Which of the following statements are true regarding the diagnosis of Acute Respiratory Distress Syndrome (ARDS)? Select All that Apply.

Common causes of ARDS include pneumonia and sepsis.

Blood gas analysis is essential to identifying the severity of ARDS.

Clients with ARDS commonly present with a decreased oxygen saturation that improves with supplemental oxygen.

Imaging must indicate bilateral lung infiltrates to support the diagnosis.

Elevated BNP is permissible for an ARDS diagnosis.

Answer and Explanation

Correct Answer : A,B,D

Acute Respiratory Distress Syndrome (ARDS) is a severe inflammatory lung condition characterized by diffuse alveolar damage, increased pulmonary capillary permeability, and non-cardiogenic pulmonary edema. It results in severe hypoxemia that is often refractory to oxygen therapy. Diagnosis is based on clinical presentation, arterial blood gas findings, and characteristic imaging showing bilateral lung involvement. Identifying the underlying cause, such as infection or systemic inflammation, is essential for targeted management.

Rationale:
A. Common causes of ARDS include pneumonia and sepsis, which are among the most frequent triggers of the inflammatory cascade leading to alveolar damage. These conditions cause widespread cytokine release, increasing capillary permeability and resulting in fluid accumulation in the alveoli. Other causes include aspiration, trauma, and pancreatitis.

B. Blood gas analysis is essential to identifying the severity of ARDS because it provides information on oxygenation status and gas exchange efficiency. A hallmark finding is severe hypoxemia with a reduced PaO₂/FiO₂ ratio. ABGs help classify ARDS severity and guide ventilatory management strategies.

C. Clients with ARDS commonly present with decreased oxygen saturation that does NOT significantly improve with supplemental oxygen. This refractory hypoxemia occurs due to intrapulmonary shunting and alveolar collapse. The statement is incorrect because oxygen therapy alone is often insufficient to correct the underlying gas exchange defect.

D. Imaging must indicate bilateral lung infiltrates to support the diagnosis of ARDS. Chest X-rays or CT scans typically show diffuse, bilateral opacities consistent with pulmonary edema not explained by cardiac failure. This radiographic finding is a key diagnostic criterion for ARDS.

E. Elevated BNP is not permissible or diagnostic for ARDS. Brain natriuretic peptide (BNP) is associated with heart failure and helps differentiate cardiogenic pulmonary edema from ARDS. In ARDS, BNP is typically normal or not significantly elevated because the condition is non-cardiogenic in origin.

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Free Nursing Study Resources

Correct Answer is C

Explanation

Bone marrow suppression leads to decreased production of blood components, including red blood cells, white blood cells, and platelets. The specific abnormality depends on the affected cell line. Epoetin alfa is used to stimulate red blood cell production in the bone marrow, particularly in clients with anemia related to chronic kidney disease, chemotherapy, or bone marrow suppression. Therefore, improvement is best reflected by an increase in hemoglobin levels.

Rationale:
A. A WBC count of 4,800 mm³ indicates a normal or near-normal white blood cell level, but it does not reflect the therapeutic effect of epoetin alfa. This medication does not stimulate leukocyte production. WBC changes are more relevant to growth factors like filgrastim, not erythropoiesis-stimulating agents.

B. A WBC count of 500 mm³ indicates severe neutropenia and significant bone marrow suppression. This reflects a high risk for infection and does not demonstrate improvement. It is unrelated to the action of epoetin alfa, which targets red blood cell production.

C. A hemoglobin level of 11.5 g/dL indicates improvement because epoetin alfa stimulates erythropoiesis, increasing red blood cell production. This rise in hemoglobin suggests improved oxygen-carrying capacity and reduced anemia. It reflects the intended therapeutic outcome of the medication.

D. A platelet count of 150,000 mm³ is within normal limits but does not reflect the action of epoetin alfa. Platelet production is regulated by different mechanisms and medications such as thrombopoietin agonists or oprelvekin. Therefore, it is not an appropriate indicator of response to epoetin alfa therapy.

A. Inhibits dopamine receptor activity in the CNS B. Decreases the side effects of levodopa therapy C. Enhances the metabolism of levodopa in peripheral tissues D. Inhibits the enzyme that breaks down levodopa

Correct Answer is D

Explanation

Parkinson’s disease is caused by decreased dopamine activity in the brain, leading to motor symptoms such as tremors, rigidity, and bradykinesia. Treatment commonly includes Entacapone in combination with levodopa to improve dopamine availability. Entacapone works by inhibiting the breakdown of levodopa in the periphery, allowing more of the drug to reach the brain. This enhances and prolongs the therapeutic effect of levodopa, improving motor control.

Rationale:
A. Inhibiting dopamine receptor activity in the CNS is incorrect because entacapone does not block dopamine receptors. Instead, it supports dopamine activity by increasing the amount of levodopa available for conversion into dopamine in the brain. Dopamine receptor blockade would actually worsen Parkinsonian symptoms.

B. Decreasing the side effects of levodopa therapy is not the primary mechanism of entacapone. Although it may allow for lower doses of levodopa and indirectly reduce some side effects such as “wearing off,” its main action is pharmacokinetic enhancement of levodopa availability rather than direct side effect reduction.

C. Enhancing the metabolism of levodopa in peripheral tissues is incorrect because entacapone actually inhibits, rather than enhances, levodopa metabolism. It blocks catechol-O-methyltransferase (COMT), an enzyme responsible for breaking down levodopa in the periphery. This increases the amount of levodopa that can cross the blood-brain barrier.

D. Inhibiting the enzyme that breaks down levodopa is correct because entacapone selectively inhibits peripheral COMT. This prevents the conversion of levodopa into inactive metabolites before it reaches the central nervous system. As a result, more levodopa is available to be converted into dopamine in the brain, improving symptom control in Parkinson’s disease.

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Which of the following statements are true regarding the diagnosis of Acute Respiratory Distress Syndrome (ARDS)? Select All that Apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory values of a client with bone marrow suppression and is receiving epoetin alfa. Which of the following values would indicate an improvement in the client's condition?

Correct Answer is C

Explanation

Which of the following is a primary action of entacapone when used with levodopa for clients with Parkinson's disease?

Correct Answer is D

Explanation

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Which of the following statements are true regarding the diagnosis of Acute Respiratory Distress Syndrome (ARDS)? Select All that Apply.

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