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?

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   34. What nursing interventions specific to ET intubation and mechanical ventilation would the nurse include in D.V.’s plan of care? (Select all that apply)

39.   The nurse is the preceptor for an RN who is undergoing orientation to the intensive care unit. The RN is providing care for a patient with acute respiratory distress syndrome who has just been intubated in preparation for mechanical ventilation. The preceptor observes the RN performing all of these actions. For which action must the preceptor intervene immediately?

19. A 1-year-old child is admitted to the pediatric unit with a diagnosis of pertussis. Which type of transmission-based precautions should the nurse institute?  

56.  The client has a small pneumothorax.  The nurse should anticipate which intervention to decrease the risk of the client from developing additional complications?

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

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)

27. Which assessment finding is the most critical and needs to be addressed first?

14. Several hours after admission of a child to the pediatric unit with laryngotracheobronchitis (viral croup), the nurse determines that tachypnea and tachycardia, accompanied by intercostal and substernal retractions and increased restlessness, have developed. What is the priority nursing action?

12. A 13-year-old child is hospitalized with an exacerbation of chronic bronchitis. What action should a nurse take to decrease retained secretions?