A patient with acute respiratory distress syndrome (ARDS) who is intubated and receiving mechanical ventilation develops a right pneumothorax. Which action will the nurse anticipate taking next?
a. Increase the tidal volume and respiratory rate.
b. Increase the fraction of inspired oxygen (FIO2).
c. Perform endotracheal suctioning more frequently.
d. Lower the positive end-expiratory pressure (PEEP).
Question 2Which statement by the nurse when explaining the purpose of positive end-expiratory pressure (PEEP) to the family members of a patient with ARDS is accurate?
a. PEEP will push more air into the lungs during inhalation.
b. PEEP prevents the lung air sacs from collapsing during exhalation.
c. PEEP will prevent lung damage while the patient is on the ventilator.
d. PEEP allows the breathing machine to deliver 100 oxygen to the lungs.
Question 3A nurse is caring for a patient with ARDS who is being treated with mechanical ventilation and high levels of positive end-expiratory pressure (PEEP). Which assessment finding by the nurse indicates that the PEEP may need to be reduced?
a. The patient's PaO2 is 50 mm Hg and the SaO2 is 88.
b. The patient has subcutaneous emphysema on the upper thorax.
c. The patient has bronchial breath sounds in both the lung fields.
d. The patient has a first-degree atrioventricular heart block with a rate of 58.
Question 4A patient with acute respiratory distress syndrome (ARDS) is placed in the prone position. When prone positioning is used, which information obtained by the nurse indicates that the positioning is effective?
a. The patient's PaO2 is 89 mm Hg, and the SaO2 is 91.
b. Endotracheal suctioning results in clear mucous return.
c. Sputum and blood cultures show no growth after 48 hours.
d. The skin on the patient's back is intact and without redness.
Question 5The nurse documents the vital signs for a patient admitted 2 days ago with gram-negative sepsis: temperature 101.2 F, blood pressure 90/56 mm Hg, pulse 92, respirations 34. Which action should the nurse take next?
a. Give the scheduled IV antibiotic.
b. Give the PRN acetaminophen (Tylenol).
c. Obtain oxygen saturation using pulse oximetry.
d. Notify the health care provider of the patient's vital signs.
Question 6A patient with acute respiratory distress syndrome (ARDS) and acute kidney injury has the following medications ordered. Which medication should the nurse discuss with the health care provider before giving?
a. Pantoprazole (Protonix) 40 mg IV
b. Gentamicin (Garamycin) 60 mg IV
c. Sucralfate (Carafate) 1 g per nasogastric tube
d. Methylprednisolone (Solu-Medrol) 60 mg IV
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