Which of the following is NOT a typical characteristic of ARDS?
Rapid onset within 1 week of a known clinical insult
Refractory hypoxemia
Respiratory failure explained by cardiac failure
Decreased lung compliance
The Correct Answer is C
A. Rapid onset within 1 week of a known clinical insult: ARDS typically develops acutely, often within one week of a known event such as sepsis, trauma, or aspiration. The rapid onset reflects the sudden inflammatory injury to the alveolar-capillary membrane, leading to fluid leakage and impaired oxygenation.
B. Refractory hypoxemia: A hallmark of ARDS is severe hypoxemia that does not improve despite high concentrations of supplemental oxygen. This occurs because of shunting and diffusion impairment caused by alveolar collapse and fluid-filled airspaces.
C. Respiratory failure explained by cardiac failure: ARDS is a non-cardiogenic form of pulmonary edema, meaning it is not caused by left ventricular dysfunction or heart failure. If respiratory failure is explained by cardiac causes, it does not meet the diagnostic criteria for ARDS.
D. Decreased lung compliance: In ARDS, inflammatory damage leads to stiff, non-compliant lungs due to alveolar collapse and fibrosis. This decreased compliance makes ventilation difficult and increases the work of breathing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Increased heart rate: Heart rate affects cardiac output but does not directly shift the oxyhemoglobin dissociation curve. It influences oxygen delivery to tissues but is not a cause of right- or leftward shifts in hemoglobin’s oxygen affinity.
B. Decreased 2,3-DPG: Lower levels of 2,3-DPG increase hemoglobin’s affinity for oxygen, causing a left shift on the dissociation curve. This makes oxygen unloading at the tissues more difficult rather than promoting a right shift.
C. Decreased temperature: Lower temperature enhances hemoglobin’s affinity for oxygen, resulting in a leftward shift of the curve. Oxygen is held more tightly by hemoglobin, which is opposite of a right shift.
D. Increased CO2: Elevated CO2 levels reduce hemoglobin’s affinity for oxygen, promoting oxygen release to the tissues. This effect, part of the Bohr effect, causes a rightward shift of the oxyhemoglobin dissociation curve, facilitating tissue oxygenation during conditions like hypercapnia or acidosis.
Correct Answer is A
Explanation
A. Oral care: Regular oral hygiene helps reduce the bacterial load in the mouth and oropharynx, which can prevent aspiration of pathogens into the lungs. This is one of the most effective nursing interventions to reduce the risk of ventilator-associated pneumonia.
B. Ordering antibiotics for the patient: Nurses do not independently order antibiotics, and prophylactic antibiotics are not routinely recommended for VAP prevention. Unnecessary antibiotic use can lead to resistance and other complications.
C. Giving patient cough medications: Suppressing cough in ventilated patients is not recommended, as effective coughing helps clear secretions. Cough medications do not prevent VAP and may interfere with natural airway clearance.
D. Monitoring patient for a fever and letting the healthcare provider know if there is one: While monitoring for infection is important, this is a reactive intervention rather than a preventive measure. Oral care and other hygiene measures directly reduce VAP risk before infection occurs.
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