BSN 445: Pulmonary Therapeutic Management Exam Questions And Answers
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Course
BSN 445
Institution
BSN 445
Noninvasive Ventilation and Positioning Therapy:
Question 1 of 3
The nurse would avoid using noninvasive ventilation in a patient admitted with which diagnosis?
Cardiogenic pulmonary edema
Type I acute lung failure
Postoperative esophageal resection
Type II acute lung failure - ANS Po...
BSN 445: Pulmonary Therapeutic
Management Exam Questions And
Answers
Noninvasive Ventilation and Positioning Therapy:
Question 1 of 3
The nurse would avoid using noninvasive ventilation in a patient admitted with which diagnosis?
Cardiogenic pulmonary edema
Type I acute lung failure
Postoperative esophageal resection
Type II acute lung failure - ANS Postoperative esophageal resection
A patient with recent surgery to the upper airway or esophagus is not eligible for noninvasive
ventilation.
Question 2 of 3
Which physiologic change would the nurse expect after implementing therapy with noninvasive
bilevel partial airway pressure (BiPAP)? Select all that apply. One, some, or all responses may
be correct.
Increased PaCO2 level
Relief of dyspnea
Decreased alveolar ventilation
Reduced accessory muscle use
Increased Pao2 level - ANS Relief of dyspnea
BiPAP relieves dyspnea and shortness of breath.
Reduced accessory muscle use
Due to the relief of dyspnea, the nurse would expect reduced accessory muscle use.
Increased Pao2 level
Due to improved oxygenation and positive pressure, the nurse would expect to assess an
increase in the Pao2 level.
Question 3 of 3
Which device can be used to deliver noninvasive ventilation to a patient in respiratory distress?
Select all that apply. One, some, or all responses may be correct.
Endotracheal tube
Full-face mask
Nasal mask
BiPAP machine
,Nasal cannula - ANS Full-face mask
A full-face mask and a face mask can both be used to provide noninvasive ventilation.
Nasal mask
A nasal mask could be used to provide noninvasive ventilation.
BiPAP machine
A bilevel positive airway pressure (BiPAP) machine can be used to deliver noninvasive
ventilation to a patient in respiratory distress.
Question 1 of 3
Which statement describes the principle of positioning therapy?
Positioning therapy is used to improve respiratory rates.
Blood flow increases to the apexes of the lungs after positioning therapy is initiated.
During positioning therapy, the least damaged lung portions are put into a dependent position.
Positioning therapy increases the ventilation-perfusion mismatch. - ANS During positioning
therapy, the least damaged lung portions are put into a dependent position.
Positioning therapy places the least damaged portions of the lungs into a dependent position,
which receive preferential blood flow.
Question 2 of 3
Which patient position would overcome ventilation-perfusion mismatching?
Supine
High Fowler
Prone
Trendelenburg - ANS Prone
Prone positioning and rotation therapy are used during positioning therapy to overcome
ventilation-perfusion mismatching.
Question 3 of 3
Match the element of prone positioning to the corresponding nursing consideration.
Correct Answer
Disconnect electrocardiogram electrodes and temperature probe prior to positioning
=Attachments
Often an ignored site for pressure sores
=Genitals
Ensure adequate slack in tubing and check positioning
=Endotracheal tube
Check for needle caps, bumps, and folds
=Bedding - ANS
Question 1 of 6
The nurse would discontinue noninvasive ventilation if which finding was assessed?
Cardiac dysrhythmias
Tachycardia
Restlessness
, Increased Sao2 - ANS Cardiac dysrhythmias
Cardiac dysrhythmias and hemodynamic instability are contraindications to noninvasive
ventilation and the nurse would discontinue treatment.
Question 2 of 6
Which intervention would the nurse include in the plan of care when caring for a patient
receiving noninvasive bilevel partial airway pressure (BiPAP)?
Apply restraints to prevent mask removal.
Administer sedation until the patient's RASS score is -3.
Elevate the head of bed to 45 degrees.
Ensure the mask is loose fitting to prevent skin breakdown. - ANS Elevate the head of bed
to 45 degrees.
The patient is positioned with the head of the bed elevated at 45 degrees to minimize aspiration
and facilitate breathing.
Question 3 of 6
Which assessment finding indicates development of a complication related to noninvasive
ventilation (NIV)? Select all that apply. One, some, or all responses may be correct.
Blanchable redness on the bridge of the nose
Distention of the abdomen
Presence of anxious behaviors
Hyperactive bowel sounds
Bilateral lower extremity swelling - ANS Blanchable redness on the bridge of the nose
Skin breakdown can occur from noninvasive ventilation and should be prevented with
transparent dressings.
Distention of the abdomen
Gastric distention can occur and would cause abdominal bloating and vomiting.
Presence of anxious behaviors
NIV can cause anxiety. The nurse should provide reassurance as the patient learns to breathe
with the machine.
Question 4 of 6
After placing a patient in the prone position, which assessment finding would indicate that the
positioning therapy is effective?
Decrease in PaCO2 from 40 to 35 mm Hg
Increase in Pao2 from 70 to 85 mm Hg within 30 min
Increase in systolic blood pressure from 100 to 115 mm Hg
Decrease in heart rate from 100 to 80 beats/min - ANS Increase in Pao2 from 70 to 85 mm
Hg within 30 min
The therapy is considered successful if the patient has improvement in Pao2 greater than 10
mm Hg within 30 minutes of being placed in the prone position.
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