PREP U Chapter 10: Nursing Management: Patients With Chest and Lower Respiratory Tract Disorders

Which action should the nurse take first when providing care for a client during an acute asthma attack? Obtain arterial blood gases. Send for STAT chest x-ray. Administer prescribed short-acting bronchodilator. Initiate oxygen therapy and reassess pulse oximetry in 10 minutes.

Administer prescribed short-acting bronchodilator

The most diagnostic clinical symptom of pleurisy is: Dullness or flatness on percussion over areas of collected fluid. Dyspnea and coughing. Fever and chills. Stabbing pain during respiratory movements.

Stabbing pain during respiratory movements.

Which vitamin is usually administered with isoniazid (INH) to prevent INH-associated peripheral neuropathy? Vitamin B6 Vitamin C Vitamin D Vitamin E

Vitamin B6

The patient with a chest tube is being transported to X-ray. Which complication may occur if the chest tube is clamped during transportation? Tension pneumothorax Cardiac tamponade Flail chest Pulmonary contusion

tension pneumothorax

A nurse is assessing the injection site of a client who has received a purified protein derivative test. Which finding indicates a need for further evaluation? 5-mm induration Reddened area 15-mm induration A blister

15-mm induration

What dietary recommendations should a nurse provide a client with a lung abscess? A diet low in calories A diet rich in protein A carbohydrate-dense diet A diet with limited fat

A diet rich in proteins

You are caring for a client with chronic respiratory failure. What are the signs and symptoms of chronic respiratory failure? Progressive loss of lung function associated with chronic disease Sudden loss of lung function associated with chronic disease Progressive loss of lung function with history of normal lung function Sudden loss of lung function with history of normal lung function

Progressive loss of lung function associated with chronic disease

A client is exhibiting signs of a pneumothorax following tracheostomy. The surgeon inserts a chest tube into the anterior chest wall. What should the nurse tell the family is the primary purpose of this chest tube? To remove air from the pleural space To drain copious sputum secretions To monitor bleeding around the lungs To assist with mechanical ventilation

To remove air from the pleural space

A client is admitted to the health care facility with active tuberculosis (TB). What intervention should the nurse include in the client's care plan? Wearing a disposable particulate respirator that fits snugly around the face Instructing the client to wear a mask at all times Wearing a gown and gloves when providing direct care Keeping the door to the client's room open to observe the client

Wearing a disposable particulate respirator that fits snugly around the face

Which of the following is a potential complication of a low pressure in the endotracheal cuff? Aspiration pneumonia Tracheal bleeding Tracheal ischemia Pressure necrosis

aspiration pneumonia

During discharge teaching, a nurse is instructing a client about pneumonia. The client demonstrates his understanding of relapse when he states that he must: follow up with the physician in 2 weeks. continue to take antibiotics for the entire 10 days. turn and reposition himself every 2 hours. maintain fluid intake of 40 oz (1,200 ml) per day.

continue to take antibiotics for the entire 10 days

A client is being admitted to the preoperative holding area for a thoracotomy. Preoperative teaching includes what? Correct use of a ventilator Correct use of incentive spirometry Correct use of a mini-nebulizer Correct technique for rhythmic breathing

correct use of incentive spirometry

A patient is diagnosed with hypoxemic hypoxia. The nurse knows that the etiology directs medical and nursing interventions. Which of the following is the cause? Inadequate capillary circulation Decreased effective hemoglobin concentration Decreased oxygen diffusion into the tissues Inability of tissues to use available oxygen due to a toxic substance

decreased oxygen diffusion into the tissues

A patient is admitted to the hospital with pulmonary arterial hypertension. What assessment finding by the nurse is a significant finding for this patient? Ascites Dyspnea Hypertension Syncope

dyspnea

A patient in the emergency department who presented with shortness of breath has been informed by her health care provider that her chest X-ray is suggestive of a pleural effusion. The health care provider recently outlined the proposed course of treatment, but the patient has just asked the nurse, "Can you tell me exactly what's wrong with me?" What response would be most accurate? "The small air sacs that make up your lungs have become infected." "A large amount of fluid has accumulated in your lungs and made it difficult to breathe." "Fluid has built up between your lungs and the lining that surrounds your lungs." "Bacteria have entered the fluid surrounding your lungs and these bacteria must be eliminated."

"Fluid has built up between your lungs and the lining that surrounds your lungs."

After diagnosing a client with pulmonary tuberculosis, the physician tells family members that they must receive isoniazid (INH [Laniazid]) as prophylaxis against tuberculosis. The client's daughter asks the nurse how long the drug must be taken. What is the usual duration of prophylactic isoniazid therapy? 3 to 5 days 1 to 3 weeks 2 to 4 months 6 to 12 months

6 to 12 months

The nurse is educating a patient who will be started on an antituberculosis medication regimen. The patient asks the nurse, "How long will I have to be on these medications?" What should the nurse tell the patient? 3 months 3 to 5 months 6 to 12 months 13 to 18 months

6 to 12 months

A client is brought to the emergency department following a motor vehicle accident. Which of the following nursing assessments is significant in diagnosing this client with flail chest? Respiratory acidosis Paradoxical chest movement Chest pain on inspiration Clubbing of fingers and toes

Paradoxical chest movement

The nurse is assessing a client who, after an extensive surgical procedure, is at risk for developing acute respiratory distress syndrome (ARDS). The nurse assesses for which most common early sign of ARDS? Rapid onset of severe dyspnea Inspiratory crackles Bilateral wheezing Cyanosis

Rapid onset of severe dyspnea

A victim has sustained a blunt force trauma to the chest. A pulmonary contusion is suspected. Which of the following clinical manifestations correlate with a moderate pulmonary contusion? Blood-tinged sputum Bradypnea Respiratory alkalosis Productive cough

blood-tinged sputum

The clinic nurse is caring for a client with acute bronchitis. The client asks what may have caused the infection. What may induce acute bronchitis? Aspiration Drug ingestion Chemical irritation Direct lung damage

chemical irritation

The occupational nurse is completing routine assessments on the employees at a company. What might be revealed by a chest radiograph for a client with occupational lung diseases? Fibrotic changes in lungs Hemorrhage Lung contusion Damage to surrounding tissues

fibrotic changes in lungs

The nurse is caring for a patient at risk for atelectasis and chooses to implement a first-line measure to prevent atelectasis development in the patient. What is an example of a first-line measure to minimize atelectasis? Incentive spirometry Intermittent positive pressure-breathing (IPPB) Positive end-expiratory pressure (PEEP) Bronchoscopy

incentive spirometry

A nurse assesses arterial blood gas results for a patient in acute respiratory failure (ARF). Which results are consistent with this disorder? pH 7.28, PaO2 50 mm Hg pH 7.46, PaO2 80 mm Hg pH 7.36, PaCO2 32 mm Hg pH 7.35, PaCO2 48 mm Hg

pH 7.28, PaO2 50 mm Hg

A recent immigrant is diagnosed with pulmonary tuberculosis (TB). Which intervention is the most important for the nurse to implement with this client? Client teaching about the cause of TB Reviewing the risk factors for TB Developing a list of people with whom the client has had contact Client teaching about the importance of TB testing

Developing a list of people with whom the client has had contact

A client at the clinic is diagnosed with tuberculosis. When developing this client's plan of care, which medication would the nurse anticipate as being prescribed as a first-line agent? Select all that apply. INH rifampin ethambutol capreomycin ethionamide

INH rifampin ethambutol

The nurse educator is discussing aspiration with new nursing graduates. Which patient would the educator tell the nurses is at the greatest risk for aspiration? A stroke patient with dysarthria An ambulatory patient with Alzheimer's disease A 92-year-old patient who needs help with activities of daily living (ADLs) A patient with severe, deforming rheumatoid arthritis

A stroke patient with dysarthria