Medical-Surgical Respiratory

A nurse on a medical-surgical unit is caring for 4 clients. Which of the following clients should the nurse monitor for crepitus?

A client who has a chest tube following pneumothorax.

A nurse is assisting with the plain of care for a client who is postoperative following a hip arthroplasty. In the client's medical record, the nurse notes a history of COPD. Which of the following oxygen-delivery methods should the nurse recommend to use for this client?

A nasal cannula

A nurse on a medical-surgical unit is caring for a client who is postoperative following a hip replacement. The client reports feeling apprehensive and restless. The nurse collects additional data from the client. Which of the following findings is an indication of pulmonary embolism?

Sudden onset of dyspnea

A nurse is reinforcing teaching with a client who has chronic cough and is scheduled for a bronchoscopy. Which fo the following client statements indicates an understanding of the teaching?

A tissue sample might be obtained during the procedure

A charge nurse receives notifications of the admission of a client who is coughing frequently and whose sputum is pink, frothy and copious. The client has a history of night sweats, anorexia, and weigh loss. Which of the following should the nurse take? (Select all that apply)

Assign the client to a private room with negative-pressure air flow Wear an N95 respirator when entering the client's room

A nurse is caring for a client who is scheduled to have his chest tube removed. Which of the following actions should the nurse take?

Auscultate the lungs after removal.

A nurse on a medical unit is assisting with the care of a client who has a possible closed pneumothorax and significant bruising on the left chest following a motor-vehicle crash. The client reports severe left chest pain on inspiration. The nurse should hear which of the following findings when auscultating the client's lung sounds?

Absence of breath sounds

A nurse is reinforcing discharge instructions with a client who has new laryngectomy. The nurse should tell the client to be careful while bathing to prevent which of the following complications?

Aspiration of water

A nurse is preparing to assist a provider in withdrawing arterial blood form a client's radial artery for ABG measurement. Which of the following actions should the nurses plan to take?

Check the circulation in the client's ulnar artery prior to obtaining the specimen

A nurse is preparing a client for discharge following a bronchoscopy. Which of the following assessments is the nurse's monitoring priority?

Confirming the gag reflex.

A nurse is assisting with the care of a client who has a chest tube inserted 12 hours ago. The nurse notes a crackling sensation upon palpation of the skin on the right side of the client's chest. The nurse should notify the charge nurse that he client is demonstrating a clinical manifestation of which of the following complications?

Crepitus

A nurse is caring for a client who has a tracheostomy with an inflated cuff in place. Which of the following findings indicates that the nurse should suction the client's airway secretions?

The clients has corse cracked in the lung fields

A nurse is reinforcing preoperative teaching with a client who undergo a total laryngectomy. Which of the following statements should the nurse identify as an indications that the clients understands the impact of the surgery?

I understand that I will have a permanent tracheostomy after the surgery

A nurse is assisting with the development of teaching plan about how to prevent an acute asthma attach for a young adult client. Which of the following points should the nurse plan to discuss first?

Determine the client's perception of the disease process and what might have triggered the current attack.

A nurse is caring for a client who smokes cigarettes and has a new diagnosis of emphysema. Which of the following actions should the nurse take to assist the client with smoking cessation?

Discuss ways the client can reduce the number of cigarettes smokes per day

A nurse in a urgent care clinic is collecting data form a client who reports exposure to anthrax. Which of the following findings is an indication of the prodromal stages fo inhalation anthrax?

Dry cough

A nurse is assisting with the plan of care for a client who has COPD and is malnourished. Which of the following recommendations to promote nutritional intake should the nurse include in the plan?

Eat high-calories food first.

A nurse is caring for a client who has pneumonia and is experiencing thick oral secretions. Which of the following actions should the nurse take first?

Encourage deep-breathing and coughing.

A nurse is caring for a client who is experiencing acute opioid toxicity. Which of the following actions should the nurse identify as the priority?

Ensure an adequate airway

A nurse is caring for a client for whom the respiratory therapist has just removed the endotracheal tube. Which of the following actions should the nurse take first?

Evaluate the client for stridor

A nurse is assisting with preparing a client for a bronchoscopy. Which of the following actions should the nurse take? (Select all that apply)

Explain that the client will receive sedation and will not remember the procedure Verify that the client understands the purpose and nature fo the procedure.

A nurse is caring for a client who is postoperative following a rhinoplasty. Which of the following should the nurse report to the surgeon?

Frequent swallowing

A nurse is reinforcing preoperative teaching with a client who is scheduled to undergo a pneumonectomy. The client sates, "I am afraid that coughing will hurt after the surgery." Which of the following responses should the nurse make?

I will show you how to splint your incision while coughing.

A nurse is reinforcing discharge teaching with a client who has pulmonary embolism. Which of the following statements should the nurse identify as an indication that the clients understands the information?

I'll call the doctor if I see any blood in my urine or stool

A nurse is caring for a client who has a chest tube. The nurse notes that the chest tube has become disconnected from the chest drainage system. Which of the following actions should the nurse take?

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

20 year history of COPD and is receiving oxygen at 2 L/min via nasal cannula.

Increase the oxygen flow and request and arterial blood gas determination

A nurse on a med-surg unit is collecting data from a client who recently transferred from the ICU following endotracheal extubation. Which fo the following findings should the nurse identify as a possible manifestation of tracheal stenosis and report to the charge nurse?

Increased coughing

A nurse is collecting data from a client who has pharyngitis. Which of the following findings is the nurse's priority to report to the provider?

Inspiratory stridor

A nurse is reinforcing teaching about pursed-lip breathing with a client who has COPD and emphysema. The nurse should explain that this breathing technique does which of the following?

Keeps the airways open on exhalation

A nurse is assisting with discharge teaching for a client who is postoperative following a rhinoplasty. Which of the following instructions should the nurse include?

Lie on your back with your head elevated 30' when resting.

A nurse is caring fro a client who has left lower lobectomy to treat lung cancer. Which of the following factors has a significant impact on the plan of care for this client?

Lung cancer usually has metastasized before the client has symptoms.

A nurse is contributing to the plan of care of a client who is receiving mechanical ventilation. Which of the following recommendations should the nurse make?

Maintain the head of the bed at 30 degrees.

A nurse is assisting a provider with a comprehensive physical examination of a client. When the provide uses transillumination, the nurse should explain to the client the this technique helps evaluate which of the following structures?

Maxillary sinuses

A nurse is assisting with planning postoperative education for a client who will undergo a radical neck dissection for cancer of the larynx. The nurse should suggest including which of the following topics?

NPO status Alternative methods of communications Changes in body images Swallowing exercises

A nurse in a provider's office is collecting data from a client who reports recent exposure to tuberculosis. Which fo the following findings is a clinical manifestation of pulmonary tuberculosis?

Nigh sweats.

A nurse is collection data from a client who has a positive tuberculin skin test. Which of the following findings should the nurse identity as an indication that he client has active tuberculosis.

Night sweats

A nurse is auscultating the lung of a client who is having an acute asthma attack. Which of the following sounds should the nurse expect to hear?

Noisy wheezing

A nurse on a medical unit is assisting with the care of a client who aspirated gastric contents prior to admission. The provider prescribed 100% oxygen by nonrebreather mask after the client reports severe dyspnea. Which of the following findings is a clinical manifestation of acute respiratory distress syndrome (ARDS)?

PaO2 50 mmHg

A nurse is caring for a client who has COPD and is experiencing shortness fo breath. Which of the following actions should the nurse take first?

Place the client in an upright position.

A nurse is assisting with the care of a client who has a chest tube in place following a thoracotomy. Which of the following actions should the nurse take?

Place the drainage unit below the client's chest level

A nurse is caring for an older adult client who as COPD and pneumonia. The nurse should monitor the client for whose which of the following acid-base imbalances?

Respiratory acidosis

A nurse is caring for a client who is extremely anxious and is hyperventilating. The client's ABG results are pH 7.50, PaCO2 27 mmHg, and HCO3- 25 mEq/L. The nurse should identify that the client has which of the following acid-base imbalances?

Respiratory alkalosis

A nurse in the PACU is collecting data form a newly admitted client and observes intercostal retraction and a high-pitched inspiratory sound. The nurse should identify that these findings are manifestations of which of the following complications?

Respiratory obstruction

A nurse is helping the provider prepare a client for a thoracentesis. The nurse should instruct the client that which of the following positions will be used for this procedure?

Sitting while leaning forward over the bedside table

A nurse in a medical-surgical unit is assessing a client. The nurse should identify that which of the following findings is a manifestation of a pulmonary embolism?

Stabbing chest pain

A nurse is collection data about the respiratory status of a client who has COPD. Which of the following manifestation should the nurse identify as an indication of the early onset of respiratory failure?

Tachycardia

A nurse is assisting with the plan of care for a client following placement of a chest tube 1 hour ago. Which of the following actions should the nurse include in the plan of care?

Tape all connections between the chest tube and drainage system.

A nurse is caring for a client who is postoperative following a thoracic lobectomy. The client has 2 chest tubes in place, 1 in the lower portion of the thorax and the other higher up on the chest wall. When the family asks the nurse why the client has 2 chest tubes, which of the following responses should the nurse make?

The lower tube will drain blood, the higher tube will remove air.

A nurse is collection data from a client who has a prescription for cisplatin IV to treat lung cancer. Which of the following finding s is an adverse effect of this medication?

Tinnitus

A nurse is reinforcing teaching with a client who has cystic fibrosis and a prescription for daily chest physiotherapy. The nurse should instruct the client that which of the following is the purpose of the treatments?

To mobilize secretion in the airway

A nurse is reinforcing teaching with a client about pulmonary function tests. Which of the following tests measure the volume of air the lungs can hold at he end of maximum inhalation?

Total lung capacity

A nurse is caring for a client following a high pleural thoracentesis. The nurse measures a total of 35 mL of purulent drainage. Which of the following findings indicate a tension pneumothorax? (Select all that apply)

Tracheal deviation to the left Absent breath sounds on the right side Neck vein distention

A nurse is reinforcing discharge teaching with a client who has emphysema. Which of the following instructions shall the nurse include?

Try to drink at least 2 to 3 liters of fluid per day

A nurse is reinforcing discharge teaching about improving gas exchange with a client who has emphysema. Which of the following pieces fo information should the nurse include in the teaching?

Use pursed-lip breathing during periods of dyspnea.

A nurse is reinforcing teaching about breathing techniques with a client who has emphysema. Which of the following statement should the nurse identify as an indication that the client understands the mechanics behind pursed-lip breathing?

When I breathe out through pursed lips, my airways don't collapse between breaths.

A nurse in a clinic is reinforcing teaching with a client who is scheduled to have a tuberculin skin test. Which of the following pieces of information should the nurse include?

You must return to the clinic to have the test read in 2 or 3 days.

A nurse is reinforcing preoperative teaching with a client who has lung cancer and will undergo a pneumonectomy. Which of the following pieces of information should the nurse include?

You will have a chest tube in place after surgery. We'll help you turn, cough, and breath deeply frequently after surgery. We'll give you oxygen to support your breathing if you need it.

A nurse is reviewing the laboratory results of a client who has metabolic alkalosis. Which of the following laboratory values should the nurse expect?

pH 7.49, HCO3-32 mEq/L, PaCO2 40 mmHg