A nurse is collecting data for a client who has acute respiratory distress syndrome (ARDS). Which of the following findings should the nurse expect?
Impaired carbon dioxide elimination due to shunting
Decreased pulmonary arterial pressure due to ventilation-perfusion (V/Q) mismatch
Hypoxemia due to dead space
Decreased pulmonary compliance due to stiffness
The Correct Answer is D
A. ARDS is characterized by severe hypoxemia due to shunting, but it typically impairs oxygenation rather than carbon dioxide elimination. The primary issue is the inability to oxygenate blood, not the elimination of carbon dioxide.
B. In ARDS, pulmonary arterial pressure often increases due to pulmonary hypertension caused by widespread inflammation and hypoxemia, not decreased pressure. V/Q mismatch contributes to hypoxemia but does not directly cause decreased pulmonary arterial pressure.
C. While hypoxemia is a hallmark of ARDS, it is primarily due to shunting (where blood passes through unventilated areas of the lung) rather than dead space, which is more associated with conditions like pulmonary embolism.
D. ARDS involves decreased pulmonary compliance due to the stiffness of the lungs, which results from diffuse alveolar damage and the formation of hyaline membranes. This stiffness makes it difficult for the lungs to expand, leading to reduced oxygenation and severe hypoxemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. The "Choice of Analgesia and Sedation" component of the ABCDEF assessment tool focuses on selecting appropriate pain relief and sedation strategies for the patient but does not directly relate to the weaning process.
B. "Assess, Prevent, and Manage Pain" involves ensuring the patient is comfortable and free from pain, which is important but not specifically related to weaning from the ventilator.
C. "Delirium: Assess, Prevent, and Manage" addresses the cognitive status of the patient, particularly the prevention and management of delirium, which is a critical aspect of care but not directly related to ventilator weaning.
D. "Breathing: Spontaneous Awakening Trials (SAT) and Spontaneous Breathing Trials (SBT)" directly involves the weaning process, as it includes assessing the patient's ability to breathe independently by reducing or removing sedation (SAT) and evaluating their capacity for spontaneous breathing (SBT).
Correct Answer is D
Explanation
A. BNP does not promote the synthesis of angiotensin II; instead, it counteracts the effects of the renin-angiotensin-aldosterone system (RAAS) by reducing fluid retention and blood pressure, which is the opposite of what angiotensin II does.
B. BNP does not increase heart rate or cardiac contractility. Its role is primarily in reducing cardiac workload by lowering blood pressure and decreasing fluid volume.
C. BNP does not increase blood pressure; rather, it acts to decrease it by causing vasodilation and inhibiting the effects of aldosterone, which would otherwise increase blood pressure by promoting sodium and water retention.
D. BNP decreases blood pressure by causing vasodilation and promoting the excretion of sodium and water, which reduces blood volume and, consequently, lowers the blood pressure. This is its primary role in cardiovascular regulation, especially in response to heart failure.
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