Adult Health 1 - CS4 discussion review

The nurse is planning the care for a client at risk of developing pulmonary embolism. What nursing interventions should be included in the care plan? Select all that apply. A) Applying a sequential compression device B) Encouraging a liberal fluid intake C) Instructing the client to move the legs in a "pumping" exercise D) Using elastic stockings, especially when decreased mobility would promote venous stasis E) Instructing the client to dangle the legs over the side of the bed for 30 minutes, four times a day

A, B, C, D

Which of the following are clinical manifestations associated with obstructive sleep apnea (OSA)? Select all that apply. A) Excessive daytime sleepiness B) Impotence C) Arrhythmias D) Insomnia E) Loud snoring

A, B, C, D, E

Which of the following are risk factors for the development of chronic obstructive pulmonary disease (COPD)? Select all that apply. A) Air pollution B) Occupational dust C) Infection D) Tobacco smoke E) Second-hand smoke

A, B, C, D, E

Late symptoms of laryngeal cancer include which of the following. Select all that apply. A) Dysphagia B) Persistent hoarseness C) Sore throat D) Dyspnea E) Burning in throat

A, B, D

A client presents to the ED experiencing symptoms of COPD exacerbation. The nurse understands that goals of therapy should be achieved to improve the client's condition. Which statements reflect therapy goals? Select all that apply. A) Provide medical support for the current exacerbation. B) Provide long-term support for medical management. C) Teach the client to suspend activity. D) Return the client to their original functioning abilities. E) Treat the underlying cause of the event.

A, B, D, E

A nurse is performing a physical assessment on a client who has a history of a respiratory infection. Which documentation, completed by the nurse, indicates the resolution of the infection? Select all that apply. A) Bronchovesicular sounds heard over the upper lung fields. B) Decreased fremitus when the client speaks "99." C) Dull sounds percussed over the lung tissue. D) Palpable vibrations over the chest wall when the client speaks. E) Lung fields documented as clear in the bases.

A, B, D, E

Late complications of radiation therapy may include which of the following? Select all that apply. A) Fibrosis B) Laryngeal necrosis C) Xerostomia D) Loss of taste E) Edema

A, B, E

A client with COPD has been receiving oxygen therapy for an extended period. What symptoms would be indicators that the client is experiencing oxygen toxicity? Select all that apply. A) Dyspnea B) Mood swings C) Substernal pain D) Fatigue E) Bradycardia

A, C, D

When the nurse is assessing the older adult patient, what gerontologic changes in the respiratory system should the nurse be aware of? (Select all that apply.) A) Decreased presence of mucus B) Increased presence of mucus C) Increased presence of collagen in alveolar walls D) Decreased gag reflex E) Decreased alveolar duct diameter

A, C, D

The nurse is caring for a client who is demonstrating signs of increased respiratory distress related to laryngeal obstruction. The nurse is calling the physician to report on the client's condition. Which of the following will the nurse report? Select all that apply. A) Increased respiratory effort B) Administration of a corticosteroid inhaler for quick relief C) Nasal flaring with abdominal retractions D) A decreased respiratory rate E) Lung sounds of wheezing F) Arterial blood gases reporting a PaCO2 of 48 and a PaO2 of 84

A, C, E, F

The nurse is working on a busy respiratory unit. In caring for a variety of clients, the nurse must be knowledgeable of diagnostic studies. With which diagnostic studies would the nurse screen the client for an allergy to iodine? Select all that apply. A) Lung scan B) Chest x-ray C) Pulmonary angiography D) Pulmonary functions test E) Bronchoscopy F) Fluoroscopy

A, C, F

The nurse is assessing a client for obstructive sleep apnea (OSA). Which are signs and symptoms of OSA? Select all that apply. A) Polycythemia B) Pulmonary hypotension C) Evening headaches D) Loud snoring E) Insomnia

A, D, E

The nurse is educating a patient diagnosed with acute bacterial rhinosinusitis about interventions that may assist with symptom control. What should the nurse include in this information? (Select all that apply.) A) Increase the humidity in the home. B) Take an over-the-counter antihistamine. C) Take an over-the-counter nasal decongestant. D) Apply local heat to promote drainage. E) Ensure an adequate fluid intake.

A, D, E

A client with chronic bronchitis is admitted with an exacerbation of symptoms. During the nursing assessment, the nurse will expect which of the following findings? Select all that apply. A) Purulent sputum with frequent coughing B) Hypoventilation breathing pattern C) Tympany percussed bilaterally over the lung bases D) Respiratory rate of 10 breaths per minute E) Use of accessory muscles to breathe

A, E

n the prevention of occupational lung diseases, the nurse would direct preventive teaching to which high-risk occupations? Select all that apply. A) Stone cutter B) Mechanic C) Nurse D) Banker E) Rock quarry worker F) Miner

A, E, F

A client is being treated in the ED for respiratory distress coupled with bacterial pneumonia. The client has no medical history. However, the client works in a coal mine and smokes 10 cigarettes a day. The nurse anticipates which order based on the client's immediate needs? A) Administration of corticosteroids and bronchodilators B) Administration of antibiotics C) Client education: avoidance of irritants like smoke and pollutants D) Completion of a 12-lead ECG

B - administration of antibiotics

A client who has been diagnosed with an early glottis cancer would likely undergo which type of surgery? A) vocal cord stripping B) laser microsurgery C) partial laryngectomy D) total laryngectomy

B - laser microsurgery

The nurse is planning for the care of a client with acute tracheobronchitis. What nursing interventions should be included in the plan of care? Select all that apply. A) Administering a narcotic analgesic for pain B) Increasing fluid intake to remove secretions C) Using cool-vapor therapy to relieve laryngeal and tracheal irritation D) Giving 3 L fluid per day E) Encouraging the client to rest

B, C, E

Which of the following is a common irritant that acts as a trigger of asthma? A) Molds B) Peanuts C) Esophageal reflux D) Aspirin sensitivity

C - esophageal reflux

The nurse, caring for a patient with emphysema, understands that airflow limitations are not reversible. The end result of deterioration is: A) Diminished alveolar surface area. B) Hypercapnia resulting from decreased carbon dioxide elimination. C) Respiratory acidosis. D) Hypoxemia secondary to impaired oxygen diffusion.

C - respiratory acidosis

Which community-acquired pneumonia demonstrates the highest occurrence during summer and fall? A) Legionnaires disease B) Viral pneumonia C) Streptococcal (pneumococcal) pneumonia D) Mycoplasma pneumonia

A - legionnaires disease

A client has a nursing diagnosis of ineffective airway clearance related to excessive mucus production. The best short-term goal is for the client to A) Report decreased congestion. B) Use a room vaporizer to loosen secretions. C) Increase fluid intake. D) Assume an upright position to facilitate drainage.

A - report decreased congestion

A client had a tracheostomy two hours ago. The nurse assesses the client and finds the client's breathing is shallow, with a respiratory rate of 30. The nurse notes increased mucus production around the tracheostomy and on the dressing. What are the priority nursing concerns? Select all that apply. A) Impaired gas exchange B) Ineffective airway clearance C) Disturbed body image D) Risk for infection E) Knowledge deficit

A, B

The nurse is using an in-line suction kit to suction a patient who is intubated and on a mechanical ventilator. What benefits does inline suction have for the patient? (Select all that apply.) A) Decreases hypoxemia B) Decreases patient anxiety C) Sustains positive end expiratory pressure (PEEP) D) Prevents aspiration E) Increases oxygen consumption

A, B, C

The diagnosis of pulmonary hypertension associated with chronic obstructive pulmonary disease (COPD) is suspected when which of the following is noted? Select all that apply. A) Dyspnea and fatigue disproportionate to pulmonary function abnormalities B) Elevated plasma brain natriuretic peptide (BNP) C) Enlargement of central pulmonary arteries D) Right ventricular enlargement E) Left ventricular hypertrophy

A, B, C, D

The nurse assesses a patient for possible acute pharyngitis. Which of the following clinical manifestations are consistent with this diagnosis? Select all that apply. A) Swollen lymphoid follicles B) A dry, nonproductive cough C) White-purple exudates on the back of the throat D) A temperature >100.4°F E) Red pharyngeal membranes

A, C, D, E

A 13-year-old soccer player presents to the emergency room with a fractured nose. The patient's mother is given which of the following post-discharge instructions? Select all that apply. A) Restrict from sports activities for 6 weeks. B) Keep the nasal packing in place for 72 hours to help reshape the form of the nose. C) Observe for any clear drainage from either nostril. D) Elevate the head of the bed for sleeping during the first week. E) Apply ice or cold compresses for 20 minutes every hour for the first 24 hours. F) Check for any unusual changes in breathing during the first 48 hours.

A, C, D, F

A nurse is assessing a client who is suspected of having bronchiectasis. The nurse should consider which of the following potential causes? Select all that apply. A) Pulmonary infections B) Pulmonary hypertension C) Airway obstruction D) Atelectasis E) Genetic disorders

A, C, E

The nurse is caring for a client with hypoxemia of unknown cause. Which of the following oxygen transport considerations does the nurse identify as crucial to circulate oxygen in the body system? Select all that apply. A) Oxygen is dissolved. B) High blood pressure disrupts oxygen transport. C) All systemic oxygen is available for diffusion. D) Adequate red blood cells are needed for oxygen transport. E) Oxyhemoglobin circulates to the body tissue.

A, D, E

The nurse is caring for a client who is scheduled for a bronchoscopy. The nurse understands that it is important to provide the required information and appropriate explanations for any diagnostic procedure to a client with a respiratory disorder in a way that A) ensures adequate rest periods. B) manages decreased energy levels. C) manages respiratory distress. D) aid the client's caregivers.

B - manages decreased energy levels

A health care provider orders a beta-2 adrenergic agonist agent (bronchodilator) that is long-acting and administered only by inhaler. What medication does the nurse anticipate will be administered? A) Terbutaline B) Salmeterol C) Foradil D) Isuprel

B - salmeterol

The nurse is caring for a client who has just returned to the unit after a colon resection. The client is showing signs of hypoxia. The nurse knows that this is probably caused by what? A) Nitrogen narcosis B) Shunting C) Impaired diffusion D) Infection

B - shunting

Which ventilation-perfusion ratio is exhibited by acute respiratory distress syndrome (ARDS)? A) low ventilation-perfusion ratio B) silent unit C) normal ratio of perfusion to ventilation D) dead space

B - silent unit

For which reason does gas exchange decrease in older adults? A) the alveolar walls become thicker B) the alveolar walls contain fewer capillaries C) the number of alveoli decrease with age D) the elasticity of the lungs increase with age

B - the alveolar walls contain fewer capillaries

A mechanically ventilated client is receiving a combination of atracurium and the opioid analgesic morphine. The nurse monitors the client for which potential complication? A) Pulmonary hypertension B) Venous thromboemboli C) Cor pulmonale D) Pneumothorax

B - venous thromboemboli

Bacterial infection occurs in about 70% of those who have acute rhinosinusitis. The nurse is aware that the least common bacteria is: A) Streptococcus pneumonia B) Hemophilus influenza C) Staphylococcus aureus D) Moraxella catarrhalis

C - Staphylococcus aureus

A client with emphysema informs the nurse, "The surgeon will be removing about 30% of my lung so that I will not be so short of breath and will have an improved quality of life." What surgery does the nurse understand the surgeon will perform? A) A wedge resection B) Lobectomy C) A lung volume reduction D) A sleeve resection

C - a lung volume reduction

A client recently diagnosed with laryngeal cancer and awaiting a laryngectomy was encouraged to attend a support group prior to surgery. The client asked the nurse about the name of the laryngeal speech method where the client speaks with the assistance of a surgically implanted device. The nurse is correct to provide teaching on which method? A) An electronic voice box B) An artificial larynx C) A tracheoesophageal puncture D) Esophageal speech

C - a tracheoesophageal puncture

Why is it important for a nurse to provide required information and appropriate explanations of diagnostic procedures to patients with respiratory disorders? A) Manage respiratory distress B) Ensure adequate rest periods C) Manage decreased energy levels D) Aid the caregivers of the client

C - manage decreased energy levels

A young adult client has had a tonsillectomy and is in the immediate postoperative period. To make the client comfortable, the nurse intervenes by A) Removing the oral airway before the gag reflex has returned for client comfort B) Sitting the client in the semi-Fowler's position C) Placing the client prone with the head turned to the side D) Maintaining a warm compress around the client's neck area

C - placing the client prone with the head turned to the side

Which action by the nurse is most appropriate when the client demonstrates subcutaneous emphysema along the suture line or chest dressing 2 hours after chest surgery? A) Apply a compression dressing to the area B) Report the finding to the physician immediately C) Record the observation D) Measure the patient's pulse oximetry

C - record the observation

Which of the following ventilation-perfusion mismatch would correlate with acute respiratory distress syndrome (ARDS)? A) Shunt B) Dead space C) Silent unit D) Normal

C - silent unit

An x-ray of a trauma client reveals rib fractures and the client is diagnosed with a small flail chest injury. Which intervention should the nurse include in the client's plan of care? A) Immobilize the ribs with an abdominal binder. B) Prepare the client for surgery. C) Suction the client's airway secretions. D) Immediately sedate and intubate the client.

C - suction the client's airway secretions

A patient's lung volumes and capacities were assessed to help determine the cause of a respiratory problem. Which of the following findings are indicative of chronic obstructive pulmonary disease (COPD)? A) Expiratory reserve volume of 1,100 mL B) Residual volume of 1,200 mL C) Vital capacity of 3,000 mL D) Functional residual capacity of 2,300 mL

C - vital capacity of 3,000 mL

A client who has recently started working in a coal mine is concerned the effects on long-term health. How does the nurse advise the client to prevent occupational lung disease? Select all that apply. A) Schedule an annual lung x-ray to monitor health. B) Try to find another occupation as soon as possible. C) Do not smoke, or quit smoking if currently smoking. D) Wear appropriate protective equipment when around airborne irritants and dusts.

C, D

A nurse is caring for an older adult with pneumonia. What are age-related structural & functional changes that occur in the respiratory system? Select all that apply. A) increased thickness of alveolar sacs B) decreased dead space C) increased diameter of alveolar ducts D) increased residual volume E) decreased pulmonary compliance F) decreased elasticity of the alveolar sacs

C, D, E, F

A nurse is caring for a client with COPD. The client's medication regimen has been recently changed and the nurse is assessing for therapeutic effect of a new bronchodilator. Therapeutic effects of this medication would include which of the following? Select all that apply. A) Negative sputum culture B) Increased respiratory rate C) Relief of dyspnea D) Increased viscosity of lung secretions E) Increased expiratory flow rate

C, E

A nurse recognizes that a client with tuberculosis needs further teaching when the client states: A) "I'll need to have scheduled laboratory tests while I'm on the medication." B) "It won't be necessary for the people I work with to take medication." C) "I'll have to take these medications for 9 to 12 months." D) "The people I have contact with at work should be checked regularly."

D - "The people I have contact with at work should be checked regularly."

A client's spouse states that she is worried about her husband because he appears to be breathing "really hard." The nurse performs a respiratory assessment. What findings would indicate a need for further interventions? A) BP 122/80, HR 116, R 24, pale and clammy skin, temp 101.3 °F (38.5 °C) B) Client states, "It always seems like I just can't catch my breath." C) Pale, paper-thin skin, O2 at 2L/min via nasal cannula D) BP 122/82, HR 102, R 24, noted barrel chest, temperature 98.4 °F (36.9 °C)

D - BP 122/82, HR 102, R 24, noted barrel chest, temperature 98.4 °F (36.9 °C)

The nurse should monitor a client receiving mechanical ventilation for which of the following complications? A) Immunosuppression B) Increased cardiac output C) Pulmonary emboli D) Gastrointestinal hemorrhage

D - GI hemorrhage

Perfusion refers to blood supply to the lungs, through which the lungs receive nutrients and oxygen. What are the two methods of perfusion? A) The two methods of perfusion are the bronchial and capillary circulation. B) The two methods of perfusion are the bronchial and alveolar circulation. C) The two methods of perfusion are the alveolar and pulmonary circulation. D) The two methods of perfusion are the bronchial and pulmonary circulation.

D - The two methods of perfusion are the bronchial and pulmonary circulation.

Which type of lung cancer is the most prevalent among both men and women? A) Small cell carcinoma B) Large cell carcinoma C) Squamous cell carcinoma D) Adenocarcinoma

D - adenocarcinoma

Understanding pulmonary physiology, what characteristic would the nurse expect to result in decreased gas exchange in older adults? A) Increased pulmonary elasticity B) thickening alveolar walls C) Reduced numbers of alveoli D) alveolar walls containing fewer capillaries

D - alveolar walls containing fewer capillaries

A thoracentesis is performed to obtain a sample of pleural fluid or a biopsy specimen from the pleural wall for diagnostic purposes. What does serous fluid indicate? A) Infection B) Trauma C) Emphysema D) Cancer

D - cancer

The nurse is caring for a client following a tonsillectomy and adenoidectomy. Two hours after the procedure, the client begins to vomit large amounts of dark blood at frequent intervals and is tachycardic and febrile. After notifying the surgeon, the nurse A) stays with and closely monitors the client. B) prepares for a needle aspiration. C) orally suctions the client, as needed. D) obtains a light, mirror, gauze, and curved hemostats.

D - obtains a light, mirror, gauze, and curved hemostats

A patient with emphysema is placed on continuous oxygen at 2 L/min at home. Why is it important for the nurse to educate the patient and family that they must have No Smoking signs placed on the doors? A) Oxygen prevents the dispersion of smoke particles. B) Oxygen is explosive. C) Oxygen is combustible. D) Oxygen supports combustion.

D - oxygen supports combusion

client suspected of developing acute respiratory distress syndrome (ARDS) is experiencing anxiety and agitation due to increasing hypoxemia and dyspnea. Which intervention may improve oxygenation and provide comfort for the client? A) Administer small doses of pancuronium B) Force fluids for the next 24 hours C) Assist the client into a chair D) Position the client in the prone position

D - position the client in the prone position

A thoracentesis is performed to obtain a sample of pleural fluid or a biopsy specimen from the pleural wall for diagnostic purposes. What does bloody fluid results indicate? A) Malignancy B) Infection C) Emphysema D) Trauma

D - trauma

A young male client has muscular dystrophy. His PaO2 is 42 mm Hg with a FiO2 of 80%. Which of the following treatments would be least invasive and most appropriate for this client? A) Negative-pressure ventilator B) Positive-pressure ventilator C) Bilevel positive airway pressure (Bi-PAP) D) Continuous positive airway pressure (CPAP)

A - Negative-pressure ventilator

A patient is brought into the emergency department with carbon monoxide poisoning after escaping a house fire. What should the nurse monitor this patient for? A) anemic hypoxia B) hypoxic hypoxia C) histotoxic hypoxia D) stagnant hypoxia

A - anemic hypoxia

The nurse is caring for a client who has recurrent sinusitis. Which consideration could the nurse suggest to best decrease the frequency of infections? A) Use an anti-allergy medication to decrease rhinitis. B) Administer an over-the-counter decongestant. C) Gently blow the nose to eliminate nasal secretions. D) Place a warm cloth over the sinus area of the forehead.

B - administer an OTC decongestant

t is important for the nurse to provide required information and appropriate explanations of diagnostic procedures to clients with respiratory disorders in order to A) aid the client's caregivers. B) manage decreased energy levels. C) ensure adequate rest periods. D) manage respiratory distress.

B - manage decreased energy levels

hat is the most commonly prescribed treatment for the common cold? A) Antitussives B) Expectorants C) Decongestants D) Antihistamines

D - antihistamines