CRITICAL CARE EXAM 2 - PRACTICE
QUESTIONS & ACTUAL ANSWERS 2024 - 2025
A,client,in,the,ICU,experiences,difficulty,breathing,in,during,exercise,following,trauma,to,the,sternum.,W
hich,muscle,injury,is,causing,the,client,to,be,short,of,breath?
a),Diaphragm
b),Sternocleidomastoid
c),external,intercostal
d),scalene,,ANS,-,,b),Sternocleidomastoid
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the,accessory,muscles,of,inspiration,include,the,scalene,and,sternocleidomastoid,muscles;,the,scalene,m
uscles,elevate,the,first,two,ribs,,and,the,sternocleidomastoid,muscles,raise,the,sternum;,during,normal,b
reathing,,these,muscles,are,not,used,,but,during,exercise,,these,muscles,contract,to,aid,in,inspiration;,inj
ury,to,the,diaphragm,would,affect,both,inspiration,and,expiration,,whether,at,rest,or,in,exercise;,althoug
h,expiration,is,a,largely,passive,process,during,normal,breathing,,it,can,become,an,active,process,during,
exercise;,the,abdominal,and,intercostal,muscles,can,increase,expiratory,effort
The,nurse,is,explaining,to,a,young,client,w/,asthma,how,air,is,conducted,from,the,nose,through,the,airw
ays,to,the,alveoli,in,the,lungs.,Which,represents,the,correct,order,of,airways?
a),Nasopharynx,,oropharynx,,trachea,,bronci,,bronchioles
b),Trachea,,nasopharynx,,oropharynx,,bronchi,,bronchioles
c),Trachea,,bronchi,,bronchioles,,nasopharynx,,oropharynx
d),Oropharynx,,nasopharynx,,trachea,,bronchioles,,bronchi,,ANS,-
,,a),Nasopharynx,,oropharynx,,trachea,,bronci,,bronchioles
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air,enters,through,the,nose,and,flows,through,the,nasopharynx,,then,the,oropharynx,,trachea,(windpipe)
,,left,and,right,bronchi,,and,then,the,bronchioles
The,nurse,is,explaining,to,a,client,in,the,ICU,unit,who,has,experienced,a,pneumothorax,the,role,of,the,alv
eoli,in,respiration.,The,nurse,should,mention,that,which,structure(s),are,present,in,the,alveoli?,Select,all,
that,apply.
,a),Macrophages
b),Surfactant
c),Epiglottis
d),Bronchus,,ANS,-,,a),Macrophages
b),Surfactant
-the,alveoli,are,thin-walled,,cup-
shaped,structures,where,gas,exchange,occurs,in,the,lungs;,the,alveoli,contains,macrophages,that,perfor
m,phagocytic,role,,along,w/,surfactant,,a,lipoprotein,that,decreases,surface,tension,in,the,alveoli;,the,epi
glottis,is,a,small,structure,that,covers,the,larynx,to,allow,food,and,liquid,to,pass,into,the,esophagus;,the,
bronchus,is,a,tube,that,serves,as,the,passageway,for,gases,into,and,out,of,the,lungs
The,nurse,is,assessing,the,client's,anterior,thorax.,The,nurse,anticipates,locating,the,base,of,the,lung,at,w
hich,location?
a),Sixth,rib,at,midclavicular,line
b),Eighth,rib,at,midclavicular,line
c),Ninth,rib,at,midaxillary,line
d),Seventh,rib,at,midclavicular,line,,ANS,-,,a),Sixth,rib,at,midclavicular,line
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the,base,of,each,lung,rests,anteriorly,at,the,level,of,the,sixth,rib,at,the,midclavicular,line,and,at,the,eight
h,rib,at,the,midaxillary,line
A,client,is,experiencing,poor,perfusion,in,the,right,thorax,as,a,result,of,suspected,partially,occluded,arteri
es.,Which,arteries,will,cause,occlusion?,Select,all,that,apply
a),Aorta
b),Internal,mammary
c),Subclavian
d),Intercostal,,ANS,-,,b),Internal,mammary
c),Subclavian
d),Intercostal
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the,bronchial,arteries,that,perfuse,the,left,side,of,the,thorax,arise,from,the,aorta,,and,the,arteries,that,p
erfuse,the,right,side,of,the,thorax,branch,from,the,internal,mammary,,subclavian,,and,intercostal,arterie
s
A,client,in,the,ICU,w/,COPD,has,mucous,secretions,throughout,the,respiratory,system.,The,client's,breath
ing,is,highly,labored.,What,is,the,primary,cause,of,the,labored,breathing?
a),Decreased,airway,resistance,d/t,increased,airway,diameter
b),Excessive,surfactant
c),Increased,airway,resistance,d/t,decreased,airway,diameter
d),Increased,lung,compliance,,ANS,-,,c),Increased,airway,resistance,d/t,decreased,airway,diameter
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in,conditions,that,decrease,airway,diameter,,such,as,those,caused,by,pulmonary,secretions,or,bronchosp
asm,,marked,increases,in,airway,resistance,occur;,to,maintain,the,same,rate,of,airflow,as,before,the,ons
et,of,increased,airway,resistance,,clients,w/,these,conditions,must,increase,the,driving,pressure,(or,respi
ratory,effort),to,move,air;,lack,of,surfactant.,not,excessive,surfactant,,would,contribute,to,labored,breat
hing;,increased,lung,compliance,would,make,breathing,easier,,not,labored
A,client,w/,pulmonary,edema,is,experiencing,respiratory,distress.,The,nurse,recognizes,that,which,factor,
affecting,gas,exchange,is,likely,responsible,for,the,client's,dyspnea?
a),Surface,area,available,for,diffusion
b),Thickness,of,the,alveolar-capillary,membrane
c),Partial,pressure,of,alveolar,gas
d),Solubility,and,molecular,weight,of,the,gas,,ANS,-,,b),Thickness,of,the,alveolar-capillary,membrane
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fick,law,states,that,the,rate,of,transfer,of,gas,through,a,semipermeable,membrane,is,proportional,to,the,
tissue,surface,area,to,the,difference,in,gas,pressures,between,the,two,sides,and,is,inversely,proportional,
to,the,tissue,thickness;,therefore,,the,thicker,the,alveolar-
capillary,membrane,,the,slower,the,rate,of,gas,transfer,and,the,more,labored,the,client's,breathing;,cond
itions,such,as,pneumonia,,interstitial,lung,disease,,and,pulmonary,edema,increase,membrane,thickness;,
the,other,factors,are,not,as,pertinent
, A,client,is,recovering,from,severe,altitude,sickness,after,a,failed,attempt,to,climb,mount,everest;,which,f
actor,affecting,gas,exchange,was,most,likely,responsible,for,the,client's,illness?
a),Surface,area,available,for,diffusion
b),Thickness,of,the,alveolar-capillary,membrane
c),Partial,pressure,of,alveolar,gas
d),Solubility,and,molecular,weight,of,the,gas,,ANS,-,,c),Partial,pressure,of,alveolar,gas
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ascent,to,high,altitudes,can,lead,to,altitude,sickness,d/t,a,decrease,in,partial,pressure,of,oxygen,,which,i
mpairs,gas,exchange,in,the,alveoli;,the,other,factors,are,less,likely,to,be,pertinent,in,this,situation
A,client,is,the,ICU,w/,pneumothorax,is,experiencing,a,ventilation-
perfusion,imbalance;,which,type,of,imbalance,is,the,client,most,likely,experiencing?
a),Physiologic,shunt
b),Anatomic,shunt
c),Alveolar,dead,space
d),Silent,unit,,ANS,-,,d),Silent,unit
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when,both,ventilation,and,perfusion,are,decreased,,a,silent,unit,occurs;,a,silent,unit,is,seen,w/,pneumot
horax,and,severe,ARDS;,when,perfusion,exceeds,ventilation,,the,ratio,is,low,and,a,shunt,is,present;,a,shu
nt,means,that,blood,passes,by,alveoli,w/o,gas,exchange,occurring;,a,shunt,is,seen,w/,pneumonia,,atelect
asis,,tumor,,or,a,mucous,plug;,when,ventilation,exceeds,perfusion,,the,ratio,is,high,and,an,alveolar,dead,
space,develops;,the,alveolus,has,inadequate,perfusion,available,,and,gas,exchange,cannot,occur;,a,high,v
entilation-to-
perfusion,ration,is,seen,w/,a,pulmonary,embolus,,pulmonary,infarction,,cariogenic,shock,,and,mechanica
l,ventilation,associated,w/,high,tidal,volumes;,the,air,in,the,conducting,airways,(abt,150,mL),does,not,par
ticipate,in,gas,exchange,and,is,referred,to,as,anatomic,dead,space
A,client,in,the,ICU,experiences,an,asthma,attack,after,a,flow,arrangement,was,delivered;,stimulation,of,
which,receptors,is,associated,w/,the,client's,asthma,attack?
a),Stretch,receptors
b),Peripheral,chemoreceptors
c),Irritant,receptors