EXAM 1 mod 1-4
What are the primary causes for an acute exacerbation of COPD? Select all that apply. Air pollution Tracheobronchial infection Change in season from spring to summer Gastrointestinal viruses Hypertension
Air pollution Tracheobronchial infection
An obese client as at risk for what cancers?
Breast, colorectal, cervical
What is the term for the air inhaled or exhaled during respiration cycle?
Tidal volume
Which substance reduces the transmission of pain? 1. Endorphins 2. Acetylcholine 3. Serotonin 4. Substance P
endorphins
Which condition is a heightened response that occurs after exposure to a noxious stimulus? Pain tolerance Sensitization Pain threshold Dependence
sensitization
A client has asthma. Which of the following medications is a commonly prescribed mast cell stabilizer used for asthma? Cromolyn sodium Budesonide Theophylline Albuterol
Cromolyn sodium
A patient is admitted to the hospital with pulmonary arterial hypertension. What assessment finding by the nurse is a significant finding for this patient? Ascites Dyspnea Hypertension Syncope
Dyspnea
Which of the following is a physiologic response to pain? Bradycardia Dry skin Pallor Hypotension
Pallor
The client is prescribed albuterol 2 puffs as a metered-dose inhaler. Which action by the client demonstrates understanding of administration for this medication? Positions the inhaler 2 finger widths away from the lips Carefully holds the inhaler upright without shaking it Holds the breath for 5 seconds after administering the medication Immediately repeats the second puff after the first puff
Positions the inhaler 2 finger widths away from the lips
A client with chronic obstructive pulmonary disease (COPD) is admitted to the medical-surgical unit. To help this client maintain a patent airway and achieve maximal gas exchange, the nurse should:
instruct the client to drink at least 2 L of fluid daily.
A nurse assesses arterial blood gas results for a patient in acute respiratory failure (ARF). Which results are consistent with this disorder? pH 7.28, PaO2 50 mm Hg pH 7.46, PaO2 80 mm Hg pH 7.36, PaCO2 32 mm Hg pH 7.35, PaCO2 48 mm Hg
pH 7.28, PaO2 50 mm Hg
A nurse is caring for a client admitted with an exacerbation of asthma. The nurse knows the client's condition is worsening when he:
uses the sternocleidomastoid muscles.
Which vitamin is usually administered with isoniazid (INH) to prevent INH-associated peripheral neuropathy?
Vitamin B6
A nurse has just completed teaching with a client who has been prescribed a meter-dosed inhaler for the first time. Which statement if made by the client would indicate to the nurse that further teaching and follow-up care is necessary? "After I breathe in, I will hold my breath for 10 seconds." "I will make sure to take a slow, deep breath as I push on my inhaler." "I do not need to rinse my mouth with this type of inhaler." "If I use the spacer, I know I am only supposed to push on the inhaler once."
"I do not need to rinse my mouth with this type of inhaler."
After teaching a client who has had a Roux-en-Y gastric bypass, which client statement indicates the need for additional teaching? 1. "I need to chew my food slowly and thoroughly." 2. "I need to drink 8 oz of water before eating." 3. "A total serving should amount to be less than 1 cup." 4. "I should pick cereals with less than 2 g of fiber per serving."
"I need to drink 8 oz of water before eating."
Which of the following is the appropriate intervention to avoid physical dependence on drugs in a client? 1. Administer adjuvant drugs along with the prescribed drug. 2. Administer subtherapeutic doses. 3. Increase dosage of the drug. 4. Discontinue drugs gradually.
Discontinue drugs gradually.
Where would pulmonary edema be auscultated?
Crackles at the base of lungs
A client reports dyspnea, fatigue, and having had a persistent productive cough for the last few months, which the client attributes to a bout with the flu. The nurse suspects that this client may have: lung cancer. pleurisy. pleural effusion. lung abscess.
lung cancer
Cyanosis, which is a late indicator of hypoxia, is present when the unoxygenated hemoglobin level is...
5 g/dL
What should the calorie deficit be for someone with obesity trying to lose weight?
500-1000 calories per day
Over inflation of lungs is associated with which chest malformation?
Barrel chest, seen in emphysema
Fluid accumulation in the lungs can be heard in which area?
Bilateral lower lobes
A nurse cares for clients who undergo bariatric surgery due to obesity. When teaching the client on the most successful surgery in clients with very high BMI's, which procedure will the nurse mention? Roux-en-Y Gastric banding Sleeve gastrectomy Biliopancreatic diversion with duodenal switch
Biliopancreatic diversion with duodenal switch
Which of the following is a leading cause of chronic obstructive pulmonary disease (COPD) exacerbation? Bronchitis Asthma Pneumonia Common cold
Bronchitis
Asthma is cause by which type of response? IgD-mediated IgA-mediated IgM-mediated IgE-mediated
IgE
At its most fundamental level, what does obesity result from? A metabolic imbalance A hormone imbalance A genetic alteration A lifestyle imbalance
Metabolic imbalance
A nurse works in a bariatric clinic and cares for client with obesity who will or have undergone bariatric surgery. What is the nurse's understanding of how the procedure works? Restricts the client's ability to eat. Impairs caloric absorption. Restricts the client's ability to digest fat. Impairs gastric motility.
Restricts the client's ability to eat.
A commonly prescribed methylxanthine used as a bronchodilator is which of the following? Levalbuteral Albuteral Theophylline Terbutaline
Theophylline
paradoxical chest movement is associated with what chest malformation?
flail chest
The nurse is reviewing pressurized metered-dose inhaler (pMDI) instructions with a client. Which statement by the client indicates the need for further instruction? "Because I am prescribed a corticosteroid-containing MDI, I will rinse my mouth with water after use." "I will take a slow, deep breath in after pushing down on the MDI." "I will shake the MDI container before I use it." "I can't use a spacer or holding chamber with the MDI."
"I can't use a spacer or holding chamber with the MDI."
A nurse cares for a client who is obese. The health care provider prescribes orlistat in an effort to help client lose weight, along with diet and exercise. When teaching the client about this medication, what will the nurse include? 1. "It binds with enzymes to help prevent digestion of fat." 2. "It decreases your appetite." 3. "It works to make you feel full." 4. "It binds with enzymes to decrease carbohydrate absorption."
"It binds with enzymes to help prevent digestion of fat."
A nurse cares for a client with obesity who is scheduled to undergo vegal blocking therapy. When teaching the client about the procedure or device, which statements will the nurse include? Select all that apply. 1. "It is a pacemaker-type device that is implanted under your skin." 2. "It is a stent-like device that is inserted into your vein." 3. "A pre-programed pulsating signal is delivered." 4. "A liquid medication is slowly delivered." 5. "Recharge the device two times per week."
"Recharge the device two times per week." "A pre-programed pulsating signal is delivered." "A pre-programed pulsating signal is delivered."
A nurse recognizes that a client with tuberculosis needs further teaching when the client states: "I'll have to take these medications for 9 to 12 months." "It won't be necessary for the people I work with to take medication." "I'll need to have scheduled laboratory tests while I'm on the medication." "The people I have contact with at work should be checked regularly."
"The people I have contact with at work should be checked regularly."
A client with obesity is prescribed lorcaserin for weight loss. The client reports dry mouth. What is the nurse's best response? 1. "This is an expected finding with this medication." 2. "How much water are drinking?" 3. "Taking this medication with meals decreases this symptom." 4. "Your dose may need to be adjusted."
"This is an expected finding with this medication."
A client at risk for pneumonia has been ordered an influenza vaccine. Which statement from the nurse best explains the rationale for this vaccine? "Getting the flu can complicate pneumonia." "Influenza vaccine will prevent typical pneumonias." "Influenza is the major cause of death in the United States." "Viruses like influenza are the most common cause of pneumonia."
"Viruses like influenza are the most common cause of pneumonia."
A nurse cares for a female client of childbearing age who will undergo bariatric surgery. When teaching the client about precautions after surgery, which teaching will the nurse include that is specific to this population? "You should avoid pregnancy for at least 18 months after surgery." "After surgery, your ability to conceive is decreased considerably." "You should avoid pregnancy for at least 9 months after surgery" "After surgery, contraceptives have much less efficacy."
"You should avoid pregnancy for at least 18 months after surgery."
A client is scheduled for a Roux-en-Y bariatric surgery. When teaching the client about the surgical procedure, which statement will the nurse use? 1. "The stomach is stapled to create a very small pouch and part of the small intestine is rerouted." 2. "A prosthetic device binds the stomach and creates a very small pouch and restricts oral intake." 3. "85% of the stomach is removed surgically, leaving a much smaller tube-like structure." 4. "The stomach is stapled to a very small pouch and the entire small intestine is rerouted.
1. "The stomach is stapled to create a very small pouch and part of the small intestine is rerouted."
The nurse is caring for a client with kidney stones who is complaining of severe pain. What type of pain does the nurse understand this client is experiencing? 1. Somatic Pain 2. Visceral Pain 3. Neuropathic Pain 4. Chronic Pain
2. Visceral pain
When administering a fentanyl patch, the last dose of sustained-release morphine should be administered at what point? 1. Immediately after the morning shower 2. Before respiratory assessment 3. At the same time the first patch is applied 4. There are no administration requirements
3. At the same time the first patch is applied
Which phase of pain transmission occurs when the brain experiences pain at a conscious level? 1. Transmission 2. Modulation 3. Transduction 4. Perception
4. Perception
The nurse establishes a learning contract with an overweight client. The contract is best if it 1. is an oral contract between the nurse and the client 2. has an overall goal of 30-pound weight loss in six months 3. contains an agreement to ingest a well-balanced diet 4. includes an incremental goal of 1-2 pound weight loss this week
4. includes an incremental goal of 1-2 pound weight loss this week
A client has been prescribed a fentanyl patch for pain control. The nurse understands that this patch should be replaced every 12-24 hours. 24-36 hours. 36-60 hours. 48-72 hour
48-12 hours
How much fluid is typically present between the pleurae, which surround the lungs, to prevent friction rub?
5 - 15 ml
What is the decrease in life expectancy associated with obesity?
6-20 years
The nurse is assessing a client who has been taking up to 4 grams of acetaminophen every day for undiagnosed pain. What reaction due to ingestion of acetaminophen will the nurse assess for? Excessive clotting of blood Abrupt onset of rash and pruritus Shortness of breath Sensitivity to hot and cold temperatures
Abrupt onset of rash and pruritus
The ICU nurse caring for a 2-year-old near drowning victim monitors for what possible complication? Atelectasis Acute respiratory distress syndrome Metabolic alkalosis Respiratory acidosis
Acute respiratory distress syndrome
A client with severe shortness of breath comes to the emergency department. He tells the emergency department staff that he recently traveled to China for business. Based on his travel history and presentation, the staff suspects severe acute respiratory syndrome (SARS). Which isolation precautions should the staff institute? Droplet precautions Airborne and contact precautions Contact and droplet precautions Contact precautions
Airborne and contact precautions
The nurse is caring for clients on the neurological unit. Which triad of neurological mechanisms does the nurse identify as most responsible when there is abnormality in ventilation control? Medulla oblongata, cerebellum, and heart rate Pons, cerebellum, and oxygen receptors Medulla oblongata, mitral valve, and central receptors Aortic arch, pons, and CO2 receptor sites
Aortic arch, pons, and CO2 receptor sites
Which of the following is a potential complication of a low pressure in the endotracheal cuff? Aspiration pneumonia Tracheal bleeding Tracheal ischemia Pressure necrosis
Aspiration pneumonia
The nurse is teaching a group of clients with obesity about the risks of disease associated with obesity. Which respiratory conditions or diseases will the nurse include in the teaching, which are associated with obesity? Select all that apply. Asthma Infection Obstructive sleep apnea Central sleep apnea Emphysema
Asthma OSA Infection
A victim has sustained a blunt force trauma to the chest. A pulmonary contusion is suspected. Which of the following clinical manifestations correlate with a moderate pulmonary contusion? Blood-tinged sputum Bradypnea Respiratory alkalosis Productive cough
Blood-tinged sputum
A nurse cares for a client with obesity who is also diagnosed with depression. Which medication does the nurse expect the health care provider will prescribe, which also aids in weight loss? Bupropion Amitriptyline Nortriptyline Doxepin
Bupropion
A nurse should include what instruction for the client during postural drainage? Lie supine to rest the lungs. Sit upright to promote ventilation. Remain in each position for 30 to 45 minutes for best results. Change positions frequently and cough up secretions.
Change positions frequently and cough up secretions.
When taking a client history, the nurse notes that the client has been taking herbal remedies in addition to acetaminophen for several years. Based on the admission history, the nurse understands that the client is experiencing which type of pain after an amputation? Breakthrough pain Chronic pain Acute pain Phantom pain
Chronic pain
A young adult with cystic fibrosis is admitted to the hospital for an acute airway exacerbation. Aggressive treatment is indicated. What is the first action by the nurse? Collects sputum for culture and sensitivity Administers vancomycin intravenously Provides nebulized tobramycin (TOBI) Gives oral pancreatic enzymes with meals
Collects sputum for culture and sensitivity
A nurse cares for a client with a BMI of 40 kg/m2. Which gastrointestinal condition or disease does the nurse recognize is associated with the client's BMI? Colorectal cancer Ulcerative colitis Crohn's disease Bowel obstruction
Colorectal cancer
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? Albuterol Levalbuterol HFA Cromolyn sodium Ipratropium
Cromolyn sodium
Which of the following clinical manifestations should a nurse monitor for during a pulmonary angiography, which indicates an allergic reaction to the contrast medium? Difficulty in breathing Hematoma Absent distal pulses Urge to cough
Difficulty breathing
A client is diagnosed with dumping syndrome after bariatric surgery. Which findings on the nursing assessment correlate with this diagnosis? Select all that apply. Dizziness Sweating Fever Hypertension Tachycardia
Dizziness Sweating Tachycardia
A nurse teaches a client who will undergo bariatric surgery the importance of avoiding problematic foods post surgery. Which foods will the nurse suggest the client avoid? Select all that apply. Doughy breads Overcooked meats Pasta Rice Mashed potatoes
Doughy breads Overcooked meats Pasta Rice
A nurse is assessing a client who comes to the clinic for care. Which findings in this client suggest bacterial pneumonia? Nonproductive cough and normal temperature Sore throat and abdominal pain Hemoptysis and dysuria Dyspnea and wheezing
Dyspnea and wheezing
The nurse is assessing a patient who has been admitted with possible ARDS. What findings would distinguish ARDS from cardiogenic pulmonary edema? Elevated white blood count Elevated troponin levels Elevated myoglobin levels Elevated B-type natriuretic peptide (BNP) levels
Elevated B-type natriuretic peptide (BNP) levels
A junior-level nursing class has just finished learning about the management of clients with chronic pulmonary diseases. They learned that a new definition of COPD leaves only one disorder within its classification. Which of the following is that disorder?
Emphysema
A nurse is caring for a patient diagnosed with empyema. Which of the following interventions does a nurse implement for patients with empyema? Encourage breathing exercises. Institute droplet precautions. Place suspected patients together. Do not allow visitors with respiratory infection.
Encourage breathing exercises.
A client being treated for rheumatoid arthritis has been prescribed a glucocorticosteroid. How should the nurse best ensure this client's safety during treatment? 1. the client knows to taper down the dose if it is discontinued by the care provider. 2. Educate the client about the need to avoid grapefruit and grapefruit juice during treatment. 3. Teach the client the signs and symptoms of gastrointestinal bleeding. 4. Educate the client about the difference between tolerance and dependence
Ensure the client knows to taper down the dose if it is discontinued by the care provider.
A client with obesity is prescribed lorcaserin for weight loss. The client reports dry mouth. What is the nurse's best response? "This is an expected finding with this medication." "How much water are drinking?" "Taking this medication with meals decreases this symptom." "Your dose may need to be adjusted."
Expected finding with this medication
The occupational nurse is completing routine assessments on the employees where you work. What might be revealed by a chest radiograph for a client with occupational lung diseases? Fibrotic changes in lungs Hemorrhage Lung contusion Damage to surrounding tissues
Fibrotic changes in lungs
A nurse consulting with a nutrition specialist knows it's important to consider a special diet for a client with chronic obstructive pulmonary disease (COPD). Which diet is appropriate for this client?
High protein
When caring for a client with acute respiratory failure, the nurse should expect to focus on resolving which set of problems? Hypotension, hyperoxemia, and hypercapnia Hyperventilation, hypertension, and hypocapnia Hyperoxemia, hypocapnia, and hyperventilation Hypercapnia, hypoventilation, and hypoxemia
Hypercapnia, hypoventilation, and hypoxemia
A patient is seen in the emergency room for a severe case of diabetic acidosis. The respiratory note indicates the presence of Kussmaul's respirations. The nurse knows that this diagnosis is associated with which of the following? Bradypnea Tachypnea Hypoventilation Hyperventilation
Hyperventilation
A client with bronchiectasis is admitted to the nursing unit. The primary focus of nursing care for this client includes teaching the family how to perform postural drainage. instructing the client on the signs of respiratory infection. implementing measures to clear pulmonary secretions. providing the client a low-calorie, high-fiber diet.
Implementing measure to clear pulmonary secretions
In a client with amyotrophic lateral sclerosis (ALS) and respiratory distress, which finding is the earliest sign of reduced oxygenation? Decreased heart rate Increased restlessness Increased blood pressure Decreased level of consciousness (LOC)
Increased restlessness
A nursing student is taking a pathophysiology examination. Which of the following factors would the student correctly identify as contributing to the underlying pathophysiology of chronic obstructive pulmonary disease (COPD)? Choose all that apply.
Inflamed airways that obstruct airflow Mucus secretions that block airways Overinflated alveoli that impair gas exchange
A nurse researcher investigates why clients with obesity who have lost weight often regain the weight. The nurse looks at the relationship of leptin and its role in weight gain. What does the nurse determine is true regarding leptin and weight gain? Select all that apply. 1. Drops in leptin level increases hunger. 2. Leptin signals satiety in the hypothalamus. 3. Leptin increases blood glucose in the pancreas. 4. Drops in leptin level increases insulin resistance. 5. Leptin signals hyperglycemia in the liver
Leptin signals satiety in the hypothalamus. 1. Drops in leptin level increases hunger.
A nurse cares for a client with obesity who has type 2 diabetes. Which medication does the nurse recognize may assist in weight loss and is also approved to treat type 2 diabetes? Lorcaserin Orlistat Liraglutide Benzphetamine
Liraglutide
What is histamine, a mediator that supports the inflammatory process in asthma, secreted by?
Mast cells
What is the difference between respiration and ventilation? 1. Ventilation is the process of gas exchange. 2. Ventilation is the movement of air in and out of the respiratory tract. 3. Ventilation is the process of getting oxygen to the cells. 4. Ventilation is the exchange of gases in the lung.
Movement of air in and out of the respiratory tract
What medication should those with bariatric surgery avoid and why?
NSAID like ibuprofen bc they increase likelihood of gastric ulcers
A client with obesity is prescribed liraglutide for weight loss. Which common side effect will the nurse include in the client teaching? Nausea Bradycardia Oily stools Flatus
Nausea
When assessing a client, which adaptation indicates the presence of respiratory distress? Respiratory rate of 14 breaths per minute Productive cough Sore throat Orthopnea
Orthopnea
The nurse auscultates the lung sounds of a client during a routine assessment. The sounds produced are harsh and cracking, sounding like two pieces of leather being rubbed together. The nurse would be correct in documenting this finding as: - pleural friction rub. - crackles. - sonorous wheezes. - sibilant wheezes.
Pleural friction rub
Which condition, approved by the U.S. Food and Drug Administration, is the only use for the lidocaine 5% patch? Postherpetic neuralgia Epidural anesthesia General anesthesia Diabetic neuropathy
Post therpetic neuralgia
The nurse is assessing a client who, after an extensive surgical procedure, is at risk for developing acute respiratory distress syndrome (ARDS). The nurse assesses for which most common early sign of ARDS? Rapid onset of severe dyspnea Inspiratory crackles Bilateral wheezing Cyanosis
Rapid onset of severe dyspnea
As status asthmaticus worsens, the nurse would expect which acid-base imbalance?
Respiratory acidosis
In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to which of the following acid-base imbalances?
Respiratory acidosis
A nurse administers albuterol (Proventil), as ordered, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect? Respiratory rate of 22 breaths/minute Dilated and reactive pupils Urine output of 40 ml/hour Heart rate of 100 beats/minute
Respiratory rate of 22 breaths/minute
A client with chronic bronchitis is admitted to the health facility. Auscultation of the lungs reveals low-pitched, rumbling sounds. Which of the following describes these sounds? Rales Venous hum Rhonchi Bronchovesicular
Rhonchi
A nurse is caring for a client who is post operative bariatric surgery. The client's pain has not been well controlled. Which nursing diagnosis is the nurse's priority? Risk for impaired gas exchange Impaired mobility Impaired tissue integrity Activity intolerance
Risk for impaired gas exchange
The nurse is providing discharge instructions to a client with pulmonary sarcoidosis. The nurse concludes that the client understands the information if the client correctly mentions which early sign of exacerbation? Shortness of breath Weight loss Fever Headache
Shortness of breath
Which hormones released throughout the gastrointestinal tract promote satiety? Select all that apply. Somatostatin Cholecystokinin Insulin Ghrelin Neuropeptide y
Somatostatin Cholecystokinin Insulin
The nurse is instructing the patient with asthma in the use of a newly prescribed leukotriene receptor antagonist. What should the nurse be sure to include in the education? The patient should take the medication with meals since it may cause nausea. The patient should take the medication separately without other medications. The patient should take the medication with a small amount of liquid. The patient should take the medication an hour before meals or 2 hours after a meal.
The patient should take the medication an hour before meals or 2 hours after a meal.
A nurse is caring for a client who has frequent upper respiratory infections. Which structure is most helpful in protecting against infection? Cilia Sinus cavity Tonsils Turbinates
Tonsils
What type of alveoli cells produce surfactant?
Type II
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)? Vital capacity of 3,000 mL Expiratory reserve volume of 1,100 mL Residual volume of 1,200 mL Functional residual capacity of 2,300 mL
Vital capacity of 3,000 mL
A nurse is preparing a client with a pleural effusion for a thoracentesis. The nurse should: 1. assist the client to a sitting position on the edge of the bed, leaning over the bedside table. 2. raise the arm on the side of the client's body on which the physician will perform the thoracentesis. 3. place the client supine in the bed, which is flat. 4. raise the head of the bed to a high Fowler's position.
assist the client to a sitting position on the edge of the bed, leaning over the bedside table.
A client with chronic obstructive pulmonary disease (COPD) is recovering from a myocardial infarction. Because the client is extremely weak and can't produce an effective cough, the nurse should monitor closely for: atelectasis. pulmonary edema. pleural effusion. oxygen toxicity.
atelectasis
The client is taking oxycodone (Oxycontin) for chronic back pain and reports decreased pain relief when he began taking a herb to improve his physical stamina. The nurse asks if the herb is valerian kava-kava chamomile ginseng
ginseng
A client is receiving theophylline for long-term control and prevention of asthma symptoms. Client education related to this medication will include taking the medication at least 1 hour prior to meals. the importance of blood tests to monitor serum concentrations. development of hyperkalemia. monitoring liver function studies as prescribed.
the importance of blood tests to monitor serum concentrations.
A client who has undergone extensive fracture repair continues to request opioid pain medication with increasing frequency. The initial surgeries occurred more than 2 months ago, and the nurse is concerned about the repeated requests. What does the nurse suspect to be the cause of the client's frequent appeals for pain medication? 1. tolerance 2. addiction 3. drug allergy 4. poor quality control by the drug manufacturer
tolerance
A nurse cares for an obese client taking phentermine for weight loss. What client teaching will the nurse include when discussing precautions about the medication? - "Do not drink alcohol while taking this medication." - "Do not drive while taking this medication." - "Take the medication at night before bedtime." - "Take the medication with a full glass of water."
"Do not drink alcohol while taking this medication."
A client sustained severe burns over both lower extremities 1 week ago. The client informs the nurse that he had to wait for 30 minutes last night to receive pain medication, which caused the pain not to be relieved after administration. What suggestions could the nurse make to the physician to provide adequate relief of pain? 1. Provide the client with a patient-controlled analgesia (PCA) pump. 2. If the nurse is going to be late with administration, have an extra dose of medication available. 3. Increase the frequency of the medication so that the client will have less time to wait. 4. Increase the dosage of the medication so the client will stay medicated longer.
1. Provide the client with a patient-controlled analgesia (PCA) pump.
A teenage client is undergoing a dressing change to burns on the thigh. The client refuses pain medication and states, "I do not hurt, and I don't need it." He is withdrawn, grimaces, and turns away during the dressing change. He was last medicated 8 hours ago. What is the best statement by the nurse? 1. "You are so brave to not take your pain medication when the dressing change will hurt." 2. "If you need pain relief, I can give you some medication when I have completed the dressing change." 3. "I saw you grimacing during the dressing change. Please explain the reason you refused the pain medication." 4. "You are so right to not take your pain medication. You can become dependent on the medication."
3. "I saw you grimacing during the dressing change. Please explain the reason you refused the pain medication."
A physician orders a beta2adrenergic-agonist agent (bronchodilator) that is short-acting and administered only by inhaler. What drug would the nurse know to administer to the client?
Albuterol
A nurse is caring for a client with status asthmaticus. Which medication should the nurse prepare to administer? An inhaled corticosteroid An oral corticosteroid An I.V. beta2-adrenergic agonist An inhaled beta2-adrenergic agonist
An inhaled beta2-adrenergic agonist
The nurse is caring for a client diagnosed with pneumonia. The nurse assesses the client for tactile fremitus by completing which action? 1. Asking the client to repeat "ninety-nine" as the nurse's hands move down the client's thorax 2. Asking the client to say "one, two, three" while the nurse auscultates the lungs 3. Instructing the client to take a deep breath and hold it while the diaphragm is percussed 4. Placing the thumbs along the costal margin of the chest wall and instructing the client to inhale deeply
Asking the client to repeat "ninety-nine" as the nurse's hands move down the client's thorax
A client with obesity is suspected of having nonalcoholic fatty liver disease. Which diagnostic labs does the nurse anticipate the client needing? Select all that apply. Glycosylated hemoglobin Fasting glucose Aspartate aminotransferase Alanine aminotransferase Triglycerides
Aspartate aminotransferase Alanine aminotransferase
A client experiencing an asthmatic attack is prescribed methylprednisolone intravenously. What action should the nurse take? Encourages the client to decrease caloric intake due to increased appetite Assesses fasting blood glucose levels Informs the client to limit fluid intake due to fluid retention Aspirates for blood return before injecting the medication
Assesses fasting blood glucose levels
A morbidly obese client asks the nurse if medications are available to assist with weight loss. The nurse knows that the client would not be a candidate for phentermine if the following is part of the client's health history: Coronary artery disease Diabetes Use of lithium Peptic ulcer disease
CAD
The nurse is caring for a client diagnosed with asthma. While performing the shift assessment, the nurse auscultates breath sounds including sibilant wheezes, which are continuous musical sounds. What characteristics describe sibilant wheezes? - They result from air passing through widened air passages. - They can be heard during inspiration and expiration. - They are heard in clients with decreased secretions. - They occur when the pleural surfaces are inflamed.
Can be heard during inspiration and expiration
The clinic nurse is caring for a client with acute bronchitis and/or tracheobronchitis. The client asks what may have caused the infection. What may induce acute bronchitis? Aspiration Drug ingestion Chemical irritation Direct lung damage
Chemical irritation
A nurse is assisting a client with mild chronic obstructive pulmonary disease (COPD) to set a goal related to the condition. Which of the following is an appropriate goal for this client? Continue with current level of mobility at home. Relieve shortness of breath to a level as close as possible to tolerable. Increase walking distance around a city block without shortness of breath. Maintain activity level of walking to the mailbox.
Increase walking distance around a city block without shortness of breath.
A physician has ordered that a client with suspected lung cancer undergo magnetic resonance imaging (MRI). The nurse explains the benefits of this study to the client. What is the reason the client with suspected lung cancer would undergo magnetic resonance imaging (MRI)? 1. Tumor densities can be seen with radiolucent images. 2. Narrow-beam x-ray can scan successive lung layers. 3. Lung blood flow can be viewed after a radiopaque agent is injected. 4. MRI can view soft tissues and can help stage cancers.
MRI can view soft tissues and can help stage cancers.
A nurse practitioner diagnosed a patient with an infection in the maxillary sinuses. Select the area that the nurse palpated to make that diagnosis. Above the eyebrows Between the eyes and behind the nose On the cheeks below the eyes Behind the ethmoid sinuses
On the cheeks below the eyes
A client with obesity reports pain in the joints. Which musculoskeletal condition related to obesity does the nurse suspect the client has? Osteoarthritis Rheumatoid arthritis Inflammatory arthritis Necrotizing arthritis
Osteoarthritis
A nurse cares for a client with obesity who reports taking "a medication of weight loss" but cannot remember the name of it. The client also reports nervousness and feeling "jittery". Which medication is the client most likely taking? Orlistat Lorcaserin Phentermine Naltrexone/buproprion
Phentermine
The nurse is assigned to care for a patient with COPD with hypoxemia and hypercapnia. When planning care for this patient, what does the nurse understand is the main goal of treatment? Increasing pH Avoiding the use of oxygen to decrease the hypoxic drive Providing sufficient oxygen to improve oxygenation Monitoring the pulse oximetry to assess need for early intervention when PCO2 levels rise
Providing sufficient oxygen to improve oxygenation
You are caring for a client status post lung resection. When assessing your client you find that the bubbling in the water-seal chamber for the chest tubes is more than you expected. What should you check when bubbling in the water-seal chamber is excessive? See if the chest tube is clogged. See if the wall suction unit has malfunctioned. See if a kink has developed in the tubing. See if there are leaks in the system.
See if there are leaks in the system.
A patient comes to the clinic with fever, cough, and chest discomfort. The nurse auscultates crackles in the left lower base of the lung and suspects that the patient may have pneumonia. What does the nurse know is the most common organism that causes community-acquired pneumonia? Staphylococcus aureus Mycobacterium tuberculosis Pseudomonas aeruginosa Streptococcus pneumoniae
Streptococcus pneumoniae
Which of the following is a clinical manifestation of a pneumothorax? Select all that apply. Sudden chest pain Asymmetry of chest movement Unilateral retractions Oxygen desaturation Bilaterally equal breath sounds
Sudden chest pain Asymmetry of chest movement Unilateral retractions Oxygen desaturation
While caring for a client with a chest tube, which nursing assessment would alert the nurse to a possible complication? Skin around tube is pink. Bloody drainage is seemed in the collection chamber. Absence of bloody drainage in the anterior/upper tube The tissues give a crackling sensation when palpated.
The tissues give a crackling sensation when palpated.
The instructor of the pre-nursing physiology class is explaining respiration to the class. What does the instructor explain is the main function of respiration? 1. To exchange oxygen and CO2 between the atmospheric air and the blood and between the blood and the cells 2. To move CO2 out of the atmospheric air and into the expired air 3. To move O2 out of the atmospheric air and into the retained air 4. To exchange atmospheric air between the blood and the cells
To exchange oxygen and CO2 between the atmospheric air and the blood and between the blood and the cells
A client is admitted with generalized abdominal pain, nausea, vomiting, and hypotension. The client has not passed stool in over 1 week and has been in pain for the past 4 days. Which type of pain would you expect the client to be experiencing? Visceral Neuropathic Deeper somatic Chronic
Visceral
A nurse cares for clients with obesity. Which clinical measurements use quantified measurements to diagnose obesity? Select all that apply. Blood pressure Total cholesterol Weight BMI Waist circumference
Weight BMI waist circumference
Upon assessment, the nurse suspects that a client with COPD may have bronchospasm. What manifestations validate the nurse's concern? Select all that apply. Wheezes Ascites Compromised gas exchange Decreased airflow Jugular vein distention
Wheezes compromised gas exchange decreased airflow
A client has gained 55 lb in the last 3 years and is concerned about developing type 2 diabetes mellitus. Additionally, the client's healthcare provider has diagnosed metabolic syndrome. What are the conditions which contribute to developing metabolic syndrome? Select all that apply. - abdominal obesity - elevated blood glucose levels - low LDL - All options are correct.
abdominal obesity elevated blood glucose levels
A patient is complaining of a headache during epidural administration of an anesthetic agent. Which of the following nursing interventions should be completed? 1. Keep the head of the bed flat. 2. Maintain a dehydrated state. 3. Place patient in semi-Fowler's position. 4. No intervention is necessary
keep head of bed flat
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 tracheobronchitis cardiovascular disease viral pneumonia
staphylococcal pneumonia
A nurse geneticist is researching the gut microbiome and its relationship to disease. What is true regarding the microbiome? It has over 100 times more genes than the human genome. It is less diverse than human genome. Its function has yet to be discovered. It has over 10 times more genes than the human genome.
100 times more genes
An obese Hispanic client, age 65, is diagnosed with type 2 diabetes. Which statement about diabetes mellitus is true? 1. Nearly two-thirds of clients with diabetes mellitus are older than age 60. 2. Diabetes mellitus is more common in Hispanics and Blacks than in Whites. 3. Type 2 diabetes mellitus is less common than type 1 diabetes mellitus. 4. Approximately one-half of the clients diagnosed with type 2 diabetes are obese.
2. DM is more common in Hispanics and blacks than whites
The nurse assessed a 28-year-old woman who was experiencing dyspnea severe enough to make her seek medical attention. The history revealed no prior cardiac problems and the presence of symptoms for 6 months' duration. On assessment, the nurse noted the presence of both inspiratory and expiratory wheezing. Based on this data, which of the following diagnoses is likely? Acute respiratory obstruction Adult respiratory distress syndrome Pneumothorax Asthma
Asthma
A nurse cares for an older adult client with obesity who also has glaucoma. Which obesity medication is contraindicated in this client? Orlistat Phentermine Lorcaserin Liraglutide
Phentermine
The nurse is admitting a client who just had a bronchoscopy. Which assessment should be the nurse's priority? Medication allergies Swallow reflex Presence of carotid pulse Ability to deep breathe
Swallow reflex and cough reflex
The patient with a chest tube is being transported to X-ray. Which complication may occur if the chest tube is clamped during transportation? Tension pneumothorax Cardiac tamponade Flail chest Pulmonary contusion
Tension pneumothorax
Which technique does the nurse suggest to a client with pleurisy while teaching about splinting the chest wall? Turn onto the affected side. Use a prescribed analgesic. Avoid using a pillow while splinting. Use a heat or cold application.
Turn onto the affected side.
A nurse assesses a client's respiratory status. Which observation indicates that the client is having difficulty breathing? Diaphragmatic breathing Use of accessory muscles Pursed-lip breathing Controlled breathing
Use of accessory muscles
The nurse is assessing an older adult patient just admitted to the hospital. Why is it important that the nurse carefully assess pain in the older adult patient? 1. Older people are expected to experience chronic pain. 2. Older people have a decreased pain threshold. 3. Older people experience reduced sensory perception. 4. Older people have increased sensory perception.
Older people experience reduced sensory perception.
A client experiences a head injury in a motor vehicle accident. The client's level of consciousness is declining, and respirations have become slow and shallow. When monitoring a client's respiratory status, which area of the brain would the nurse realize is responsible for the rate and depth? The pons The frontal lobe Central sulcus Wernicke's area
Pons
A client is scheduled for a Roux-en-Y bariatric surgery. When teaching the client about the surgical procedure, which statement will the nurse use? "The stomach is stapled to create a very small pouch and part of the small intestine is rerouted." "A prosthetic device binds the stomach and creates a very small pouch and restricts oral intake." "85% of the stomach is removed surgically, leaving a much smaller tube-like structure." "The stomach is stapled to a very small pouch and the entire small intestine is rerouted.
The stomach is stapled to create a very small pouch and part of the small intestine is rerouted."
A male client in a wheelchair comes in for his yearly physical examination. He is unable to stand. The nurse retrives the wheelchair scale to obtain an accurate weight. The nurse understands the importance of this assessment with this client. What is the nurse's reasoning for obtaining an accurate weight? 1. People with disabilities have an increased incidence of obesity. 2. A wheelchair-bound client is usually depressed about his or her weight. 3. Wheelchairs make clients very self-conscious about their weight. 4. Weight is more difficult to control if a client is wheelchair-bound.
People with disabilities have an increased incidence of obesity.
A mediastinal shift occurs in which type of chest disorder? Tension pneumothorax Traumatic pneumothorax Simple pneumothorax Cardiac tamponade
Tension pneumothorax
What is the purpose of the vascular and ciliated mucous lining of the nasal cavities? Cool and dry expired air Move mucus to the back of the throat Moisten and filter expired air Warm and humidify inspired air
Warm and humidify inspired air
A patient comes to the emergency department complaining of a knifelike pain when taking a deep breath. What does this type of pain likely indicate to the nurse? Bacterial pneumonia Bronchogenic carcinoma Lung infarction Pleurisy
Pleurisy
Nociception includes four specific processes: transduction, transmission, perception, and modulation. Which action illustrates the nociception process of pain transmission? 1. A child quickly removing a hand when touching a hot object 2. A surgeon making an incision to perform surgery 3. A mother in labor utilizing imagery to reduce pain 4. A patient taking tramadol to enhance pain management
1. A child quickly removing a hand when touching a hot object
A nurse cares for a client who is 36 hours postoperative from bariatric surgery and is suspected of having a hemorrhage related to the procedure. What is the nurse's understanding of the most likely cause of the hemorrhage? 1. Disruption of a staple 2. Formation of a gastric ulcer 3. Formation of a duodenal ulcer 4. Dehiscence of the surgical site
1. Disruption of a staple
A nurse cares for a client who is obese. The health care provider prescribes orlistat in an effort to help client lose weight, along with diet and exercise. When teaching the client about this medication, what will the nurse include? "It binds with enzymes to help prevent digestion of fat." "It decreases your appetite." "It works to make you feel full." "It binds with enzymes to decrease carbohydrate absorption."
Prevents fat digestion
A nurse caring for clients with obesity understands these clients are at increased risk for developing pressure ulcers. What does the nurse recognize increases the client's risk for developing pressure ulcers? Select all that apply. 1. Increased adipose tissue decreases the supply of blood, oxygen, and nutrients to peripheral tissue. 2. Skin folds are associated with more moisture and friction. 3. Normal healing mechanisms are impaired. 4. Increased adipose tissue causes thinning of the skin and risk for decreased integrity. 5. Inflammation is worse and leads to risk of infection.
Skin folds are associated with more moisture and friction. Increased adipose tissue decreases the supply of blood, oxygen, and nutrients to peripheral tissue.
A nurse is developing a teaching plan for a client with asthma. Which teaching point has the highest priority? Avoid contact with fur-bearing animals. Change filters on heating and air conditioning units frequently. Take ordered medications as scheduled. Avoid goose down pillows.
Take ordered medications as scheduled.
A nurse documents the presence of chronic pain on an electronic health record. Choose a description that could be used. The pain can be: 1. Attributed to a specific cause. 2. Prolonged in duration. 3. Rapidly occurring and subsiding with treatment. 4. Separate from any central or peripheral pathology.
2. Prolonged in duration.
The client takes naproxen for arthritic pain and is now prescribed warfarin for persistent atrial fibrillation. Due to the interactions of the medications, what is the nurse's best response? 1. Assess the client's stool for color 2. Teach the client to ingest foods high in vitamin K 3. Administer both medications with food to increase absorption 4. Inform the client to decrease alcohol to one glass each day
1. Assess the client's stool for color
A client reports abdominal pain as "8" on a pain intensity scale of 0-10 thirty minutes after receiving an opioid intravenously. Her past medical history includes partial-thickness burns to approximately 60% of her body several years ago. The nurse assesses: 1. That the client's past experiences with pain may influence her perception of current pain 2. That based on her past experiences the client's perception of pain should be less 3. That the client has become dependent on drugs from her previous experience of burns 4. That the client is experiencing pain relating to the burn injuries from several years ago
1. That the client's past experiences with pain may influence her perception of current pain
About which issue should the nurse inform clients who use pain medications on a regular basis? 1. Avoid harsh sunlight for 2 hours after administering analgesic agents or salicylates. 2. Inform the primary health care provider about the use of salicylates before any procedure, and avoid over-the-counter analgesics consistently without consulting a physician. 3. Minimize fiber intake during the therapy. 4. Consume the medications just before or along with meals.
2. Inform the primary health care provider about the use of salicylates before any procedure, and avoid over-the-counter analgesics consistently without consulting a physician.
A nurse cares for a client who is postoperative bariatric surgery and has experienced frequent episodes of dumping syndrome. The client now reports anorexia. What is the primary reason for the client's report of anorexia? Fear of eating Taste of food Size of the stomach Absorption of food
Fear of eating
A nurse cares for a client who is post op bariatric surgery and the nurse offers the client a sugar-free beverage. What is the primary purpose of offering a sugar-free beverage? These are less likely to cause dumping syndrome. These are less likely to raise the blood sugar. These ease nausea. These ease gastric distention.
Less likely to cause dumping syndrome
The nurse admits a woman reporting severe right upper quadrant pain after eating Christmas dinner. The nurse suspects gallbladder disease. Statistics show that incidence of gallbladder disease is greater for women who are Multiparous Obese Older than 40 years Thin
Multiparous obese over 40 years of age
