Respiratory Care Modalities

A client is on a ventilator. Alarms are sounding, indicating an increase in peak airway pressure. The nurse assesses first for: A. A kink in the ventilator tubing B. Higher than normal endotracheal cuff pressure C. Malfunction of the alarm button D. A cut or slice in the tubing from the ventilator

A. A kink in the ventilator tubing

What assessment method would the nurse use to determine the areas of the lungs that need draining? A. Inspection B. Auscultation C. Arterial blood gas (ABG) levels D. Chest x-ray

B. Auscultation

An adult client with cystic fibrosis is admitted to an acute care facility with an acute respiratory infection. The ordered respiratory treatment includes chest physiotherapy. When should the nurse perform this procedure? (Select all that apply.) A. When secretions have mobilized B. After meals C. At bedtime D. Before meals E. When bronchospasms occur

C. At bedtime D. Before meals

The nurse suctions a patient through the endotracheal tube for 20 seconds and observes dysrhythmias on the monitor. What does the nurse determine is occurring with the patient? A. The patient is having a myocardial infarction B. The patient is in a hyper metabolic state C. The patient is having a stress reaction D. The patient is hypoxic from suctioning

D. The patient is hypoxic from suctioning

Which is the most reliable and accurate method for delivering precise concentrations of oxygen through noninvasive means? A. T-piece B. Partial-rebreather mask C. Nasal cannula D. Venturi mask

D. Venturi mask

A nurse is teaching a client about using an incentive spirometer. Which statement by the nurse is correct? A. "Before you do the exercise, I'll give you pain medication if you need it." B. "Don't use the incentive spirometer more than 5 times every hour." C. "You need to start using the incentive spirometer 2 days after surgery." D. "Breathe in and out quickly."

A. "Before you do the exercise, I'll give you pain medication if you need it."

The nurse is preparing to perform chest physiotherapy (CPT) on a client. Which statement by the client tells the nurse that the procedure is contraindicated? A. "I just finished eating my lunch; I'm ready for my CPT now." B. "I just received my pain medication 10 minutes ago, let's do my CPT now." C. "I just changed into my running suit; we can do my CPT now." D. "I have been coughing all morning and am barely bringing anything up."

A. "I just finished eating my lunch; I'm ready for my CPT now."

A client with a respiratory condition is receiving oxygen therapy. While assessing the client'sPaO2, the nurse knows that the therapy has been effective based on which of the following readings? A. 84 mmHg B. 45 mmHg C. 58 mmHg D. 120 mmHg

A. 84 mmHg

A client has a sucking stab wound to the chest. Which action should the nurse take first? A. Apply a dressing over the wound and tape it on three sides B. Prepare to start an IV line C. Prepare a chest tube insertion tray D. Draw blood for a hematocrit and hemoglobin level

A. Apply a dressing over the wound and tape it on three sides

A client with chronic obstructive pulmonary disease (COPD) os incubated and placed on continuous mechanical ventilation. Which equipment is most important for the nurse to keep at the client's bedside? (Select all that apply.) A. Manual resuscitation bag B. Water-seal chest drainage set-up C. Pulse oximeter D. Tracheostomy cleaning kit E. Hemostat

A. Manual resuscitation bag C. Pulse oximeter

When performing endotracheal suctioning, the nurse applies suctioning while withdrawing and gently rotating the catheter 360 degrees for how long? A. 20-25 seconds B. 10-15 seconds C. 30-35 seconds D. 0-5 seconds

B. 10-15 seconds

A new ICU nurse is observed by her preceptor entering a patient's room to suction the tracheostomy after performing the task 15 minutes before. What should the preceptor educate the new nurse to do to ensure that the patient needs to be suctioned? A. Have the patient cough B. Auscultate the lungs for adventitious sounds C. Have the patient inform the nurse of the need to be suctioned D. Assess the CO2 level to determine if the patient requires suctioning

B. Auscultate the lungs for adventitious sounds

A client is on a positive-pressure ventilator with a synchronized intermittent mandatory ventilation (SIMV) setting. The ventilator is set for 8 breaths per minute. he client is taking 6 breaths per minute independently. The nurse: A. Contacts the respiratory therapy department to report the ventilator is malfunctioning B. Continues assessing the client's respiratory status frequently C. Consults with the physician about removing the client from the ventilator D. Changes the setting on the ventilator to increase breaths to 14 per minute

B. Continues assessing the client's respiratory status frequently

A nurse is caring for a client who has a tracheostomy and temperature of 103 F (39.4 C). Which intervention will most likely lower the client's arterial blood oxygen saturation? A. Use of a cooling blanket B. Endotracheal suctioning C. Encouragement of coughing D. Incentive spirometry

B. Endotracheal suctioning

A client is prescribed postural drainage because secretions are building in the superior segment of the lower lobes. Which is the best position to teach the client to use for postural drainage? A. High-Fowler's position B. Face-down, pillows supporting abdomen and arms crossed below head C. Laying down with buttocks and thighs elevated, feet flat on bed D. Sitting on bed, pillow supporting abdomen, legs outstretched

B. Face-down, pillows supporting abdomen and arms crossed below head

A home health nurse is visiting a home care client with advanced lung cancer. Upon assessing the client, the nurse discovers wheezing, bradycardia, and a respiratory rate of 10 breaths per minute. These signs are associated with which condition? A. Semi consciousness B. Hypoxia C. Hyperventilation D. Delirium

B. Hypoxia

A client suffers acute respiratory distress syndrome as a consequence of shock. The client's condition deteriorated rapidly, and endotracheal (ET) intubation and mechanical ventilation are initiated. When the high-pressure alarm on the mechanical ventilator sounds, the nurse starts to check for the cause. Which condition triggers the high-pressure alarm? A. A disconnected ventilator circuit B. Kinking of the ventilator tube C. A change in the oxygen concentration without resetting the oxygen level alarm D. An ET cuff leak

B. Kinking of the ventilator tubing

For a client who has a chest tube connected to a closed water-seal drainage system, the nurse should include which action in the care plan? A. Keeping the collection chamber at chest level B. Measuring and documenting the drainage in the collection chamber C. Maintaining continuous bubbling in the water-seal chamber D. Stripping the chest tube every hour

B. Measuring and documenting the drainage in the collection chamber

Which oxygen administration device has the advantage of providing a high oxygen concentration? A. Catheter B. Nonrebreathing mask C. Face tent D. Venturi mask

B. Nonrebreathing mask

Which oxygen administration device has the advantage of providing a high oxygen concentration? A. Venturi mask B. Nonrebreathing mask C. Face tent D. Catheter

B. Nonrebreathing mask

Which type of ventilator has a preset volume of air to be delivered with each inspiration? A. Time cycled B. Volume cycled C. Pressure cycled D. Negative pressure

B. Volume cycled

A client in the intensive care unit has a tracheostomy with humidified oxygen being instilled through it. The client is expectorating thick yellow mucous through the tracheostomy tube frequently. The nurse: A. Encourages the client to cough very 30 minutes and PRN B. Sets a schedule to suction the tracheostomy every hour C. Assess the client's tracheostomy and lung sounds every 15 minutes D. Decreases the amount of humidity set to flow through the tracheostomy tube

C. Assess the client's tracheostomy and lung sounds every 15 minutes

A nurse is planing care for a client after a tracheostomy. One of the client's goals is to overcome verbal communication impairment. Which intervention should the nurse include in the care plan? A. Avoid using a tracheostomy plug because it blocks the airway B. Answer questions for the client to reduce his frustration C. Encourage the client's communication attempts by allowing him time to select or write words D. Make an effort to read the client's lips to foster communication

C. Encourage the client's communication attempts by allowing him time to select or write words

The nurse is assisting a client with postural drainage. Which of the following demonstrates correct implementation of this technique? A. Administer bronchodilators and mucolytic agents following the sequence B. Perform this measure with the client once a day C. Instruct the client to remain in each position of the postural drainage sequence for 10-15 minutes D. Use aerosol sprays to deodorize the client's environment after postural drainage

C. Instruct the client to remain in each position of the postural drainage sequence for 10-15 minutes

A client with chronic obstructive pulmonary disease (COPD) is incubated and placed on continuous mechanical ventilation. Which equipment is most important for the nurse to keep at the client's bedside? A. Tracheostomy cleaning kit B. Oxygen analyzer C. Manual resuscitation bag D. Water-seal chest drainage set-up

C. Manual resuscitation bag

The nurse is admitting a patient with COPD. The decrease of what substance in the blood gas analysis would indicate to the nurse the patient is experiencing hypoxemia? A. PCO2 B. HCO3 C. PaCO2 D. pH

C. PaCO2

The nurse is caring for a client with an endotracheal tube (ET). Which nursing intervention is contraindicated? A. Ensuring that humidified oxygen is always introduced through the tube B. Deflating the cuff before removing the tube C. Routinely deflating the cuff D. Checking the cuff pressure every 6 to 8 hours

C. Routinely deflating the cuff

The nurse is assisting a physician with an endotracheal intubation for a client in respiratory failure. It is most important for the nurse to assess for: A. Cool air humidified through the tube B. A scheduled time for deflation of the tracheal cuff C. Symmetry if the client's chest expansion D. Tracheal cuff pressure set at 30 mmHg

C. Symmetry of the client's chest expansion

After lobectomy for lung cancer, a client receives a chest tube connected to a disposable chest drainage system. The nurse observes that the drainage system is functioning correctly when she notes tidal movement or fluctuations in which compartment of the system as the client breathes? A. Suction control chamber B. Collection chamber C. Water-seal chamber D. Air-leak chamber

C. Water-seal chamber

Hyperbaric oxygen therapy increases the blood's capacity to carry and delivery oxygen to compromised tissues. This therapy may be used for a client with: A. Hyperthermia B. A malignant tumor C. Pneumonia D. A compromised skin graft

D. A compromised skin graft

For a client with an endotracheal (ET) tube, which nursing action is most important? A. Providing frequent oral care B. Turning the client from side to side every 2 hours C. Monitoring serial blood gas values every 4 hours D. Auscultate the lungs for bilateral breath sounds

D. Auscultate the lungs for bilateral breath sounds

The nurse is caring for a client with an endotracheal tube (ET). Which nursing intervention is contraindicated? A. Deflating the cuff before removing the tube B. Ensuring that humidified oxygen is always introduced through the tube C. Routinely deflating the cuff D. Checking the cuff pressure every 6 to 8 hours

D. Checking the cuff pressure every 6 to 8 hours

The nurse assesses a patient with a heart rate of 42 and a blood pressure of 70/46. What type of hypoxia does the nurse determine the patient is displaying? A. Hypoxia hypoxia B. Anemic hypoxia C. Histotoxic hypoxia D. Circulatory hypoxia

D. Circulatory hypoxia

A client with supraglottic cancer undergoes a partial laryngectomy. Postoperatively, a cuffed tracheostomy tube is in place. When removing secretions that pool above the cuff, the nurse should instruct the client to: A. Exhale deeply as the nurse reinflates the cuff B. Hold the breath as the cuff is being reinflated C. Take a deep breath as the nurse deflated the cuff D. Cough as the cuff is being deflated

D. Cough as the cuff is being deflated

A patient is being educated in the use of incentive spirometry prior to having a surgical procedure. What should the nurse be sure to include in the education? A. Have the patient lie in the spine position during the use of spirometry. B. Inform the patient that using the spirometer is not necessary if the patient is experiencing pain. C. Encourage the patient to try to stop coughing during and after using the spirometer. D. Encourage the patient to take approximately 10 breaths per hour, while awake.

D. Encourage the patient to take approximately 10 breaths per hour, while awake.

A client is receiving mechanical ventilation. How frequently should the nurse auscultate the client's lung to check for secretions? A. Every 1-2 hours B. Every 30-60 minutes C. Every 4-6 hours D. Every 2-4 hours

D. Every 2-4 hours

A nurse is caring for a client who recently underwent a tracheostomy. The first priority when caring for a client with a tracheostomy is: A. Preventing him from developing an infection B. Encouraging him to perform activities of daily living (ADLs) C. Healing him communicate D. Keeping his airway patent

D. Keeping his airway patent

A nurse is weaning a client from mechanical ventilation. Which nursing assessment finding indicates the weaning process should be stopped? A. Oxygen saturation of 93% B. Blood pressure remains stable C. Respiratory rate of 16 breaths per minute D. Runs of ventricular tachycardia

D. Runs of ventricular tachycardia

The nurse observed constant bubbling in the water-seal chamber of a closed chest drainage system. What should the nurse include? A. The chest tube is obstructed B. The client has a pneumothorax C. The system is functioning normally D. The system has an air leak

D. The system has an air leak

Which type of ventilator has a preset volume of air to be delivered with each inspiration? A. Pressure-cycled B. Negative-pressure C. Time-cycled D. Volume-controlled

D. Volume-controlled