NP Test Prep: Respiratory Exam Questions And Answers
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Course
NP RESPIRATORY
Institution
NP RESPIRATORY
A 57 yo female with an exacerbation of COPD is intubated and initially placed on the following ventilator settings: TV 750/SIMV 18/FiO2 60%/PEEP 5. The following morning her ABG results are as follows: pH 7.45/CO2 38/PaO2 88/HCO3 35. Which of the following actions by the AGACNP would be most approp...
NP Test Prep: Respiratory Exam
Questions And Answers
A 57 yo female with an exacerbation of COPD is intubated and initially placed on the following
ventilator settings: TV 750/SIMV 18/FiO2 60%/PEEP 5. The following morning her ABG results
are as follows: pH 7.45/CO2 38/PaO2 88/HCO3 35. Which of the following actions by the
AGACNP would be most appropriate?
A. increase the FiO2
B. Increase the PEEP
C. Decrease the rate of ventilation
D. Add a nebulized bronchodilator - ANS C. Decrease the rate of the ventilator
(Fitzgerald Review, 2018, p. 58)
A 45 yo male patient is admitted to the intensive care unit and progresses to respiratory failure
requiring intubation and mechanical ventilation. The NP chooses assist control with volume
targets. The patient's ideal body weight is 220 pounds (99.79 kg). What would be the best initial
ventilator settings?
A. TV 800 mL and PEEP 5
B. TV 400 mL and PEEP 10
C. TV 600 mL and PEEP 10
D. TV 1000 mL and PEEP 5 - ANS A. TV 800 mL and PEEP 5
(Fitzgerald Review, 2018, p. 59)
You are called to the emergency department to admit a 48 yo male for an asthma exacerbation.
The patient's vital signs are as follows: HR 45, RR 24, BP 96/45, SpO2 87% on 4LNC. The peak
flow on arrival was 40% of the predicted value. The patient is on continuous albuterol nebulizers
and was given a dose of methylprednisolone (Solumedrol) 125 mg IV. An ABG was just resulted
and reveals the following: pH 7.3, pCO2 40, HCO3 30, PaO2 55%. The patient appears drowsy
with confused conversation and is unable to speak more than a few words during your
evaluation. You also note that the patient appears severely short of breath, however there is no
audible or auscultated wheezing. What is your priority intervention?
A. Order an additional dose of methylprednisolone (Solumedrol)
B. Order a dose of lorazepam (Ativan)
C. Intubate the patient
D. Increase the oxygen to high flow therapy - ANS C. Intubate the patient
(Fitzgerald Review 2018, p. 125)
, While admitting a 30 yo female patient for an asthma exacerbation you discover that the patient
has been in the emergency department 7 times in the past 2 months for asthma-related
symptoms. She also reports shortness of breath 3-4 times per week that she is able to manage
at home. The patient is currently on an albuterol (Proventil) inhaler only. Which of the following
medications would you add on for this patient?
A. formoterol (Foradil)
B. fluticasone (Flovent)
C. montelukast (Singulair)
D. ipratropium bromide (Atrovent) - ANS B. fluticasone (Flovent)
(Fitzgerald Review 2018, p. 125)
What is the purpose of referring a patient to pulmonary rehabilitation?
A. reduce hospitalization
B. maximize function
C. restore lost function
D. increase functional residual capacity - ANS B. maximize function
(Fitzgerald Review 2018, p. 125)
The typical radiographic appearance of emphysema includes:
A. the presence of Kerley's lines
B. redistribution of flow in pulmonary vasculature
C. flattened diaphragm and increased retrosternal airspace
D. whitening of the terminal airspaces - ANS C. flattened diaphragm and increased
retrosternal airspace
(Fitzgerald Review 2018, p. 126)
Diagnosis of a patient with COPD must include the notation of a:
A. FEV1 < 80% predicted
B. FVC < 80% predicted
C. FEV1/FVC ratio < 0.7
D. FEV1/FVC ratio < 1 - ANS C. FEV1/FVC ratio < 0.7
(Fitzgerald Review 2018, p. 126)
Which of the following would be indicators for starting antimicrobial therapy in a patient with a
COPD exacerbation? (Select all that apply.)
A. An elderly patient with no comorbidities
B. A patient on mechanical ventilation
C. A patient with increased, purulent sputum production
D. A patient being discharged with poor follow-up
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