A patient is having difficulty weaning from mechanical ventilation. Which of the following might be a cause of inability to wean?

Cardiac output of 6 L/min

Hemoglobin of 8 g/dL

Sputum culture and sensitivity are negative

White blood cell count of 8000

Answer and Explanation

The Correct Answer is B

Rationale:
A. Cardiac output of 6 L/min is incorrect because a cardiac output in this range is generally adequate for tissue perfusion. Normal adult cardiac output is roughly 4–8 L/min, so this value alone would not impair the ability to wean from a ventilator.

B. Hemoglobin of 8 g/dL is correct. Low hemoglobin (normal 13.5–17.5 g/dL in males, 12–15.5 g/dL in females) reduces the oxygen-carrying capacity of the blood, meaning tissues—including respiratory muscles—receive less oxygen. This can lead to fatigue of the respiratory muscles and difficulty weaning from mechanical ventilation. Patients with anemia may require transfusion or optimization of oxygen delivery before successful weaning.

C. Sputum culture and sensitivity are negative is incorrect because the absence of infection does not contribute to weaning difficulty. In fact, a negative culture suggests no ongoing pulmonary infection, which would favor weaning.

D. White blood cell count of 8000 is incorrect because this is within the normal range (approximately 4,000–11,000/mm³). A normal WBC count does not indicate infection or inflammation that would interfere with ventilator weaning.

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Correct Answer is A

Explanation

A. Step 1: Identify what the question is asking
The order is for 28 units. The options are asking how many units to administer.

Step 2: Verify the concentration
Supply = 100 units/mL
(This means 1 mL contains 100 units.)

Step 3: Determine the correct amount in units
The prescribed dose is already written in units: 28 units.

Step 4: Match to the options
28 units

Final Answer: A. 28 units

B. This is incorrect

C. This is incorrect

D. This is incorrect

A. A pneumectomy patient that had surgery 2 days ago with vital signs RR 20, B/P 150/82, HR 90, and Temp 99. B. A patient recently diagnosed with Guillain-Barré who had numbness in the upper chest with vital signs RR 12, B/P 100/80, HR 90, and Temp 100. C. An appendectomy patient that is resting quietly with vital signs RR 26, B/P 85/60, HR 112, Temp 101.4. D. A patient with restrictive cardiac myopathy with vital signs RR 24, B/P 100/70, HR 110, and Temp 98.6

Correct Answer is A

Explanation

Rationale:
A. A pneumectomy patient that had surgery 2 days ago with vital signs RR 20, B/P 150/82, HR 90, and Temp 99 is correct. This patient is hemodynamically stable, with normal respiratory rate and heart rate, and a low-grade temperature that is not concerning. They are recovering appropriately postoperatively and do not require the intensive monitoring provided in the ICU, making them appropriate for transfer to the floor.

B. A patient recently diagnosed with Guillain-Barré who had numbness in the upper chest with vital signs RR 12, B/P 100/80, HR 90, and Temp 100 is incorrect. Guillain-Barré patients are at risk for rapid respiratory compromise due to neuromuscular weakness. Numbness in the upper chest may indicate early respiratory involvement, so this patient requires continued ICU-level monitoring.

C. An appendectomy patient that is resting quietly with vital signs RR 26, B/P 85/60, HR 112, Temp 101.4 is incorrect. Despite resting, the patient has signs of instability: hypotension, tachycardia, tachypnea, and fever, which may indicate sepsis or hemorrhage. They require ICU care for close monitoring and intervention.

D. A patient with restrictive cardiac myopathy with vital signs RR 24, B/P 100/70, HR 110, and Temp 98.6 is incorrect. Although not febrile, the patient shows mild tachypnea and tachycardia with borderline hypotension, which could signal heart failure exacerbation. ICU monitoring is appropriate to manage potential rapid deterioration.

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A patient is having difficulty weaning from mechanical ventilation. Which of the following might be a cause of inability to wean?

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