A patient has been hospitalized in the ICU for a near drowning event. The patient's respiratory function has been deteriorating over the last 24 hours. The physician suspects acute respiratory distress syndrome. A STAT chest x-ray is ordered. What finding on the chest x-ray is indicative of ARDS?

localized infiltrate

enlargement of the heart

white-out infiltrates bilaterally

hyperinflation of lungs

Answer and Explanation

The Correct Answer is C

A. Localized infiltrates indicate a focal process, such as bacterial pneumonia or aspiration in a single lobe. ARDS affects the lungs diffusely, so a localized pattern would not support the diagnosis.

B. Cardiomegaly is associated with cardiogenic pulmonary edema, where heart failure causes fluid accumulation in the lungs. In ARDS, the pulmonary edema is non-cardiogenic, and the heart size is typically normal.

C. In ARDS, the alveoli fill with fluid, protein, and inflammatory cells, causing widespread opacification on chest x-ray. This appears as bilateral, patchy, or confluent “white-out” infiltrates, indicating severe alveolar involvement and impaired oxygenation. These findings correlate with the patient’s rapidly worsening hypoxemia and respiratory distress.

D. Hyperinflation is characteristic of obstructive airway diseases like COPD or asthma, where air is trapped in the lungs. In ARDS, the lungs are stiff and noncompliant, so hyperinflation does not occur.

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Correct Answer is A

Explanation

A. Norepinephrine is a potent vasoconstrictor, and if it infiltrates peripheral tissue, it can cause severe tissue necrosis and extravasation injury. Administering it through a central venous catheteris the highest priority safety measurewhen initiating the infusion to prevent serious complications.

B. Continuous cardiac monitoring is importantbecause norepinephrine can cause tachycardia, arrhythmias, and increased myocardial oxygen demand, but the risk of tissue injury from peripheral administration is more immediately critical.

C. Assessing baseline blood glucose is not a priorityfor norepinephrine administration. Blood glucose monitoring may be relevant in critical care, but it does not directly prevent complications from norepinephrine infusion.

D. Documenting the client’s level of consciousness is important for ongoing assessment of perfusion and neurological status, but it is not the highest-priority actionat the time of initiating a vasopressor infusion.

A. Snakebite B. Heat exhaustion. C. Altitude sickness D. Brown recluse spider bite

Correct Answer is A

Explanation

A. The client’s swollen, red, painful foot, hypotension (90/60), and vomitingare classic signs of a venomous snakebite, which can cause systemic toxicity, hypotension, coagulopathy, and tissue necrosis. Snakebite is a life-threatening emergencythat requires immediate assessment, stabilization, and possible administration of antivenom, making it the priority condition.

B. Heat exhaustionpresents with weakness, nausea, headache, and mild hypotension, but the localized swelling and redness in the leg are not consistent with heat exhaustion.

C. Altitude sicknesstypically develops at higher elevations and manifests as headache, nausea, dizziness, and fatigue, not a localized extremity injury with hypotension.

D. Brown recluse spider bitescan cause localized pain, redness, and necrosis, but systemic symptoms such as hypotension and vomitingare less common, making snakebite the higher-priority assessment.

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A patient has been hospitalized in the ICU for a near drowning event. The patient's respiratory function has been deteriorating over the last 24 hours. The physician suspects acute respiratory distress syndrome. A STAT chest x-ray is ordered. What finding on the chest x-ray is indicative of ARDS?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

The nurse is caring for a client who was camping overnight. The client is vomiting and has severe pain in the left foot Blood pressure is 90/60, and the left lower leg is swollen and red. For which condition will the nurse assess as the priority?

Correct Answer is A

Explanation

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