NRNP 6566 Week 7 Knowledge Check (Collection)

(NRNP 6566 Week 7 Knowledge Check, NRNP 6566 Week 7 Knowledge Check)

NRNP 6566 Week 7 Knowledge Check (Version 1)

1. Question: A patient with respiratory failure has hemodynamic monitoring and is receiving mechanical ventilation with peak end-expiratory pressure (PEEP) of 10 cm H2O. Which information indicates that a change in the ventilator settings may … ?
2. Question: The APRN is monitoring a newly … patient. He appears to be very anxious and “fighting” the ventilator. What would be the most appropriate action?
3. Question: A 59 year old man was … to the ICU for a COPD exacerbation. He was … earlier in the day. Initially after being intubated his static pressure was 23 cm H2o and peak pressure 47 cm H20. The APRN is notified that currently his peak pressure has risen to 62 cm H20 and the static pressure is 42 cm H20. His heart rate has increased from 88 to 112beats / minute and his blood pressure has decreased from 112/88 to 92/ 72. He has decreased breath sounds on the left side.
4. Question: A 34 year ole email who weights 96 kg (211 lbs.) and is 165 cm (5 ft. 6 inches) tall has chest trauma due to a motorcycle accident. The patient has just been intubated, sedated and … with morphine sulfate and pancuronium bromide. What initial ventilator settings are appropriate for this patient?…. Where do you think the problem lies with this particular patient?
5. Question: A 40 year-old. 6-foot tall man has been inpatient on the step down unit for the past 2 days. He was … for fever and cough with production of yellow sputum. His admission blood pressure was 128/72 and initial chest x-ray … a left lower lobe infiltrate. His ABG on room air … : pH 7.31, PCO2 30, PO2 78, HCO3 17. He was started on antibiotics and progress notes from he past two days indicate improvement in his condition.The APRN is called by the nurse because of worsening of the patients condition….. On your arrival to the room, vitals signs are. 86/60 P 118 RR 38 oxygen saturation on a non-rebreather mask is 78% (this am it was 97% on 2L per NC). The patient is laboring to breath with accessory muscle use. He is less responsive, diaphoretic, and is speaking in short sentences. Repeat chest x-ray shows bilateral diffuse lung opacities. ABG on the non-rebreather mask show: pH 7.18, PCO2 47, PO2 56, HCO313…… The decision to intubate the patient is made. What initial ventilator settings would you order?
6. Question: Four hours after mechanical ventilation is … for a patient with chronic obstructive pulmo-nary disease (COPD), the patient’s arterial blood gas (ABG) results include a pH of 7.50, PaO2 of 80 mm Hg, PaCO2 of 29 mm Hg, and HCO3- of 23 mEq/. What change in ventilator settings would be indicated?
7. Question: The APRN is … that an … patients endotracheal tube (ET) was … at 21 cm and is not at the 24 cm line. The patient appears anxious and restless. What action should the APRN take?
8. Question: A 59 year old man was … to the ICU for a COPD exacerbation. He was intubated earlier in the day. Initially after being intubated his static pressure was 23 cm H2o and peak pressure 47 cm H20. The APRN is notified that currently his peak pressure has risen to 62 cm H20 and the static pressure is 42 cm H20. His heart rate has increased from 88 to 112beats / minute and his blood pressure has decreased from 112/88 to 92/ 72. He has … breath sounds on the left side….. What management steps should you institute at this point?
9. Question: A 59 year old man was … to the ICU for a COPD exacerbation. He was … earlier in the day. Initially after being … his static pressure was 23 cm H2o and peak pressure 47 cm H20. The APRN is notified that currently his peak pressure has risen to 62 cm H20 and the static pressure is 42 cm H20. His heart rate has increased from 88 to 112beats / minute and his blood pressure has decreased from 112/88 to 92/ 72. He has decreased breath sounds on the left side….. What do states and peek pressures represent on the ventilator?
10. Question: A 58 year-old man with a history of COPD presents to the emergency room with a two day history of increasing shortness of breath that … after a recent viral infection.His current oxygen saturation is 87% on room He is able to speak one to two words at a time and is working hard to breath. On exam, he has diffuse wheezes and a prolonged expiratory phase. His chest x-ray reveals changes consistent with COPD but no new focal infiltrates. An arterial blood gas (ABG) is done and … pH 7.15, PCO2 57, PO2 61, HCO324…… What are the indications for initiating mechanical ventilation?

NRNP 6566 Week 7 Knowledge Check (Version 2)

1. Question: When possible, where is the best place to position the board for a chest X-ray?
2. Question: When reviewing an X-ray, all of the following are correct EXCEPT:
3. Question: Prostate-specific antigen (PSA) is controversial; however, it is useful in some cases. What is the normal level of PSA for an older man over 65?
4. Question: What area of the heart conducts the electrical signal down and up through the heart from the nodes to the myocardium?
5. Question: Your patient’s liver enzyme panel results came back. Which of the following are abnormal results?
6. Question: The pulmonic valve is one of two semilunar valves in the heart. The other is the:
7. Question: When performing a CBC on your older adult, all of the following values are within normal levels EXCEPT:
8. Question: What area of the heart is … the “pacemaker of the heart”?
9. Question: When reviewing the chest X-ray, a review of the bony structures of the clavicle, ribs, and spine can indicate which of the following pathologies if present?
10. Question: The EKG or ECG is looking at the electrical activity of the heart. True or false?
    

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NRNP 6566 Week 7 Knowledge Check (Version 3)

1. For the following ABGs, identify the level of hypoxemia, the primary acid base disorder, and the type of compensation. Example – acute respiratory acidosis with metabolic alkalosis and severe hypoxemia
2. A 54 year old female has a 30 year pack smoking history. She recently underwent pulmonary function testing which … moderate obstructive lung disease. What would your treatment plan (including medications) include for this patient?
3. A is a 25 year old male who comes to the ER complaining of increasing shortness of breath and upper respiratory symptoms – cough, fever, and progressive dyspnea for three days. On exam he appears cyanotic, has respiratory distress and inspiratory crackles over the left base. RR = 40 CXR – left lobar pneumonia. Temp = 102° and WBC = 17,000. ABG and electrolytes:
4. A 23-year-old male with Type 1 diabetes presents to the ER complaining of fatigue and malaise. He tells you he has … his insulin injections the previous two days. His labsare:
5. For the following ABGs, identify the level of hypoxemia, the primary acid base disorder, and the type of compensation. Example – acute respiratory acidosis with metabolic alkalosis and severe hypoxemia
6. For the following ABGs, identify the level of hypoxemia, the primary acid base disorder, and the type of compensation. Example – acute respiratory acidosis with metabolic alkalosis and severe hypoxemia
7. A 65-year-old female suddenly becomes hypotensive one day following surgery for a … Her ABG before surgery on room air showed a pO2 of 84 and pCo2 of 39.
8. For the following ABGs, identify the level of hypoxemia, the primary acid base disorder, and the type of compensation.
9. For the following ABGs, identify the level of hypoxemia, the primary acid base disorder, and the type of compensation. Example – acute respiratory acidosis with metabolic alkalosis and severe hypoxemia
10. A 14 year old female asthmatic is brought to the ER in moderate respiratory distress. Her PEF is 55% of … . What would your immediate medication orders include?