CMSRN Respiratory and Pulmonary Care 2

Question 1

A patient on mechanical ventilation develops high peak airway pressures. What is the priority nursing assessment?

Accepted Answer

Assess for kinking of the ventilator tubing or ET tube

Answer

High peak airway pressures often result from obstruction such as kinked tubing, secretions, or biting of the ET tube, which must be assessed immediately.

Question 2

Which position is best for a spontaneously breathing patient with unilateral pneumonia to improve oxygenation?

Accepted Answer

Good lung down (unaffected side dependent)

Answer

Positioning the good (unaffected) lung down uses gravity to improve perfusion to the better-ventilated lung, optimizing V/Q matching.

Question 3

A patient with asthma is experiencing an acute exacerbation. What is the first-line medication the nurse should administer?

Accepted Answer

Short-acting beta-2 agonist (SABA)

Answer

Short-acting beta-2 agonists (e.g., albuterol) are the first-line treatment for acute asthma exacerbations due to their rapid bronchodilating effect.

Question 4

The nurse is caring for a patient with a pleural effusion. Which intervention would the nurse anticipate assisting with to relieve symptoms?

Accepted Answer

Thoracentesis to drain fluid

Answer

Thoracentesis is performed to drain fluid from the pleural space, relieving dyspnea and allowing lung re-expansion.

Question 5

A patient with pulmonary embolism (PE) is being treated with heparin infusion. Which lab value requires immediate dose adjustment?

Accepted Answer

aPTT of 120 seconds (therapeutic range 60–100 seconds)

Answer

An aPTT above the therapeutic range indicates excessive anticoagulation with heparin, requiring dose reduction to prevent hemorrhagic complications.

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN Respiratory and Pulmonary Care 2