Med Surg 26,27,28,67

Which instruction does the nurse give to a patient when removing the patient's chest tube?

"Bear down while the tube is being removed."

After the nurse has finished teaching about metered-dose inhaler (MDI) use for asthma, which patient statement indicates the need for additional teaching?

"I should avoid using a spacer with this inhaler because it is ineffective."

The nurse will provide which instructions to the patient with chronic obstructive pulmonary disease (COPD) about pursed lip breathing (PLB)?

"Make breathing out (exhalation) three times longer than breathing in (inhalation)."

Which statement by a patient indicates good understanding of the purpose of a spacer when using a metered-dose inhaler?

"More of the medication will get down into my lungs to help my breathing.

Which statement by a patient indicates good understanding of the purpose of a spacer when using a metered-dose inhaler?

"More of the medication will get down into my lungs to help my breathing."

The patient has a prescription for albuterol 3 mg by nebulizer. Available is a solution containing 24 mg/mL. How many mL should the nurse administer?

0.125 mL

Which actions help to prevent the development of volutrauma in a patient receiving positive pressure mechanical ventilation? Select all that apply.

3,4,

Which intervention does the nurse perform 30 minutes before removing a chest tube from a patient?

Administer a pain medication to the patient.

Which topic will the nurse include when teaching a patient with pharyngeal cancer about brachytherapy?

Artificial saliva

Which medication helps to treat infection in a patient with acute respiratory failure?

Azithromycin

Which parameters would the nurse monitor in a patient directly following a thoracentesis? Select all that apply.

BP Oxygen saturation

The nurse expects which treatment therapy will be prescribed for a patient with massive hemoptysis?

Bronchial artery embolization

A patient diagnosed with which respiratory condition would the nurse identify as being at risk for developing cor pulmonale as a complication?

Chronic obstructive pulmonary disorder

The nurse is providing postoperative care for a patient following a left pneumonectomy. Which is an appropriate nursing intervention?

Encouraging range-of-motion exercises on the left upper extremity

Following a direct lung injury, which pathophysiologic process occurs in the first few days as the patient develops acute respiratory distress syndrome (ARDS)?

Engorgement of the peribronchial interstitial space

The nurse should instruct a patient with chronic obstructive pulmonary disease (COPD) to perform which action for effective huff coughing?

Forcefully exhale quickly and cough when mucus is felt in the breathing tubes.

The nurse expects which test will be prescribed for a patient who experiences pleuritic chest pain, dyspnea, wheezing, clubbing of digits, weight loss, and blood-streaked sputum?

High-resolution CT

Which factor causes the clinical manifestations of chronic obstructive pulmonary disease (COPD)?

Inability to effectively expire air

Which instructions will the nurse include when teaching a patient about using a dry powder inhaler (DPI)? Select all that apply.

Keep the device in a dry area. Inhale quickly to pull medication into the lungs.

Which diagnostic test will the clinic nurse anticipate to confirm a diagnosis of chronic obstructive pulmonary disease (COPD) in a patient with dyspnea?

Spirometry

Which intervention should be included in the plan of care for a patient who has lost 30 lb and has a nursing diagnosis of impaired nutritional status?

Suggest a high-calorie, high-protein diet with six small meals a day.

The nurse assesses a patient following a transthoracic needle aspiration and notes excess air in the pleural space. How does the nurse interpret the finding?

The patient has an iatrogenic pneumothorax.

Which action will the nurse take when caring for a patient with acute respiratory failure due to left-sided pneumonia?

Use huff coughing to help to clear secretions.

Which treatment may increase restlessness and insomnia in a patient with chronic obstructive pulmonary disease (COPD)?

β2 agonists

Which interprofessional action will the nurse take first for a patient who has hypoxemia caused by pneumonia?

Administer oxygen.

When caring for a patient diagnosed with cor pulmonale, which finding will the nurse expect?

Ankle edema

While obtaining a health history for a patient with suspected tuberculosis (TB), the nurse expects which early signs or symptoms of the disease? Select all that apply.

Anorexia Fatigue night sweats

Which organisms may be present in the sputum of a patient hospitalized with an acute exacerbation of cystic fibrosis (CF)? Select all that apply.

Burkholderia cepacia Staphylococcus aureus Haemophilus influenzae Pseudomonas aeruginosa

Which intervention by the nurse is the priority for a patient with expiratory airflow obstruction, ineffective cough, decreased airway humidity, and abnormal breath sounds?

Instruct the patient to inhale deeply, bend forward slightly, and perform three or four huffs.

Which advantages of a diskus over a metered-dose inhaler would the nurse share when providing education on the device? Select all that apply.

It requires less manual dexterity. It contains an easily visible color that indicates the number of doses left.

The nurse learns that a patient with asthma has a three-year history of chronic sinusitis. Which action by the nurse is appropriate?

Obtain a surgeon referral.

Which actions will the nurse take to relieve anxiety for a patient who is experiencing an acute asthma attack? Select all that apply.

Remain calm, quiet, and reassuring. Utilize the "talking down" technique. Place the patient in a semi-Fowler's position. Coach the patient to use pursed lip breathing

Which measure should a patient with chronic obstructive pulmonary disorder (COPD) take when performing physical activity?

Remember to think about steps and breathing while walking.

Which pathophysiologic processes occur during the fibrotic phase of acute respiratory distress syndrome (ARDS)? Select all that apply.

Remodeled lung Correct2 Deceased lung compliance Correct3 Impairment of gas exchange

Which patient statement about the use of an ipratropium inhaler for chronic obstructive pulmonary disease (COPD) indicates a need for further teaching?

"If my breathing gets worse, I should keep taking extra puffs of the inhaler until I can breathe more easily."

Which method of oral care helps to prevent oral infection for the patient who is taking fluticasone?

Rinse the mouth with water after the second puff of medication.

Which statement by the caregiver of a patient with asthma indicates a need for more education about management of the disease?

"If the peak flow is in the yellow zone, we will need to go to the hospital."

Which explanation will the nurse give when teaching a patient who is at risk for respiratory failure about the benefits of pursed lip breathing?

"It increases the saturation of oxygen."

Which statements made by the student nurse indicate effective learning about performing pilocarpine iontophoresis diagnostic testing? Select all that apply.

"It takes about five minutes to collect the patient's sweat." "The patient may feel tingling and warmth while conducting the test."

Which instruction will the nurse include when teaching a patient how to do huff coughing?

"Say the word 'huff' while coughing."

Which statement made by a student nurse indicates understanding of education about conception and pregnancy for a female patient with cystic fibrosis (CF)?

"She may have menstrual irregularities and secondary amenorrhea."

The nurse is teaching a student nurse about breath sounds in a patient with asthma. Which statement made by the student indicates the need for further teaching?

"The patient wheezes loudly during expiration when the asthma is severe."

Which statement made by the student nurse indicates effective learning about antibiotic therapy for a patient with cystic fibrosis (CF) who experiences a productive cough, PaO2 of 50 mmHg, arteriolar vasoconstriction, and cor pulmonale?

"The patient will require prolonged high-dose antibiotic therapy."

A patient with a sudden onset of respiratory distress is scheduled for a ventilation-perfusion scan. Which instruction does the nurse provide to the patient about the procedure?

"The test involves the injection of a radioisotope and the inhalation of a radioactive gas."

The nurse teaches a group of nursing students about lung volume parameter in patients with asthma. Which statement made by a student indicates the need for further teaching?

"With asthma, there is increased forced expiratory volume in one second."

Which response by the nurse is best when a patient with asthma asks "How will I know when my metered-dose inhaler (MDI) is empty?"

"You need to keep track of how many puffs you have used."

Which instruction will the nurse give a patient who has had a laryngectomy and reports dryness and crusting of the stoma?

"You should spray a nasal wash spray on the stoma."

Which instruction will the nurse give a patient whose peak flow meter reading indicates peak flow at 80% of the personal best?

"You should take your medicines as usual."

When a patient hospitalized with chronic obstructive pulmonary disease (COPD) asks the nurse whether oxygen use will be needed at home, which response by the nurse is best?

"You will qualify for supplemental oxygen therapy if your resting oxygen saturation drops to 88%."

Pancreatic insufficiency is associated with which complications? Select all that apply.

Steatorrhea Low body mass index (BMI)

Which patient action indicates good understanding of the nurse's instructions about the use of a metered-dose inhaler (MDI)?

Waits one minute between each puff from the MDI

Which exercise goal is most appropriate for a patient with chronic obstructive pulmonary disease (COPD)?

Walking for 20 minutes/day, keeping the pulse rate less than 130 beats/minutes

How many minutes is the appropriate recovery period after activity for the patient with chronic obstructive pulmonary disease (COPD)?

5

Which information will the nurse obtain when collecting subjective data about a patient with respiratory failure?

Health history

Which common causes would the nurse identify for accumulation of fluid in the alveoli and interstitial spaces of the lungs? Select all that apply.

Heart failure Oxygen toxicity Opioid overuse

Which action will the nurse take when a patient who has had a total laryngectomy expresses concern about sexuality? Select all that apply.

Help the patient plan ways to discuss sexuality with the partner. Acknowledge that surgery and cancer treatment may affect sexuality.

A patient with chest wall trauma has diminished breath sounds on the affected side, dyspnea, and bleeding in the chest wall. A chest tube is inserted immediately after the injury. Which diagnosis does the nurse expect to find in the patient's medical record?

Hemopneumothorax

The treatment plan for a patient with tuberculosis includes isoniazid and rifampin. Which data found in the patient's health history cause the nurse to question the medication prescriptions?

Hepatitis

Which laboratory abnormality confirms the diagnosis of cystic fibrosis (CF)?

High sweat chloride level

The nurse expects that which interventions will be listed on a treatment plan for a patient with bronchitis? Select all that apply.

Humidify the oxygen. Encourage the consumption of hot tea. Increase fluid intake to 3 L per day if tolerated.

The nurse would identify which structural changes as occurring during chronic inflammation? Select all that apply.

Hypersecretion of mucus Progressive loss of lung function Proliferation of new blood vessels

The nurse is caring for a patient admitted to the hospital with pneumonia. Upon assessment, the nurse notes a temperature of 101.4° F, a productive cough with yellow sputum, and a respiratory rate of 20 breaths/minute. Which is an appropriate nursing diagnosis?

Hyperthermia related to infectious illness

Which explanation is likely when the nurse notes a hemoglobin level of 20 g/dL in a patient admitted with chronic obstructive pulmonary disease (COPD)?

Hypoxia has stimulated erythropoiesis.

Which findings will the nurse expect when assessing a clinic patient with chronic obstructive pulmonary disease (COPD)? Select all that apply.

Hypoxia has stimulated erythropoiesis.

The nurse provides education for a patient about reducing the risk of atelectasis while undergoing chest tube drainage. Which statements made by the patient indicate effective learning? Select all that apply.

I should cough at regular intervals." "I should use my incentive spirometer." "I should perform range-of-motion exercises."

Which medication plan may be included in the home care treatment plan for a patient with cystic fibrosis (CF) who has a PaO2 of 50 mm Hg, arteriolar vasoconstriction, and cor pulmonale?

IV cephalosporin and aminoglycoside therapy

Which interprofessional action would the nurse anticipate next when a patient having an asthma attack has used albuterol and oxygen with inadequate improvement?

IV corticosteroids

Which interprofessional treatment will the nurse anticipate being prescribed first for a patient who is seen in the emergency department for an asthma attack and has not improved after administration of albuterol?

IV methylprednisolone

A patient, one week after a single lung transplantation, develops a temperature of 99° F, fatigue, and shortness of breath; and has an oxygen saturation level of 80%. Which medication intervention would the nurse anticipate incorporating into the plan of care?

IV methylprednisolone daily for three days

Which condition would the nurse suspect in a patient with dyspnea, clubbing of the fingers, and nonproductive cough?

Idiopathic pulmonary fibrosis

A nursing student asks the nurse how much drainage from a patient's chest tube warrants the need to contact the health care provider (HCP). Which criterion does the nurse give to the student?

If the drainage is greater than 100 mL/hr

Which factor contributes to loss of lung elastic recoil in a patient with chronic obstructive pulmonary disease (COPD) due to cigarette smoking?

Imbalance of protease and antiprotease activity

Which statements about health disparities that contribute to chronic obstructive pulmonary diseases are accurate? Select all that apply.

Imbalance of protease and antiprotease activity

Which immediate action does the nurse take when discovering that a patient's chest tube is disconnected from the chest drainage unit (CDU)?

Immerse the distal end of the chest tube in sterile water.

The nurse presents education related to pulmonary embolism (PE) to a group of nursing students and includes which risk factors? Select all that apply.

Immobility Pregnancy Pelvic surgery within the last three month Cigarette smoking

The nurse is providing education about the risk factors of asthma. Which factors would the nurse explain are associated with asthma? Select all that apply.

Immune response Genetic predisposition Exposure to air pollutants

Which process causes hypoxemic respiratory failure?

Inadequate oxygen transfer between the alveoli and the pulmonary capillaries

When a patient has alveolar hypoventilation, which arterial blood gas finding will the nurse expect?

Increase in PaCO2

Which instructions does the nurse provide to a patient with acute bronchitis? Select all that apply.

Increase oral fluid intake. Avoid secondhand smoke Eat a spoonful of honey to help relieve cough.

During which phase of acute respiratory distress syndrome (ARDS) does atelectasis occur due to decreased synthesis of surfactant and inactivation of existing surfactant?

Injury

When a patient is using beclomethasone to control asthma symptoms, which action will the nurse take to check for adverse effects of the medication?

Inspect the tongue and pharynx.

Which assessment has priority when the nurse is caring for a patient with Guillain-Barré syndrome?

Inspecting for weak respiratory effort

Which is the priority assessment for a patient experiencing an acute asthma exacerbation?

Inspection of the chest wall

A child with a nonproductive cough states, "I am having trouble breathing." Which action would the nurse take to reduce the severity of breathlessness in the child?

Instruct the child to bend forward slightly.

After the inhalation of puffs of mometasone, a patient develops oropharyngeal candidiasis, hoarseness, and dry cough. Which action would the nurse take to reduce the symptoms?

Instruct the patient to rinse the mouth with water after inhalation.

The nurse recognizes that which patient condition is associated with a sweat chloride level of 75 mmol/L and chromosome 7 mutation's effect on the development of bone?

Insufficient testosterone levels

The nurse expects which medication will be prescribed for a patient with cystic fibrosis (CF) who is hospitalized with an exacerbation of symptoms, wheezing, purulent sputum, and a fasting blood glucose level of 194 mmol/L?

Insulin

A patient's initial purified protein derivative (PPD) skin test result is positive. A repeat skin test is also positive. No signs or symptoms of tuberculosis or allergies are evident. Which medication therapy does the nurse anticipate will be prescribed?

Isoniazid (INH)

A patient who has tuberculosis (TB) is being treated with combination drug therapy. The nurse explains that combination drug therapy is essential for which reason?

It discourages the development of resistant strains of the TB organism.

The nurse collaborates with the health care team to arrange for home care for a patient with pulmonary tuberculosis (TB). Of the family members who live with the patient, which one is at the greatest risk for contracting the disease?

A 75-year-old parent who takes prednisone

Which of these is a clinical manifestation of early chronic obstructive pulmonary disease (COPD)?

A chronic, intermittent cough

Which test result indicates to the nurse that a patient with asthma is responding to treatment?

A decrease in exhaled nitric oxide

Which patient would the nurse identify as appropriate for treatment with a tissue plasminogen activator?

A patient with right ventricular dysfunction

Forty-eight hours after a patient received an intradermal tuberculin skin test (Mantoux), the nurse assesses the injection site and notes a 12-mm area of palpable induration. How does the nurse interpret this result?

A significant indication that the patient has been exposed to tuberculosis

Which benefits does noninvasive positive pressure ventilation (NIPPV) have over other artificial airways? Select all that apply.

It provides ventilatory support without endotracheal intubation. Correct5 It decreases the need for intubation in patients who are spontaneously breathing.

After observing blood-tinged mucous when suctioning a patient who has just arrived on the medical-surgical unit after a laryngectomy, which action by the nurse is best?

Keep monitoring the oxygen saturation and respiratory rate

Which action by a patient indicates a good understanding of the best way to determine if the prescribed metered-dose inhaler (MDI) canister is empty?

Keeping track of the number of inhalations used

A patient with chronic obstructive pulmonary disease (COPD) is suspected to have developed cor pulmonale. The nurse recognizes that which test result would confirm the diagnosis?

Large pulmonary vessels on chest x-ray

Which equipment would the clinic nurse anticipate needing to assist the health care provider with in diagnostic testing of a patient who reports voice hoarseness for the last month?

Laryngoscope

A patient experiences a chest injury as a result of a motor vehicle accident. The patient's assessment findings include asymmetric chest excursion and an absence of breath sounds on the left side. Which condition does the nurse suspect?

Left-sided pneumothorax

Which prescribed medication will the nurse administer first for a patient who has just been diagnosed with pneumonia?

Levofloxacin

The nurse cares for a patient with a diagnosis of tuberculosis. Which assessment finding best indicates that the patient has been following the prescribed treatment plan?

Negative sputum cultures

Which cells cause inflammation in a patient with an inflamed airway, productive cough, and Pseudomonas aeruginosa infection?

Neutrophils

Which are the predominant inflammatory cells in chronic obstructive pulmonary disease (COPD)? Select all that apply.

Neutrophils Lymphocytes Macrophages

Which finding is the best indicator that a patient with viral pneumonia is developing acute respiratory distress syndrome (ARDS)?

No improvement in O2 saturation with oxygen administration

Which technique is the most beneficial for airway clearance for a patient with cystic fibrosis (CF)?

No single technique has been shown superiority to the others.

When a patient with pneumonia has worsening oxygen levels while receiving oxygen at 6 L/min by nasal cannula, which interprofessional actions will the nurse anticipate implementing? Select all that apply.

Noninvasive positive pressure ventilation via tight- 5

Which action will the nurse take when a patient with chronic obstructive pulmonary disease (COPD) who was initially experiencing tachycardia, tachypnea, and restlessness becomes lethargic and has a normal respiratory rate?

Notify the health care provider.

The nurse is caring for a patient who is at risk for a flail chest and recalls which information about the condition? Select all that apply.

Palpation must be performed to assess for crepitus. At times, intubation and ventilation may be needed. In cases of extreme chest trauma, surgical fixation of the flail segment may be done.

The nurse expects which diagnostic finding for a patient with a body mass index of 15.3 kg/m2 who has poor absorption of protein and fatty foods?

Pancreatic enzyme insufficiency

Which teaching will the nurse include when instructing a patient with cystic fibrosis about diet and medications?

Pancreatic enzymes and adequate fat, calories, protein, and vitamins are needed.

A 5-year-old with low body weight and poor growth who is unable to digest fat- and protein-rich foods may be experiencing which condition?

Pancreatic insufficiency

Which medication may be included in the plan of care for a patient with cystic fibrosis (CF) who has a body mass index (BMI) of 15.6 kg/m2 and experiences frequent, bulky, and foul-smelling stools?

Pancrelipase before each meal

Which medication plan does the nurse expect will be prescribed for a patient with cystic fibrosis (CF) who experiences oily, irregular bowel movements and has a fat-soluble vitamin deficiency?

Pancrelipase before each meal

After observing a patient whose chest and abdomen move inward during inspiration, how will the nurse document this finding?

Paradoxical breathing

Which finding in a patient who is receiving mechanical positive pressure ventilation with 5 cm of positive end expiratory pressure indicates that the patient has severe acute respiratory distress syndrome?

Partial pressure of arterial oxygen /fractional inspired oxygen (P/F) ratio is 95.

Which laboratory finding for a patient with chronic obstructive pulmonary disease (COPD) is most important to report to the health care provider?

Partial pressure of carbon dioxide (PaCO2) is 55 mm Hg.

Which diagnostic finding for a patient is most important to report to the health care provider?

Partial pressure of oxygen in arterial blood (PaO2) is 50 mm Hg.

The nurse reviews the medical records of six adults and determines that the pneumococcal polysaccharide vaccine will be recommended for which patients? Select all that apply.

Patient B: age 35; smokes cigarettes Patient C: age 45; diabetes Patient D: age 55; had spleen removed as a teenager Patient E: age 65; elevated cholesterol level Patient F: age 75; no significant medical history

Which assessment finding in a patient who reports dyspnea requires the most rapid action by the nurse?

Patient becomes less agitated and is difficult to arouse.

The nurse will include which teaching to a student nurse about cystic fibrosis (CF)?

Patients with CF often survive into their 40s.

Which information about a patient with asthma who is seen in the clinic is most important for the nurse to report to the health care provider?

Peak flow reading is 48% of personal best.

Which physical assessment findings will the nurse expect when caring for a patient with cor pulmonale? Select all that apply.

Pedal edema Hepatomegaly Jugular vein distention

Which action by the student nurse while performing chest percussion indicates the need for further teaching?

Percussing with both hands simultaneously

Which instruction will the nurse include when teaching a patient with chronic obstructive pulmonary disease (COPD) about using pursed lip breathing (PLB)?

Perform PLB before, during, and after activities that cause shortness of breath.

Which nursing intervention is most appropriate during admission of a patient with acute respiratory distress related to cor pulmonale?

Perform a physical assessment of the respiratory system and ask specific questions related to this episode of respiratory distress.

Which action will the nurse suggest to decrease anxiety related to chronic obstructive pulmonary disease (COPD)?

Perform pursed lip breathing.

A patient is transported to the emergency department by the emergency response system (ERS) with a sudden change in mental status and a feeling of impending doom. The nurse reviews the patient's medical history and notes recent international air travel. The nurse suspects that the patient is experiencing which condition?

Pulmonary embolism (PE)

Which interventions would the nurse question when caring for a patient who is having an acute asthma attack? Select all that apply.

Prednisone 10 mg, PO X1 stat Administration of blood products to increase oxygen saturation

When admitting a female patient with a diagnosis of pulmonary embolism (PE), the nurse assesses for which risk factors? Select all that apply.

Pregnancy Cancer Oral contraceptive use Hormone therapy

After the nurse has taught the technique of pursed lip breathing, which patient action indicates a need for correction?

Puffing of cheeks while exhaling air

In which condition will the nurse expect to hear fine and coarse crackles during lung auscultation?

Pulmonary edema

A patient reports to the nurse he has had difficulty breathing the last few months and has just retired from working in the coal mines. Which manifestations would the nurse assess for in this patient?

Pulmonary fibrosis

A patient receives a prescription for amphotericin B. The nurse identifies that the medication is being given to treat which respiratory condition?

Pulmonary fungal infection

Which finding in a patient with asthma indicates a possible adverse effect of the prescribed albuterol?

Pulse rate 112 beats/min

Which exercise will the nurse teach to improve expiratory effort and decrease air trapping for a patient with chronic obstructive pulmonary disease?

Pursed lip breathing (PLB)

The nurse provides care for a patient with a suspected lung abscess and expects which assessment finding?

Purulent sputum that has a foul odor

Which instruction will the nurse include when teaching a patient with asthma about use of a peak flow meter?

Record the peak flow daily to determine if airway narrowing is occurring.

A patient with cystic fibrosis (CF) may experience which conditions? Select all that apply.

Recurring lung infections Decreased life expectancy Abundant bronchial mucus Altered pancreatic enzyme production

A patient with cystic fibrosis (CF) may experience which conditions? Select all that apply.

Recurring lung infections Decreased life expectancy Abundant bronchial mucus Altered pancreatic enzyme production

The nurse is caring for a patient who experiences shortness of breath, severe productive cough, and fever. A specimen of the sputum, which is yellow, has been obtained, but the laboratory results are pending. Which action does the nurse take next?

Administer antibiotics.

When a patient admitted with respiratory failure has a low central venous pressure (CVP), which action prescribed by the health care provider will the nurse question?

Administer furosemide 20 mg per hour IV. 2

The nurse is assessing a patient who is having an acute asthma attack. Which nursing intervention would be the priority for this patient?

Administering an albuterol bronchodilator

When caring for a patient with pertussis, which intervention does the nurse prioritize?

Administering antibiotic therapy

Which patient action when using albuterol and beclomethasone inhalers indicates a need for further teaching?

Administering the beclomethasone before the albuterol

A 70-year-old patient presents to the emergency department with symptoms that indicate pneumonia. Assessment findings include a new onset of confusion, a respiratory rate of 42 breaths/minute, a blood urea nitrogen (BUN) of 24 mg/dL, and a BP of 80/50 mm Hg. The nurse expects which treatment plan?

Admit the patient to the intensive care unit.

Which action would the nurse take when caring for a patient who has a history of asthma and experiences wheezing after vigorous exercise?

Advise the patient to avoid breathing dry air.

Which nursing intervention is appropriate for a patient whose laboratory report shows oxygen saturation of 45 mm Hg and carbon dioxide saturation of 60 mm Hg?

Advise the patient to plan sexual activity during the early afternoon.

Which treatment regimen may help reduce symptoms of infection and enhance lung function for a patient with Pseudomonas aeruginosa infection who experiences thick and sticky mucus and nasal polyps?

Aerosolized tobramycin daily, twice a day, every other month

Which instruction would the nurse give to a patient with asthma who has received a prescription for albuterol and ipratropium nebulization?

After the treatment, cough effectively.

Which assessment findings are the earliest indicators of hypoxemic respiratory failure? Select all that apply.

Agitation 'Restlessness Confusion

An asthmatic patient is in acute respiratory distress. The nurse auscultates the lungs and notes cessation of inspiratory wheezing. Which interpretation would the nurse derive from this finding?

Airway inflammation and bronchoconstriction are worsening.

Which inhaler would the nurse be prepared to administer to the patient at the onset of an asthma attack?

Albuterol

Which medications will the nurse administer for a patient with wheezing? Select all that apply.

Albuterol Metaproterenol

Which treatment will the nurse expect to be prescribed for a patient who has had chronic obstructive pulmonary disease (COPD) for three months and whose forced expiratory volume in one second (FEV1) is 65%?

Albuterol and ipratropium combination

When a patient with an asthma exacerbation develops acute respiratory failure, which prescribed therapy will the nurse administer first?

Albuterol nebulizer treatment

Which is the purpose of lung reduction surgery for the patient with chronic obstructive pulmonary disease (COPD)?

Allows more room for normal alveoli to expand

A patient with right ventricular dysfunction has a body temperature of 100° F, shortness of breath, syncope, tachycardia, and chest pain. Which medication treatment would the nurse expect to incorporate into the patient's plan of care?

Alteplase

Which drug would the nurse identify as effective in treating New York Heart Association (NYHA) class II right-sided heart failure patients?

Ambrisentan

A patient with acute respiratory distress syndrome (ARDS) on mechanical ventilation is receiving vecuronium by continuous IV infusion. The nurse anticipates that which other types of medications will be prescribed?

An analgesic and sedative

A patient with asthma has a body temperature of 102° F and produces purulent sputum. The nurse anticipates incorporating which medication into the plan of care?

An antibiotic

A patient presents to the emergency department with sudden-onset wheezing and coughing with progressive respiratory distress. Which condition would the nurse associate with these manifestations?

An asthma attack

Which actions will the nurse take when a patient is receiving oxygen (O2) through a nasal cannula? Select all that apply.

Assess ears for skin breakdown caused by the cannula Assist the patient to position the nasal cannula correctly Assure that there is water in the bubble-through humidifier

Which action will the nurse take when caring for a patient with acute respiratory distress syndrome (ARDS) who is receiving continuous lateral rotation therapy (CLRT) while on mechanical ventilation?

Assess skin condition frequently to detect skin breakdown.

A patient has a chest tube with a chest drainage unit (CDU) in place. The nurse notes that the tidaling in the water-seal chamber has stopped. Which action does the nurse take?

Assess the drainage system for occlusion.

A patient presents with a traumatic hemothorax. Which immediate action does the nurse take?

Assist the health care provider in inserting a chest tube.

Which action will the nurse take to prevent respiratory failure when caring for an obese patient?

Assist the patient to ambulate frequently. Incorrect3

Which actions will the nurse take to lower the risk for respiratory failure in a patient who has had rib fractures and head injury during a motor vehicle accident? Select all that apply.

Assist the patient to cough and take deep breaths. Correct5 Remind patient to use the incentive spirometer frequently. 6 Monitor respiratory rate and depth. Correct2 Check orientation and alertness frequently.

Which action will the nurse take to help a patient to perform staged coughing?

Assist the patient to push a pillow against the diaphragm while coughing.

Which actions will the nurse include when planning care for a patient who has respiratory distress because of thick mucus and poor cough effort? Select all that apply.

Assist with augmented coughing. Administer prescribed nebulized acetylcysteine.

Which actions will the nurse take to minimize adverse effects of head and neck radiation for a patient with laryngeal cancer? Select all that apply.

Assist with choosing soft foods. Encourage increased fluid intake. Give prescribed pilocarpine hydrochloride.

When arterial blood gases for a patient with respiratory failure who is receiving bilevel positive airway pressure (BiPAP) indicate a PaO2 of 48 mm Hg, which interprofessional action will the nurse anticipate?

Assisting with endotracheal intubation

A patient reports shortness of breath one day after a cholecystectomy. The nurse assesses the right lung sounds and notes dullness to percussion and decreased breath sounds. Which is the most probable reason for the assessment findings?

Atelectasis

Which condition would the nurse identify as possibly leading to intrapulmonary restrictive disease in a patient?

Atelectasis

Which action will the nurse take to improve oxygenation in a patient with left-sided pneumonia?

Augmented coughing or huff coughing

Which actions will the nurse take when administering an albuterol inhaler to a patient with respiratory failure? Select all that apply.

Auscultate lungs before and after inhaler use. Correct2 Check heart rate before and after inhaler use.

Which action will the nurse take to evaluate whether an asthmatic patient's prescribed ipratropium has been effective?

Auscultate lungs for wheezing.

The nurse is caring for a patient with a diagnosis of active tuberculosis (TB) and anticipates that which item will be included in the patient's treatment plan?

Avoid alcohol because it increases the hepatotoxicity associated with isoniazid (INH).

When teaching a patient with asthma about ways to reduce the severity of asthma and asthma attacks, which measures would be included? Select all that apply.

Avoid food irritants. Avoid animals with fur. Identify personal triggers

Which treatment strategy may be beneficial for a patient who has a hemoglobin level of 7.8 mg/dL, inflammation, hemoptysis, and elastic and muscular structural changes to the bronchial wall?

Bronchial artery embolization

The nurse expects which diagnosis for a patient who has permanent, abnormal dilation of medium-sized bronchi, inflammation, and elastic and muscular structural destruction of the bronchial wall?

Bronchiectasis

Which condition may develop if severe pneumonia is left untreated?

Bronchiectasis

Which is a manifestation of chronic rejection in a lung transplant patient?

Bronchiolitis obliterans (BOS)

The nurse assesses a patient with wheezing and dyspnea and determines that these symptoms are related to which pathophysiologic feature asthma?

Bronchoconstriction

The registered nurse is evaluating the actions of a nursing student who is maintaining a chest drainage unit (CDU) for a patient with chest trauma. The nurse intervenes when the student performs which actions? Select all that apply.

Coils the tubing above the chest level Connects the chest tube to wall suction to check for tidaling

A patient presents with a pneumonia score of 5 on the Expanded CURB-65 scale. Which action does the nurse take?

Consider admission to an intensive care unit.

Which teaching will the nurse include when providing information related to health promotion and disease prevention to a patient with cystic fibrosis (CF)? Select all that apply.

Consume more fluids and caloric supplements. Learn about central venous access devices (CVADs) that may be used for long-term medication administration.

Smoking may have which effects that increase the risk of pulmonary infections in the lungs of a patient with chronic obstructive pulmonary disease (COPD)?

Decreased alveolar macrophage function

Dornase alfa may be prescribed for a patient with cystic fibrosis (CF) to manage which treatment goal?

Degrade deoxyribonucleic acid in sputum.

Which process causes hypercapnic respiratory failure in a patient who arrives in the emergency department after an overdose of opioids?

Depressed central nervous system response to carbon dioxide

The nurse expects which diagnostic findings in a patient with a blood sugar level of 210 mg/dL and bone density of -1.5 standard deviation? Select all that apply.

Destruction of islet cells in the pancreas Insufficient levels of testosterone hormone Chronically elevated inflammatory cytokines

Which diagnostic test will help to determine the condition of a patient that has a productive cough, perfuse sweating, local hypoxia, and arteriolar vasoconstriction?

Sweat test

Which assessment finding by the nurse indicates a common adverse effect of a patient's prescribed albuterol inhaler?

Tachycardia

Which instruction will the nurse include when teaching a patient with chronic obstructive pulmonary disease (COPD) about use of theophylline?

Take the medication with food.

The nurse assesses a postoperative abdominal surgery patient who reports shortness of breath. Upon auscultation, the nurse notes diminished breath sounds and dullness on percussion. Which intervention would the nurse implement?

Teach coughing techniques to the patient.

Which nursing intervention assists a patient with pneumonia in managing thick secretions and fatigue?

Teaching the patient how to cough effectively and expectorate secretions

The nurse is caring for a patient with inflammation associated with sharp and abrupt pain upon inspiration. Which action by the nurse would be beneficial to the patient?

Teaching the patient to splint the ribs while coughing

Which prescribed intervention will the nurse implement first for an unresponsive patient admitted with a barbiturate overdose who has BP 90/60 mm Hg, apical pulse 110, and respiratory rate 8?

Use a bag-valve-mask system to ventilate the patient. 4

When teaching patients about preventing occupational lung diseases, which instructions would the nurse include? Select all that apply.

Use effective ventilation systems. Wear masks for high-risk occupations. Ensure periodic inspection of workplaces

When teaching patients about preventing occupational lung diseases, which instructions would the nurse include? Select all that apply.

Use effective ventilation systems. Wear masks for high-risk occupations. Ensure periodic inspection of workplaces.

Which patient action promotes energy conservation?

Using a tripod posture and placing the mirror on the table while using an electric razor

Which interventions does the nurse anticipate will be included in pulmonary rehabilitation (PR)? Select all that apply.

Using the Internet to deliver daily motivational messages Teaching exercises that focus on the muscles used for ambulation along with upper limb exercises

Which interprofessional action will the nurse implement to prevent barotrauma in a patient with acute respiratory distress syndrome (ARDS)?

Utilize low ventilator tidal volumes.

When a patient has asthma-chronic obstructive pulmonary disease overlap syndrome, which action will best promote the patient's ability to cough up mucus?

Utilizing the Flutter airway clearance device

Which information will the nurse educator include when teaching staff nurses about hypercapnic respiratory failure? Select all that apply.

Ventilatory failure leads to carbon dioxide (CO2) retention in arterial blood. Arterial carbon dioxide (PaCO2) is greater than 50 mm Hg, and arterial pH is less than 7.35.

Which oxygen delivery device will the nurse set up for a patient who needs to receive oxygen at a 28% concentration?

Venturi mask

Which type of equipment will the nurse use to deliver a precise amount of oxygen to a patient experiencing an exacerbation of chronic obstructive pulmonary disease (COPD)?

Venturi mask

Which of these methods for oxygen administration are high-flow devices? Select all that apply.

Venturi mask Mechanical ventilator

Which actions will the nurse include when performing chest physiotherapy on a patient with chronic obstructive pulmonary disease? Select all that apply.

Vibration Percussion Postural drainage

After the nurse assesses a patient in the clinic who reports a history of heavy cigarette smoking, which finding is most important to report to the health care provider?

Vocal hoarseness for two months

Which complication can occur when a patient with acute respiratory distress syndrome (ARDS) is receiving mechanical ventilation with positive end-expiratory pressure (PEEP) or high tidal volumes?

Volutrauma

Which risk factor would the nurse recognize as an absolute contraindication to receiving lung transplantation?

Chronic active hepatitis B

When caring for a patient with chronic obstructive pulmonary disease (COPD), which assessment finding will the nurse expect?

Chronic intermittent cough

Which disorder would the nurse recognize as the most likely cause of cor pulmonale?

Chronic obstructive pulmonary disease (COPD)

Which corticosteroid would the nurse administer to a patient directly through inhalation?

Ciclesonide

Which medications would the nurse anticipate administering for a patient with stage III head and neck cancer?

Cisplatin, docetaxel, and fluorouracil

Which organism is most likely to be present in the sputum of an adult patient with cystic fibrosis (CF)?

Pseudomonas aeruginosa

Which test is the gold standard for diagnosing cystic fibrosis (CF)?

Sweat chloride test

The nurse provides education for a group of nursing students about acute bronchitis and includes which information?

Therapy is mainly supportive

The nurse provides education for a group of nursing students about acute bronchitis and includes which information?

Therapy is mainly supportive.

The nurse is assisting a patient to learn the self-administration of beclomethasone, two puffs inhaled every six hours. Which instruction would the nurse give to explain the best way to prevent oral infection while taking this medication?

" Rinse the mouth with water following the second puff of medication."

Which statements about health disparities that contribute to chronic obstructive pulmonary diseases are accurate? Select all that apply.

"Asthma prevalence and age-adjusted death rates are the highest among Puerto Ricans." Correct4 "Hispanics have lower death rates from chronic obstructive pulmonary diseases than other ethnic groups." Correct5 "Despite higher rates of smoking in other groups, whites have the highest incidence of chronic obstructive pulmonary diseases."

Which instructions would the nurse give to a patient with newly diagnosed asthma? Select all that apply.

"Avoid contact with furred animals." "Wash bed covers in hot water and detergent." "Hire an exterminator to get rid of cockroaches." "Use ranitidine if gastric reflux causes symptoms.

After the nurse has finished teaching about how to manage fatigue induced by radiation therapy, which patient statement indicates effective teaching?

"Because I have the most energy in the morning, I will plan my errands during this time." Since fatigue is a co

Which instruction should be included in teaching a patient with chronic obstructive pulmonary disease (COPD) how to self-administer ipratropium via a metered-dose inhaler (MDI)?

"Breathe out slowly before positioning the inhaler."

When reviewing the use of dry powder inhalers (DPIs) with a patient who has asthma, which instruction would the nurse provide?

"Close your lips tightly around the mouthpiece and breathe in deeply and quickly."

Which instruction will the nurse include in the diet plan for a patient with chronic obstructive pulmonary disease (COPD)?

"Eat ice cream every day."

Following a thoracotomy, a patient uses patient-controlled analgesia (PCA). Which related outcomes does the nurse expect? Select all that apply.

"I should cough at regular intervals." "I should use my incentive spirometer." "I should perform range-of-motion exercises." Nursing care and patient teaching can minimiz

The nurse teaches a patient regarding the administration of fluticasone through an inhaler. Which statements made by the patient indicate effective learning? Select all that apply.

"I should keep my medicine away from humid places." "I should engage the lever while loading the medicine."

The nurse determines that additional discharge teaching is needed for a patient with pneumonia when the patient makes which statement?

"I should take antibiotics for all upper respiratory infections."

After the nurse has instructed a patient on ways to manage xerostomia during head and neck radiation therapy, which patient statements indicate a need for further teaching? Select all that apply.

"I use alcohol-containing mouthwash." "I forget to take the pilocarpine hydrochloride."

Which statement by a patient with newly diagnosed asthma indicates a good understanding of the nurse's teaching about asthma?

"I will keep my rescue inhaler with me at all times."

The nurse is explaining the pathophysiology of asthma to a patient. Which is the most appropriate explanation?

"Inflammation causes bronchoconstriction, hyperreactivity, and edema of the airways."

When a patient hospitalized with chronic obstructive pulmonary disease (COPD) asks the nurse whether oxygen use will be needed at home, which response by the nurse is best?"

"You will qualify for supplemental oxygen therapy if your resting oxygen saturation drops to 88%."

The nurse anticipates that which procedure will be prescribed as the main diagnostic test for cystic fibrosis?

Sweat chloride test

Which medication therapy would the nurse expect to incorporate into the plan of care for a patient with New York Heart Association (NYHA) class III right-sided heart failure?

Adenosine

Which patient statement indicates understanding of teaching about pursed lip breathing (PLB)?

"My exhalation should be longer than my inhalation."

Which statements by a patient's caregiver indicate understanding of the nurse's teaching about tracheostomy stoma care at home? Select all that apply.

"Nasal wash spray can be used to prevent dryness of the stoma." "The stoma will need to be covered before the patient showers."

The nurse teaches a student nurse regarding the administration of corticosteroids to a patient with wheezing, dyspnea, and chest tenderness. Which statement made by the student indicates effective learning?

"Provide inhaled corticosteroids to the patient while still in the hospital."

Which prescribed medications will the nurse anticipate administering for a patient with respiratory failure caused by pneumonia? Select all that apply.

1 3 5

Which interprofessional actions will the nurse take to assure adequate nutrition for a patient with respiratory failure? Select all that apply

1,2, 4, 5

Which patient care goals are appropriate for a patient with chronic obstructive pulmonary disease (COPD)? Select all that apply.

1,2,4,5

Which respiratory complications will the nurse assess for when caring for a patient with acute respiratory distress syndrome who requires mechanical ventilation with positive end-expiratory pressure (PEEP)? Select all that apply.

1,2,4,5

Which findings will the nurse observe due to compensatory mechanisms in a patient who is in the earliest stage of acute respiratory distress syndrome (ARDS)? Select all that apply.

1,3,4

The patient has a prescription to receive 600 mg of guaifenesin every four hours PRN. Available are 400-mg tablets. How many tablets should the nurse prepare to give?

1.5 tablets

A child with a nonproductive cough states, "I am having trouble breathing." Which action would the nurse take to reduce the severity of breathlessness in the child?

2

In which order do the pathophysiologic changes leading to clinical manifestations of acute respiratory distress syndrome occur? Incorrect1.

2,3,4

Which assessment findings will the nurse expect when caring for a patient with acute respiratory distress syndrome (ARDS)? Select all that apply.

2,3,5

Which actions will the nurse take to prevent ventilator-associated pneumonia (VAP) in a patient with acute respiratory distress syndrome who is on a ventilator? Select all that apply.

2,4

The patient has a prescription to receive methylprednisolone sodium succinate 150 mg IV push stat. Available is a solution containing 60 mg/mL. How many mL of methylprednisolone should the nurse administer?

2.5 mL

Which would the nurse identify as the pulmonary artery pressure at rest in a patient with pulmonary hypertension?

25 mm Hg

Which actions will the nurse take to help to prevent stress ulcers in a patient with acute respiratory distress syndrome (ARDS) who is receiving mechanical ventilation? Select all that apply.

3,4

Which interprofessional actions taken by the nurse will help to prevent development of stress ulcers in a patient with acute respiratory distress syndrome (ARDS)? Select all that apply.

3,4,5

A patient is hospitalized with symptoms of tuberculosis (TB). The nurse recognizes that at least one of the sputum specimens for acid-fast bacilli (AFB) needs to be obtained at which time of the day?

6 a.m.

The nurse prepares staff education related to lung transplantation and includes which information? Select all that apply.

Accurate diagnosis of rejection is by transtracheal biopsy. Cytomegalovirus (CMV) is a common causative agent of infection after lung transplant. Lung transplant recipients usually receive higher levels of immunosuppressive therapy than other organ recipients.

Which information will the nurse include when a patient with respiratory failure asks about the purpose of the prescribed arterial blood gases (ABGs)? Select all that apply.

Acid-base balance changes are diagnosed with ABGs. Carbon dioxide level in the blood is determined by ABG testing. Arterial oxygen level can be accurately determined by ABG testing.

The nurse will suggest which dietary modification for a patient with intermittent obstruction of the terminal ileum, thickened and dehydrated stools, increased mucus production, a temperature of 99.8° F, and profuse perspiration due to hot weather conditions?

Add foods rich in dietary salt.

Which actions will the nurse take when a patient first resumes eating after partial laryngectomy for laryngeal cancer? Select all that apply.

Add gravy to meats, rice, and potatoes. Encourage oral nutritional supplements. Have oral suction available at the bedside.

A patient is hospitalized with a diagnosis of pneumonia. When reviewing the patient's history, the nurse finds that the patient experienced a seizure with profuse vomiting four days prior to the hospital admission. Which type of pneumonia does the nurse suspect?

Aspiration pneumonia

Which diagnostic test will provide the best information about the respiratory status of a patient with chronic obstructive pulmonary disease (COPD) and pneumonia?

Arterial blood gas analysis 4

Which clinical manifestations indicate an exacerbation of chronic obstructive pulmonary disease (COPD)? Select all that apply.

Arterial pH 7.26 Patient in tripod position Increased difficulty sleeping Increased sputum expectoration

When the patient with a persistent cough is diagnosed with pertussis, the nurse expects that which type of medication will be prescribed?

Antibiotic

A patient presents with a lung abscess. The nurse expects that which intervention will be included in the patient's treatment plan?

Antibiotic therapy

Which clinical manifestation would alert the nurse to an early manifestation of an exacerbation of asthma in a patient brought to the emergency department following an automobile accident?

Anxiety

Which nursing interventions may be included to improve the nutritional status of a patient with chronic obstructive pulmonary disease (COPD) who is undernourished and underweight? Select all that apply.

Avoid overfeeding the patient. Provide five to six small meals per day. Provide a diet high in protein and calories.

Which complication will the nurse monitor for when caring for a patient receiving mechanical ventilation with high levels of positive end-expiratory pressure (PEEP)?

Barotrauma

The nurse is caring for a patient with acute respiratory distress syndrome (ARDS) who is receiving mechanical ventilation. The nurse monitors for which complications? Select all that apply.

Barotrauma Correct2 Stress ulcers Correct3 Acute kidney injury Correct4 Venous thromboembolism (VTE)

Which findings will the nurse expect when assessing a clinic patient with chronic obstructive pulmonary disease (COPD)? Select all that apply.

Barrel chest on inspection Wheezes on auscultation

Which physical assessment finding in a patient with a lower respiratory problem best supports the nursing diagnosis of ineffective airway clearance?

Basilar crackles

Which time is best to obtain peak flow readings?

Between noon and 2:00 p.m.

Which statement best describes intrapulmonary shunt?

Blood flows through the lungs without taking part in gas exchange.

Which parameter should be monitored for a patient with diabetes mellitus and chronic obstructive pulmonary disease (COPD) who is taking oral prednisone?

Blood sugar

Which benefits of a pulmonary rehabilitation (PR) program will the nurse include when encouraging a patient to consider PR? Select all that apply.

Boosts mood Reduces dyspnea Enhances quality of life

Which benefits of a pulmonary rehabilitation (PR) program will the nurse include when encouraging a patient to consider PR? Select all that apply.

Boosts mood Correct3 Reduces dyspnea Correct4 Enhances quality of life

The family of a patient with newly diagnosed tuberculosis is tested for infection with Mycobacterium tuberculosis. The patient's spouse, who has a history of alcoholism, has had two negative Mantoux (purified protein derivative [PPD]) tests. Both of their children have positive Mantoux results. The nurse recognizes that a course of preventive treatment with isoniazid (INH) will be recommended for which family members?

Both children only

Which parameter is most important to monitor for the patient who has been started on prednisone for an asthma exacerbation?

Breath sounds

Which nursing actions will be included for a patient with chronic obstructive pulmonary disease (COPD) who is receiving oxygen therapy through a mask? Select all that apply.

Choose the optimal oxygen device. Assess the need to adjust the oxygen flow rate. Monitor for signs of adverse effects of oxygen therapy.

The nurse notes that a patient is experiencing breathlessness, chest tightness, and a cough after climbing stairs. Which cause is the most likely reason for these symptoms?

Capillary leakage in the airway

When educating a patient with chronic obstructive pulmonary disease (COPD) who continues to smoke cigarettes, which complication of smoking would the nurse discuss with the patient?

Cardiovascular disease

Which suggestions will the nurse make for a patient with radiation-induced xerostomia? Select all that apply.

Carry a water bottle. Suck on sugarless candy. Use artificial saliva solutions

Which action will the nurse take when assessing a patient with possible oral cancer?

Check mouth for leukoplakia.

Which action will the nurse take first for a patient who has new onset confusion and agitation?

Check oxygen saturation.

Which action will the nurse take first when a patient presents to the emergency department with acute shortness of breath and possible asthma attack?

Check pulse oximetry.

Which action will the nurse take first when a patient with respiratory failure becomes agitated and restless?

Check pulse oximetry.

Which treatment strategy would the nurse expect to incorporate into the plan of care for a patient with dyspnea, cough, pain upon inhalation, decreased movement of the chest on the affected side, and decreased breath sounds upon auscultation?

Chemical pleurodesis

Which food will the nurse suggest for a patient with oral mucositis?

Cherry yogurt

Which clinical manifestations of bronchiectasis should be reported to the health care provider? Select all that apply.

Chest pain Fever and chills Blood clots in the sputum Increased sputum production

Which treatment strategy may help to relieve the patient's symptoms of chronic sinusitis caused by impaired ciliary movement in the airway?

Chest wall oscillation

The nurse observes another staff member providing care for a patient who has a chest tube in place. Which action by the staff member may result in increased air in the pleural space and requires the nurse to intervene?

Clamps the chest tube while ambulating the patient in the hallway

The registered nurse mentors a new graduate nurse. The new graduate provides care for a patient who has a chest tube in place after a partial lobectomy. Which action by the new graduate requires the mentor to intervene?

Clamps the chest tube while the patient is ambulating

Before administering prescribed oxygen therapy via face mask, the nurse would assess whether the patient has a history of which problem?

Claustrophobia

Which assessment finding by the nurse indicates that a patient's prescribed ipratropium inhaler has been effective?

Clear lung sounds

Which assessment is most helpful in evaluating whether nursing interventions to improve a patient's ineffective cough have been successful?

Clearance of mucus from the bronchi

A patient with a spontaneous pneumothorax has a chest tube in place that is attached to a chest drainage unit (CDU) with no suction being applied. The water level in the water-seal chamber is fluctuating. Which action does the nurse take?

Continue to monitor and document the respiratory status.

Which conditions are late complications of cystic fibrosis (CF) caused by pulmonary hypertension? Select all that apply.

Cor pulmonale Respiratory failure

After the inhalation of puffs of mometasone, a patient develops oropharyngeal candidiasis, hoarseness, and dry cough. Which action would the nurse take to reduce the symptoms?

Correct2 Instruct the patient to rinse the mouth with water after inhalation. Incorrect3

Which change in lung function occurs as a result of loss of surfactant production in a patient with acute respiratory distress syndrome (ARDS)?

Correct2 Loss of alveolar stability

Which instruction will the nurse give a patient with chronic obstructive pulmonary disease (COPD) who shows increased work of breathing (WOB)?

Correct3 "Sit with your arms propped on the overbed table."

Which diagnostic test result will the nurse expect when a patient has respiratory failure as a result of a pulmonary embolism?

Correct4 Ventilation-perfusion (V/Q) mismatch on lung scan

Which manifestations would the nurse identify with asthma? Select all that apply.

Cough Wheezing Chest tightness

Which early clinical manifestations of acute respiratory distress syndrome (ARDS) will the nurse monitor for when caring for a patient admitted with sepsis? Select all that apply.

Cough and restlessness Correct4 Dyspnea and tachypnea Correct5 Adventitious lung sounds

Inadequate oxygen transfer between the alveoli and the pulmonary capillaries

Crackles

When caring for a patient who has pulmonary edema, which finding will the nurse expect when listening to breath sounds?

Crackles

Which clinical manifestations of acute respiratory distress syndrome (ARDS) are caused by increased pulmonary capillary permeability during the initial phase of ARDS? Select all that apply.

Crackles Intercostal retractions Decreasing oxygen saturation

Which adventitious sounds may be auscultated when assessing a patient with pleuritic chest pain and dyspnea? Select all that apply.

Crackles Wheezes

Which diagnostic testing will the nurse monitor to evaluate for adverse effects of vancomycin that has been prescribed for a patient with acute respiratory distress syndrome (ARDS)?

Creatinine 2

Which term describes an autosomal recessive, multisystem disease characterized by altered function of the exocrine glands?

Cystic fibrosis (CF)

Which pathophysiologic process results in surfactant dysfunction during the injury phase of acute respiratory distress syndrome (ARDS)?

Damage to alveolar type I and II cells

A patient recovering from thoracic surgery reports to the nurse feeling short of breath. Upon auscultation, which finding would confirm the nurse's suspicion of atelectasis?

Diminished breath sounds with dullness to percussion

A patient hospitalized with a cough, weight loss, increased sputum, decreased pulmonary function, pain in the lower right quadrant, nausea, and emesis may be experiencing which condition?

Distal intestinal obstructive syndrome

Which instructions will the nurse give to the patient with chronic obstructive pulmonary disease (COPD) to promote sleep? Select all that apply.

Do not smoke between periods of sleep. Ask the health care provider about testing for sleep apnea. Use saline nasal sprays before sleep if experiencing postnasal drip.

Which treatment helps to degrade deoxyribonucleic acid of neutrophils in the sputum of a patient with cystic fibrosis (CF)?

Dornase alfa

The nurse notes that a patient's treatment plan for chylothorax includes chemical pleurodesis. The nurse expects that which medication will be prescribed?

Doxycycline

Postural drainage is the use of positioning techniques to accomplish which clinical action?

Drain secretions from specific segments of the lungs and bronchi into the trachea.

The nurse is assessing a patient who is hospitalized with suspected tuberculosis (TB) and expects which initial manifestations? Select all that apply.

Dry cough that becomes productive Malaise Low-grade fever Unexplained weight loss

Which side effect of radiation therapy will the nurse anticipate for a patient who has laryngeal cancer?

Dry mouth

Which action will the nurse take for a male patient with cystic fibrosis (CF) who states, "I hope that this condition allows me to have biologic children"?

Educate the patient about assisted reproductive technology.

Which action by the student nurse indicates effective learning about measures to be followed for a patient who is receiving radiation therapy for head and neck cancer?

Educating patients to avoid using over-the-counter lotions on irradiated skin

Outpatient pulmonary rehabilitation (PR) for a patient with chronic obstructive lung disease (COPD) usually includes which components? Select all that apply.

Education Exercise training Nutrition counseling

Which finding indicates that interventions to promote airway clearance in a patient admitted with chronic obstructive pulmonary disease (COPD) have been successful?

Effective and productive coughing

Which actions will the nurse take as part of the ventilator bundle when caring for a patient with acute respiratory failure who requires mechanical ventilation? Select all that apply.

Elevate head of bed to 30-45 degrees. Administer proton pump inhibitors. Give injectable anticoagulant medications.

Which nursing interventions are a priority for a patient with cystic fibrosis admitted for treatment of bronchiectasis who has begun coughing up bloody sputum? Select all that apply.

Elevate the head of the bed. Immediately contact the health care provider. Place the patient in a side-lying position, suspected bleeding side down.

The nurse expects which assessment finding in a patient with wheezing, coughing, and frequent pneumonia who experiences large, oily, and frequent bowel movements, and whose medical history reveals poor absorption of fats and proteins?

Emaciated appearance of the extremities

When a patient in respiratory distress has thick and viscous secretions that are difficult to expel, which actions will the nurse take? Select all that apply.

Encourage oral fluid intake of 2 to 3 L daily. Correct2 Use a nebulizer to administer aerosolized normal saline. Incorrect3 5

Which interventions may be included in the plan of care for a patient with advanced stage chronic obstructive pulmonary disease (COPD) who has experienced significant weight loss? Select all that apply.

Encourage rest before meals. Encourage high-protein supplements between meals.

How will the nurse respond to a patient who has been prescribed oxygen (O2) for home use and states, "Does this mean that I will not be able to go anywhere?"

Encourage the patient to continue normal activity and travel plans.

The nurse will include which intervention when caring for a patient with bloody sputum, dyspnea, fever, chills, and chest pain?

Encourage the patient to drink 3 liters of water daily.

Which intervention may be beneficial to a patient with pleuritic chest pain, dyspnea, wheezing, and mouth bleeding?

Encourage the patient to receive the pneumococcal and influenza vaccinations.

The nurse is caring for a patient with acute pulmonary embolism (PE) and expects that which subcutaneous medication will be included in the patient's treatment plan?

Enoxaparin

A patient started treatment for sputum smear-positive tuberculosis (TB) 1 week prior to the home health nurse's visit. Which instructions does the nurse provide to the patient to minimize exposure to close contacts and household members? Select all that apply.

Ensure that the home is well ventilated. Correct3 Sleep alone. Correct4 Spend as much time as possible outdoors. Correct5 Minimize time in congregate settings. Correct6 Minimize time on public transportation.

Which interprofessional intervention will the nurse anticipate implementing for a patient with stage IV oral cancer who has a low body mass index (BMI)?

Enteral nutrition

Which nursing interventions may be included in the plan of care for a patient with pancreatic insufficiency associated with cystic fibrosis (CF)? Select all that apply.

Evaluate blood glucose levels. Provide fat-soluble vitamin supplementation. Prepare to provide pancreatic enzyme replacement medications.

When admitting a patient with a diagnosis of asthma exacerbation, the nurse will assess for which potential triggers? Select all that apply.

Exercise Allergies Emotional stress upper respiriatoy distress

Which action is important for energy conservation for a patient undergoing chronic obstructive pulmonary disease (COPD) rehabilitation?

Exercise training

A pediatric patient presents with a 2-week history of cough, clear sputum, headache, hoarseness, and myalgias. The patient has no significant medical history. The patient's parent asks why there is no plan to administer an antibiotic. How does the nurse respond?

Explain that antibiotics are not required for the patient.

When a patient with fractured ribs reports pain but does not want to use prescribed pain medications, which action by the nurse is best?

Explain that pain medications will improve deep breathing and coughing.

Which action would the clinic nurse take when a patient with asthma requests that the prescribed monthly dose of omalizumab be administered at home instead of at the clinic?

Explain to the patient that the medication must be administered at the clinic.

Which finding would confirm a diagnosis of chronic obstructive pulmonary disease (COPD) in a patient with dyspnea and a history of tobacco use?

FEV1/FVC ratio of 65%

Which clinical manifestations of respiratory failure are associated with hypoxemia? Select all that apply.

Fatigue Confusion Restlessness

A patient with dyspnea, cough, chest pain, and a body temperature of 101° F has crackling and wheezing sounds upon auscultation. Which treatment strategy would the nurse expect to incorporate into the patient's plan of care?

Fibrinolytic agents

Which condition in a patient with chest trauma requires treatment with positive pressure ventilation?

Flail chest

The nurse expects which assessment finding in a patient with cystic fibrosis (CF) who has a body temperature of 102° F, shortness of breath, sore throat, and purulent mucus?

Formation of bullae and blebs in lungs

Which intervention may be included in the plan of care for a patient with intermittent obstruction of the terminal ileum who experiences thickened, dehydrated stools, increased mucus production and who develops chronic malabsorption due to partial bowel obstruction?

Gastric decompression and ingesting polyethylene glycol

When a patient has been diagnosed with advanced head and neck cancer, which interprofessional intervention will the nurse expect in addition to chemotherapy, radiation, and surgical treatment?

Gastrostomy tube

A patient who is being treated at home for pneumonia reports fatigue to the home health nurse. Which instructions does the nurse provide for the patient? Select all that apply.

Get adequate rest. Avoid alcohol and smoking. Take every dose of the prescribed antibiotic.

When diagnostic testing indicates ventilation-perfusion (V/Q) mismatch in a patient with respiratory failure who is hypoxemic, which prescribed action will the nurse implement first?

Give oxygen using a non-rebreather mask.

Before administering ipratropium bromide, the nurse must confirm that the patient does not have which comorbidity?

Glaucoma

Which action will the nurse take first when a patient with asthma calls the clinic and reports a peak flow rate of 45% of the personal best and dyspnea that occurs with any exertion?

Have the patient take 4 puffs of the prescribed albuterol inhaler.

Which clinical manifestation does the nurse expect to find during the respiratory assessment of a patient with pneumonia?

Increased fremitus

Which change occurs with cystic fibrosis (CF)?

Increased inflation of lungs

When the nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) exacerbation who requires oxygen administration, which assessment finding is of most concern?

Increased lethargy

Which finding indicates treatment with ipratropium has been effective?

Increased peak flow readings

The nurse expects to find which pathologic change in a patient with pulmonary arterial hypertension (PAH)?

Increased pulmonary vascular resistance

The nurse will instruct a patient with bronchiectasis to report which clinical manifestation to the health care provider?

Increasing dyspnea

When planning care for a patient with pneumonia, the nurse recognizes that which is a high-priority intervention?

Increasing fluids to at least 6 to 10 glasses/day, unless contraindicated

To prevent respiratory complications of chronic obstructive pulmonary disease, which vaccines will the nurse plan to administer? Select all that apply.

Influenza, Pneumococcal

A patient with a 10-year history of regular (three beers per week) alcohol consumption began taking rifampin to treat tuberculosis (TB). During a follow-up visit one week after starting the medication, the patient tells the nurse, "In the last week, my urine turned orange, and I am very worried about it." How does the nurse respond?

Inform the patient that it is one of the side effects of the medication.

When a patient presents with acute exacerbation of asthma, which actions will the nurse anticipate as part of the interprofessional treatment plan? Select all that apply.

Infuse IV corticosteroids. Provide oxygen through a non-rebreather mask. Start nebulized short-acting β2-adrenergic agonist.

Which action by a student nurse who is caring for a patient who, after laryngectomy and tracheostomy, indicates the need for further training?

Infuses saline into the tube to remove thickened secretions

A patient who is receiving therapy for bronchial hyperresponsiveness has developed oropharyngeal candidiasis, hoarseness, and dry cough. The nurse suspects which medication as the cause of the patient's symptoms?

Inhaled fluticasone

Which nursing action may be included in the plan of care for a patient with chronic obstructive pulmonary disease (COPD) who is complaining of difficulty breathing?

Initiate oxygen (O2) administration at low flow rates.

When the nurse does patient teaching about how to decrease risk for head and neck cancer, which instructions will be included? Select all that apply.

Limit your alcohol intake. Brush your teeth at least daily. Stop use of chewing tobacco and cigarettes. Use condoms for oral sex and sexual intercourse.

Which action may be beneficial to a patient with chronic obstructive pulmonary disease (COPD) to maximize food intake?

Limiting fluids during mealtimes

Which complication would the nurse expect in a patient with chronic obstructive pulmonary disease who has α1-antitrypsin (AAT) deficiency?

Liver disease

Which parameter must the nurse monitor in a patient taking ambrisentan?

Liver function test

Which prescribed medication will the nurse question for a patient who has respiratory failure caused by opioid overdose and aspiration?

Lorazepam

When teaching a class on smoking cessation, which benefits of tobacco cessation will the nurse include? Select all that apply.

Lower cancer risk Improvement in chronic cough Enhanced sense of taste and smell

The nurse should instruct a patient with chronic obstructive pulmonary disease (COPD) to perform which action for effective huff coughing?

Lung volume reduction surgery (LVRS)

Which surgical option may be utilized to reduce the size of hyperinflated emphysematous lungs and decrease airway obstruction for a patient with severe chronic obstructive pulmonary disease (COPD)?

Lung volume reduction surgery (LVRS)

Which actions will the nurse take to help a patient to clear copious thick respiratory secretions after surgery for neck cancer? Select all that apply.

Maintain oral and IV fluid intake. Provide humidification for inspired gases. Assist the patient with coughing and deep breathing.

An unconscious patient who was brought to the emergency department responded well to cardiopulmonary resuscitation (CPR). After several hours in stable condition, the patient experiences dyspnea, tachycardia, cyanosis, and neck vein distention. The nurse prepares for which immediate intervention?

Needle decompression

Which intervention will the nurse anticipate when a patient is diagnosed with acute respiratory distress syndrome (ARDS)?

Mechanical ventilation

Which finding helps to diagnose cystic fibrosis (CF) in a newborn?

Meconium ileus

A patient with asthma has been taking low-dose inhaled corticosteroids along with long-acting ß 2-agonists for three months and shows signs of inadequate control. Which treatment would the nurse expect to incorporate into the plan of care?

Medium-dose inhaled corticosteroids and long-acting ß 2-agonist

A patient with an ineffective breathing pattern due to alveolar hypoxia may benefit from which nursing interventions? Select all that apply.

Monitor for respiratory muscle fatigue. Encourage slow, deep breathing and coughing. Elevate the head of the bed and provide an over-bed table for the patient. Titrate supplemental oxygen according to arterial blood gas (ABG) readings.

The nurse is caring for a patient who receives enteral feeding through a nasogastric (NG) tube. Which actions does the nurse perform to prevent aspiration in this patient? Select all that apply.

Monitor gastric residual volumes. Assess the gag reflex before giving foods or fluids by mouth. Elevate the head of the bed to at least 30 degrees. Encourage the patient to sit upright for all meals.

Which actions will the nurse take when administering benzodiazepines and opioids to a patient with respiratory failure? Select all that apply.

Monitor heart rate and BP. Correct2 Assess respiratory rate and depth frequently.

Which action will the nurse take when a patient is receiving methylprednisolone IV?

Monitor serum potassium levels.

A patient is diagnosed with pulmonary embolism. Which interventions are appropriate to be included in the patient's plan of care? Select all that apply.

Monitor the patient's hemoglobin level. Maintain an IV line for medications and fluid therapy. Monitor for complications of anticoagulant therapy.

The nurse is caring for a patient with pneumonia and expects which interventions to be included in the treatment plan? Select all that apply.

Monitor the patient's response to treatment. Provide adequate hydration by encouraging fluid intake Provide postural drainage and chest percussion.

Which prescribed medication will the nurse administer when a patient with respiratory failure caused by pulmonary edema develops tachypnea, agitation, and restlessness?

Morphine sulfate 4

The nurse cares for a patient who is immunocompetent and presents with pulmonary tuberculosis (TB). Which clinical manifestation does the nurse expect?

Mucopurulent sputum

During an assessment of a patient with asthma, the nurse notes wheezing and dyspnea. The nurse interprets these symptoms as related to which pathophysiologic change?

Narrowing of the airway

Which action will the nurse include in the plan of care for a patient who had modified radical neck surgery for laryngeal cancer?

Neck and shoulder range of motion exercises

The nurse finds that a patient with chest trauma exhibits cyanosis, air hunger, neck vein distention, and an increase in intrathoracic pressure. The nurse prepares for which procedure?

Needle decompression

The nurse is caring for a patient with a diagnosis of restrictive lung disease caused by an extrapulmonary condition. Which finding indicates to the nurse a possible relation to Pickwickian syndrome?

Obesity hypoventilation

Which action will the nurse take to evaluate for adverse effects after albuterol administration?

Obtain pulse rate

The health care provider prescribes IV vancomycin for a patient with pneumonia. Which action does the nurse perform first?

Obtain sputum cultures for sensitivity.

Which discharge instructions will the nurse give the caregiver for a patient who has undergone a radical neck dissection and is being discharged with a feeding tube? Select all that apply.

Obtain the patient's weight every day." "Have the patient start taking short daily walks." "Be sure the patient is sitting up for tube feedings.

When would the nurse schedule postural drainage for a patient who has chronic obstructive pulmonary disease (COPD)?

One hour before a meal

Which physical assessment findings will the nurse expect when caring for a patient with cor pulmonale? Select all that apply.

One hour before a meal

A patient with human immunodeficiency virus (HIV) infection has been admitted with pneumonia. The nurse anticipates that the patient will receive treatment for which type of pneumonia?

Opportunistic pneumonia caused by Pneumocystis jiroveci

When a patient is diagnosed with a lung abscess, which does the nurse teach the patient?

Oral antibiotics will be used when the patient and x-ray show evidence of improvement.

Which finding indicates that a patient with chronic obstructive pulmonary disease (COPD) requires home oxygen therapy?

Oxygen saturation (SaO2) 87% at rest

Which finding by the nurse is the best indicator that measures to improve oxygenation in a patient on mechanical ventilation for acute respiratory distress syndrome have been effective?

Oxygen saturation 90% to 93%

Which delivery device is used for long-term oxygen therapy?

Oxygen-conserving cannula

When the nurse notes difficulty in waking a patient with respiratory failure who also reports a headache, which diagnostic test will be most useful to check?

PaCO2

Which assessment finding would the nurse expect when caring for a patient with asthma?

PaCO2 of 30 mm Hg

Which finding for a patient with acute respiratory distress syndrome (ARDS) who is receiving mechanical ventilation with positive end-expiratory pressure (PEEP) indicates that current therapies are effective?

PaO2 is greater than or equal to 60 mm Hg.

Which action will the nurse take to prevent complications when a patient is using an oxygen-conserving cannula?

Pad the tubing over the patient's ears.

Which medication will the nurse expect to administer to a patient who is receiving head and neck radiation for laryngeal cancer?

Pilocarpine hydrochloride

Which action by a new nurse, while providing enteral feedings to a patient who is scheduled for laryngectomy for head and neck cancer, indicates a need for correction?

Placing the patient in a supine position during feedings

Which intervention may be included in the plan of care for a patient with cystic fibrosis (CF) who experiences wheezing, coughing, and frequent pneumonia, and whose CT shows bullae and blebs of 1 to 2 cm in the lungs?

Pleural abrasion

Which condition would the nurse suspect in a patient when the breath sounds are loud and squeaking during inhalation?

Pleuritis

Which vaccine would the nurse recommend to a 65-year-old patient with chronic obstructive pulmonary disease (COPD)?

Pneumococcal

A patient presents to the emergency department with a temperature of 101.4°F (38.6°C) and a productive cough with rust-colored sputum. The nurse suspects which diagnosis?

Pneumonia

Which complications in a patient with chronic obstructive pulmonary disorder (COPD) require acute intervention? Select all that apply.

Pneumonia Cor pulmonale Exacerbations

Which complication will the nurse suspect when a patient who is being mechanically ventilated for acute respiratory distress syndrome (ARDS) suddenly develops tachycardia, has increased respiratory rate, and has absent breath sounds on one side?

Pneumothorax

Which condition may develop if cystic fibrosis of the liver is left untreated?

Portal hypertension

Which actions will the nurse take to improve oxygenation in a patient who is being treated for respiratory failure due to chronic obstructive pulmonary disease (COPD) and right-sided pneumonia? Select all that apply.

Position the patient on the left side. Assist the patient with huff coughing or staged coughing. Correct4 Titrate oxygen administration to keep pulse oximetry reading at 90%. 5

Which information about the purpose of pursed-lip breathing will the nurse include when teaching a patient with chronic obstructive pulmonary disease about breathing exercises?

Preventing air trapping

Which description best characterizes chronic obstructive pulmonary disease (COPD)?

Progressive persistent expiratory airflow limitation

Which position is used to decrease atelectasis and improve refractory hypoxemia in patients with acute respiratory distress syndrome (ARDS)?

Prone position

The nurse expects which assessment findings in a patient with cystic fibrosis (CF) and bronchiectasis? Select all that apply.

Protuberant abdomen Emaciated appearance of the extremities

Which actions will the nurse take to prevent respiratory failure in a patient who has rhonchi, crackles, and a nonproductive, weak cough? Select all that apply.

Provide humidified oxygen. Correct3 Provide chest physiotherapy. Assist the patient with staged coughing.

Which nursing interventions will the nurse include while providing care to a patient after a total laryngectomy? Select all that apply.

Provide wound care. Ensure proper nutrition. Provide an alternate form of communication

The nurse is caring for a patient with an acute pulmonary embolism (PE). Which nursing intervention would be appropriate for this patient?

Providing comfort by elevating the bed to 45 degrees

When planning care for a group of patients who are hospitalized with upper respiratory problems, which actions will the registered nurse delegate to unlicensed assistive personnel (UAP)? Select all that apply.

Providing oral care to a patient Suctioning a patient's oropharynx

Which is the most common organism found in heated nebulizers used for humidification during oxygen administration?

Pseudomonas aeruginosa

A patient with a diagnosis of chylothorax is prescribed octreotide. Which outcome does the nurse expect after the treatment?

Reduced flow of lymphatic fluid

When a patient who has been successfully treated for acute respiratory distress syndrome (ARDS) reports anxiety and vivid dreams that interfere with sleep, which action will the nurse take?

Refer the patient for counselling. Incorrect3

Which teaching will the nurse include for a patient with difficulty in breathing due to a low oxygen level in the blood?

Refrain from sexual activity after eating.

Which patient care goals are appropriate for a patient with chronic obstructive pulmonary disease (COPD)? Select all that apply.

Relief of symptoms Improved quality of life Prevention of disease progression Ability to perform activities of daily living (ADLs)

Which pathophysiologic change occurs in the fibrotic phase of acute respiratory distress syndrome (ARDS)?

Remodeling of the lung by collagenous and fibrous tissues

Which condition would the nurse monitor for in a patient after a rapid draining of 1500 mL of fluid during a thoracentesis?

Respiratory distress

Which information would the nurse educator include when explaining respiratory failure to new nursing staff members? Select all that apply.

Respiratory failure is categorized as hypoxemic or hypercapnic. Correct3 Respiratory failure is insufficient oxygen transfer into the blood. Correct4 Respiratory failure is inadequate carbon dioxide removal from the lungs.

Which physiologic effect of ongoing tobacco smoking leads to chronic obstructive pulmonary disease (COPD)?

Respiratory tract cell hyperplasia

Which teaching will the nurse include in the plan of care for a patient with chronic obstructive pulmonary disease (COPD)?

Rest at least 30 minutes before eating.

Which discharge teaching about nutrition will the nurse include for a patient with chronic obstructive pulmonary disease (COPD) and pneumonia?

Rest for 30 minutes before eating.

The nurse is monitoring a patient who is undergoing a thoracentesis for recurrent pleural effusion. Which assessment finding is of concern?

Restlessness and sudden onset of dyspnea

Which intervention by the nurse would provide stabilization for a patient with cor pulmonale who has an enlarged liver, distended neck veins, and clear fluid accumulated in the pleural space?

Restricting sodium diet

Which instruction will the nurse give to a patient who has a prescription for beclomethasone?

Rinse mouth thoroughly after each use.

Which action will the nurse take for a patient who has theophylline prescribed for asthma control?

Schedule monitoring of serum levels of theophylline.

The nurse identifies that which factor places a patient at risk for aspiration pneumonia?

Seizures

Which conditions predispose a patient to acute respiratory distress syndrome (ARDS) by causing an indirect lung injury? Select all that apply.

Sepsis Opioid drug overdose Severe massive trauma

The nurse cares for a 75-year-old patient with pneumonia and identifies that the patient is at risk for which complications? Select all that apply.

Sepsis Pleurisy Pleural effusion

Which condition is an example of an indirect lung injury that increases the risk for developing acute respiratory distress syndrome (ARDS)?

Severe trauma

Which type of medication may be included in the plan of care for a patient with chronic obstructive pulmonary disease (COPD) who experiences dyspnea and has a forced expiratory volume (FEV1) of 70% of predicted value?

Short-acting bronchodilator

A patient with asthma is prescribed formoterol. Which directive would the nurse include in the medication education provided to the patient? Select all that apply.

Side effects include cold or flu-like symptoms." "Formoterol is not the only medication that you will need to treat your asthma." "If wheezing gets worse, there are other types of medications that are more beneficial than formoterol."

Which medication for the treatment of pulmonary hypertension would the nurse identify as being contraindicated with the administration of nitroglycerin?

Sildenafil

Which assessment finding indicates a life-threatening situation for a patient experiencing an acute asthma attack?

Silent chest

When the nurse needs to transport a patient who needs an FiO2 of 45% to a different department, which oxygen delivery device will be best to use?

Simple face mask

Which instruction will the nurse give to the patient who is receiving a nebulized bronchodilator treatment?

Sit in an upright position during the treatment.

The nurse is providing postoperative care for a patient three days after a total knee arthroplasty. The patient reports a sudden onset of shortness of breath, slight chest pain, and that "something is wrong." The assessment findings include a temperature of 98.4°F (36.9°C), BP 130/88 mm Hg, respirations 36 breaths/min, and an oxygen saturation reading of 91% on room air. Which immediate action does the nurse take?

Sit the patient up in bed as tolerated and apply oxygen.

Which intervention may improve gas exchange for a patient with chronic obstructive pulmonary disease (COPD) whose oxygen saturation is 88%?

Sit the patient upright in a chair leaning slightly forward.

Which instruction will the nurse give a patient with chronic obstructive pulmonary disease who is using the Flutter airway clearance device?

Sit upright while using the device.

When caring for a patient who is scheduled for total laryngectomy, which interprofessional interventions will the nurse anticipate for voice restoration? Select all that apply.

Speech-therapy referral Transesophageal puncture surgery

Which test should a patient undergo regularly to assess the severity of α1-antitrypsin deficiency (AATD)?

Spirometry

A patient is admitted to a general medical-surgical hospital unit from the home setting for the treatment of pneumonia. The patient receives a prescription for cefuroxime. The nurse verifies that which diagnostic study is completed before administering the first dose of the medication?

Sputum culture and sensitivity

A patient presents with a productive cough, a temperature of 102°F (38.9°C), and a white blood cell (WBC) count of 15,000/mm3. The nurse would expect which diagnostic test to be ordered?

Sputum culture test

A patient with asthma calls the clinic and reports chest tightness, a peak flow meter reading at 65% of personal best, and waking up short of breath frequently during the night. Which interprofessional action will the nurse anticipate being taken first?

Start oral corticosteroid.

Which finding by the nurse indicates that administration of pantoprazole to a patient with respiratory failure has been effective?

Stool testing for occult blood is negative.

A patient with an iatrogenic pneumothorax has a chest tube that is connected to a chest drainage unit (CDU). The nurse assesses swelling in the head and neck and a compromised airway. The nurse suspects which complication?

Subcutaneous emphysema

A patient is admitted to an intensive care unit in stable condition with suspected acute pulmonary embolism (PE). The nurse prepares for the administration of which medication?

Subcutaneous enoxaparin

Which medication route of administration and schedule would the nurse include in the information provided to a patient who has been prescribed omalizumab?

Subcutaneously every two to four weeks

Which action would the nurse take first for a patient with a tracheostomy who appears anxious and is having difficulty in coughing up thick respiratory secretions?

Suction the tracheostomy.

Which treatment strategy does the nurse expect will be prescribed for a patient with cor pulmonale, arteriolar vasoconstriction, and a PaO2 of 50 mm Hg?

Supplemental oxygenation

A patient with dyspnea and who is unable to speak clearly has a respiratory rate of 45 breaths/min, a pulse of 130 beats/min, oxygen saturation of 90%, and neck vein distention. Which treatment would the nurse expect to incorporate into the plan of care?

Supplementary oxygen through nasal cannula

A patient with heart failure has a pulmonary arterial pressure of 28 mm Hg when at rest. Which intervention would the nurse implement?

Supplying oxygen to the patient

The bubbling in a patient's chest drainage unit (CDU) has increased, and the nurse suspects an air leak. The patient's chest tube is numbered from 1 to 5 in regular increments on the tube. To determine the location of the air leak, the nurse briefly and methodically clamps down the tubing away from the patient. The leak stops when the tube is clamped between the numbers 3 and 4. How does the nurse interpret the finding?

The air leak is in the tube between points 3 and 4.

The nurse presents education about pertussis for a group of nursing students and includes which information? Select all that apply.

The cough may last from 6 to 10 weeks. It is a highly contagious respiratory tract infection. Treatment usually includes macrolide antibiotics. Cough suppressants and antihistamines should not be used.

A pediatric patient receives treatment for pertussis. During a follow-up visit, the parent states, "I have given my child cough suppressants and the prescribed antibiotics since the diagnosis was made 2 weeks ago. But my child's cough has worsened." How does the nurse interpret the information?

The cough suppressants have induced coughing.

The nurse provides care for a patient who has a chest drainage unit (CDU) in place. Which assessment finding indicates the need for the nurse to contact the health care provider immediately?

The drainage is 120 mL/hr.

One week after a thoracotomy, a patient with a chest tube attached to a chest drainage unit (CDU) experiences an air leak in the system. Which assessment finding warrants follow-up nursing interventions?

The dressing over the chest tube insertion site is loose.

A patient has a chest tube inserted to treat a pneumothorax. Which observation causes the nurse to conclude that the water-seal chamber of the chest drainage unit (CDU) is functioning properly?

The level in the water-seal chamber fluctuates with respirations.

The nurse presents education to a group of nursing students about lung abscess and includes which information?

The purulent sputum that is produced is often dark brown

A patient with asthma develops nausea, vomiting, headache, tachycardia, and dysrhythmias. The nurse would suspect which medication as the cause of the symptoms?

Theophylline

Which patient actions indicate a need for more education about how to use a dry powder inhaler device? Select all that apply.

The patient breathes into the inhaler. The patient shakes the medicine before using it. The patient inhales more than 1 puff with each inspiration.

A patient admitted with severe wheezing in the exacerbation of asthma continues to struggle with breathing after the wheezes dissipate. Which interpretation would the nurse derive from the assessment findings?

The patient has respiratory failure and needs mechanical ventilation.

Which actions by a patient with asthma who is using a metered-dose inhaler (MDI) indicate a need for more teaching by the nurse? Select all that apply.

The patient holds the breath for five seconds. The patient presses the MDI gently.

A patient with chronic obstructive pulmonary disease is being considered for lung transplantation. The patient's medical history includes melanoma and hepatitis A, and the patient is not a current smoker. Which statement is true regarding transplantation eligibility?

The patient is eligible for lung transplantation.

Which patient with respiratory failure is a good candidate for noninvasive positive pressure ventilation (NIPPV)?

The patient who has decreased ventilation because of myasthenia gravis crisis

Which patient who has just arrived in the emergency department will the nurse assess first?

The patient who is sitting in tripod position and not speaking

When four patients arrive in the emergency department reporting respiratory distress, which patient will the nurse assess first?

The patient whose chest and abdomen are moving inward during inspiration

Following a thoracotomy, a patient uses patient-controlled analgesia (PCA). Which related outcomes does the nurse expect? Select all that apply.

The patient will have an effective cough. The patient will be able to take deep breaths. The patient will be able to move the arm on the operative side

Which statement made by the student nurse indicates effective learning about antibiotic therapy for a patient with cystic fibrosis (CF) who experiences a productive cough, PaO2 of 50 mmHg, arteriolar vasoconstriction, and cor pulmonale?

The patient will require prolonged high-dose antibiotic therapy."

The nurse reviews the medical records of patients diagnosed with community-acquired pneumonia (CAP) and identifies that the patients meet which criterion?

The patients have not been hospitalized or have not lived in a long-term care facility within 14 days of the onset of symptoms.

The nurse is caring for a patient who has a chest tube with a wet suction system in place. There is no bubbling in the suction control chamber of the chest drainage unit (CDU). How does the nurse interpret the finding?

The pleural air leak is very large.

A patient with a pneumothorax has a chest tube in place. The nurse verifies that there are no leaks in the tubing or at the insertion site. The nurse notes that there is no bubbling in the suction control chamber of the chest drainage unit (CDU). Which are the most probable reasons for the absence of bubbling? Select all that apply.

There is no suctioning being applied. The suction pressure is very low. The pleural air leak is so large that the suction is not high enough to evacuate it.

When selecting a diet for a patient who has had partial laryngectomy, which item would the nurse avoid?

Thin, watery fluids

The nurse recognizes that airborne infection isolation for a patient with pulmonary tuberculosis (TB) can be discontinued when which criterion is met?

Three consecutive acid-fast bacillus (AFB) smears are negative.

The nurse recognizes that which number of nighttime awakenings caused by asthma symptomology would be classified as mild disease?

Three to four days per month

A patient with chest pain and dyspnea has increased pulmonic and right-sided S4 heart sound. Which treatment strategy would the nurse expect to incorporate into the plan of care?

Thromboendarterectomy

The nurse is caring for a patient with pulmonary hypertension. Which treatments would the nurse question? Select all that apply.

Thrombolytics Antibiotics

The nurse is assigned to care for a patient who is experiencing an exacerbation of asthma and is very anxious. Which would be the primary reason for the nurse to carefully inspect the chest wall of this patient?

To evaluate the use of intercostal muscles

The nurse provides care for a patient who is in the early phases of acute respiratory distress syndrome (ARDS). The nurse identifies that the patient is placed in the prone position for which primary reason?

To reexpand alveoli

When providing community teaching about how to lower risk for head and neck cancer, which topic will the nurse list as the main cause of head and neck cancers?

Tobacco

The nurse provides care for a patient who sustained multiple injuries as a result of a motor vehicle accident. Which assessment finding requires immediate intervention?

Tracheal deviation

When teaching a patient who is scheduled for radiation therapy to treat head and neck cancer, which topic will the nurse include?

Treatment of xerostomia

Which postural drainage position will the nurse avoid when caring for a patient with chronic obstructive pulmonary disease and cor pulmonale?

Trendelenburg position

After connecting a patient's chest tube to a dry suction system, which action does the nurse take next?

Turn the suction dial on the CDU to -20 cm H2O pressure.

Which factor is the primary cause of bronchiectasis?

Untreated or delayed treatment of bacterial lung infections

Which interventions to prevent respiratory infection may be included in discharge instructions for a patient with chronic obstructive pulmonary disease (COPD) who has been advised to use oxygen therapy at home? Select all that apply.

Use mouthwash several times a day. Wash the nasal cannula twice a week Change the nasal cannula every two weeks.

The nurse will suggest which intervention for the patient experiencing an acute exacerbation of chronic obstructive pulmonary disease (COPD)?

Use typed messages to communicate.

Which discharge instructions would the nurse include for the patient with asthma? Select all that apply.

Wash the nebulizer regularly. Medication noncompliance may lead to exacerbations. It is important to know the purpose and side effects of prescribed medications

Which complications would the nurse monitor for when caring for a patient with chronic obstructive pulmonary disease (COPD) and cor pulmonale? Select all that apply.

Weight gain Polycythemia Hepatomegaly Jugular vein distension

Which assessment finding is the most common clinical manifestation of an asthma attack?

Wheezing

After initial treatment of a patient with an acute asthma exacerbation, which finding indicates improvement in the patient's respiratory function?

Wheezing becomes louder.

Which action would the clinic nurse take when a patient with asthma requests that the prescribed monthly dose of omalizumab be administered at home instead of at the clinic?

Wheezing becomes louder.

A patient received antibiotic treatment for bacterial pneumonia. The nurse determines that the levofloxacin therapy has not been effective after noting which indicator?

White blood cell count 16,000/μL

Which information about gender, cultural differences, and ethnic differences in patients with obstructive lung disease will the nurse use when planning care?

Whites have the highest incidence of cystic fibrosis.

Which etiologic factor would the nurse use when choosing the nursing diagnosis of activity intolerance for a patient with asthma?

Work of breathing

The nurse is preparing a community education session related to the increased incidence of tuberculosis (TB) among the city's residents. The nurse identifies that which populations are most at risk for the disease? Select all that apply.

Workers at a nearby prison Adults who are homeless Middle-aged adults who live in the inner-city neighborhood Immigrants from an underdeveloped country who live in temporary housing in the city

When a patient is receiving external radiation therapy to the lower jaw and neck for cancer of the larynx, which complication will the nurse expect?

Xerostomia

A patient presents for a follow-up office visit one week after sustaining rib fractures that resulted in flail chest. Which instructions does the nurse provide to the patient? Select all that apply.

You may want to sleep in the semi-Fowler's position to make your breathing easier." "You may experience intercostal pain for several more weeks, so pain medication may still be needed."

A patient with chest trauma has a chest tube in place. Upon entering the patient's room, the nurse notes that the chest tube is completely broken at the midpoint and is no longer attached to the drainage unit. Which action does the nurse take?

laces the tubing in a sterile water container

In which position will the nurse place the patient with right-sided pneumonia to improve pulmonary gas exchange?

lying on left side position

Which diagnostic findings will the nurse expect when caring for a patient who is experiencing worsening of asthma symptoms? Select all that apply.

positive skin test for allergies Serum and sputum eosinophilia Chest x-ray indicating hyperinflation