Deck 27: Overview of Oxygen and Carbon Dioxide Exchange

Question 1

What intervention is necessary when weaning a child from the ventilator?

A) Light sedation before scheduled extubation
B) No suctioning before scheduled extubation
C) Cool mist begun immediately after extubation
D) Vigorous chest physiotherapy and suctioning performed immediately after extubation

Answer 1

Cool mist begun immediately after extubation

Question 2

Respiratory failure can result from many causes. What condition is a specific primary cause of inefficient gas transfer?

A) Anemia
B) Pneumothorax
C) Cystic fibrosis
D) Laryngospasm

Answer 2

Anemia

Question 3

What is the best explanation for using pulse oximetry on young children to determine oxygen saturation?

A) Pulse oximetry is noninvasive.
B) Pulse oximetry is better than capnography.
C) Pulse oximetry is more accurate than arterial blood gases.
D) Pulse oximetry provides intermittent measurements of oxygen.

Answer 3

Pulse oximetry is noninvasive.

Question 4

How much oxygen is contained in ambient air (room air)?

A) 15%
B) 21%
C) 30%
D) 42%

Question 5

During a respiratory assessment, the nurse notes a sinking in of soft tissues relative to the cartilaginous and bony thorax. What is the term for this finding?

A) Grunting
B) Tachypnea
C) Retractions
D) Nasal flaring

Question 6

What respiratory condition or disease results in both increased compliance and increased resistance?

A) Asthma
B) Atelectasis
C) Surfactant deficiency
D) Bronchopulmonary dysplasia

Question 7

The nurse must suction a 6-month-old infant with a tracheostomy. What intervention should be included?

A) Encourage the child to cough to raise the secretions before suctioning.
B) Perform each pass of the suction catheter for no longer than 5 seconds.
C) Allow the child to rest after every five times the suction catheter is passed.
D) Select a catheter with a diameter three quarters of the diameter of the tracheostomy tube.

Question 8

Cardiopulmonary resuscitation is begun on a toddler. What pulse is usually palpated because it is the most central and accessible?

A) Radial
B) Carotid
C) Femoral
D) Brachial

Question 9

What nursing consideration is most important in the care of a child on a mechanical ventilator?

A) Humidification is not necessary.
B) Respiratory assessment is done by the ventilator.
C) Positioning the child for comfort and optimum ventilation is necessary.
D) Support and reassurance are not as important because the child is unconscious.

Question 10

It is important to make certain that sensory connectors and oximeters are compatible because incompatible wiring can cause which condition?

A) Hyperthermia
B) Electrocution
C) Pressure necrosis
D) Burns under sensors

Question 11

What medication is considered to be the most useful in treating cardiac arrest?

A) Bretylium tosylate (Bretylium)
B) Xylocaine (lidocaine)
C) Adrenaline (epinephrine)
D) Naloxone (Narcan)

Question 12

The continuous administration of mist, or aerosolized water, for the treatment of inflammatory conditions of the airways is a common practice that functions in which manner?

A) Has no proven benefit
B) Decreases the viscosity of mucus
C) Decreases bronchoconstriction
D) Reduces the inflammation of the lower airways

Question 13

When is bronchial (postural) drainage generally performed?

A) Before meals and at bedtime
B) Right before all aerosol therapy
C) Immediately on arising and at bedtime
D) Thirty minutes after meals and at bedtime

Question 14

What test should the nurse do as a precautionary measure before doing an arterial puncture to obtain an arterial blood sample?

A) Allen test
B) Smith test
C) Venipuncture
D) Cold compress

Question 15

What test measures the amount of air inhaled and exhaled during any respiratory cycle?

A) Tidal volume
B) Vital capacity
C) Dynamic compliance
D) Pulmonary resistance

Question 16

Effective cardiopulmonary resuscitation (CPR) on a 5-year-old child should include what technique?

A) Provide one breath to every five chest compressions.
B) Provide two breaths to every 30 chest compressions.
C) Reassess the child every 10 minutes while CPR continues.
D) Evaluate the child after 50 cycles of compression and ventilation.

Question 17

The nurse is caring for a child with a tracheostomy. What clinical manifestation should the nurse recognize as an early sign of impending respiratory distress or failure?

A) Cyanosis
B) Restlessness
C) Audible stridor
D) Crowing respirations

Question 18

The nurse is planning home care for a 2-year-old child with a tracheostomy. What recommendation should be included?

A) Sterile technique is essential in home care of the tracheostomy.
B) Parents are able to change the tracheostomy tube when needed.
C) Play activities must be sedentary such as listening to music and working on puzzles.
D) The child must wear a plastic bib when eating or drinking to prevent aspiration into the stoma.

Question 19

Arterial blood gases have just been drawn on a child. What should the nurse do next?

A) Take the sample to the laboratory immediately.
B) Pack the sample in ice and take it to the laboratory immediately.
C) Place the sample in a brown bag until it can be taken to laboratory.
D) Refrigerate the sample until it can be taken to the laboratory.

Question 20

A 3-year-old child with a tracheostomy will soon be discharged. What recommendation should the nurse share with the family?

A) Tub baths cannot be given.
B) The child cannot be allowed to play outdoors.
C) Avoid exposure to noxious fumes such as paint or varnish.
D) Cover the tracheostomy with a plastic bib when exposed to cold air.

Question 21

The nurse is caring for a 4-year-old child who is receiving 2 L of oxygen per nasal cannula. What disadvantage should the nurse consider when planning care for the child?

A) The child may need to have high humidity administered with the oxygen.
B) The child may not be able to eat and drink comfortably.
C) A nasal cannula may cause an accumulation of moisture on the face.
D) A nasal cannula may cause abdominal distention.

Question 22

A nurse is calculating the correlation of Pao₂ with Sao₂ according to the oxyhemoglobin dissociation curve. What parameter should indicate that the Pao₂ is less than 50 to 60 mm Hg?

A) Coarse lung sounds
B) Temperature of 100° F
C) Respiratory rate of 58
D) Pulse oximetry reading of 90% or less

Question 23

A child is in uncompensated metabolic alkalosis. What should the nurse expect the arterial blood gas to be?

A) HCO₃, 24; pH, 7.35
B) HCO₃, 28; pH, 7.50
C) HCO₃, 20; pH, -7.30
D) HCO₃, 26; pH, 7.40

Question 24

The nurse is evaluating arterial blood gas results. What condition can cause an increase in HCO₃?

A) Renal failure
B) Lactic acidosis
C) Diabetic ketoacidosis
D) Fluid loss from upper gastrointestinal tract

Question 25

A 5-month-old infant is in respiratory distress. What should the nurse expect to find?

A) Nasal flaring
B) Bradycardia
C) Abdominal breathing
D) Capillary refill of 2 seconds

Question 26

A child is in uncompensated respiratory acidosis. What should the nurse expect the arterial blood gas to be?

A) O₂, 95; CO₂, 45; pH, 7.40
B) O₂, 88; CO₂, 55; pH, 7.30
C) O₂, 88; CO₂, 35; pH, 7.28
D) O₂, 92; CO₂, 54; pH, 7.35

Question 27

The nurse is caring for a child in respiratory distress. What is an early but less obvious sign of respiratory failure?

A) Stupor
B) Headache
C) Bradycardia
D) Somnolence

Question 28

The nurse is caring for a child on oxygen being delivered by a nasal cannula. What is the advantage of delivering oxygen in this manner?

A) It can deliver mist if desired.
B) It is less likely to cause abdominal distention.
C) The child is able to eat and talk while getting oxygen.
D) This method can deliver a higher concentration of oxygen.

Question 29

The nurse is analyzing an arterial blood gas of pH, 7.50; PCO₂, 30; and HCO₃, 20. What result should the nurse document for this blood gas?

A) Fully compensated metabolic alkalosis
B) Partially compensated metabolic alkalosis
C) Fully compensated respiratory alkalosis
D) Partially compensated respiratory alkalosis

Question 30

What condition or disease decreases lung compliance? (Select all that apply.)

A) Asthma
B) Atelectasis
C) Pneumothorax
D) Pulmonary edema
E) Lobar emphysema

Question 31

The nurse is analyzing an arterial blood gas of pH, 7.30; PCO₂, 50; and HCO₃, 29. What result should the nurse document for this blood gas?

A) Fully compensated respiratory acidosis
B) Partially compensated respiratory acidosis
C) Fully compensated metabolic acidosis
D) Partially compensated metabolic acidosis

Question 32

A child is in uncompensated metabolic acidosis. What should the nurse expect the arterial blood gas to be?

A) HCO₃, 24; pH, 7.35
B) HCO₃, 28; pH, 7.50
C) HCO₃, 20; pH, 7.30
D) HCO₃, 26; pH, 7.40

Question 33

The nurse is evaluating arterial blood gas results. What condition can cause an increase in PCO₂?

A) Hypoxia
B) Hyperventilation
C) Pulmonary embolism
D) Obstructive lung disease

Question 34

The nurse is reviewing factors that affect lung development. What factor delays surfactant production and maturation of alveolar cells?

A) Thyroxine
B) Prolactin
C) Glucocorticosteroids
D) Excess of endogenous insulin

Question 35

The mother of a toddler yells to the nurse, "Help! He is choking to death on his food!" The nurse determines that lifesaving measures are necessary based on which finding?

A) Gagging
B) Coughing
C) Pulse over 100 beats/min
D) Inability to speak

Question 36

A child is in uncompensated respiratory alkalosis. What should the nurse expect the arterial blood gas to be?

A) CO₂, 30; pH, 7.50
B) CO₂, 55; pH, 7.30
C) CO₂, 35; pH, 7.28
D) CO₂, 54; pH, 7.35

Question 37

The nurse is analyzing an arterial blood gas of pH, 7.50; PCO₂, 50; and HCO₃, 29. What result should the nurse document for this blood gas?

A) Fully compensated metabolic alkalosis
B) Partially compensated metabolic alkalosis
C) Fully compensated respiratory alkalosis
D) Partially compensated respiratory alkalosis

Question 38

The nurse is analyzing an arterial blood gas of pH, 7.29; PCO₂, 30; and HCO₃, 20. What result should the nurse document for this blood gas?

A) Fully compensated respiratory acidosis
B) Partially compensated respiratory acidosis
C) Fully compensated metabolic acidosis
D) Partially compensated metabolic acidosis

Question 39

What conditions can produce hyperventilation? (Select all that apply.)

A) Hysteria
B) Narcotics
C) Atelectasis
D) Salicylate intoxication
E) Mechanical ventilation

Question 40

A series of subdiaphragmatic abdominal thrusts (the Heimlich maneuver) is recommended for airway obstruction in children older than which age?

A) 1 year
B) 4 years
C) 8 years
D) 12 years

Question 41

The nurse is calculating the amount of expected urinary output for a 24-hour period on an intubated young child who weighs 33 lb. The nurse recognizes the formula to be used is 2 ml/kg/hr. What is the expected 24-hour urinary output for this child in milliliters? Record your answer below in a whole number.
_____________

Question 42

The nurse recognizes that oxygen mist tents are rarely used for a child with respiratory distress. What are reasons for not using an oxygen mist tent? (Select all that apply.)

A) Poor access to the child
B) Cool and wet tent environment
C) Oxygen levels fall when tent is entered
D) Child may not tolerate it around the crib/bed
E) Lower oxygen concentrations cannot be achieved

Question 43

The nurse is participating in a code blue on a 12-year-old child in a full respiratory arrest. The child weighs 110 lb. The health care provider has ordered an initial dose of epinephrine hydrochloride (1:10,000) given intravenously. Calculate the correct initial dose of epinephrine in mg. Record your answer using one decimal place.
_____________

Question 44

The nurse is calculating the amount of expected urinary output for a 24-hour period on an intubated young child who weighs 22 lb. The nurse recognizes the formula to be used is 2 ml/kg/hr. What is the expected 24-hour urinary output for this child in milliliters? Record your answer below in a whole number.
_____________

Question 45

The nurse is caring for an intubated child on mechanical ventilation. What interventions should the nurse implement to prevent ventilator-assisted pneumonia (VAP)? (Select all that apply.)

A) Routine oral hygiene
B) Appropriate hand hygiene
C) Limit oropharyngeal suctioning of secretions
D) Elevating the head of the bed 30 to 45 degrees
E) Wearing gloves to handle respiratory secretions