Module 9 Study Quiz
Which side effect of radiation therapy will the nurse anticipate for a patient who has laryngeal cancer?
Dry mouth
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. Select all that apply Some correct answers were not selected "I should change positions slowly." "I should cough at regular intervals." "I should use my incentive spirometer." "I should reduce the intake of protein in my diet." "I should perform range-of-motion exercises."
"I should perform range-of-motion exercises." "I should cough at regular intervals." "I should use my incentive spirometer."
After the nurse has provided teaching to a community group about how to prevent head and neck cancer, which statement by a group member indicates that more teaching is needed? "Chewing tobacco is better than smoking." "If you smoke, stop. If you don't, don't start." "Alcohol in moderation, but no alcohol is best." "Brush three times daily and floss at least once."
"Chewing tobacco is better than smoking."
Which questions will the nurse ask when assessing the effects of a patient's respiratory diagnosis on activity-exercise patterns? Select all that apply. Select all that apply "Are you ever incontinent of urine when you cough?" "Do you have trouble walking due to shortness of breath?" "Does your spouse wake you in the middle of the night due to snoring?" "How many flights of stairs can you walk up before you are short of breath?" "Do you ever feel full very quickly when eating due to your breathing issues?"
"How many flights of stairs can you walk up before you are short of breath?" "Do you have trouble walking due to shortness of breath?"
Which patient conditions may cause recurrent episodes of epistaxis? Select all that apply. Nasal tumors Facial trauma High humidity Fever of unknown origin Foreign bodies inserted into the nares Overuse of nasal decongestant sprays
Nasal tumors Facial trauma Foreign bodies inserted into the nares Overuse of nasal decongestant sprays
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. Select all that apply Anorexia Fatigue Dizziness Night sweats Chest tightness
Night sweats Anorexia Fatigue
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 15-year-old child who has a history of asthma A 25-year-old daughter who is seven months pregnant A 50-year-old spouse who is 20 pounds overweight A 75-year-old parent who takes prednisone
A 75-year-old parent who takes prednisone
Which postoperative patient is at the greatest risk for development of atelectasis? A patient after a hypoxic episode during an acute asthma attack An older adult patient who has undergone cardiothoracic surgery A patient not adherent with the pulmonary regimen after surgery A patient experiencing an acute exacerbation of chronic obstructive pulmonary disease (COPD)
A patient not adherent with the pulmonary regimen after surgery
Which actions will the nurse take when a patient first resumes eating after partial laryngectomy for laryngeal cancer? Select all that apply. Select all that apply Offer water at frequent intervals. Add gravy to meats, rice, and potatoes. Encourage oral nutritional supplements. Have oral suction available at the bedside. Lower the head of the bed while the patient is eating.
Add gravy to meats, rice, and potatoes. Encourage oral nutritional supplements. Have oral suction available at the bedside.
A patient is admitted to a health care facility with a respiratory infection suspected to be caused by tuberculosis (TB). Which infection precaution does the nurse initiate? Contact precautions Droplet precautions until the presence of TB is confirmed Airborne precautions Standard precautions only, until a diagnosis is made
Airborne precautions
Which assessment has the highest priority when the nurse is caring for a patient who is three hours postoperative laryngectomy? Patient pain Airway patency Incisional drainage BP and heart rate
Airway patency
A patient presents with a pneumonia score of 5 on the Expanded CURB-65 scale. Which action does the nurse take? Advise no treatment. Advise treating in an outpatient setting. Consider admission to an inpatient medical-surgical unit. Consider admission to an intensive care unit.
Consider admission to an intensive care unit.
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.
A healthy 70-year-old patient asks the nurse, "Which types of vaccinations are recommended for people my age?" Which vaccinations should the nurse suggest? Select all that apply. Select all that apply Influenza Pneumonia Meningococcal Hemophilus influenzae type b (Hib) Measles, mumps, and rubella (MMR)
Influenza Pneumonia
The nurse provides education to a patient who is prescribed a metered dose inhaler (MDI). Which actions taken by the patient indicate the need for further teaching? Select all that apply. Select all that apply Waits between puffs Activates the inhaler during inspiration Holds the breath for 10 seconds after a puff Inhales more than one puff with each inspiration Does not shake the MDI before use
Inhales more than one puff with each inspiration Does not shake the MDI before use
Which action by the student nurse for a patient who has had epistaxis for 15 minutes after being admitted to the hospital indicates the need for further teaching? Applying anterior packing Elevating the head of the patient Laying the patient in a supine position Pinching the lower soft part of the nose
Laying the patient in a supine position
The nurse provides teaching for a patient who is scheduled for a bedside thoracentesis. Which does the nurse explain as the primary purpose of the procedure?
Relieving an abnormal accumulation of fluid in the pleural space
Which instruction will the nurse include when teaching a patient to use a hand-held nebulizer?
Sit in an upright position during the treatment.
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 water-seal chamber contains 5 cm of sterile water. There is no new drainage in the collection chamber. The dressing over the chest tube insertion site is loose. The patient has a small pneumothorax.
The dressing over the chest tube insertion site is loose.
A positron emission tomography (PET) scan is used for which respiratory assessment? To assess ventilation and perfusion of lungs To distinguish benign and malignant nodules To visualize pulmonary vasculature and locate obstruction To diagnose lesions difficult to see by CT scan
To distinguish benign and malignant nodules
Which purpose would the nurse explain to the patient as the primary reason for continuous positive airway pressure (CPAP) therapy?
To prevent airway collapse
An older adult may present with which respiratory assessment findings? Select all that apply. Select all that apply Thicker mucus Normal partial pressure of oxygen (PaO 2) and arterial oxygen saturation (SaO 2) Decreased chest wall movement Increased breath sounds in the lung apices Diminished breath sounds, particularly at lung bases
Thicker mucus Decreased chest wall movement Diminished breath sounds, particularly at lung bases
Which chest palpation finding is a medical emergency? Increased tactile fremitus Trachea moved to the left Decreased tactile fremitus Diminished chest movement
Trachea moved to the left
Which diagnostic test result will the nurse expect when a patient has respiratory failure as a result of a pulmonary embolism? Congestion on chest x-ray Increased PaO 2 on arterial blood gases Gram-positive organisms in the sputum specimen Ventilation-perfusion (V/Q) mismatch on lung scan
Ventilation-perfusion (V/Q) mismatch on lung scan
When caring for patients, which action does the nurse take to prevent health care-associated infections (HAIs)? Avoid direct contact with patients. Wash hands before and after patient care. Wear sterile gloves when working with patients. Treat all patients as if they are infected with mycobacterium tuberculosis.
Wash hands before and after patient care.
Which assessment is most important to obtain for a patient with a radical neck dissection who is refusing any enteral feeding? Weight Pulse rate BP Respiratory rate
Weight
A patient underwent a radical neck dissection due to oral cancer and is receiving enteral nutrition at 50 mL/hour. The nurse reviews the patient's medical record and completes an assessment. Considering the patient's laboratory results, the nurse identifies that which assessment finding should be reported to the health care provider immediately?
Weight loss of 4 pounds in one week
Which intervention does the nurse perform 30 minutes before removing a chest tube from a patient? Prepare a sterile field that includes a petroleum dressing. Administer a pain medication to the patient. Clamp the chest tube. Ensure that the patient has nothing NPO.
Administer a pain medication to the patient.
A patient presents with a lung abscess. The nurse expects that which intervention will be included in the patient's treatment plan? Postural drainage Antibiotic therapy Chest physiotherapy Fluid restriction
Antibiotic therapy
The nurse must perform which intervention for a patient receiving a pulmonary function test? Schedule the test to occur after a meal. Assess the patient for respiratory distress. Provide a rest period before the procedure. Give a bronchodilator an hour before the test.
Assess the patient for respiratory distress.
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? Positions the patient in the semi-Fowler's position Encourages the patient to increase fluid intake Clamps the chest tube while the patient is ambulating Administers the patient's prescribed narcotic analgesic before activity
Clamps the chest tube while the patient is ambulating
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.
The nurse is reviewing the assessment findings of four patients. Which patient should be evaluated for pleural effusion?
Decreased tactile fremitus unequal chest movement dullness of percussion absence of breath sounds
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? Loud squeaking sounds during inspiration Diminished breath sounds with dullness to percussion Crackling, wheezing, and accentuation of pulmonic breath sound Increased pulmonic heart sound and right-sided fourth heart sound
Diminished breath sounds with dullness to percussion
A patient with a history of deep vein thrombosis is recovering in the postanesthesia care unit (PACU) after surgery. Which symptoms would the nurse assess if this patient develops a pulmonary embolism (PE)? Select all that apply. Dyspnea Tachypnea Tachycardia Coarse crackles Noisy respirations
Dyspnea Tachypnea Tachycardia
A patient is receiving enteral nutrition through a nasogastric tube. Which measure does the nurse take to reduce the risk for aspiration? Uses a high-fiber formula Labels or color-codes feeding tubes and connectors Marks the exit site of the feeding tube Elevates the head of bed to 45 degrees
Elevates the head of bed to 45 degrees
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. Select all that apply Increase the intake of foods that are high in vitamin C. Ensure that the home is well ventilated. Sleep alone. Spend as much time as possible outdoors. Minimize time in congregate settings. Minimize time on public transportation.
Ensure that the home is well ventilated. Sleep alone. Spend as much time as possible outdoors. Minimize time in congregate settings. Minimize time on public transportation.
Which process is stimulated by hypoxia?
Erythropoiesis
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. Select all that apply Workers at a nearby prison Elderly adults who attend activities at a local senior center Adults who are homeless Children who attend a preschool three days a week Middle-aged adults who live in the inner-city neighborhood Immigrants from an underdeveloped country who live in temporary housing in the city
Middle-aged adults who live in the inner-city neighborhood Immigrants from an underdeveloped country who live in temporary housing in the city Adults who are homeless Workers at a nearby prison
The nurse is caring for a patient with pneumonia and expects which interventions to be included in the treatment plan? Select all that apply. Select all that apply Reposition the patient at least once per hour. Monitor the patient's response to treatment. Provide adequate hydration by encouraging fluid intake. Administer analgesics on an around-the-clock basis for 24 hours. Provide postural drainage and chest percussion.
Monitor the patient's response to treatment. Provide adequate hydration by encouraging fluid intake. Provide postural drainage and chest percussion.
Which action will the nurse include in the plan of care for a patient who had modified radical neck surgery for laryngeal cancer? Use of a shoulder immobilizer Assistance with putting on neck brace Neck and shoulder range of motion exercises Instructions to minimize turning the head from side to side
Neck and shoulder range of motion exercises
After noting that a patient's tracheostomy tube is dislodged, which action will the nurse take first? Observe for increased respiratory effort. Put the patient in the semi-Fowler's position. Ventilate the patient with a bag-valve-mask. Hold the stoma open with a sterile hemostat.
Observe for increased respiratory effort.
Which medication or therapy would the nurse administer to a patient who is having acute tachypnea, dyspnea, tachycardia, and decreased oxygen saturation following a major orthopedic procedure? Select all that apply. Lidocaine Oxygen therapy Bronchodilators Anticoagulant therapy Skeletal muscle relaxant
Oxygen therapy Anticoagulant therapy
Which action by the student nurse while performing chest percussion indicates the need for further teaching? Percussing with both hands simultaneously Placing a thin towel over the area being percussed Positioning the fingers and thumb in cup-like position Creating an air pocket between the patient's chest and the hand
Percussing with both hands simultaneously
Following a bedside thoracentesis, the nurse will continue to assess the patient for signs and symptoms of which condition?
Pneumothorax
Which patient assessment data indicate increased risk for head and neck cancer? Select all that apply. Select all that apply Tobacco use Female gender Poor oral hygiene Age 40 to 50 years Excessive alcohol consumption
Poor oral hygiene Tobacco use Excessive alcohol consumption
Which nursing interventions are appropriate to help control bleeding for a patient with epistaxis? Select all that apply. Select all that apply Reassure the patient and keep him or her quiet. Administer saline nasal sprays to relieve congestion. Place the patient in a sitting position with the head tilted forward. Ask the patient to blow the nose to remove all the collected blood. Apply direct pressure by pinching the entire soft lower portion of the nose.
Reassure the patient and keep him or her quiet. Place the patient in a sitting position with the head tilted forward. Apply direct pressure by pinching the entire soft lower portion of the nose.
Which assessments are the highest priority to obtain when caring for a patient who has a tracheostomy? Total protein level and daily weights Assessment of speech and swallowing Respiratory rate and oxygen saturation Pain assessment and assessment of mobility
Respiratory rate and oxygen saturation
Which cognitive changes are characteristic of a patient experiencing hypoxia? Select all that apply. Select all that apply Restlessness Apprehension Improved mood Memory changes Pursed lip breathing Improved concentration
Restlessness Apprehension Memory changes
Which nursing action is the priority for a patient admitted to the hospital with cyanosis, dyspnea, and tachycardia and who is sweating and has cold, clammy skin? Start a glucose drip. Start oxygen therapy. Administer IV mannitol. Administer antihistamines.
Start oxygen therapy.