anxiety... Ensure early progressive mobility... Administer bronchodilators... A nurse monitoring a patient undergoing bedside bronchoscopy notes a decline in a patient's oxygen saturation. Which should the nurse anticipate? - ANS Auscultate lung sounds... Provide supplemental O2... Monitor EtCO The ABG test results for a patient with a spinal cord injury are pH 7.29, PaCO2 54, and HCO3- 25. Which acid-base disorder is reflected? - ANS Respiratory acidosis A patient with COPD on PEEP reports sudden chest pain. The nurse observes tachycardia and shortness of breath. Which other conditions should the nurse expected? - ANS Decreased PaCO2 levels... Decreased chest excursion on one side... Decreased SaO2 level

Which are correct statements about a closed-chest drainage system or component? - ANS To drain, system pressure must be lower... Gravity, and sometimes suction... Wet suction chambers create suction... A nurse caring for a patient with worsening hypoxia should anticipate which signs of ARDS? - ANS PaO2/FiO2 below 300... PEEP requirements of at least 5... Respiratory failure unexplained... Which may affect pulse oximetry accuracy? - ANS Cardiac arrest By what signs or symptoms should the nurse recognize tension pneumothorax in a patient with worsening respiratory distress? - ANS WRONG Progressive tachy... Decreased PaCO Absence of breath sounds... A patient with hemopytsis reports pleuritic chest pain. the nurse auscultates a pleural friction rub. What additional symptoms/signs should the nurse expect? - ANS WRONG Metabolic acidosis Sinus tachy... Hypoxemia... A patient with a hip fracture fro a fall has a sudden decrease in SpO2, from 99% to 92%, and reports dyspnea. Which other signs or symptoms should the nurse anticipate?

  • ANS Pleural friction rub and pleuritic chest pain A patient is admitted with acute hypoxemic respiratory failure. Which assessments confirm the diagnosis? - ANS WRONG Tachypnea Tachycardia PaO2 55 mmHg Which patient in the immediate postoperative period should be given a a NC or simple face mask? A patient requiring: - ANS FiO2 of 0.4 or less A patient in respiratory failure has a low expiratory airflow unresponsive to medication. The nruse observes tachycardia and hypoxemia. What additional signs/symptoms should the nurse anticipate? - ANS WRONG Respiratory acidosis on ABG A-fib Declining PaO

A nurse is monitoring patient undergoing bedside bronchoscopy notes a decline in patient's oxygen saturation. What should you anticipate? - ANS Auscultate lungs bilaterally Monitor EtCO Provide supplemental oxygen Patient with pneumothorax is admitted. Which intervention should be anticipated? - ANS Prepare for chest tube insertion Patient with acute respiratory failure admitted. What ABG result do you anticipate? - ANS B: 7.29 pH Which pt most likely to have indication for non-rebreather mask? - ANS NOT: Who is post-op lobectomy NOT: Asthma exacerbation DeMontel admitted after thoracotomy. - ANS Verify chest tube is secured. Pulmonary embolism sequelae: - ANS Ischemia Hypoxemia RV failure In patient with respiratory distress, what s/s should lead you to suspect pleural effusion? - ANS Diminished breath sounds Sharp chest pain Tachycardia CT with IV contrast. Observe for what after the procedure? - ANS Renal function Crackles are caused by: - ANS Small airways opening Which of these accurately describe the clinical significance of breath sounds? - ANS Fluids or secretions in large airways → rhonchi Pleural rubs on inspiration and expiration Wheezes indicate narrow airways Which ABG result requires provider be notified immediately? - ANS pH less than 7. COPD exacerbation. ABGs: pH 7.28, PaO2 60, PaCO2 76, HCO3 27, SaO2 86 on FiO2 50% via air entrainment device. Which treatment is anticipated next? - ANS NIPPV ABG test results for patient with spinal cord injury are pH 7.55, PaCO2 31, and HCO

  1. Which acid-base disorder? - ANS Respiratory alkalosis

In caring for patient who has undergone bronchoscopy, you should monitor for s/s of? - ANS Vagal Laryngospasms Pneumothorax Which ABG result indicates partial compensation? - ANS pH 7. For which pulmonary chest x-ray findings should nurse immediately notify provider? - ANS Trachea deviated Increased patchy opacity ETT >4cm above carina Correct statements about closed-chest drainage system or component? - ANS Wet suction chambers create suction by changing water level; Gravity, and sometimes suction, creates a negative pressure; To drain, system pressure must be lower than chest pressure. Patient with pleural effusion develops empyema. Which is initially indicated? - ANS ABX Which patient has an indication for ventilatory replacement? ABG results of: - ANS pH 7.20, 58, 55, 24, 88 ABG test results for a patient with a spinal cord injury are pH 7.29, PaCO2 54, HCO

  1. Which acid-base disorder is reflected? - ANS Respiratory acidosis Patient with respiratory distress on 4 L/min NC is admitted. ABG reveals pH 7.30, PaO2 57, PaCO2 50, SaO2 89%, HCO3 27, and P/F 150. Which is indicated? - ANS Initiation of BiPAP Nursing priorities for patient care before, during, or after thoracentesis? - ANS Help attache tubes Continually monitor v/s Position sit/lie near bed edge Pt with hip fracture from fall has sudden ↓ in SpO2 from 99% to 92% and reports dyspnea. What other s/s should you anticipate? - ANS Pleural friction rub and pleuritic chest pain. A nurse caring for a patient with ARDS on BiPAP observes rapid progression and tachypnea with RR between 37 and 41. What intervention should the nurse anticipate? - ANS Call emergency response for intubation

Decrease Decrease Which ABG result indicates complete compensation? - ANS C: 7.35, 89, 47, 29, 93% Which patient in the immediate postoperative period should be given a a NC or simple face mask? A patient requiring: - ANS FiO2 of 0.4 or less Patient who underwent thoracotomy is admitted. Which intervention is indicated? - ANS Maintain patency of chest tube Patient with hemothorax is admitted. Anticipate which intervention? - ANS Prepare for chest tube insertion Which are nursing care priorities for a post-thoracotomy patient? - ANS NOT: Elevate, Use, Manage A patient with respiratory failure following cardiac surgery has crackles in bilateral posterior lower lobes and is on 4 L/min NC. Which interventions will promote normal respiratory function? - ANS Reduce anxiety Ensure early mobility Administer bronchodilators Which may affect pulse oximetry accuracy? - ANS Cardiac Arrest How does tension pneumothorax destabilize circulation? - ANS Intrathoracic pressure reduces venous return and preload A nurse caring for a patient with worsening hypoxia should anticipate which signs of ARDS? - ANS PaO2/FiO2 below 300 PEEP requirements of at least 5 Respiratory failure unexplained For which complication should the nurse observe in a patient following bronchoscopy? - ANS Dysrhythmias