NCLEX respiratory system

The nurse is teaching a client who has asthma about using a peak flow meter. Which statement by the client reflects a correct understanding of the use of a peak flow meter? Select all that apply. A. "Readings in the green zone mean that my asthma is under control." B. "If I get a reading in the yellow zone, I need to stop what I'm doing and rest, then recheck in an hour." C. "If I get a reading in the red zone, then I need to take my reliever drug and have my wife take me to the hospital." D. "I should check the peak flow readings at least twice a day." E. "I don't need to check my peak flow readings if I take a reliever drug."

A. "Readings in the green zone mean that my asthma is under control." C. "If I get a reading in the red zone, then I need to take my reliever drug and have my wife take me to the hospital." D. "I should check the peak flow readings at least twice a day."

The nurse places a pulse oximetry probe on the finger and toe of a client with a respiratory disorder to determine the oxygen saturation of hemoglobin (SpO2). Which other parameter can be determined using this technique? A. Arterial oxygen saturation B. Partial pressure of oxygen in arterial blood C. Partial pressure of arterial carbon dioxide D. Partial pressure of oxygen in venous blood

A. Arterial oxygen saturation

A 3 year old arrives to the ER. The child has a temperature of 102.4 'F, respiratory rate of 45, and is agitated. The child is diagnosed with epiglottitis. You note the child is sitting up, positioned forward with chin in the air and the tongue is protruding with the mouth open. Which nursing intervention below is NOT appropriate for this patient? A. Assist the patient in a supine position. B. Keep the child on the parent's lap during treatments. C. Keep the child nothing by mouth. D. Avoid taking a temperature on the patient orally.

A. Assist the patient in a supine position.

A client is admitted to the hospital with chronic asthma. Which complication should the nurse monitor in this client? A. Atelectasis B. Pneumothorax C. Pulmonary edema D. Respiratory alkalosis

A. Atelectasis

You're providing discharge teaching to a patient who was admitted with asthma. You discussed the early warning signs of an asthma attack and ask the patient to list some of them. Select all the correct early warning signs verbalized by the patient: A. Easily fatigued with physical activity B. Reduced peak flow meter reading C. Chest retractions D. Cyanosis E. Wheezing with activity F. Nighttime coughing G. No relief with short-acting bronchodilator inhaler

A. Easily fatigued with physical activity B. Reduced peak flow meter reading

Regarding question 2, what is the recommended preventive administration schedule for this medication in preventing epiglottitis? A. 4, 6, 12-15 months and 4-6 years B. 2, 4, 6, 12-15 months C. 4, 6 months and 4-6 years D. 2 and 6 months

B. 2, 4, 6, 12-15 months

A client has a leaking thoracic duct following a radical neck surgery. What does the nurse expect the postoperative plan of care to include? A. A gastrostomy tube, a high-fat diet, and bed rest B. A chest tube, total parenteral nutrition (TPN), and bed rest C. A rectal tube, a low-fat diet, and increased activity D. A nasogastric tube, a moderate-fat diet, and increased activity

B. A chest tube, total parenteral nutrition (TPN), and bed rest

A patient has exercise-induced asthma. Which of the following actions can the patient perform to help prevent an attack during exercise. Select all that apply: A. Avoid warming up before exercise. B. Administer a short-acting beta agonist before exercise. C. Administer a short-acting beta agonist after exercise. D. Avoid exercising when experiencing a respiratory illness.

B. Administer a short-acting beta agonist before exercise. D. Avoid exercising when experiencing a respiratory illness.

After a client with multiple fractures of the left femur is admitted to the hospital for surgery, the client demonstrates cyanosis, tachycardia, dyspnea, restlessness, and petechiae on the chest. What should the nurse do first? A. Obtain vital signs. B. Administer oxygen. C. Call the healthcare provider. D. Place the client in the high-Fowler position.

B. Administer oxygen.

Select all the signs and symptoms that can present with epiglottitis? A. Slow onset B. Difficulty swallowing C. Drooling D. High Fever E. Barking cough F. Stridor G. Exudate on Tonsils H. Crackles

B. Difficulty swallowing C. Drooling D. High Fever F. Stridor

A client is admitted for a rhinoplasty. To monitor for hemorrhage after the surgery, the nurse should assess specifically for the presence of which response? A. Facial edema B. Excessive swallowing C. Pressure around the eyes D. Serosanguineous drainage on the dressing

B. Excessive swallowing

A client with a pulmonary embolus is intubated and placed on mechanical ventilation. What nursing action is important when suctioning the endotracheal tube? A. Apply negative pressure while inserting the suction catheter. B. Hyperoxygenate with 100% oxygen before and after suctioning. C. Suction two to three times in succession to effectively clear the airway. D. Use rapid movements of the suction catheter to loosen secretions.

B. Hyperoxygenate with 100% oxygen before and after suctioning.

Your educating a patient how to use a peak flow meter to help monitor the status of their asthma. Which statement by the patient demonstrates they understand how to use the device? A. "This device will help keep my lungs strong so I don't have another asthma attack." B. "I will inhale as hard as I can while using the device." C. "I will use this device at the same time, either in the morning or before bedtime, and compare the readings with my personal best reading." D. "I will notify the doctor if my peak flow rating is 90% or more than my personal best peak flow."

C. "I will use this device at the same time, either in the morning or before bedtime, and compare the readings with my personal best reading."

An older adult client who complains of difficulty breathing after a surgery is found to have decreased vital capacity on spirometry. Which nursing intervention should be performed in this situation? A. Assess the client's mobility. B. Monitor respirations and breathing effort. C. Teach coughing and deep-breathing exercises. D. Determine normal activity levels and note when the client tires.

C. Teach coughing and deep-breathing exercises.

A nurse receives a call from the emergency department about a client with tuberculosis (TB) who will be admitted to the medical unit. Which precaution should the nurse take? A. Put on a gown when entering the room B. Place the client with another client who has TB C. Wear a particulate respirator when caring for the client D. Don a surgical mask with a face shield when entering the room

C. Wear a particulate respirator when caring for the client

During a 2 month well visit with a patient and her mother you educate the parent on the most common cause of epiglottitis. You explain to the mother the most common cause of this condition is the _______________. In addition, you explain _________ can help prevent most cases of this condition? A. respiratory syncytial virus, palivizumab B. influenza virus, annual flu shot C. haemophilus influenzae type b, Hib vaccine D. rotavirus, RV vaccine

C. haemophilus influenzae type b, Hib vaccine

The nurse is caring for a client two days after the client was admitted with burn injury. When performing the respiratory assessment, the nurse observes for which type of sputum? A. Sooty B. Frothy C. Yellow D. Tenacious

A. Sooty

A patient received a nebulizer of Albuterol. What is a side effect of this medication? A. Bradycardia B. Tachycardia C. Drowsiness D. Feeling cold

B. Tachycardia

When assessing a client with pleural effusion, what does the nurse expect to identify? A. Moist crackles at the posterior of the lungs B. Deviation of the trachea toward the involved side C. Reduced or absent breath sounds at the base of the lung D. Increased resonance with percussion of the involved area

C. Reduced or absent breath sounds at the base of the lung

You assist your patient with using their inhaler. The inhaler contains the medication Budesonide. Before administering the inhaler, you will want to connect what device to the inhaler to help decrease the patient from developing ________? A. Peak flow meter; pneumonia B. Incentive spirometer; thrush C. Spacer; thrush D. Peak flow meter; mouth sores

C. Spacer; thrush

Which diagnostic test would the nurse consider to be the gold standard for diagnosis of pulmonary embolism? A. Pulmonary angiography B. Helical computed tomography (CT) C. Ventilation-perfusion (V/Q) scans D. Computed tomography pulmonary angiography (CT-PA)

A. Pulmonary angiography

Which statement is correct regarding the role of the epiglottis? A. This structure prevents food from entering the nasopharynx. B. The epiglottis helps with vocal cord vibration. C. After swallowing this structure moves downward to prevent swallowed contents from entering the trachea. D. The epiglottis is found in between the vocal folds.

C. After swallowing this structure moves downward to prevent swallowed contents from entering the trachea.

A nurse gave a client naloxone. To evaluate the effectiveness of the medication, what should the nurse assess for? A. Change in level of consciousness B. Increased pain C. Increased respiration D. Decreased heart rate

C. Increased respiration

A 5 year old with acute epiglottitis is intubated for airway management. As the nurse you know that all of the following can be prescribed as treatment for this condition EXCEPT? A. Intravenous fluids B. Antipyretics C. Corticosteroids D. Cough suppressants

D. Cough suppressants

Which pulmonary function test provides a more sensitive index of obstruction in smaller airways? A. Forced vital capacity B. Functional residual capacity C. Forced expiratory volume in 1 second D. Forced expiratory flow over the 25% to 75% volume of the forced vital capacity

D. Forced expiratory flow over the 25% to 75% volume of the forced vital capacity

Your patient with asthma is taking Theophylline. Which product below should the patient avoid consuming? A. Caffeine B. Dairy C. Wheat D. Shellfish

A. Caffeine

After a laryngectomy is scheduled, what is the most important factor for the nurse to include in the preoperative teaching plan? A. Establishing a means for communicating postoperatively B. Explaining that there will be a feeding tube postoperatively C. Demonstrating how to care for a permanent laryngeal stoma D. Teaching how to cough to expectorate bronchial secretions effectively

A. Establishing a means for communicating postoperatively

A healthcare provider prescribes oropharyngeal suctioning as needed for a client in a coma. Which assessment made by the nurse indicates the need for suctioning? A. Gurgling sounds with each breath B. Fine crackles at the base of the lungs C. Cyanosis in the nail beds of the fingers D. Dry cough at increasingly frequent intervals

A. Gurgling sounds with each breath

Which statement appropriately describes tidal volume? A. It is the volume of air inhaled and exhaled with each breath. B. It is the amount of air remaining in the lungs after forced expiration. C. It is the additional air that can be forcefully inhaled after normal inhalation. D. It is the additional air that can be forcefully exhaled after normal exhalation.

A. It is the volume of air inhaled and exhaled with each breath.

A client is shot in the chest during a holdup and is transported to the hospital via ambulance. In the emergency department, chest tubes are inserted, one in the second intercostal space and one at the base of the lung. What does the nurse expect the tube in the second intercostal space to accomplish? A. Remove the air that is present in the intrapleural space B. Drain serosanguineous fluid from the intrapleural compartment C. Permit the development of positive pressure between the layers of the pleura D. Provide access for the instillation of medication into the pleural space

A. Remove the air that is present in the intrapleural space

You're assessing a 4 year old with epiglottitis who just arrived to the pediatric clinic. The child is drooling and has a respiratory rate of 45 breaths per minute. In addition, the child is becoming increasingly apprehensive. Which findings below exhibited by the patient represents an acute upper airway obstruction that requires IMMEDIATE treatment? Select all that apply: A. Stridor B. Cyanosis C. Chest retractions D. Nasal flaring

A. Stridor B. Cyanosis C. Chest retractions D. Nasal flaring

Select all the following that can trigger an asthma attack: A. Sulfites B. Smoke C. Caffeine D. GERD E. Cold, windy weather F. Beta agonist G. Cockroaches

A. Sulfites B. Smoke D. GERD E. Cold, windy weather G. Cockroaches

A patient with asthma is prescribed to take inhaled Salmeterol and Fluticasone for long-term management of asthma. You observe the patient taking these medications. Which option below best describes the correct order in how to take these medications? A. The patient inhales the Salmeterol first and then waits 5 minutes before inhaling the Fluticasone. B. The patient inhales the Fluticasone first and then waits 5 minutes before inhaling the Salmeterol. C. The patient inhales the Salmeterol first and then waits 1 minute before inhaling the Fluticasone. D. The patient inhales the Fluticasone and immediately inhales the Salmeterol.

A. The patient inhales the Salmeterol first and then waits 5 minutes before inhaling the Fluticasone.

A nurse is caring for a client with a nosebleed originating from the anterior aspect of the nose. Which nursing interventions would help the client? Select all that apply. A. Positioning the client horizontally without a pillow B. Applying direct lateral pressure to the nose for 10 minutes C. Reducing anxiety and blood pressure by reassuring the client D. Instructing the client to blow his or her nose to remove the blood E. Loosely packing the client's nares with gauze or nasal tampons

B. Applying direct lateral pressure to the nose for 10 minutes C. Reducing anxiety and blood pressure by reassuring the client E. Loosely packing the client's nares with gauze or nasal tampons

Your patient's asthma is poorly controlled. The patient reports using their rescue inhaler 4 times a week. In addition, the patient's asthma is not responding to other treatments. The physician orders the patient to take a medication that works by blocking the role of the immunoglobulin IgE. This describes which medication below? A. Montelukast B. Omalizumab C. Cromolyn D. Salmeterol

B. Omalizumab

A client with a 10-year history of emphysema is admitted in acute respiratory distress. During assessment, what does the nurse expect to identify? A. Chest pain on inspiration B. Prolonged expiration with use of accessory muscles C. Signs and symptoms of respiratory alkalosis D. Decreased respiratory rate

B. Prolonged expiration with use of accessory muscles

A nurse is caring for a client who underwent surgery for laryngeal cancer. Which nursing action may help to communicate effectively with the client? Select all that apply. A. Asking the client open-ended questions B. Providing the client with praise and encouragement C. Collaborating with a speech and language pathologist D. Using a high-pitched tone of voice to speak with the client E. Asking the client to make noise when immediate attention is required

B. Providing the client with praise and encouragement C. Collaborating with a speech and language pathologist E. Asking the client to make noise when immediate attention is required

A nurse is caring for a client experiencing an acute episode of bronchial asthma. What should nursing interventions achieve? A. Curing the condition permanently B. Raising mucous secretions from the chest C. Limiting pulmonary secretions by decreasing fluid intake D. Convincing the client that the condition is emotionally based

B. Raising mucous secretions from the chest

A client with acquired immunodeficiency syndrome (AIDS) and Cryptococcal pneumonia frequently is incontinent of feces and urine and produces copious sputum. When giving this client a bath, which protective equipment should the nurse make it a priority to use? Select all that apply. A. Goggles B. Surgical mask C. Shoe covers D. Gown E. Gloves F. N95 hepa mask

B. Surgical mask D. Gown E. Gloves

Select all the correct options that represent the pathophysiology of an asthma attack. A. The smooth muscle surrounding the alveoli constricts, limiting oxygenation. B. The mucosa lining experiences severe inflammation. C. The goblet cells within the mucosa lining produce excessive amounts of mucous. D. Too much carbon dioxide is exhaled due to hyperventilation and the patient experiences respiratory alkalosis.

B. The mucosa lining experiences severe inflammation. C. The goblet cells within the mucosa lining produce excessive amounts of mucous.

You're assisting your patient who has asthma to bed. The patient is experiencing a frequent cough and chest tightness. You auscultate the patient's lung fields and note expiratory wheezes. The patient's peak flow rate is 78% less than their best peak flow reading. Which medication will provide the patient with the fastest relief from these signs and symptoms of an asthma attack? A. Theophylline B. Tiotropium C. Albuterol D. Cromolyn

C. Albuterol

A client with a suspected pulmonary embolism is scheduled for a spiral computed tomography scan. Which intervention should the nurse perform when preparing the client for the test? A. Check the client's blood glucose levels. B. Obtain informed consent from the client. C. Assess if the client is allergic to shellfish. D. Instruct the client to remove his or her dentures.

C. Assess if the client is allergic to shellfish.

The parents of a 3 year old bring their child to the ER. The parents report the child suddenly developed a fever overnight and has had issues swallowing, which has led to excessive drooling. In addition, the parents explain that the child complains of sore throat, and it is hard to understand the child's speech because her voice is muffled. Based on this information, your next nursing actions will be? Select all that apply: A. Assess the child's temperature orally B. Obtain a throat culture C. Count the patient's respirations D. Assess the child's throat for tonsillar exudate E. Keep the child NPO

C. Count the patient's respirations E. Keep the child NPO

A client with emphysema is admitted to the hospital with pneumonia. On the third hospital day, the client complains of a sharp pain on the right side of the chest. The nurse suspects a pneumothorax. What breath sound is most likely to be present when the nurse assesses the client's right side? A. Crackling B. Wheezing C. Decreased sounds D. Adventitious sounds

C. Decreased sounds

On admission to the intensive care unit, a client is diagnosed with compensated metabolic acidosis. During the assessment, what is the nurse most likely to identify? A. Muscle twitching B. Mental instability C. Deep and rapid respirations D. Tachycardia and cardiac dysrhythmias

C. Deep and rapid respirations

A client who is admitted with emphysema shows progressive respiratory failure and has a Paco2 of 60. To address the problems, the nurse expects to receive a prescription for: A. Mucolytics B. Bronchodilators C. Mechanical ventilation D. Intermittent positive-pressure breathing (IPPB)

C. Mechanical ventilation

A client with emphysema experiences a sudden episode of shortness of breath and is diagnosed with a spontaneous pneumothorax. The client asks, "How could this have happened?" The nurse's response is based on what likely cause of the spontaneous pneumothorax? A. Pleural friction rub B. Tracheoesophageal fistula C. Rupture of a subpleural bleb D. Puncture wound of the chest wall

C. Rupture of a subpleural bleb

During the first 36 hours after the insertion of chest tubes, when assessing the function of a three-chamber, closed-chest drainage system, the nurse identifies that the water in the underwater seal tube is not fluctuating. What initial action should the nurse take? A. Take the client's vital signs. B. Inform the healthcare provider. C. Turn the client to the unaffected side. D. Check the tube to ensure that it is not kinked.

D. Check the tube to ensure that it is not kinked.

The nurse assists with a client's yearly physical examination. After the examination is completed, the client is diagnosed with tuberculosis. Which action best reflects appropriate epidemiological follow-up? A. Obtaining a list of people the client has had contact with over the past year B. Suggesting that the client notify acquaintances that the disease has developed C. Requiring employees at the client's work site to have chest x-rays as soon as possible D. Encouraging close family members, friends, and coworkers of the client to have a skin test

D. Encouraging close family members, friends, and coworkers of the client to have a skin test

A client with a 30-year history of smoking has several episodes of blood in the sputum. A bronchoscopy with a lung biopsy is performed. After the procedure, what is the most important nursing intervention? A. Assess for signs of hemoptysis B. Have the client rest in the supine position C. Check the client's level of consciousness frequently D. Ensure nothing by mouth (NPO) until the gag reflex returns

D. Ensure nothing by mouth (NPO) until the gag reflex returns

During the evening after a paracentesis, the nurse identifies that the client, although denying any discomfort, is very anxious. Which action is best for the nurse to take? A. Offer the client a back rub B. Administer the prescribed opioid C. Reinforce the primary healthcare provider's explanation of the procedure D. Explore the client's concerns while administering the prescribed anxiolytic

D. Explore the client's concerns while administering the prescribed anxiolytic

Rehabilitation of a client with chronic obstructive pulmonary disease (COPD) involves strategies to decrease hospital admissions and to live a more active life. What should the nurse teach the client to do? A. Initiate activities to eliminate infection. B. Inhale during movements that require energy. C. Implement breathing that uses the thoracic muscles. D. Incorporate humidification into the home environment.

D. Incorporate humidification into the home environment.

Which medication below blocks the function of Leukotriene for the treatment of asthma? A. Salmeterol B. Theophylline C. Tiotropim D. Montelukast

D. Montelukast

A patient with asthma is receiving a nebulizer of Cromolyn. The patient reports a burning sensation in the nose along with a horrible taste in their mouth. As the nurse you will? A. Immediately stop the nebulizer B. Re-adjust the nebulizer C. Call a rapid response because the patient is having a potential anaphylactic reaction to the medication. D. Reassure the patient this is a temporary side effect of this medication.

D. Reassure the patient this is a temporary side effect of this medication.

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

D. Reporting surveillance findings to appropriate public health officials

A client is admitted with possible tuberculosis. To make a definitive diagnosis, the nurse expects which diagnostic test to be prescribed? A. Chest x-ray film B. Tuberculin skin test C. Pulmonary function test D. Sputum test for acid-fast bacilli

D. Sputum test for acid-fast bacilli

The physician orders the patient to start taking Omalizumab. How will you administer this medication as the nurse? A. Intravenous B. Intramuscular C. Orally D. Subcutaneously

D. Subcutaneously