Respiratory final

Which statement would indicate that the parents of child with cystic fibrosis understand the disorder? A) "Early treatment can stop the progression of the disease." B) "The mucus-secreting glands are abnormal." C) "There are fibrous cysts in the lungs." D) "Allergic reactions cause inflammation in the lungs."

B.) "The mucus-secreting glands are abnormal."

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? A) Aspiration B) Drug ingestion C) Chemical irritation D) Direct lung damage

C.) Chemical irritation

The ICU nurse is caring for a client who was admitted with a diagnosis of smoke inhalation. The nurse knows that this client is at increased risk for which of the following? A) Acute respiratory distress syndrome B) Lung cancer C) Bronchitis D) Tracheobronchitis

A.) Acute respiratory distress syndrome

The nurse is caring for a client who has recurrent sinusitis. Which consideration could the nurse suggest to best decrease the frequency of infections? A.) Administer an over-the-counter decongestant B.) Use an anti-allergy medication to decrease rhinitis C.) Place a warm cloth over the sinus area of the forehead D.) Gently blow the nose to eliminate nasal secretions

A.) Administer an over-the-counter decongestant.

The nurse is caring for a client who has just had a tracheostomy. What should the nurse monitor frequently? A.) Airway patency B.) Level of consciousness C.) Psychological status D.) Pain level

A.) Airway patency

The nurse is an occupational health nurse who is presenting a workshop on laryngeal cancer. What risk factors would the nurse be sure to include in the workshop? Select all that apply. A.) Alcohol B.) Age C.) Tobacco D.) Industrial pollutants E.) Region of country lived in

A.) Alcohol C.) Tobacco D.) Industrial pollutants

The client admitted with a deep vein thrombosis (DVT) is now complaining of chest pain and dyspnea. Which is the primary intervention for the nurse to take? A) Apply oxygen via face mask. B) Assess and rate the chest pain. C) Apply compression stockings. D) Prepare for ventilation-perfusion scan.

A.) Apply oxygen via face mask.

The client has been self-medicating with antitussives. Which assessment finding would alert the nurse to an adverse effect of this medication? A) Crackles in the bases B) Increased coughing C) Temperature 101°F D) Nausea and vomiting

A.) Crackles in the bases

The nurse is caring for a client who had a recent laryngectomy. Which of the following is reflected in the nursing plan of care? A) Develop an alternate method of communication. B) Encourage oral nutrition on the second postoperative day. C) Maintain the client in a low-Fowler's position. D) Assess the tracheostomy cuff for leaks.

A.) Develop an alternate method of communication.

What is the reason for chest tubes after thoracic surgery? A) Draining secretions, air, and blood from the thoracic cavity is necessary. B) Chest tubes allow air into the pleural space. C) Chest tubes indicate when the lungs have reexpanded by ceasing to bubble. D) Draining secretions and blood while allowing air to remain in the thoracic cavity is necessary.

A.) Draining secretions, air, and blood from the thoracic cavity is necessary.

A client recently diagnosed with laryngeal cancer and awaiting a laryngectomy was encouraged to attend a support group prior to surgery. The client asked the nurse about the name of the laryngeal speech method where the client regurgitates swallows air and forms words with his lips. The nurse is correct to provide teaching on which method? A) Esophageal speech B) An electric larynx C) A tracheoesophageal puncture D) An artificial voice box

A.) Esophageal speech

The nurse is caring for a client status post-nasal polypectomy. What would the nurse instruct this client to report? A.) Excessive swallowing B.) Nasal stuffiness C.) Diarrhea d.) Coughing

A.) Excessive swallowing

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

A.) Fibrotic changes in lungs

When the nurse monitors the water-sealed drainage system, which finding suggests the system is working properly? A) Fluid rises and falls with respirations. B) Level of fluid is lowered in suction chamber. C) Fluid is bubbling vigorously. D) Fluid appears white and frothy.

A.) Fluid rises and falls with respirations.

What are the conditions that make up Virchow's triad? Select all that apply. A) Hypercoagulability B) Disruption of the vessel lining C) Hypocoagulability D) Edema E) Venostasis

A.) Hypercoagulability B.) Disruption of the vessel lining E.) Venostasis

The nurse is caring for a client with a new tracheostomy. Select two nursing diagnosis that have the highest priority when caring for this patient. A) Ineffective Airway Clearance related to increased secretions B) Risk for Infection related to operative incision and tracheostomy tube placement C) Knowledge Deficit related to care of the tracheostomy tube and surrounding site D) Impaired Gas Exchange related to shallow breathing and anxiousness E) Disturbed Body Image

A.) Ineffective Airway Clearance related to increased secretions. D.) Impaired Gas Exchange related to shallow breathing and anxiousness.

The nurse identifies which finding to be most consistent prior to the onset of acute respiratory distress? A) Normal lung function B) Loss of lung function C) Chronic lung disease D) Slow onset of symptoms

A.) Normal lung function

The nurse is receiving a client in the postanesthesia care unit (PACU) diagnosed with postoperative tonsillectomy and adenoidectomy. The unlicensed assistive personnel is assisting the client from the stretcher to the bed. The client remains drowsy from anesthesia. In which position would the nurse instruct the unlicensed assistive personnel to place the client? A.) On a side B.) Supine C.) Semi-Fowler's D.) High-Fowler's

A.) On a side

The nurse is caring for a client who has just been diagnosed with lung cancer. What is a cardinal sign of lung cancer? Select all that apply A) Persistent cough B) Blood-streaked sputum C) Obvious trauma D) Shortness of breath

A.) Persistent cough. B.) Blood-streaked sputum

Which is a primary nursing intervention in caring for a client with the diagnosis of bronchiectasis? A) Postural drainage B) Droplet precautions C) Preventative antibiotic use D) Administration of antitussives

A.) Postural drainage

The nurse is caring for a respiratory client who uses a noninvasive positive pressure device. Which medical equipment does the nurse anticipate to find in the client's room? A) A ventilator B) A face mask C) A rigid shell D) A nasal cannula

B.) A face mask

The nurse caring for a 2-year-old near-drowning victim monitors for what possible complication? A) Atelectasis B) Acute respiratory distress syndrome C) Metabolic alkalosis D) Respiratory acidosis

B.) Acute respiratory distress syndrome

The nurse is caring for a client who is demonstrating signs of increased respiratory distress related to laryngeal obstruction. The nurse is calling the physician to report on the client's condition. Which of the following will the nurse report? Select all that apply. A) A decreased respiratory rate B) Arterial blood gases reporting a PaCO2 of 48 and a PaO2 of 84 C) Nasal flaring with abdominal retractions D) Increased respiratory effort E) Lung sounds of wheezing F) Administration of an inhaled corticosteroid

B.) Arterial blood gases reporting a PaCO2 of 48 and a PaO2 of 8. C.) Nasal flaring with abdominal retractions. D.) Increased respiratory effort. E.) Lung sounds of wheezing

The nurse is mentoring a new graduate nurse, caring for a client with a new tracheostomy. The new graduate nurse asks what the complications of tracheostomy are. What would the nurse respond? Select all that apply. A.) Absence of secretions B.) Aspiration C.) Infection D.) Injury to the laryngeal nerve E.) Penetration of the anterior tracheal wall

B.) Aspiration C.) Infection D.) Injury to the laryngeal nerve

The nurse is caring for a client experiencing laryngeal trauma. Upon assessment, swelling and bruising is noted to the neck. Which breath sound is anticipated? A) Rhonchi in the bronchial region B) Audible stridor without using a stethoscope C) Crackles in the bases of the lungs D) Diminished breath sounds throughout

B.) Audible stridor without using a stethoscope

The nurse is providing discharge instructions to a client diagnosed with postoperative tonsillectomy and adenoidectomy. Which discharge instructions would the nurse include? Select all that apply. A.) Postoperative bleeding most frequently occurs in the hours after surgery. B.) Avoid carbonated fluids. C.) Gradually increase fluids then add soft foods. D.) Apply an ice collar to the neck area. E.) Gargle with warm saline water. F.) Limit pain medications to the nighttime.

B.) Avoid carbonated fluids. C.) Gradually increase fluids then add soft foods. D.) Apply an ice collar to the neck area. E.) Gargle with warm saline water.

The nurse is obtaining data from a client with a respiratory disorder. Which information would be considered a part of the functional assessment and assist in the diagnosis of an occupational lung disease? A) Cough and dyspnea B) Black-streaked sputum C) Tenacious secretions D) Barrel chest

B.) Black-streaked sputum

Following a femur fracture surgical repair, the client develops hemoptysis, wheezing, and cyanosis. The nurse suspects a pulmonary embolus that originated from which site? A) Deep veins of the legs B) Bone marrow C) Myocardial tissue D) Superior vena cava

B.) Bone marrow

The client with acute respiratory distress syndrome (ARDS) presents with severe hypoxemia, in spite of oxygen administration via face mask. Which intervention would the nurse anticipate and prepare for? A) Intermittent positive pressure breathing B) Insertion of endotracheal tube C) Increasing oxygen to 12 to 15 L flow D) Insertion of chest tube

B.) Insertion of endotracheal tube

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

B.) Paradoxical chest movement

A graduate practical nurse is caring for a client who has a tracheostomy tube. A seasoned nurse is assisting in providing guidance for completing tracheostomy care. When changing the ties, the client moves and dislodges the tube. Which of the following does the seasoned nurse do first? A) Call for the registered nurse to reinsert the tube. B) Place a dilator in the stoma to maintain the opening. C) Cover the tracheostomy site with a sterile gauze to prevent infection. D) Call for an ambulance and transfer the client to the emergency department.

B.) Place a dilator in the stoma to maintain the opening.

Upon assessing a client with emphysema, the nurse notes increased difficulty with inspiration. What is the likely cause of this finding? A) Prolonged tobacco use B) Rigid chest cage C) Saccular dilatation D) Inflammation of the bronchioles

B.) Rigid chest cage

In the prevention of occupational lung diseases, the nurse would direct preventative teaching to which high-risk occupations? Select all that apply. A) Banker B) Rock quarry worker C) Nurse D) Miner E) Mechanic

B.) Rock quarry worker D.) Miner E.) Mechanic

The nurse is caring for a client with an endotracheal tube. Which client data does the nurse interpret as a life-threatening situation? A) Copious mucous secretions B) Sudden restlessness C) Harsh cough D) Rhonchi in lung fields

B.) Sudden restlessness

The nurse is caring for the client who presents to the clinic with hoarseness for 2 months. Further testing revealed a diagnosis of laryngeal cancer with a treatment plan for a radical neck dissection. When reinforcing information provided by the physician to the client, which nursing instruction is most correct? A) Laser surgery is a possibility with limited side effects. B) The physician removes lymph nodes, muscles, and tissue. C) Once the tissue is removed, no further treatment is necessary. D) The client will be able to speak normally once the swelling subsides.

B.) The physician removes lymph nodes, muscles, and tissue.

The nurse is caring for a client following sinus surgery. When assessing the client, the nurse asks him how many fingers are being held up. Why does the nurse assess postoperative visual acuity? A.) To assess possible hemorrhage B.) To assess damage to the optic nerve C.) To assess postoperative infection D.) To assess impaired drainage

B.) To assess damage to the optic nerve

The nurse is caring for a client in the physician's office with a potential sinus infection. The physician orders a diagnostic test to identify if fluid is found in the sinus cavity. Which diagnostic test, written by the physician, is specifically ordered for this purpose? A.) CBC with differential B.) Transillumination of the sinus C.) Nasal culture D.) MRI

B.) Transillumination of the sinus

The nurse in the walk-in clinic is caring for a client complaining of a sore throat and fever for 3 days. Upon inspection, the nurse notes the client's throat is red, with raised, white patches. Which nursing assessment should be stressed? A.) Lung fields B.) Voiding C.) Joint pain D.) Mentation

B.) Voiding

The nurse is caring for a client with an upper respiratory disorder. The client states he has a hacky, nonproductive cough, which wakens him during the night. Which over-the-counter medication would the nurse suggest to diminish the cough during the night? A) Diphenhydramine B) Dextromethorphan C) Pseudoephedrine D) Fluticasone

B.)Dextromethorphan

A client with pulmonary hypertension asks the nurse to explain the heart changes that can occur with this disorder. Which is the best response? A) "I will ask your physician to discuss this with you." B) "Blood pressure is high as it leaves the heart." C) "The right side of the heart enlarges as pressure backs from the lungs." D) "The left side of the heart is not pumping well and blood backs into the lungs."

C.) "The right side of the heart enlarges as pressure backs from the lungs."

Which action should the nurse take first in caring for a client during an acute asthma attack? A) Obtain arterial blood gases. B) Send for STAT chest X-ray. C) Administer bronchodilator as ordered. D) Initiate oxygen therapy and reassess pulse oximetry in 10 minutes.

C.) Administer bronchodilator as ordered.

A client is admitted to the emergency department with a stab wound and is now presenting dyspnea, tachypnea, and sucking noise heard on inspiration and expiration. The nurse should care for the wound in which manner? A) Clean the wound and leave open to the air. B) Apply vented dressing. C) Apply airtight dressing. D) Apply direct pressure to the wound.

C.) Apply airtight dressing.

A client comes into the emergency department with epistaxis. What intervention should the nurse perform when caring for a client with epistaxis? A.) Apply a moustache dressing B.) Provide a nasal splint C.) Apply direct continuous pressure D.) Place the client in a semi-fowler's position

C.) Apply direct continuous pressure.

The nurse is caring for the client in the intensive care unit immediately after removal of the endotracheal tube. Which of the following nursing actions is most important to complete every hour to ensure that the respiratory system is not compromised? A) Obtain vital signs. B) Monitor heart rhythm. C) Auscultate lung sounds. D) Assess capillary refill.

C.) Auscultate lung sounds.

The nurse is caring for a client with a closed chest drainage system. While repositioning the client, the chest tube dislodges. What is the immediate nursing intervention? A) Reinsert the chest tube. B) Notify the physician. C) Cover the exit site. D) Apply oxygen via face mask.

C.) Cover the exit site.

Which of the following provides the best example of documentation for a client who is presenting with acute bronchitis? A) Physical activity seems to increase incidence of paroxysmal coughing. B) Expectorating moderate amounts of thick, green mucus. C) Dry, frequent cough with occasional production of sputum. D) Less crackles today. No cough or mucus noted.

C.) Dry, frequent cough with occasional production of sputum

The nurse is caring for a client status after adenoidectomy. The nurse finds the client in severe respiratory distress when entering the room. What does the nurse suspect? A.) Infection B.) Postoperative bleeding C.) Edema of the upper airway D.) Plugged tracheostomy tube

C.) Edema of the upper airway

A nurse is caring for a client following nasal surgery. Which assessment finding best indicates current bleeding? A.) Ruddy colored drainage of the nasal dressing B.) Occasional nonproductive cough C.) Frequent swallowing D.) Pressure in the nasal cavity

C.) Frequent swallowing

The nurse is preparing a client for emergency thoracic surgery. What would the nurse document in the assessment? A) Emergency contacts B) IV fluids ordered C) General statement of the client's condition D) Detailed physical assessment

C.) General statement of the client's condition

The nurse is obtaining a health history from a client on an annual physical exam. Which documentation should be brought to the physician's attention? A) Epistaxis, twice last week B) Aphonia following a football game C) Hoarseness for 2 weeks D) Laryngitis following a cold

C.) Hoarseness for 2 weeks

The client, with a lower respiratory airway infection, is presenting with symptoms such as fever, chills, dry hacking cough, and wheezing. Which nursing diagnosis best supports the assessment by the nurse? A) Risk for Infection B) Impaired Gas Exchange C) Ineffective Airway Clearance D) Ineffective Breathing Pattern

C.) Ineffective Airway Clearance

The nurse is caring for a client in a physician's office whose X-ray of the sinus reveals exudate in the maxillary sinus. Which equipment must the nurse have present in the room? A.) Otoscope B.) Ophthalmoscope C.) Irrigation equipment D.) Tuning fork

C.) Irrigation equipment

The nurse is caring for a client diagnosed with coryza, possibly from the rhinovirus. Vital signs are temperature: 101.2°F, pulse: 72 beats/minute, respirations: 28 breaths/minute, and blood pressure: 112/70 mm Hg. Upon morning assessment, the client states a sore throat, moist cough, and watery eyes. The lungs are course in the bases. Which afternoon assessment finding suggests the advancement to an infectious process? A.) Achiness B.) Haedache C.) Temperature rise D.) Increased respiratory rate

C.) Temperature rise

The emergency department nurse is assessing a client following a motor vehicle accident. The nurse notes facial deformities with swelling and bleeding and a clear drainage coming from the nares. Which diagnostic test is completed to determine whether the clear drainage is cerebrospinal fluid? A) Draw a serum CBC B) Test fluid with Nitrazine paper C) Test fluid with a Dextrostix D) Perform a glucometer check

C.) Test fluid with a Dextrostix

The nurse initiates the following intervention upon receiving a client back to the clinical unit after a throat-related procedure, "Elevate the head of the bed 45°." Which nursing goal is met in this assessment? A.) The client will have decreased pain B.) The client will remain alert and oriented C.) The client will have decreased edema D.) The client will have increased tissue perfusion

C.) The client will have decreased edema.

The nurse is presenting about upper respiratory infections at an educational event for a local community group. What should the nurse be sure to include regarding cold tablets containing first-generation antihistamines? A.) They dilute the nasal secretions B.) They lead to frequent sinus drainage C.) They can cause drowsiness D.) They prolong bleeding

C.) They can cause drowsiness

The nurse is performing a preoperative assessment on a client who is scheduled for a tonsillectomy. Why would the nurse ask the client about the use of herbal supplements? A.) They produce anorexia B.) They impair the immune system C.) They may prolong bleeding D.) They lower high-density lipoprotein levels

C.) They may prolong bleeding.

The nurse knows the mortality rate is high in lung cancer clients due to which factor? A) Increased in women smokers B) Increased incidence among the elderly C) Increased exposure to industrial pollutants D) Few early symptoms

D) Fee early symptoms

A client visits the physician's office concerned about possible sleep apnea. The client states he lives alone and fears that he will not awaken from sleep. The client states that he has many symptoms which may indicate sleep apnea. Which symptom, stated by the client, is not a symptom of sleep apnea? A) "I wake myself up by snoring several times each night." B) "I wake up in the morning with a headache." C) "I have trouble concentrating throughout the day." D) "I have pressure in the middle of my chest at night."

D.) "I have pressure in the middle of my chest at night."

The nurse is obtaining a health history from a client with laryngitis. Which causative factor, stated by the client, is least likely? A) "I have environmental allergies." B) "I smoke a pack of cigarettes a day." C) "I used my voice in excess over the weekend." D) "I was chewing ice chips all day long."

D.) "I was chewing ice chips all day long."

A nurse is evaluating teaching when discussing care of a new tracheostomy. Which statement, made by the client, indicates that the client does not accept the new tracheostomy? A) "I must carry tissues with me." B) "I must give up my love of pool aerobics." C) "I will not be able to have the tracheostomy removed." D) "Tell my wife about it, I do not want to touch it."

D.) "Tell my wife about it, I do not want to touch it."

The client asks the nurse to explain the reason for a chest tube insertion in treating a pneumothorax. Which is the best response by the nurse? A) "Chest tube will allow air to be restored to the lung." B) "The tube will drain secretions from the lung." C) "Chest tubes provide a route for medication instillation to the lung." D) "The tube will drain air from the space around the lung."

D.) "The tube will drain air from the space around the lung."

A client, who is at risk for pneumonia, has been ordered influenza vaccine. Which statement from the nurse best explains the rationale for this vaccine? A) "Getting the flu can complicate pneumonia." B) "Influenza vaccine will prevent typical pneumonias." C) "Influenza is the major cause of death in the United States." D) "Viruses, like influenza, are common causes of pneumonia."

D.) "Viruses, like influenza, are common causes of pneumonia."

While caring for a client with a chest tube, which nursing assessment would alert the nurse to a possible complication? A) Skin around tube is pink. B) Bloody drainage is seemed in the collection chamber. C) Absence of bloody drainage in the anterior/upper tube D) Crackling is heard when skin around tube is touched.

D.) Crackling is heard when skin around tube is touched.

The nurse is assessing a client's potential for pulmonary emboli. What finding indicates possible deep vein thrombosis? A) Pain in the feet B) Coolness to lower extremities C) Decreased urinary output D) Localized calf tenderness

D.) Localized calf tenderness

The nurse is caring for a client diagnosed with enlarged adenoids. What condition is produced by enlarged adenoids? A.) Incrusted mucous membranes B.) Hardened secretions C.) Erosion of the trachea D.) Noisy breathing

D.) Noisy breathing

When managing the postoperative pain after a pneumonectomy, the nurse is most concerned about which assessment data? A) Blood pressure 100/60 mm Hg B) Temperature 97.8°F C) Heart rate 100 beats/minute D) Respirations 10 breaths/minute

D.) Respirations 10 breaths/minute

The nurse is providing suggestions to a client diagnosed with the effects of coryza. Which home remedy is appropriate when combined with medical treatment for pharyngitis? A.) Cool mist humidifier B.) Lavender scent C.) Ice chips D.) Salt water gargle

D.) Salt water gargle

Which nursing assessment would alert a nurse to the development of a mediastinal shift, in a client with tension pneumothorax? A) Fluctuation of the fluid in the water-seal chamber B) Shift of rib cage toward the affected side C) Sucking sound heard on inspiration and expiration D) Shift of trachea, esophagus, heart, and great vessels

D.) Shift of trachea, esophagus, heart, and great vessels