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30.  A client has been receiving mechanical ventilation for four hours. The patient’s initial arterial blood gas (ABG) results include a pH of 7.51, PaO2 of 82 mm Hg, PaCO2 of 26 mm Hg, and HCO3– of 23 mEq/L (23 mmol/L). As the nurse taking care of him, you recognize that your client will need which of the following interventions?

26.  When a client suffers a pneumothorax, there is danger of a mediastinal shift.  If such a shift occurs, what potential effect should cause the nurse to be concerned? (Select all that apply)

60. The HCP prescribes Dobutamine drip at 7.5 mcg/kg/min for a client with CHF and pulmonary edema. Dobutamine drip is supplied as 250mg in 250ml of D5W%. The client weighs 176 lbs. What is the rate of infusion in mL/hr? 

57.  An ICU nurse is preparing a plan of care for a client who is receiving intravenous fentanyl drip. Which side/adverse effects should the nurse monitor in the client receiving this medication?  Select all that apply.

13. A client is hospitalized with pneumococcal pneumonia. Which drug will the nurse most likely administer?

20. After a tonsillectomy, the nurse reviews the health care provider’s postoperative prescriptions. Which prescriptions should the nurse question? (Select all that apply) 

46.  A nurse is weaning a 68-kg patient who has chronic obstructive pulmonary disease (COPD) is receiving mechanical ventilation. Which client assessment finding indicates that the weaning protocol should be stopped?

The next two questions are in regards to the following scenario  D.V., 42-years-old, has a history of human immunodeficiency virus (HIV) infection with the development of manifes-tations of acquired immunodeficiency syndrome (AIDS) 2 years ago. He has been hospitalized and treated twice for Pneumocystis jiroveci pneumonia and is now admitted to ICU with suspected cryptococcal meningitis. ET intubation with assist-control mechanical ventilation at 12 breaths/min, 15 cm H2O PEEP, and FiO2 of 50% is established. Subjective Data A friend reports that D.V. had 2 generalized tonic-clonic seizures in the 2 hours before admission Objective Data Glasgow Coma Scale (GCS) score: 6 Weight 65.9 kg, height 6 ft 1 in Vital signs: temp 102.2°F (39°C), HR 80 beats/min, RR 26 breaths/min, BP 100/46 mm Hg ABGs: pH 7.26, PaCO2 32 mm Hg, PaO2 65 mm Hg, HCO3 16 mEq/L, SaO2 92% Other laboratory tests: glucose 228 mg/dL (12.6 mmol/L), lactate 3 mEq/L (3 mmol/L), white blood cells (WBCs) 18,500/μL Skin warm and dry Indwelling urinary catheter inserted with 30 mL returned   33. What effects of PEEP would the nurse expect? (Select all that apply)

44.  The nurse finds it necessary to assess for a possible leak in a chest tube system.  When checking, the nurse clamps the chest tube closest to the client’s dressing, the bubbling stops. What is your interpretation of this finding?

54.  A client with a suspected pulmonary embolus is brought to the emergency department.  He complains of shortness of breath and pleuritic chest pain.  Which other clinical findings would support this diagnosis?