A nurse is collecting data for a client who has acute respiratory distress syndrome (ARDS). Which of the following findings should the nurse expect?

Impaired carbon dioxide elimination due to shunting

Decreased pulmonary arterial pressure due to ventilation-perfusion (V/Q) mismatch

Hypoxemia due to dead space

Decreased pulmonary compliance due to stiffness

Answer and Explanation

The Correct Answer is D

A. ARDS is characterized by severe hypoxemia due to shunting, but it typically impairs oxygenation rather than carbon dioxide elimination. The primary issue is the inability to oxygenate blood, not the elimination of carbon dioxide.
B. In ARDS, pulmonary arterial pressure often increases due to pulmonary hypertension caused by widespread inflammation and hypoxemia, not decreased pressure. V/Q mismatch contributes to hypoxemia but does not directly cause decreased pulmonary arterial pressure.
C. While hypoxemia is a hallmark of ARDS, it is primarily due to shunting (where blood passes through unventilated areas of the lung) rather than dead space, which is more associated with conditions like pulmonary embolism.
D. ARDS involves decreased pulmonary compliance due to the stiffness of the lungs, which results from diffuse alveolar damage and the formation of hyaline membranes. This stiffness makes it difficult for the lungs to expand, leading to reduced oxygenation and severe hypoxemia.

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Correct Answer is D

Explanation

A. "No, you should wait for lab confirmation because taking antivirals for a nonviral infection can increase side effects.": While unnecessary use of antivirals can lead to side effects, prompt treatment in high-risk individuals (such as those with asthma) is crucial to mitigate complications, making this response less appropriate.

B. "No, you should wait for lab confirmation before beginning antiviral treatment, to prevent resistant viruses.": Delaying treatment in high-risk populations is not recommended as antivirals are most effective early in the course of the illness. This statement does not consider the urgency of treating influenza in vulnerable clients.

C. "Yes, antiviral treatment will ensure that you are less contagious and do not spread influenza to others.": While antivirals can reduce viral shedding, this response overlooks the critical importance of early treatment in reducing the severity of the illness and preventing complications.

D. "Yes, antiviral treatments are most effective when they are started within 48 hours of symptom onset.": Antivirals are most effective when initiated within 48 hours of the onset of influenza symptoms, especially in individuals with underlying conditions like asthma. Starting treatment early can reduce the severity and duration of symptoms, making this the most appropriate response.

A. Apply positive pressure ventilation and provide supportive care with pain management. B. Perform needle decompression of the pleural space followed by chest tube insertion. C. Administer intravenous antibiotics and arrange for an elective surgical repair. D. Provide high-flow oxygen and intubate the patient for mechanical ventilation.

Correct Answer is B

Explanation

A. Apply positive pressure ventilation and provide supportive care with pain management: While supportive care is important, positive pressure ventilation may not be sufficient to address the underlying issue, which is likely a pneumothorax or hemothorax.
B. Perform needle decompression of the pleural space followed by chest tube insertion: This is the most appropriate initial management for a patient with paradoxical chest wall movement, which is a sign of flail chest and likely pneumothorax. Needle decompression can relieve pressure in the pleural space, and chest tube insertion can help drain any fluid or air that has accumulated.
C. Administer intravenous antibiotics and arrange for an elective surgical repair: While infection may be a concern, it is not the most immediate priority in this case. The patient's respiratory distress needs to be addressed first.
D. Provide high-flow oxygen and intubate the patient for mechanical ventilation: While oxygen therapy may be necessary, intubation should be considered as a last resort if other measures fail to improve oxygenation. In this case, needle decompression and chest tube insertion are more likely to be effective in improving respiratory function.

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A nurse is collecting data for a client who has acute respiratory distress syndrome (ARDS). Which of the following findings should the nurse expect?

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

Exhibits What is the most appropriate initial management for this patient?

Correct Answer is B

Explanation

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