303 Respiratory Exam- ATI and PREPU

Which statement indicates a client understands teaching about the purified protein derivative (PPD) test for tuberculosis?

"Because I had a previous reaction to the test, this time I need to get a chest X-ray."

You are caring for a client admitted with chronic bronchitis. The client is having difficulty breathing, and the family asks you what causes this difficulty. What would be your best response?

"Conditions such as chronic bronchitis cause thickening of the bronchial mucosa so it makes it harder to breathe."

A physician orders metaproterenol by metered-dose inhalation four times daily for a client with acute bronchitis. Which statement by the client indicates effective teaching about this medication?

"I need to hold my breath as long as possible after I take a deep inhalation."

What should the nurse do when assisting with a thoracentesis?

-wear goggles and a mask -apply pressure to the site after the procedure -cleanse the procedure area with an antiseptic

A 73-year-old client is admitted to the pulmonology unit of the hospital. She was admitted with pleural effusion and was "tapped" to drain the fluid to reduce her mediastinal pressure. How much fluid is typically present between the pleurae, which surround the lungs, to prevent friction rub?

20 mL or less

Which statement describes emphysema?

A disease of the airways characterized by destruction of the walls of overdistended alveoli

A nurse is planning care for a patient with asthma? What medication should be given for an acute asthma attack?

Albuterol

A nurse is caring for a client with status asthmaticus. Which medication should the nurse prepare to administer?

An inhaled beta2-adrenergic agonist

A client is being admitted to the medical-surgical unit for the treatment of an exacerbation of acute asthma. Which medication is contraindicated in the treatment of asthma exacerbations?

Cromolyn sodium

Which interventions does a nurse implement for clients with empyema?

Encourage breathing exercises

The nurse has instructed the client to use a peak flow meter. The nurse evaluates client learning as satisfactory when the client

Exhales hard and fast with a single blow

How should a client be positioned when diagnosed with emphysema?

High fowlers with arms over the bedside table -want to provide maximum expansion of lungs

Asthma is cause by which type of response?

IgE-mediated

A client who underwent surgery 12 hours ago has difficulty breathing. He has petechiae over his chest and complains of acute chest pain. What action should the nurse take first?

Initiate oxygen therapy

The ICU nurse is caring for a client who was admitted with a diagnosis of smoke inhalation. The nurse knows that this client is at increased risk for which of the following?

acute respiratory distress syndrome

What is a nurses priority when caring for a client with a pulmonary embolism

administer heparin via continuous IV infusion

What assessment method would the nurse use to determine the areas of the lungs that need draining?

auscultation

What is a manifestation of lung cancer?

blood tinged sputum

The nurse is assessing the lungs of a patient diagnosed with pulmonary edema. Which of the following would be expected upon auscultation?

crackles at lung bases

The nurse is auscultating the patient's lung sounds to determine the presence of pulmonary edema. What adventitious lung sounds are significant for pulmonary edema?

crackles in lung bases

Which intervention regarding nutrition is implemented for clients who have undergone laryngectomy?

enteral feedings

The nurse knows the mortality rate is high in lung cancer clients due to which factor?

few early symptoms

What should the nurse report as a priority finding for COPD?

green sputum

What is a manifestation of acute respiratory distress syndrome?

intercostal retractions

A client has a history of chronic obstructive pulmonary disease (COPD). Following a coughing episode, the client reports sudden and unrelieved shortness of breath. Which of the following is the most important for the nurse to assess?

lung sounds

A nurse reading a chart notes that the client had a Mantoux skin test result with no induration and a 1-mm area of ecchymosis. How does the nurse interpret this result?

negative

What type of airflow should be in the room of a patient with tuberculosis?

negative airflow pressure

What type of oxygen equipment has the highest flow of O2?

nonrebreather mask

Influenza, an annual epidemic in the U.S., creates a significant increase in hospitalizations and an rise in the death rates from pneumonia and cardiovascular disease. Besides death, what is the most serious complication of influenza?

staphylococcal pneumonia

When the nurse gives a client and family instructions after laryngeal surgery, which does the nurse indicate should be avoided?

swimming

What finding indicates that the client is possibly experiencing a tension pneumothorax?

tracheal deviation to the unaffected side

Which diagnostic test is most accurate in assessing acute airway obstruction?

Pulmonary function studies

The nurse is caring for a patient with status asthmaticus in the intensive care unit (ICU). What does the nurse anticipate observing for the blood gas results related to hyperventilation for this patient?

Respiratory alkalosis

What type of diet should someone with COPD have?

high in calories and protein

A nurse is receivng prescriptions for clients for nasopharyngeal suctioning. What client should the nurse clarify with the doctor?

patient with epistaxis -suctioning may cause increased bleeding

A nurse is caring for a client 1 hr post op for a thoracentesis? What is the priority assessment?

persistent cough -can indicate a tension pneumothorax

A physician stated to the nurse that the client has fluid in the pleural space and will need a thoracentesis. The nurse expects the physician to document this fluid as

pleural effusion -build up of excess fluid between the layers of the pleura outside the lungs

A son brings his father into the clinic, stating that his father's color has changed to bluish around the mouth. The father is confused, with a respiratory rate of 28 breaths per minute and scattered crackles throughout. The son states this condition just occurred within the last hour. Which of the following factors indicates that the client's condition has lasted for more than 1 hour?

cyanosis -cyanosis is a late stage of hypoxia