ARDS NCLEX Quiz Questions And Answers

1. A male client suffers acute respiratory distress syndrome as a consequence of shock. The client's condition deteriorates rapidly, and endotracheal (ET) intubation and mechanical ventilation are initiated when the high-pressure alarm on the mechanical ventilator sounds, the nurse starts to check for the cause. Which condition triggers the high-pressure alarm?

Kinking of the ventilator tubing

A disconnected ventilator tube

An ET cuff leak

A change in the oxygen concentration without resetting the oxygen level alarm

Conditions that trigger the high-pressure alarm include kinking of the ventilator tubing, bronchospasm or pulmonary embolism, mucus plugging, water in the tube, coughing or biting on the ET tube, and the client’s being out of breathing rhythm with the ventilator. A disconnected ventilator tube or an ET cuff leak would trigger the low-pressure alarm. Changing the oxygen concentration without resetting the oxygen level alarm would trigger the oxygen alarm.

Explanation

Conditions that trigger the high-pressure alarm include kinking of the ventilator tubing, bronchospasm or pulmonary embolism, mucus plugging, water in the tube, coughing or biting on the ET tube, and the client’s being out of breathing rhythm with the ventilator. A disconnected ventilator tube or an ET cuff leak would trigger the low-pressure alarm. Changing the oxygen concentration without resetting the oxygen level alarm would trigger the oxygen alarm.

2. During the Fibrotic Phase of ARDS, ____________________ .

Fluids shift into the alveoli, the alveoli, and bronchial collapse, and they lose lung compliance.

The lung starts to repair itself; this is when the patient starts to get better or the condition deteriorates.

None of these

During the Fibrotic Phase of ARDS, fibrous tissue forms, and the lungs don't expand well. This leads to a decrease in lung compliance, making it difficult for the patient to breathe. As a result, the effort required to breathe increases, leading to an increased demand for oxygen. This vicious cycle further exacerbates the breathing difficulties experienced by the patient.

Explanation

During the Fibrotic Phase of ARDS, fibrous tissue forms, and the lungs don't expand well. This leads to a decrease in lung compliance, making it difficult for the patient to breathe. As a result, the effort required to breathe increases, leading to an increased demand for oxygen. This vicious cycle further exacerbates the breathing difficulties experienced by the patient.

3. A nurse is assessing a female client with multiple trauma who is at risk of developing acute respiratory distress syndrome. The nurse assesses for which earliest sign of acute respiratory distress syndrome?

Bilateral wheezing

Inspiratory crackles

Intercostal retractions

Increased respiratory rate

The earliest detectable sign of acute respiratory distress syndrome is an increased respiratory rate, which can begin from 1 to 96 hours after the initial insult to the body. This is followed by increasing dyspnea, air hunger, retraction of accessory muscles, and cyanosis. Breath sounds may be clear or consist of fine inspiratory crackles or diffuse coarse crackles.

Explanation

The earliest detectable sign of acute respiratory distress syndrome is an increased respiratory rate, which can begin from 1 to 96 hours after the initial insult to the body. This is followed by increasing dyspnea, air hunger, retraction of accessory muscles, and cyanosis. Breath sounds may be clear or consist of fine inspiratory crackles or diffuse coarse crackles.

4. A black male client with asthma seeks emergency care for acute respiratory distress. Because of this client’s dark skin, the nurse should assess for cyanosis by inspecting the:

Lips

Mucous membranes

Nail beds

Earlobes.

Skin color doesn’t affect the mucous membranes. The lips, nail beds, and earlobes are less reliable indicators of cyanosis because they’re affected by skin color.

Explanation

Skin color doesn’t affect the mucous membranes. The lips, nail beds, and earlobes are less reliable indicators of cyanosis because they’re affected by skin color.

5. A nurse is taking pulmonary artery catheter measurements of a male client with acute respiratory distress syndrome. The pulmonary capillary wedge pressure reading is 12mm Hg. The nurse interprets that this reading is:

High and expected

Low and unexpected

Normal and expected

Uncertain and unexpected

The normal pulmonary capillary wedge pressure (PCWP) is 8 to 13 mm Hg, and the patient is considered to have high readings if they exceed 18 to 20 mm Hg. The client with acute respiratory distress syndrome has a normal PCWP, which is an expected finding because the edema is in the interstitium of the lung and is noncardiac.

Explanation

The normal pulmonary capillary wedge pressure (PCWP) is 8 to 13 mm Hg, and the patient is considered to have high readings if they exceed 18 to 20 mm Hg. The client with acute respiratory distress syndrome has a normal PCWP, which is an expected finding because the edema is in the interstitium of the lung and is noncardiac.

6. Which of the following would lead the nurse to suspect that a client with a fracture of the right femur may be developing a fat embolus?

Acute respiratory distress syndrome

Migraine like headaches

Numbness in the right leg

Muscle spasms in the right thigh

The development of acute respiratory distress syndrome (ARDS) in a client with a fracture of the right femur may indicate the presence of a fat embolus. Fat embolism syndrome occurs when fat globules from the broken bone enter the bloodstream and travel to the lungs, causing respiratory distress. This can lead to symptoms such as shortness of breath, rapid breathing, low oxygen levels, and the need for mechanical ventilation. Therefore, the presence of ARDS in this scenario suggests that a fat embolus may be developing.

Explanation

The development of acute respiratory distress syndrome (ARDS) in a client with a fracture of the right femur may indicate the presence of a fat embolus. Fat embolism syndrome occurs when fat globules from the broken bone enter the bloodstream and travel to the lungs, causing respiratory distress. This can lead to symptoms such as shortness of breath, rapid breathing, low oxygen levels, and the need for mechanical ventilation. Therefore, the presence of ARDS in this scenario suggests that a fat embolus may be developing.

7. During the Proliferative Phase of ARDS, ____________________ .

Fluids shift into the alveoli, the alveoli, and bronchial collapse, and they lose lung compliance.

The lung starts to repair itself; this is when the patient starts to get better or the condition deteriorates.

None of these

During the Proliferative Phase of ARDS, the lung starts to repair itself. This phase is crucial as it determines whether the patient will start to get better or if the condition will deteriorate further. The formation of fibrous tissue during this phase leads to decreased lung expansion and increased effort to breathe. This increased demand for oxygen further exacerbates the breathing difficulties. Therefore, the repair process during the Proliferative Phase plays a significant role in the patient's prognosis.

Explanation

During the Proliferative Phase of ARDS, the lung starts to repair itself. This phase is crucial as it determines whether the patient will start to get better or if the condition will deteriorate further. The formation of fibrous tissue during this phase leads to decreased lung expansion and increased effort to breathe. This increased demand for oxygen further exacerbates the breathing difficulties. Therefore, the repair process during the Proliferative Phase plays a significant role in the patient's prognosis.

8. Management of ARDS is usually only supportive. There is little we can do to reverse the process.

True

False

The explanation for the given correct answer is that management of ARDS (Acute Respiratory Distress Syndrome) is primarily focused on providing supportive care. This means that the treatment mainly involves measures such as providing supplemental oxygen, mechanical ventilation, and addressing the underlying cause of ARDS. Unfortunately, there are currently no specific medications or interventions that can completely reverse the process of ARDS. Therefore, the statement that "there is little we can do to reverse the process" is true.

Explanation

The explanation for the given correct answer is that management of ARDS (Acute Respiratory Distress Syndrome) is primarily focused on providing supportive care. This means that the treatment mainly involves measures such as providing supplemental oxygen, mechanical ventilation, and addressing the underlying cause of ARDS. Unfortunately, there are currently no specific medications or interventions that can completely reverse the process of ARDS. Therefore, the statement that "there is little we can do to reverse the process" is true.

9. Acute Respiratory Distress Syndrome (ARDS) can be defined as _____________________________.

Sudden life-threatening deterioration of gas exchange in the lungs

Non-cardiac pulmonary edema with increasing hypoxemia despite treatment with O2

Sudden life-threatening pulmonary edema that causes a deterioration of gas exchange despite treatment with O2

None of these

ARDS is a condition characterized by non-cardiac pulmonary edema, which refers to the accumulation of fluid in the lungs, leading to impaired gas exchange. In ARDS, this pulmonary edema is accompanied by increasing hypoxemia, which is a low level of oxygen in the blood. Despite treatment with oxygen, the patient's condition continues to worsen, indicating a life-threatening deterioration of gas exchange. Therefore, the correct answer is "Non-cardiac pulmonary edema with increasing hypoxemia despite treatment with O2."

Explanation

ARDS is a condition characterized by non-cardiac pulmonary edema, which refers to the accumulation of fluid in the lungs, leading to impaired gas exchange. In ARDS, this pulmonary edema is accompanied by increasing hypoxemia, which is a low level of oxygen in the blood. Despite treatment with oxygen, the patient's condition continues to worsen, indicating a life-threatening deterioration of gas exchange. Therefore, the correct answer is "Non-cardiac pulmonary edema with increasing hypoxemia despite treatment with O2."

10. CHECK ALL THAT APPLY: Which of the following are the 5 characteristics of ARDS?

Dyspnea

Myasthenia Gravis

Refractory hypoxemia

Cyanosis

Dense pulmonary infiltrates on CXR.

Decreased pulmonary compliance

Non-cardiac pulmonary edema

Chest pain

The 5 characteristics of ARDS are dyspnea, refractory hypoxemia, dense pulmonary infiltrates on CXR, decreased pulmonary compliance, and non-cardiac pulmonary edema. These symptoms and findings are commonly seen in patients with ARDS, indicating severe lung injury and respiratory distress. Myasthenia Gravis, cyanosis, and chest pain are not specific to ARDS and are not included in the list of characteristics.

Explanation

The 5 characteristics of ARDS are dyspnea, refractory hypoxemia, dense pulmonary infiltrates on CXR, decreased pulmonary compliance, and non-cardiac pulmonary edema. These symptoms and findings are commonly seen in patients with ARDS, indicating severe lung injury and respiratory distress. Myasthenia Gravis, cyanosis, and chest pain are not specific to ARDS and are not included in the list of characteristics.

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11. CHECK ALL THAT APPLY:

Which of the following are advanced s/sx of ARDS?

Retractions - though not always (tissues between ribs and above sternum pull in)

Dyspneic

Non-productive cough

Accessory muscle used

Pallor or cyanosis

Significant CXR changes; pulmonary infiltrates

Restlessness

CXR clear

Respiratory alkalosis

Respiratory acidosis

The advanced signs and symptoms of ARDS include retraction of tissues between the ribs and above the sternum, the use of accessory muscles for breathing, pallor or cyanosis (bluish discoloration of the skin), significant changes in the chest X-ray showing pulmonary infiltrates, and respiratory acidosis (a decrease in blood pH due to increased carbon dioxide levels). These signs indicate the severity of ARDS and the compromised respiratory function in the patient.

Explanation

The advanced signs and symptoms of ARDS include retraction of tissues between the ribs and above the sternum, the use of accessory muscles for breathing, pallor or cyanosis (bluish discoloration of the skin), significant changes in the chest X-ray showing pulmonary infiltrates, and respiratory acidosis (a decrease in blood pH due to increased carbon dioxide levels). These signs indicate the severity of ARDS and the compromised respiratory function in the patient.

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12. CHECK ALL THAT APPLY: Which of the following are early s/sx of ARDS?

Retractions - not always (tissues between ribs and above sternum pull in)

Dyspneic

Non-productive cough

Accessory muscle used

Pallor or cyanosis

Significant CXR changes; pulmonary infiltrates

Restlessness

CXR clear

Respiratory alkalosis

Respiratory acidosis

The early signs and symptoms of ARDS include dyspnea (difficulty breathing), non-productive cough, restlessness, clear chest X-ray (CXR), and respiratory alkalosis (a decrease in blood carbon dioxide levels). These symptoms may indicate the onset of ARDS before significant changes are seen on a CXR or before respiratory acidosis (an increase in blood carbon dioxide levels) occurs. Retractions, accessory muscle use, pallor or cyanosis, and significant CXR changes are not always present in the early stages of ARDS.

Explanation

The early signs and symptoms of ARDS include dyspnea (difficulty breathing), non-productive cough, restlessness, clear chest X-ray (CXR), and respiratory alkalosis (a decrease in blood carbon dioxide levels). These symptoms may indicate the onset of ARDS before significant changes are seen on a CXR or before respiratory acidosis (an increase in blood carbon dioxide levels) occurs. Retractions, accessory muscle use, pallor or cyanosis, and significant CXR changes are not always present in the early stages of ARDS.

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