respiratory chapter 20 questions

The nurse is working on a busy respiratory unit. In caring for a variety of clients, the nurse must be knowledgeable of diagnostic studies. With which diagnostic studies would the nurse screen the client for an allergy to iodine? Select all that apply. a) Pulmonary angiography b) Bronchoscopy c) Fluoroscopy d) Chest x-ray e) Pulmonary functions test f) Lung scan

Lung scan Fluoroscopy Pulmonary angiography

The nurse is interviewing a patient who says he has a dry, irritating cough that is not "bringing anything up." What medication should the nurse question the patient about taking? a) Angiotensin converting enzyme (ACE) inhibitors b) Aspirin c) Cardiac glycosides d) Bronchodilators

a) Angiotensin converting enzyme (ACE) inhibitors

The nurse is caring for clients on the neurological unit. Which triad of neurological mechanisms does the nurse identify as most responsible when there is abnormality in ventilation control? a) Aortic arch, pons, and CO2 receptor sites b) Pons, cerebellum, and oxygen receptors c) Medulla oblongata, cerebellum, and heart rate d) Medulla oblongata, mitral valve, and central receptors

a) Aortic arch, pons, and CO2 receptor sites

Which of the following disease processes cause increased compliance? a) Emphysema b) Acute respiratory distress syndrome c) Pulmonary edema d) Pulmonary fibrosis

a) Emphysema

A student nurse is working with a client who is diagnosed with head trauma. The nurse has documented Cheyne-Stokes respirations. The student would expect to see which of the following? a) Regular breathing where the rate and depth increase, then decrease b) Irregular breathing at 14 to 18 breaths per minute c) Periods of normal breathing followed by periods of apnea d) Period of cessation of breathing

a) Regular breathing where the rate and depth increase, then decrease

A client arrives at the physician's office stating 2 days of febrile illness, dyspnea, and cough. Upon assisting the client into a gown, the nurse notes that the client's sternum is depressed, especially on inspiration. Crackles are noted in the bases of the lung fields. Based on inspection, which will the nurse document? a) The client has a funnel chest. b) The client has chronic respiratory disease. c) The client needs a cough suppressant. d) The client has pneumonia in the bases.

a) The client has a funnel chest.

The nurse is caring for a patient complaining of chest discomfort. The patient's admitting diagnosis is left lower lobe pneumonia. Which of the following strategies will the nurse instruct the patient to use to help alleviate the discomfort? a) Complete deep breathing exercises when chest discomfort occurs b) Assume a left side-lying position while in bed c) Lying on the right side d) Request narcotic medication when pain is experienced

b) Assume a left side-lying position while in bed

The nurse inspects the thorax of a patient with advanced emphysema. The nurse expects chest configuration changes consistent with a deformity known as: a) Funnel chest b) Barrel chest c) Kyphoscoliosis d) Pigeon chest

b) Barrel chest

A client presents to the emergency department with fluid overload. The nurse is concerned about fluid accumulation in the lungs. On which of the following areas would the nurse focus the lung assessment? a) Posterior bronchioles b) Bilateral lower lobes c) Anterior bronchial tree d) Right lower lobe

b) Bilateral lower lobes

A thoracentesis is performed to obtain a sample of pleural fluid or a biopsy specimen from the pleural wall for diagnostic purposes. What does serous fluid indicate? a) Emphysema b) Cancer c) Infection d) Trauma

b) Cancer

A client has a nursing diagnosis of "ineffective airway clearance" as a result of excessive secretions. An appropriate outcome for this client would be which of the following? a) Client reports no chest pain. b) Lungs are clear on auscultation. c) Client can perform incentive spirometry. d) Respiratory rate is 12 to 18 breaths per minute.

b) Lungs are clear on auscultation.

The nurse is caring for a client in the immediate post-thoracentesis period. In which position is the client placed? a) In the supine position b) Lying on the unaffected side c) In the high Fowler's position d) Prone with a pillow under the head

b) Lying on the unaffected side

The nurse working in the radiology clinic is assisting with a pulmonary angiography. The nurse knows that when monitoring clients after a pulmonary angiography, what should the physician be notified about? a) Flushed feeling in the client b) Excessive capillary refill c) Absent distal pulses d) Raised temperature in the affected limb

c) Absent distal pulses

Which diagnostic is more accurate in detecting malignancies than a CT scan? a) MRI b) Gallium scan c) PET scan d) Pulmonary angiography

c) PET scan

You are caring for a client admitted with chronic bronchitis. The client is having difficulty breathing, and the family asks you what causes this difficulty. What would be your best response? a) "Anytime there is a chronic disease process it is hard for the person to breathe." b) "Having a chronic respiratory disease scars the lung and affects the effort it takes to breathe." c) "In this particular case your family member is just overly tired and having problems breathing." d) "Conditions such as chronic bronchitis cause thickening of the bronchial mucosa so it makes it harder to breathe."

d) "Conditions such as chronic bronchitis cause thickening of the bronchial mucosa so it makes it harder to breathe."

A nurse understands that a safe but low level of oxygen saturation provides for adequate tissue saturation while allowing no reserve for situations that threaten ventilation. What is a safe but low oxygen saturation level for a patient? a) 75% b) 80% c) 40% d) 95%

d) 95%

A nurse would question the accuracy of a pulse oximetry evaluation in which of the following conditions? a) A client on a ventilator with PEEP b) A client sitting in a chair after prolonged bed rest c) A client receiving oxygen therapy via Venturi mask d) A client experiencing hypothermia

d) A client experiencing hypothermia

A 6-month-old male client and his elder brother, a 3-year-old male, are being seen in the pediatric clinic for their third middle ear infection of the winter. The mother reports they develop an upper respiratory infection and an ear infection seems quick to follow. What contributes to this event? a) Genetics b) Oropharynx c) Epiglottis d) Eustachian tubes

d) Eustachian tubes

A physician wants a study of diaphragmatic motion because of suspected pathology. What does the nurse anticipate that the physician will most likely order? a) Tomogram b) Barium swallow c) Bronchogram d) Fluoroscopy

d) Fluoroscopy

Upon palpation of the sinus area, what would the nurse identify as a normal finding? a) Tenderness during palpation b) Pain sensation behind the eyes c) Light not going through the sinus cavity d) No sensation during palpation

d) No sensation during palpation

The nurse is instructing the patient on the collection of a sputum specimen. What should be included in the instructions? (Select all that apply.) a) Spit surface mucus and saliva into a sterile specimen container. b) Initially, clear the nose and throat. c) Rinse with mouthwash prior to providing the specimen. d) Use diaphragmatic contractions to aid in the expulsion of sputum. e) Take a few deep breaths before coughing.

• Initially, clear the nose and throat. • Take a few deep breaths before coughing. • Use diaphragmatic contractions to aid in the expulsion of sputum.

Which respiratory volume is the maximum volume of air that can be inhaled after maximal expiration? a) Inspiratory reserve volume b) Residual volume c) Expiratory reserve volume d) Tidal volume

a) Inspiratory reserve volume

Lung compliance (the ability of the lungs to stretch) is a physical factor that affects ventilation. A nurse is aware that a patient who has lost elasticity in the lung tissue has a condition known as: a) Pleural effusion b) Emphysema c) Atelectasis d) Pulmonary edema

b) Emphysema

Which of the following terms is used to describe the inability to breathe easily except in an upright position? a) Hypoxemia b) Orthopnea c) Hemoptysis d) Dyspnea

b) Orthopnea

Which of the following ventilation-perfusion ratios is exhibited when a patient is diagnosed with pulmonary emboli? a) Normal perfusion to ventilation ratio b) Silent unit c) Dead space d) Low ventilation-perfusion ratio

c) Dead space

What finding by the nurse may indicate that the patient has chronic hypoxia? a) Cyanosis b) Peripheral edema c) Crackles d) Clubbing of the fingers

d) Clubbing of the fingers

A client with chronic bronchitis is admitted to the health facility. Auscultation of the lungs reveals low-pitched, rumbling sounds. Which of the following describes these sounds? a) Bronchovesicular b) Venous hum c) Rales d) Rhonchi

d) Rhonchi

Which of the following alveolar cells secrete surfactant? a) Type IV b) Type I c) Type III d) Type II

d) Type II

The nursing instructor is teaching a pre-nursing pathophysiology class. The class is covering the respiratory system. The instructor explains that the respiratory system is comprised of both the upper and lower respiratory system. The nose is part of the upper respiratory system. The instructor continues to explain that the nasal cavities have a vascular and ciliated mucous lining. What is the purpose of the vascular and ciliated mucous lining of the nasal cavities? a) Moisten and filter expired air b) Cool and dry expired air c) Move mucus to the back of the throat d) Warm and humidify inspired air

d) Warm and humidify inspired air

A client is receiving moderate sedation while undergoing bronchoscopy. Which assessment finding should the nurse attend to immediately? a) Oxygen saturation of 90% b) Respiratory rate of 13 breaths/min c) Absent cough and gag reflexes d) Blood-tinged secretions

a) Oxygen saturation of 90%

The nurse assessed a 28-year-old woman who was experiencing dyspnea severe enough to make her seek medical attention. The history revealed no prior cardiac problems and the presence of symptoms for 6 months' duration. On assessment, the nurse noted the presence of both inspiratory and expiratory wheezing. Based on this data, which of the following diagnoses is likely? a) Asthma b) Pneumothorax c) Acute respiratory obstruction d) Adult respiratory distress syndrome

a) Asthma

A client arrives at the physician's office stating dyspnea; a productive cough for thick, green sputum; respirations of 28 breaths/minute, and a temperature of 102.8° F. The nurse auscultates the lung fields, which reveal poor air exchange in the right middle lobe. The nurse suspects a right middle lobe pneumonia. To be consistent with this anticipated diagnosis, which sound, heard over the chest wall when percussing, is anticipated? a) Dull b) Resonant c) Tympanic d) Hyperresonant

a) Dull

The nurse is caring for a patient who is scheduled for a bronchoscopy. The nurse understands that it is important to provide the required information and appropriate explanations for any diagnostic procedure to a patient with a respiratory disorder in order to do which of the following? a) Manage decreased energy levels b) Ensure adequate rest periods c) Aid the caregivers of the patient d) Manage respiratory distress

a) Manage decreased energy levels

A patient comes to the emergency department complaining of a knifelike pain when taking a deep breath. What does this type of pain likely indicate to the nurse? a) Pleurisy b) Lung infarction c) Bronchogenic carcinoma d) Bacterial pneumonia

a) Pleurisy

The nurse receives an order to obtain a sputum sample from a client with hemoptysis. When advising the client of the physician's order, the client states not being able to produce sputum. Which suggestion, offered by the nurse, is helpful in producing the sputum sample? a) Take deep breaths and cough forcefully. b) Use the secretions present in the oral cavity. c) Drink 8 oz of water to thin the secretions for expectoration. d) Tickle the back of the throat to produce the gag reflex.

a) Take deep breaths and cough forcefully.

A client appears to be breathing faster than during the last assessment. Which of the following interventions should the nurse perform? a) Inquire if there have been any stressful visitors. b) Count the rate of respirations. c) Assist the client to lie down. d) Assess the radial pulse.

b) Count the rate of respirations.

High or increased compliance occurs in which of the following conditions? a) Pneumothorax b) Emphysema c) ARDS (acute respiratory distress syndrome) d) Pleural effusion

b) Emphysema

A nurse practitioner diagnosed a patient with an infection in the maxillary sinuses. Select the area that the nurse palpated to make that diagnosis. a) Above the eyebrows b) On the cheeks below the eyes c) Between the eyes and behind the nose d) Behind the ethmoid sinuses

b) On the cheeks below the eyes

The nurse is reviewing the blood gas results for a patient with pneumonia. What arterial blood gas measurement best reflects the adequacy of alveolar ventilation? a) pH b) PaCO2 c) PaO2 d) SaO2

b) PaCO2

The nurse is caring for a client whose respiratory status has declined since shift report. The client has tachypnea, is restless, and displays cyanosis. Which diagnostic test should be assessed first? a) Pulmonary function test b) Pulse oximetry c) Chest x-ray d) Arterial blood gases

b) Pulse oximetry

A nurse is reviewing arterial blood gas results on an assigned client. The pH is 7.32 with PCO2 of 49 mm Hg and a HCO3−of 28 mEq/L. The nurse reports to the physician which finding? a) Metabolic alkalosis b) Respiratory acidosis c) Respiratory alkalosis d) Metabolic acidosis

b) Respiratory acidosis

The nurse is caring for a patient who is to undergo a thoracentesis. In preparation for the procedure, the nurse will position the patient in which of the following positions? a) Lateral recumbent b) Sitting on the edge of the bed c) Prone d) Supine

b) Sitting on the edge of the bed

Which of the following results in decreased gas exchange in older adults? a) The elasticity of the lungs increases with age. b) The alveolar walls contain fewer capillaries. c) The alveolar walls become thicker. d) The number of alveoli decreases with age.

b) The alveolar walls contain fewer capillaries.

A client experiences a head injury in a motor vehicle accident. The client's level of consciousness is declining, and respirations have become slow and shallow. When monitoring a client's respiratory status, which area of the brain would the nurse realize is responsible for the rate and depth? a) Wernicke's area b) The pons c) Central sulcus d) The frontal lobe

b) The pons

The volume of air inhaled and exhaled with each breath is termed which of the following? a) Expiratory reserve volume b) Tidal volume c) Vital capacity d) Residual volume

b) Tidal volume

A nurse caring for a patient with a pulmonary embolism understands that a high ventilation-perfusion ratio may exist. What does this mean for the patient? a) There is an absence of perfusion and ventilation. b) Ventilation exceeds perfusion. c) Ventilation matches perfusion. d) Perfusion exceeds ventilation.

b) Ventilation exceeds perfusion.

You are caring for a 65-year-old client who has been newly diagnosed with emphysema. The client is confused by the new terms and wants to know what ventilation means. Which of the following can instruct this client? a) Ventilation provides a blood supply to the lungs. b) Ventilation is breathing air in and out of the lungs. c) Ventilation is when the body changes oxygen into CO2. d) Ventilation helps clients who cannot breathe on their own.

b) Ventilation is breathing air in and out of the lungs

What is the difference between respiration and ventilation? a) Ventilation is the process of getting oxygen to the cells. b) Ventilation is the movement of air in and out of the respiratory tract. c) Ventilation is the process of gas exchange. d) Ventilation is the exchange of gases in the lung.

b) Ventilation is the movement of air in and out of the respiratory tract.

For air to enter the lungs (process of ventilation), the intrapulmonary pressure must be less than atmospheric pressure so air can be pulled inward. Select the movement of respiratory muscles that makes this happen during inspiration. a) Intercostals muscles relax to allow for expansion. b) Lungs are pulled up and pushed back against the thoracic cage. c) Diaphragm contracts and elongates the chest cavity. d) Anteroposterior rib diameter decreases.

c) Diaphragm contracts and elongates the chest cavity.

A pediatrician diagnosed a child with swollen and inflamed adenoids. The nurse practitioner confirmed the diagnosis by: a) Palpating the throat above the cricoid cartilage. b) Inspecting the posterior region of the epiglottis. c) Inspecting the roof of the nasopharynx. d) Examining the base of the oropharynx.

c) Inspecting the roof of the nasopharynx.

A patient presents to the ED complaining of severe coughing episodes. The patient states the "episodes are more intense at night." The nurse should suspect which of the following conditions based on the patient's primary complaint? a) Bronchitis b) Emphysema c) Left-sided heart failure d) Chronic obstructive pulmonary disorder (COPD)

c) Left-sided heart failure

A physician has ordered that a client with suspected lung cancer undergo magnetic resonance imaging (MRI). The nurse explains the benefits of this study to the client. Included in teaching would be which of the following regarding the MRI? a) Lung blood flow can be viewed after a radiopaque agent is injected. b) Tumor densities can be seen with radiolucent images. c) MRI can view soft tissues and can help stage cancers. d) Narrow-beam x-ray can scan successive lung layers.

c) MRI can view soft tissues and can help stage cancers.

The clinical finding of pink frothy sputum may be an indication of which of the following? a) An infection b) A lung abscess c) Pulmonary edema d) Bronchiectasis

c) Pulmonary edema

The client is returning from the operating room following a broncho scopy. Which action, performed by the nursing assistant, would the nurse stop if began prior to nursing assessment? a) The nursing assistant is assisting the client to the side of the bed to use a urinal. b) The nursing assistant is assisting the client to a semi-Fowler's position. c) The nursing assistant is pouring a glass of water to wet the client's mouth. d) The nursing assistant is asking a question requiring a verbal response.

c) The nursing assistant is pouring a glass of water to wet the client's mouth.

A 53-year-old male is a regular client in the respiratory group where you practice nursing. As with all adults, millions of alveoli form most of the pulmonary mass. The squamous epithelial cells lining each alveolus consist of different types of cells. Which type of the alveoli cells produce surfactant? a) Type IV cells. b) Type III cells. c) Type II cells d) Type I cells

c) Type II cells

The nurse is caring for a client with a decrease in airway diameter causing airway resistance. The client experiences coughing and mucus production. Upon lung assessment, which adventitious breath sounds are anticipated? a) Rubs b) Rhonchi c) Wheezes d) Crackles

c) Wheezes

The nurse is caring for a patient diagnosed with pneumonia. The nurse will assess the patient for tactile fremitus by completing which of the following? a) Placing the thumbs along the costal margin of the chest wall and instructing the patient to inhale deeply b) Asking the patient to say "one, two, three" while auscultating the lungs c) Instructing the patient to take a deep breath and hold it while the diaphragm is percussed d) Asking the patient to repeat "ninety-nine" as the nurse's hands move down the patient's thorax

d) Asking the patient to repeat "ninety-nine" as the nurse's hands move down the patient's thorax

A son brings his father into the clinic, stating that his father's color has changed to bluish around the mouth. The father is confused, with a respiratory rate of 28 breaths per minute and scattered crackles throughout. The son states this condition just occurred within the last hour. Which of the following factors indicates that the client's condition has lasted for more than 1 hour? a) Respiratory rate b) Son's statement c) Crackles d) Cyanosis

d) Cyanosis

An 18-year-old male client is described as having pectus carinatum. The nurse is aware that the manifestation of this condition would be: a) The chest is rounded, ribs are horizontal, and sternum is pulled forward. b) The thoracic and lumbar spine have a lateral S-shaped curvature. c) The sternum is depressed from the second intercostal space. d) The sternum protrudes and the ribs are sloped backward.

d) The sternum protrudes and the ribs are sloped backward.

The nurse is caring for a client diagnosed with asthma. While performing the shift assessment, the nurse auscultates breath sounds including sibilant wheezes, which are continuous musical sounds. What characteristics describe sibilant wheezes? a) They are heard in clients with decreased secretions. b) They result from air passing through widened air passages. c) They occur when the pleural surfaces are inflamed. d) They can be heard during inspiration and expiration.

d) They can be heard during inspiration and expiration.

You are studying for a physiology test over the respiratory system. What should you know about central chemoreceptors in the medulla? a) They respond to changes in CO2 levels in the brain. b) They respond to changes in O2 levels and bicarbonate levels in the cerebrospinal fluid. c) They respond to changes in the O2 levels in the brain. d) They respond to changes in CO2 levels and hydrogen ion concentrations (pH) in the cerebrospinal fluid.

d) They respond to changes in CO2 levels and hydrogen ion concentrations (pH) in the cerebrospinal fluid.

Knowing respiratory physiology is important to understand how the disease process can work within that system. Which hollow tube transports air from the laryngeal pharynx to the bronchi? a) Larynx b) Pharynx c) Bronchioles d) Trachea

d) Trachea