Which of the following is a clinical symptom most commonly associated with Acute Respiratory Distress Syndrome (ARDS)?

Hypercapnia with respiratory alkalosis

Pulmonary hypertension

Severe hypoxemia despite supplemental oxygen

Pleural effusion

Answer and Explanation

The Correct Answer is C

Choice A reason: Hypercapnia with respiratory alkalosis is not typical in ARDS. ARDS primarily causes severe hypoxemia due to alveolar damage and impaired gas exchange. Hypercapnia (elevated CO2) may occur in advanced respiratory failure, but respiratory alkalosis is more associated with hyperventilation in early stress responses, not ARDS’s hallmark of refractory hypoxemia.

Choice B reason: Pulmonary hypertension can develop in ARDS due to hypoxic vasoconstriction and vascular remodeling from inflammation, but it is not the primary or most common symptom. ARDS is characterized by diffuse alveolar damage leading to severe hypoxemia, with pulmonary hypertension being a secondary complication rather than the defining clinical feature.

Choice C reason: Severe hypoxemia despite supplemental oxygen is the hallmark of ARDS. It results from alveolar flooding, surfactant loss, and ventilation-perfusion mismatch, impairing oxygen diffusion. Even high-flow oxygen fails to correct low PaO2 due to shunting and non-functional alveoli, making this the most common and critical symptom requiring urgent intervention.

Choice D reason: Pleural effusion is not a primary feature of ARDS. It may occur in conditions like heart failure or infection but is less common in ARDS, which primarily involves alveolar edema and inflammation. The dominant clinical issue in ARDS is severe hypoxemia due to impaired gas exchange, not fluid accumulation in the pleural space.

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Correct Answer is A

Explanation

Choice A reason: Chest tube discomfort can significantly limit deep breathing and ambulation, increasing atelectasis risk. Administering pain medication reduces discomfort, enabling the patient to perform deep breathing exercises and ambulate, which promote lung expansion and prevent complications like pneumonia. Pain control directly enhances compliance with these critical activities.

Choice B reason: Educating the patient about lung expansion’s importance may improve understanding but does not address the physical barrier of pain. Pain limits the ability to perform deep breathing and ambulation, making education alone insufficient. Pain management is needed first to enable compliance with these respiratory and mobility interventions.

Choice C reason: Arranging rest periods supports patient recovery but does not directly address pain, the primary barrier to deep breathing and ambulation. While rest is important, it does not facilitate the active participation required for lung expansion or mobility, which are critical to prevent respiratory complications in chest tube patients.

Choice D reason: Teaching incentive spirometer use promotes lung expansion but is ineffective if pain prevents deep breathing. The chest tube’s discomfort limits the patient’s ability to use the device effectively. Pain management must precede teaching to ensure the patient can perform the necessary respiratory exercises without discomfort hindering compliance.

A. Oxygen saturation of 88% on room air B. Respiratory rate of 26 breaths/min C. Use of accessory muscles to breathe D. Arterial pH of 7.28

Correct Answer is D

Explanation

Choice A reason: Oxygen saturation of 88% in COPD is low but may be baseline for severe disease. It warrants oxygen therapy but is not the most urgent finding. Arterial pH of 7.28 indicates acute respiratory acidosis, a life-threatening complication requiring immediate ventilatory support to correct CO2 retention and acid-base imbalance.

Choice B reason: A respiratory rate of 26 breaths/min indicates tachypnea, common in COPD exacerbation, but is not immediately life-threatening. It reflects respiratory effort to compensate for hypoxia. Arterial pH of 7.28 suggests acute acidosis from CO2 retention, requiring urgent intervention like non-invasive ventilation, making tachypnea a lower priority.

Choice C reason: Accessory muscle use indicates increased work of breathing in COPD exacerbation, signaling distress but not immediate danger. It reflects compensatory efforts for airway obstruction. Arterial pH of 7.28 indicates severe acidosis, a life-threatening condition requiring urgent ventilatory support, making muscle use less critical in this scenario.

Choice D reason: Arterial pH of 7.28 in a COPD exacerbation indicates acute respiratory acidosis due to CO2 retention from hypoventilation. This life-threatening imbalance can lead to coma or cardiac arrest if uncorrected. Immediate intervention, such as non-invasive ventilation, is needed to restore pH and CO2 levels, making this the priority finding.

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Which of the following is a clinical symptom most commonly associated with Acute Respiratory Distress Syndrome (ARDS)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is unable to take a deep breath and does not want to get out of bed due to chest tube discomfort. To increase the client's compliance with ambulation and deep breathing, the nurse should:

Correct Answer is A

Explanation

A client with chronic obstructive pulmonary disease (COPD) is admitted with acute exacerbation and respiratory distress. Which finding requires immediate intervention by the nurse?

Correct Answer is D

Explanation

A client in severe pulmonary edema is being intubated by the resident. What action by the nurse will assist in the confirmation of the endotracheal tube placement in the proper position?

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A nurse is caring for a client with septic shock. The client’s blood pressure is 80/50 mm Hg, and lactate levels are elevated. Which intervention is the nurse’s priority?

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Question 28

The emergency room nurse is assigned the following clients at the beginning of their shift. Which client does the nurse see first?

A client with respiratory failure has a respiratory rate of 6 breaths/min and an oxygen saturation (SpO2) of 88%. The client is increasingly lethargic. Which intervention will the nurse anticipate?

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