Respiratory Care Flashcards
7 cards from real MSNCB practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Respiratory Care flashcards as text
A patient with a chest tube for hemothorax drains 250 mL of bright red blood in the first 30 minutes post-insertion. The nurse should:
Answer: Notify the physician immediately and prepare for possible surgical intervention
Drainage of >200 mL/hr of bright red blood from a chest tube indicates active hemorrhage requiring immediate physician notification and potential surgical exploration.
Which position is optimal for a patient with unilateral pneumonia affecting the right lung to improve oxygenation?
Answer: Left lateral decubitus (left side down)
Placing the healthy lung (left) in the dependent position increases perfusion to the better-ventilated lung, optimizing the V/Q ratio and improving oxygenation.
A patient is prescribed theophylline for COPD management. Which serum level indicates toxicity risk?
Answer: 22 mcg/mL
The therapeutic range for theophylline is 5–15 mcg/mL; levels above 20 mcg/mL are associated with toxicity including seizures, dysrhythmias, and nausea.
A nurse notes that a patient's pulse oximetry reads 98% but the patient appears cyanotic and confused. Which condition best explains this discrepancy?
Answer: Carbon monoxide poisoning falsely elevating SpO2
Standard pulse oximetry cannot differentiate carboxyhemoglobin from oxyhemoglobin, so CO poisoning reads falsely normal while the patient is actually hypoxic.
Which finding in a patient with a new pleural effusion most strongly suggests an exudate rather than a transudate?
Answer: Unilateral effusion with elevated LDH and pleural fluid protein >0.5 serum ratio
Exudates meet Light's criteria: pleural fluid protein >0.5 of serum protein and/or pleural LDH >0.6 of serum LDH, indicating inflammation or malignancy.
A patient with acute respiratory distress syndrome (ARDS) is on lung-protective ventilation. Which ventilator settings reflect this strategy?
Answer: Tidal volume 6 mL/kg IBW, plateau pressure <30 cmH2O, PEEP 8–12 cmH2O
ARDSNet lung-protective ventilation uses low tidal volumes (6 mL/kg IBW) with plateau pressure ≤30 cmH2O and higher PEEP to prevent ventilator-induced lung injury.
A nurse is caring for a patient with obstructive sleep apnea (OSA) who was just extubated. Which is the most important nursing intervention in the first two hours post-extubation?
Answer: Apply continuous pulse oximetry and keep CPAP device at bedside
Patients with OSA are at high risk for upper airway obstruction after extubation; continuous SpO2 monitoring and bedside CPAP allow rapid intervention if obstruction occurs.