INTRODUCTION TO CRITICAL CARE NURSING 7TH EDITION SOLE TEST BANK
Chapter 09: Ventilatory Assistance Sole: Introduction to Critical Care Nursing, 7th Edition MULTIPLE CHOICE 1. A patient has coronary artery bypass graft surgery and is transported to the surgical intensive
care unit at noon and is placed on mechanical ventilation. Interpret the initial arterial blood gas levels pH: 7.31 PaCO2: 48 mm Hg Bicarbonate: 22 mEq/L PaO2: 115 mm Hg O2 saturation: 99% a. Normal arterial blood gas levels with a high oxygen level b. Partly compensated respiratory acidosis; normal oxygen c. Uncompensated metabolic acidosis with high oxygen levels d. Uncompensated respiratory acidosis; hyperoxygenated ANS: D
The high PaO2 level reflects hyperoxygenation; the PaCO2 and pH levels show respiratory acidosis. The respiratory acidosis is uncompensated as indicated by a pH of 7.31 (acidosis) and a normal bicarbonate level. No metabolic compensation has occurred. DIF: Cognitive Level: Analyze/Analysis REF: Box 9-3 | Table 9-3 OBJ: Describe methods for assessing the respiratory system, including physical assessment, interpretation of arterial blood gases,NURSINGTB.COM and noninvasive techniques. TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 2. The provider orders the following mechanical ventilation settings for a patient who weighs 75
kg. The patient’s spontaneous respiratory rate is 22 breaths/min. Which arterial blood gas abnormality may occur if the patient continues to be tachypneic at these ventilator settings? Settings: Tidal volume: 600 mL (8 mL per kg) FiO2: 0.5 Respiratory rate: 14 breaths/min Mode assist/control Positive end-expiratory pressure: 10 cm H2O a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis ANS: D
Assist/control ventilation may result in respiratory alkalosis, especially when the patient is breathing at a higher rate that the ventilator rate. Each time the patient initiates a spontaneous breath—in this case 22 times per minute—the ventilator will deliver 600 mL of volume. DIF: Cognitive Level: Analyze/Analysis
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