Evolve-Respiratory

A client with a long history of asthma is scheduled for surgery. What information should be included in preoperative teaching? 1 There is an increased risk of respiratory tract infections. 2 Relaxation techniques limit the severity of asthmatic attacks. 3 Coughing forcibly must be avoided because it increases the intrathoracic pressure. 4 Local anesthesia is preferred because it has fewer side effects than general anesthesia.

1

The nurse is caring for a client who recently returned from another country who exhibits signs and symptoms suspicious of severe acute respiratory syndrome (SARS). Which clinical manifestations support this diagnosis? (Select all that apply.) 1 Dry cough 2 Chest pain 3 Hemoptysis 4 Shortness of breath 5 Fever greater than 100.4° F

1-4-5

A client develops increased respiratory secretions because of radiation therapy to the lung, and the health care provider prescribes postural drainage. What client assessment leads the nurse to determine that the postural drainage is effective? 1 Is free of crackles 2 Has a productive cough 3 Is able to expectorate saliva 4 Can breathe deeply through the nose

2

A nurse is caring for several postoperative clients. For what clinical manifestations of a pulmonary embolus should the nurse monitor these clients? (Select all that apply.) 1 Apathy 2 Dyspnea 3 Hemoptysis 4 Bronchial wheezes 5 Feeling of impending doom

2-3-5

A client is admitted to the hospital for a surgical resection of the lower left lobe of the lung. After surgery the client has a chest tube to a closed-chest drainage system. What should the nurse do to determine if the chest tube is patent? 1 Milk the chest tube toward the drainage unit 2 Check the amount of bubbling in the suction control chamber 3 Observe for fluctuations of the fluid in the water-seal chamber 4 Assess for extent of chest expansion in relation to breath sounds

3

A client reports having a bad cold and chest pain that worsens when the client takes deep breaths. Where should the nurse place the stethoscope to determine the presence of a pleural friction rub? 1.a 2.b 3.c 4.d

4

A client with emphysema has a history of smoking two packs of cigarettes a day. What is the best approach for the nurse to help the client stop smoking? 1 Teach pursed-lip breathing 2 Encourage the client to reduce emotional stress 3 Obtain a referral to a smoking cessation program in the community 4 Suggest that the client limit smoking to one pack of cigarettes a day

4

What should the nurse expect when assessing a client with pleural effusion? 1 Crackles or rhonchi at the posterior of the lungs 2 Deviation of the trachea toward the affected side 3 Increased resonance on percussion of the affected area 4 Reduced or absent breath sounds at the base of the lung

4

A nurse witnesses a client collapse during a home care visit. Place the basic life support actions in the order they should be performed by the nurse. Correct 1. Use physical and auditory stimulation to attempt to elicit a response. Correct 2. Direct the client's spouse to call the emergency management system. Incorrect 3. Palpate to determine the presence of a carotid pulse. Incorrect 4. Open the airway with the head tilt-chin lift method and give two breaths. Correct 5. Perform 30 chest compressions. Incorrect 6. Listen and observe for spontaneous breaths.

??? 1-2-?-?-5-?

When auscultating a client's chest, the nurse hears swishing sounds of normal breathing. The nurse should document: 1 Adventitious sounds 2 Fine crackling sounds 3 Vesicular breath sounds 4 Diminished breath sounds

3

There is a fire on an inpatient unit at the hospital. List the actions the nurse should take in the order in which they should be performed. 1.Move clients and others away from the immediate vicinity of the fire. 2.Initiate the fire code alarm system. 3.Close the doors to the rooms on the unit. 4.Evacuate clients and others to a safe area off the unit with the fire. 5.Inform the clients' families that a fire is occurring.

1-2-3-4-5

A healthcare provider prescribes a medication to be administered via a metered dose inhaler (MDI) for a young adult with asthma. List in order the steps the nurse teaches the client to follow when using the inhaler. 1.Shake the inhaler for 30 seconds 2.Exhale slowly and deeply to empty the air from the lungs 3.Hold the inhaler upright in the mouth 4.Start breathing in and press down on the inhaler once

1-2-3-4

A nurse is caring for a female client who is receiving rifampin (Rifadin) for tuberculosis. Which statements indicate that the client understands the teaching about rifampin? (Select all that apply.) 1 "This drug may be hard on my liver so I must avoid alcoholic drinks while taking it." 2 "This drug may reduce the effectiveness of the oral contraceptive I am taking." 3 "I can take an antacid 15 minutes after I take my medicine." 4 "My health care provider must be called immediately if my eyes and skin become yellow." 5 "If I can't swallow the pill, I cannot open the capsule and mix the powder with applesauce."

1-2-4

During a client's routine physical examination, a chest x-ray film reveals a lesion in the right upper lobe. What information in the client's history supports the health care provider's diagnosis of pulmonary tuberculosis? (Select all that apply.) 1 Fever 2 Dry cough 3 Night sweats 4 Frothy sputum 5 Engorged neck veins 6 Blood-tinged sputum

1-3-6

A client is admitted to the emergency department with a stab wound of the left thorax. The nurse should position the client: 1 On the left side with the head of the bed elevated 2 In the Trendelenburg position with knees gatched 3 In the high-Fowler position with the left side supported 4 On the right side flat in bed with a pillow supporting the left arm

1

A client who is a pipe smoker is diagnosed with cancer of the tongue. A hemiglossectomy and right radical neck dissection are performed. To ensure airway patency during the first hours after surgery, the nurse should: 1 Suction as needed 2 Apply an ice collar 3 Maintain a high-Fowler position 4 Encourage expectoration of secretions

1

While walking in a hallway, a client with a chest tube becomes confused and pulls the chest tube out. What is the nurse's immediate action? 1 Place the client in the supine position 2 Spread a clamp in the insertion side to hold the site open 3 Obtain a sterile Vaseline gauze to cover the opening 4 Cover the opening with the cleanest material available

4

After emergency surgery, the nurse teaches a client how to use an incentive spirometer. What client behavior indicates to the nurse that the spirometer is being used correctly? 1 Inhales deeply through the mouthpiece, relaxes, and then exhales. 2 Inhales deeply, seals the lips around the mouthpiece, and exhales. 3 Uses the incentive spirometer for 10 consecutive breaths per hour. 4 Coughs several times before inhaling deeply through the mouthpiece.

1

Several days after a client had a total laryngectomy, the health care provider prescribes a progressive diet as tolerated. What should the nurse do? 1 Keep suction apparatus readily available in case excessive respiratory secretions occur. 2 Administer the diet through a nasogastric tube until the suture line heals. 3 Encourage intake of pureed foods to help promote the swallowing reflex. 4 Administer the prescribed pain medication before meals to limit discomfort.

1

The nurse is providing care during the immediate postoperative period for a client that had a radical neck dissection. The best method to assess for stridor is: 1 Listen with a stethoscope over the trachea 2 Determine the client's ability to do neck exercises 3 Listen with a stethoscope over the base of the lungs 4 Determine the client's ability to cough and deep breathe

1

A client just had a thoracentesis. For which response is it most important for the nurse to observe the client? 1 Signs of infection 2 Expectoration of blood 3 Increased breath sounds 4 Decreased respiratory rate

2

After surgery for cancer of the posterior pharynx, a client is receiving gavage feedings through a nasogastric tube. A family member asks why this is necessary. What is the nurse's best response? 1 "Tube feedings prevent aspiration of food into the lungs." 2 "Tube feedings promote healing by reducing the risk for infection." 3 "Let me show you how to do a gavage. It will make you less anxious." 4 "You seem concerned about the gavage. You probably will not have to do this at home.

2

The nurse is caring for a 75-year-old client that had radical head and neck surgery. Thirty minutes after awakening from anesthesia, the client becomes agitated, disoriented, and confused. The nurse should: 1 Notify the health care provider immediately of the findings 2 Administer the prescribed oxygen 3 Record the observations and continue to observe the client 4 Administer the prescribed antianxiety medication

2

The nurse who is teaching the client with chronic obstructive pulmonary disease (COPD) to use pursed-lip breathing (PLB) is aware that this is beneficial for the client through which mechanism? 1 Increased respiratory rate to improve arterial oxygenation 2 Prolonged exhalation to decrease air trapping 3 Shortened inhalation to reduce bronchial swelling 4 Use of the diaphragm to increase the amount of inspired air

2

Two portable drainage catheters with hemovacs attached were placed during a client's hemiglossectomy and right radical neck dissection. Six hours after the catheters were placed, the nurse empties 180 mL of serosanguineous drainage from one of the drainage catheters. The priority nursing intervention is to: 1 Turn the client onto the right side 2 Notify the health care provider immediately 3 Document the output as an expected finding 4 Irrigate the drainage catheter to ensure patency

2

The nurse auscultates fine crackles in a client who has been in respiratory distress. When the nurse is providing information to the client about crackles, which would be appropriate to include? 1 They are indicative of pleural rubbing. 2 They are signs of bronchial constriction. 3 Crackles are located in the smaller air passages. 4 Crackles are heard during respiratory expiration.

3

What response provides evidence that a client with chronic obstructive pulmonary disease (COPD) understands the nurse's instructions about an appropriate breathing technique? 1 Inhales through the mouth. 2 Increases the respiratory rate. 3 Holds each breath for a second at the end of inspiration. 4 Progressively increases the length of the inspiratory phase.

3

The nurse reinforces instructions about how to use a nebulizer to a client with chronic obstructive pulmonary disease (COPD). The nurse concludes that additional teaching is needed when the client: 1 Places the tip of the mouthpiece an inch beyond the lips 2 Holds the inspired breath for at least three seconds 3 Exhales slowly through the mouth with lips pursed slightly 4 Inhales with the lips tightly sealed around the mouthpiece of the nebulizer

4

A nurse works with a large population of immigrant clients and is concerned about the debilitating effects of influenza. Which action is the first line of defense against an emerging influenza pandemic? 1 Complying with quarantine measures 2 Instituting strict international travel restrictions 3 Seeking aid from the international public health community 4 Reporting surveillance findings to appropriate public health officials

4

Which method of oxygen delivery should a nurse anticipate will be prescribed for a client with a pulse oximetry reading of 65%? 1 Face tent 2 Venturi mask 3 Nasal cannula 4 Nonrebreather mask

4