A patient with ARDS is receiving high levels of PEEP. What complication is the nurse most concerned about?

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Question 1 of 5

A patient with ARDS is receiving high levels of PEEP. What complication is the nurse most concerned about?

Correct Answer: B

Rationale: The correct answer is B: Pneumothorax. High levels of PEEP in ARDS can lead to overdistension of alveoli, causing barotrauma and increasing the risk of pneumothorax. Pneumothorax is a serious complication that can lead to respiratory distress and requires immediate intervention. Pulmonary embolism (A) is a concern in ARDS but is not directly related to high PEEP levels. Bronchospasm (C) is not a common complication of high PEEP in ARDS. Pleural effusion (D) is caused by fluid accumulation in the pleural space, which is not directly related to high PEEP levels.

Question 2 of 5

A nurse walks in to a client who is in respiratory distress. The client has tracheal deviation to the right side. The nurse knows to prepare for which of the following emergent procedures?

Correct Answer: B

Rationale: The correct answer is B: Chest tube insertion on the left side. Tracheal deviation to the right side indicates tension pneumothorax, where air accumulates in the pleural space, displacing the mediastinum and trachea. Inserting a chest tube on the left side will decompress the pneumothorax, restoring normal breathing. Option A is incorrect because the chest tube should be inserted on the side opposite the deviation. Option C, intubation, is not the first-line treatment for tension pneumothorax. Option D, tracheostomy, is not indicated in this emergent scenario.

Question 3 of 5

The client is on CPAP for weaning from a mechanical ventilator. Assessment reveals a respiratory rate of 32/min, oxygen saturation of 88 percent, and use of accessory muscles. What should the nurse anticipate will occur?

Correct Answer: C

Rationale: The correct answer is C: The client will be placed back on full ventilatory support. Based on the assessment findings of a respiratory rate of 32/min, oxygen saturation of 88 percent, and use of accessory muscles, the client is showing signs of respiratory distress and not tolerating CPAP. The nurse should anticipate that the client will require full ventilatory support to manage their respiratory status effectively. Increasing FiO2 (choice A) may not be sufficient to address the underlying issue. Weaning should not continue (choice B) as the client is not tolerating CPAP. Extubation (choice D) is not appropriate given the client's current respiratory status.

Question 4 of 5

A nurse is caring for a client who has severe head injuries and is declared brain dead. The transplant coordinator has spoken with the client's family about organ donation. The client's spouse states she is confused and does not know what she should do. Which of the following responses by the nurse is appropriate?

Correct Answer: B

Rationale: The correct answer is B: 'What do you think your spouse would have wanted?' Rationale: 1. This response shows empathy and respect for the spouse's feelings and autonomy. 2. It allows the spouse to reflect on the wishes and values of the brain-dead client. 3. It helps the spouse make a decision based on what the client would have wanted, rather than external pressures. Incorrect choices: A: A shortage of organs is not a valid reason to pressure the spouse into donating organs. C: Bringing up religion may only add unnecessary complexity to an already difficult decision. D: Emphasizing personal feelings may guilt-trip the spouse into making a decision that may not align with the client's wishes.

Question 5 of 5

A volunteer assigned to the pediatric unit reports to the charge nurse for an assignment. Which of the following assignments is unsafe for the volunteer?

Correct Answer: A

Rationale: The correct answer is A. Transporting a school-age client who is in traction to another department is unsafe for a volunteer as it involves moving a patient with a specific medical condition that requires careful handling and knowledge of proper techniques to prevent injury. The volunteer may not be trained in how to safely transport a patient in traction, which could lead to harm for the patient. Choice B is incorrect because playing a computer video game with an adolescent who has sickle cell disease is a safe and appropriate activity for a volunteer to engage in to provide companionship and distraction for the patient. Choice C is incorrect because reading a book to a preschool client who has AIDS is a safe and appropriate activity that can help provide comfort and support to the patient. Choice D is incorrect because rocking an infant who was admitted for croup is a safe and appropriate activity that can help soothe the infant and provide comfort.

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