week 1

Question 1

If you have a patient that is hypoxic (blue) and is on O2 via NC how would you know
your interventions is effective

Answer 1

Cap refill normal, pink mucus membrane

Question 2

This patient has an ETT tube (throat) and you’re about to ventilate them and suction them,. What are you going to do first?

Answer 2

Pre-oxygenate patient, wait 2 minutes

Question 3

Patients trached with mechanical ventilation, how can you reduce pneumonia in those patients?

Answer 3

Give patient oral care: brush teeth with suction

Question 4

ARDS patient using medication called vecuronium and is on ventilators, it can cause what?

Answer 4

Suppression of respiratory efforts, it lowers RR

Question 5

What is the best position for a patient dealing with ARDS

Answer 5

Prone position

Question 6

Dealing with 4 patients who are at risk for ards? (SATA)

Answer 6

History of Aspiration and lung trauma (chest injury), or systemic infection such as sepsis

Question 7

Blood gasses (ABGS) what to use to see if a patient can come off a ventilator or getting correct ventilation. (SATA)

a. ABG
b. pH: determines if blood gas acidotic or alkalotic
c. CO2
d. HCO3
e. Uncompensated respiratory acidosis** (look at ABGs)

Answer 7

a. ABG
e. Uncompensated respiratory acidosis** (look at ABGs)

Question 8

SATA: talking about Acute respiratory failure

Answer 8

All except nausea

Question 9

Teaching a patient or family member for skill at home which indicates teaching is
effective

Answer 9

Caregiver can do skill independently and safely

Question 10

A person is receiving a neuromuscular blocking agent, what should you have at your bedside when giving this medication?

Answer 10

Have ambu bag and oxygen at bedside, ett tubes at bedside

Question 11

Patients with SPO2 below 90% what would you give them?

Answer 11

Give patient O2

Question 12

If a patient has a trach, and you’re in PACU and assessing and their chest isn’t rising and falling and no breath sounds what does that mean?

Answer 12

The ETT needs to be replaced because it may be dislodged (in bronchus)

Question 13

SATA: (3 answers) a person is on mechanical ventilation what interventions should you do to prevent complications?

Answer 13

a. Raise head of bed at least 30 degrees
b. Administer protonix (pantoprazole) for stress ulcers
c. ETT tube in mouth: move tube left to right every 12 hours

Question 14

If you have a patient who has a bronchoscopy, what must return to ensure a patent airway?

Answer 14

a. Gag reflex

Question 15

A patient who is experiencing possible respiratory failure which blood gas would indicate
that they are experiencing it?

Answer 15

a. High PaCO2
b. Sleepy (somnolent) and RR will drop

Question 16

Patient with ards can develop emphysema if their mechanical vent and high PEEP

Answer 16

a. Statement

Question 17

Patients with ards there are two O2s to determine if proning is effective with improving oxygenation. 2 questions

Answer 17

a. PaO2
b. SaO2

Question 18

delegation : what can you delegate to an LVN with patient on mechanical ventilator? Choose one

a. RN will prone patient, monitor breath sounds, central venous pressure
b. RN can delegate to LVN to insert foley catheter

Answer 18

b. RN can delegate to LVN to insert foley catheter

Question 19

Positive pressure ventilation with a patient with ARDS and a NG tube with what color in
drainage what does that mean?

Answer 19

Red, brown drainage indicate GI bleeding

Question 20

How do you check a person’s oxygenation levels?

Answer 20

Pulse oximeter

Question 21

81 year old lady with a broken hip what are we going to look at? 2 answers only

Answer 21

Check albumin levels (shows nutrition/protein) and weight loss

Question 22

ABG results that are abnormal?

Answer 22

pH: 7.28

Question 23

A person who has a positive and expiratory pressure peep (increased pressure) can cause what?

Answer 23

Can decline blood pressure: hypotension

Question 24

If you find that your PEEP is worsening and at a level in regards to the water, what
means an emergency to call the doctor

Answer 24

If lung sounds are greater one side, call doctor immediately; it can be a pneumothorax

Question 25

Guillain barre patient that is hyperventilating what ABG is gonna be increased?

Answer 25

High PaCO2

Question 26

Hallmark manifestation of ARDS

Answer 26

Refractory Hypoxemia

Question 27

A patient with an ETT with a cuff leak what are we going to hear?

Answer 27

a. Hissing sound

Question 28

SATA (3 answers) Patient diagnosed with sepsis and on mechanical ventilator, which
criteria shows they are improving and starting to wean off ventilator

Answer 28

a. Hgb in normal range above 7.5
b. No systemic problems (no sepsis)
c. Initiate inspiratory efforts or breath in and breath out (weaned off ventilator)

Question 29

When you are removing a copious amount of secretion from a patient trach what are you going to do first?

Answer 29

always administer 100% oxygen for over 2 minutes