Chapter 20 Assessment of Respiratory Function Review Book Exam 2

The nurse is educating a patient who is scheduled for a perfusion lung scan. What should be included in the information about the procedure? (Select all that apply.)

- A mask will be placed over the nose and mouth during the test - The patient will be expected to lie under the camera - The imaging time will amount to 20 to 40 minutes

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.)

- Decreased gag reflex - Increased presence of collagen in alveolar walls - Decreased presence of mucus

The nurse is instructing the patient on the collection of a sputum specimen. What should be included in the instructions? (Select all that apply.)

- Initially, clear the nose and throat - Take a few deep breaths before coughing - Use diaphragmatic contractions to aid in the expulsion of sputum

The nurse is taking a respiratory history for a patient who has come into the clinic with a chronic cough. What information should the nurse obtain from this patient? (Select all that apply.)

-Previous history of lung disease in the patient or family -Occupational and environmental influences -Previous history of smoking

The alveoli begin to lose elasticity at about age __________, resulting in decreased gas diffusion.

50 years

A nurse understands that a safe but low level of oxygen saturation provides for adequate tissue saturation while allowing no reserve for situations that threaten ventilation. What is a safe but low oxygen saturation level for a patient?

95 mmHg

The nurse is performing an assessment of a patient who arrived in the emergency department with a barbiturate overdose. The respirations are normal for 3 to 4 breaths followed by a 60-second period of apnea. How does the nurse document the respirations?

Biot respirations

What is the purpose of cilia?

Cilia move the mucus back to the larynx.

What finding by the nurse may indicate that the patient has chronic hypoxia?

Clubbing of the fingers

The nurse auscultates crackles in a patient with a respiratory disorder. What condition does the nurse recognize that these symptoms are indicative of?

Collapsed alveoli

The nurse is caring for a patient with a pulmonary disorder. What observation by the nurse is indicative of a very late symptom of hypoxia?

Cyanosis

When observing the chest wall of a patient, the nurse detects a depression in the lower portion of the sternum. What assessment finding will the nurse anticipate detecting due to this condition?

Cyanosis

A patient with sinus congestion reports discomfort when the nurse is palpating the supraorbital ridges. The nurse is aware that the patient is referring to which sinus?

Frontal

The nurse is performing an assessment for a patient with congestive heart failure. The nurse asks if the patient has difficulty breathing in any position other than upright. What is the nurse referring to?

Orthopnea

A patient comes to the emergency department reporting a knifelike pain when taking a deep breath. What does this type of pain likely indicate to the nurse?

Pleurisy

The nurse is reviewing the blood gas results for a patient with pneumonia. What arterial blood gas measurement best reflects the adequacy of alveolar ventilation?

PaCO2

The symbol used to identify the partial pressure of oxygen is _______

PaO2

What are four common phenomena that can alter bronchial diameter?

Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, and Moraxella catarrhalis

A nurse caring for a patient with a pulmonary embolism understands that high ventilation-perfusion ratio may exist. What does this mean for the patient?

Ventilation exceeds perfusion

The nurse is performing chest auscultation for a patient with asthma. How does the nurse describe the high-pitched, sibilant, musical sounds that are heard?

Wheezes

List four conditions that are influenced by genetic factors that affect respiratory function:

asthma, COPD, cystic fibrosis, alpha-1 antitrypsin deficiency

The exchange of oxygen and carbon dioxide from the alveoli into the blood occurs by _________

diffusion

List six major signs and symptoms of respiratory disease.

dyspnea, cough, sputum production, chest pain, wheezing and hemoptysis, tachypnea, hypoxia.

The maximum volume of air that can be inhaled after a normal inhalation is known as _________________

inspiratory reserve volume

The divisions of the lung proceed in the following order, beginning at the mainstem bronchi: lobar bronchi, segmented bronchi, subsegmented bronchi, bronchioles

lobar bronchi, segmented bronchi, subsegmented bronchi, bronchioles

The pulmonary circulation is considered a ____________

low-pressure system

The left lung, in contrast to the right lung, has __________

one less lobe

The lungs are enclosed in a serous membrane called the _______

pleura

Gas exchange between the lungs and blood and between the blood and tissues is called

respiration

Pulmonary perfusion

the actual flow of blood through the pulmonary circulation.

The two centers in the brain that are responsible for the neurologic control of ventilation are

the apneustic center in the lower pons, the pneumotaxic center in the upper pons

Diffusion

the exchange of oxygen and carbon dioxide at the air-blood interface

Tidal volume, which may not significantly change with disease, has a normal value of approximately _____________

500 mL

During a preadmission assessment, for what diagnosis would the nurse expect to find decreased tactile fremitus and hyperresonant percussion sounds?

Emphysema

A health care provider requests a study of diaphragmatic motion because of suspected pathology. What diagnostic test will the nurse prepare the patient for?

Fluoroscopy

The nurse inspects the thorax of a patient with advanced emphysema. What does the nurse expect the chest configuration to be for this patient?

Barrel chest

The nurse is interviewing a patient who reports a dry, irritating cough that is not "bringing anything up." What medication should the nurse question the patient about taking?

Angiotensin converting enzyme (ACE) inhibitors

Define the term partial pressure.

Partial pressure is the pressure exerted by each type of gas (e.g., oxygen, carbon dioxide) in a mixture of gases.