Respiratory Practice Questions
How would you analyze the following ABG results? pH7.25; PaCO@ 75; PaO2 50; HCO3 27 a. Respiratory alkalosis b. respiratory acidosis c. metabolic acidosis d. metabolic alkalosis
B
A client appears dyspneic, but the oxygen saturation is 97%. What action by the nurse is best? a.Assess for other manifestations of hypoxia. b.Change the sensor on the pulse oximeter. c.Obtain a new oximeter from central supply. d.Tell the client to take slow, deep breaths
A
A client has a tracheostomy that is 3 days old. Upon assessment, the nurse notes the client's face is puffy and the eyelids are swollen. What action by the nurse takes priority? a. Assess the client's oxygen saturation. b. Notify the Rapid Response Team. c. Oxygenate the client with a bag-valve-mask. d. Palpate the skin of the upper chest.
A
A client has been diagnosed with a very large pulmonary embolism (PE) and has a dropping blood pressure. What medication should the nurse anticipate the client will need as the priority? a.Alteplase (Activase) b.Enoxaparin (Lovenox) c.Unfractionated heparin d.Warfarin sodium (Coumadin
A
A client in the emergency department has several broken ribs. What care measure will best promote comfort? a.Allowing the client to choose the position in bed b.Humidifying the supplemental oxygen c.Offering frequent, small drinks of water d.Providing warmed blankets
A
A client is receiving oxygen at 4 liters per nasal cannula. What comfort measure may the nurse delegate to unlicensed assistive personnel (UAP)? a. Apply water-soluble ointment to nares and lips. b. Periodically turn the oxygen down or off. c. Remove the tubing from the client's nose. d. Turn the client every 2 hours or as needed.
A
A nurse auscultates a harsh hollow sound over a client's trachea and larynx. Which action should the nurse take first? a. Document the findings. b. Administer oxygen therapy. c. Position the client in high-Fowler's position. d. Administer prescribed albuterol.
A
A nurse is caring for a client on mechanical ventilation and finds the client agitated and thrashing about. What action by the nurse is most appropriate? a.Assess the cause of the agitation. b.Reassure the client that he or she is safe. c.Restrain the client's hands. d.Sedate the client immediately
A
A nurse plans care for a client who is experiencing dyspnea and must stop multiple times when climbing a flight of stairs. Which intervention should the nurse include in this client's plan of care? a. Assistance with activities of daily living b. Physical therapy activities every day c. Oxygen therapy at 2 liters per nasal cannula d. Complete bedrest with frequent repositioning
A
A home health nurse is visiting a new client who uses oxygen in the home. For which factors does the nurse assess when determining if the client is using the oxygen safely? (Select all that apply.) a. The client does not allow smoking in the house. b. Electrical cords are in good working order. c. Flammable liquids are stored in the garage. d. Household light bulbs are the fluorescent type. e. The client does not have pets inside the home.
A B C
When working with women who are taking hormonal birth control, what health promotion measures should the nurse teach to prevent possible pulmonary embolism (PE)? (Select all that apply.) a.Avoid drinking alcohol. b.Eat more omega-3 fatty acids. c.Exercise on a regular basis. d.Maintain a healthy weight. e.Stop smoking cigarettes.
C D E
A client has a tracheostomy tube in place. When the nurse suctions the client, food particles are noted. What action by the nurse is best? a. Elevate the head of the client's bed. b. Measure and compare cuff pressures. c. Place the client on NPO status. d. Request that the client have a swallow study
B
A client is hospitalized with a second episode of pulmonary embolism (PE). Recent genetic testing reveals the client has an alteration in the gene CYP2C19. What action by the nurse is best? a.Instruct the client to eliminate all vitamin K from the diet. b.Prepare preoperative teaching for an inferior vena cava (IVC) filter. c.Refer the client to a chronic illness support group. d.Teach the client to use a soft-bristled toothbrush.
B
A client is on intravenous heparin to treat a pulmonary embolism. The client's most recent partial thromboplastin time (PTT) was 25 seconds. What order should the nurse anticipate? a.Decrease the heparin rate. b.Increase the heparin rate. c.No change to the heparin rate. d.Stop heparin; start warfarin (Coumadin
B
A client is scheduled to have a tracheostomy placed in an hour. What action by the nurse is the priority? a. Administer prescribed anxiolytic medication. b. Ensure informed consent is on the chart. c. Reinforce any teaching done previously. d. Start the preoperative antibiotic infusion.
B
A client is wearing a Venturi mask to deliver oxygen and the dinner tray has arrived. What action by the nurse is best? a. Assess the client's oxygen saturation and, if normal, turn off the oxygen. b. Determine if the client can switch to a nasal cannula during the meal. c. Have the client lift the mask off the face when taking bites of food. d. Turn the oxygen off while the client eats the meal and then restart it
B
A client with a new tracheostomy is being seen in the oncology clinic. What finding by the nurse best indicates that goals for the nursing diagnosis Impaired Self-Esteem are being met? a. The client demonstrates good understanding of stoma care. b. The client has joined a book club that meets at the library. c. Family members take turns assisting with stoma care. d. Skin around the stoma is intact without signs of infection.
B
A nurse answers a call light and finds a client anxious, short of breath, reporting chest pain, and having a blood pressure of 88/52 mm Hg on the cardiac monitor. What action by the nurse takes priority? a.Assess the client's lung sounds b.Notify the Rapid Response Team. c.Provide reassurance to the client d.Take a full set of vital signs.
B
A nurse is assessing a client who is recovering from a lung biopsy. Which assessment finding requires immediate action? a. Increased temperature b. Absent breath sounds c. Productive cough d. Incisional discomfort
B
A nurse is caring for a client on the medical stepdown unit. The following data are related to this client: Shortness of breath for 20 minutes Feels frightened "Can't catch my breath" pH: 7.12 PaCO2: 28 mm Hg PaO2: 58 mm Hg SaO2: 88% Pulse: 120 beats/min Respiratory rate: 34 breaths/min Blood pressure 158/92 mm Hg Lungs have crackles What action by the nurse is most appropriate? a.Call respiratory therapy for a breathing treatment. b.Facilitate a STAT pulmonary angiography. c.Prepare for immediate endotracheal intubation. d.Prepare to administer intravenous anticoagulants
B
A nurse is caring for a client who received benzocaine spray prior to a recent bronchoscopy. The client presents with continuous cyanosis even with oxygen therapy. Which action should the nurse take next? a. Administer an albuterol treatment. b. Notify the Rapid Response Team. c. Assess the client's peripheral pulses. d. Obtain blood and sputum cultures.
B
A nurse is caring for an older adult client who has a pulmonary infection. Which action should the nurse take first? a. Encourage the client to increase fluid intake. b. Assess the client's level of consciousness. c. Raise the head of the bed to at least 45 degrees. d. Provide the client with humidified oxygen.
B
A nurse is caring for four clients on intravenous heparin therapy. Which laboratory value possibly indicates that a serious side effect has occurred? a.Hemoglobin: 14.2 g/dL b.Platelet count: 82,000/L c.Red blood cell count: 4.8/mm3 d.White blood cell count: 8.7/mm3
B
A nurse is preparing to admit a client on mechanical ventilation from the emergency department. What action by the nurse takes priority? a.Assessing that the ventilator settings are correct b.Ensuring there is a bag-valve-mask in the room c.Obtaining personal protective equipment d.Planning to suction the client upon arrival to the room
B
The nurse is caring for a patient with a chest tube. The family sees an up and down movement of the fluid in the water seal chamber and wants the nurse to explain it. What is the nurse's best response? a. Explain to the family that the patient has an air leak which will gradually seal itself off. b. Tell the family that this is a normal movement call tidaling. c. Call the physician to find out what the movement means. d. Check the patient for subcutaneous emphysema.
B
The nurse is caring for a patient with acute respiratory failure. in monitoring the oxygenation level of the patient, the nurse plans to keep the patient's pulse oximetry at greater than or equal to a. 85% b. 90% c. 94% d. 100%
B
A nurse is caring for five clients. For which clients would the nurse assess a high risk for developing a pulmonary embolism (PE)? (Select all that apply.) a.Client who had a reaction to contrast dye yesterday b.Client with a new spinal cord injury on a rotating bed c.Middle-aged man with an exacerbation of asthma d.Older client who is 1-day post hip replacement surgery e.Young obese client with a fractured femur
B D E
A nurse cares for a client who had a bronchoscopy 2 hours ago. The client asks for a drink of water. Which action should the nurse take next? a. Call the physician and request a prescription for food and water. b. Provide the client with ice chips instead of a drink of water. c. Assess the client's gag reflex before giving any food or water. d. Let the client have a small sip to see whether he or she can swallow.
C
A nurse is assisting the health care provider who is intubating a client. The provider has been attempting to intubate for 40 seconds. What action by the nurse takes priority? a.Ensure the client has adequate sedation. b.Find another provider to intubate. c.Interrupt the procedure to give oxygen. d.Monitor the client's oxygen saturation
C
A nurse obtains the health history of a client who is recently diagnosed with lung cancer and identifies that the client has a 60-pack-year smoking history. Which action is most important for the nurse to take when interviewing this client? a. Tell the client that he needs to quit smoking to stop further cancer development. b. Encourage the client to be completely honest about both tobacco and marijuana use. c. Maintain a nonjudgmental attitude to avoid causing the client to feel guilty. d. Avoid giving the client false hope regarding cancer treatment and prognosis.
C
A nurse teaches a client who is prescribed nicotine replacement therapy. Which statement should the nurse include in this client's teaching? a. "Make a list of reasons why smoking is a bad habit." b. "Rise slowly when getting out of bed in the morning." c. "Smoking while taking this medication will increase your risk of a stroke." d. "Stopping this medication suddenly increases your risk for a heart attack."
C
An intubated client's oxygen saturation has dropped to 88%. What action by the nurse takes priority? a.Determine if the tube is kinked. b.Ensure all connections are patent. c.Listen to the client's lung sounds. d.Suction the endotracheal tube
C
A client is brought to the emergency department after sustaining injuries in a severe car crash. The client's chest wall does not appear to be moving normally with respirations, oxygen saturation is 82%, and the client is cyanotic. What action by the nurse is the priority? a.Administer oxygen and reassess. b.Auscultate the client's lung sounds. c.Facilitate a portable chest x-ray. d.Prepare to assist with intubation
D
A client is on mechanical ventilation and the client's spouse wonders why ranitidine (Zantac) is needed since the client "only has lung problems." What response by the nurse is best? a."It will increase the motility of the gastrointestinal tract." b."It will keep the gastrointestinal tract functioning normally." c."It will prepare the gastrointestinal tract for enteral feedings." d."It will prevent ulcers from the stress of mechanical ventilation."
D
A nurse assesses a client after a thoracentesis. Which assessment finding warrants immediate action? a. The client rates pain as a 5/10 at the site of the procedure. b. A small amount of drainage from the site is noted. c. Pulse oximetry is 93% on 2 liters of oxygen. d. The trachea is deviated toward the opposite side of the neck.
D
A nurse assesses a client's respiratory status. Which information is of highest priority for the nurse to obtain? a. Average daily fluid intake b. Neck circumference c. Height and weight d. Occupation and hobbies
D
A nurse is assessing a client who has a tracheostomy. The nurse notes that the tracheostomy tube is pulsing with the heartbeat as the client's pulse is being taken. No other abnormal findings are noted. What action by the nurse is most appropriate? a. Call the operating room to inform them of a pending emergency case. b. No action is needed at this time; this is a normal finding in some clients. c. Remove the tracheostomy tube; ventilate the client with a bag-valve-mask. d. Stay with the client and have someone else call the provider immediately.
D
A nurse is caring for a client on mechanical ventilation. When double-checking the ventilator settings with the respiratory therapist, what should the nurse ensure as a priority? a.The client is able to initiate spontaneous breaths. b.The inspired oxygen has adequate humidification. c.The upper peak airway pressure limit alarm is off. d.The upper peak airway pressure limit alarm is on
D
A nurse is caring for a client who is scheduled to undergo a thoracentesis. Which intervention should the nurse complete prior to the procedure? a. Measure oxygen saturation before and after a 12-minute walk. b. Verify that the client understands all possible complications. c. Explain the procedure in detail to the client and the family. d. Validate that informed consent has been given by the client.
D
A student is practicing suctioning a tracheostomy in the skills laboratory. What action by the student demonstrates that more teaching is needed? a. Applying suction while inserting the catheter b. Preoxygenating the client prior to suctioning c. Suctioning for a total of three times if needed d. Suctioning for only 10 to 15 seconds each time
A
An unlicensed assistive personnel (UAP) was feeding a client with a tracheostomy. Later that evening, the UAP reports that the client had a coughing spell during the meal. What action by the nurse takes priority? a. Assess the client's lung sounds. b. Assign a different UAP to the client. c. Report the UAP to the manager. d. Request thicker liquids for meals
A
A patient's family is having difficulty understanding what "PEEP" is. The nurse explains that PEEP Select All That Apply. a. Stands for positive end expiratory pressure b. Increases the functional residual capacity c. Helps to open collapsed alveoli d. Increases tidal volume e. increases surfactant
A B C
The nurse caring for mechanically ventilated clients uses best practices to prevent ventilator-associated pneumonia. What actions are included in this practice? (Select all that apply.) a.Adherence to proper hand hygiene b.Administering anti-ulcer medication c.Elevating the head of the bed d.Providing oral care per protocol e.Suctioning the client on a regular schedule
A B C D
A client with a new pulmonary embolism (PE) is anxious. What nursing actions are most appropriate? (Select all that apply.) a.Acknowledge the frightening nature of the illness. b.Delegate a back rub to the unlicensed assistive personnel (UAP). c.Give simple explanations of what is happening. d.Request a prescription for antianxiety medication. e.Stay with the client and speak in a quiet, calm voice
A B C E
A nurse is teaching a client about possible complications and hazards of home oxygen therapy. About which complications does the nurse plan to teach the client? (Select all that apply.) a. Absorptive atelectasis b. Combustion c. Dried mucous membranes d. Oxygen-induced hyperventilation e. Toxicity
A B C E
The nurse caring for mechanically ventilated clients knows that older adults are at higher risk for weaning failure. What age-related changes contribute to this? (Select all that apply.) a.Chest wall stiffness b.Decreased muscle strength c.Inability to cooperate d.Less lung elasticity e.Poor vision and hearing
A B D
A nurse is caring for a client who is on mechanical ventilation. What actions will promote comfort in this client? (Select all that apply.) a.Allow visitors at the client's bedside. b.Ensure the client can communicate if awake. c.Keep the television tuned to a favorite channel. d.Provide back and hand massages when turning. e.Turn the client every 2 hours or more
A B D E
A nurse is planning discharge teaching on tracheostomy care for an older client. What factors does the nurse need to assess before teaching this particular client? (Select all that apply.) a. Cognition b. Dexterity c. Hydration d. Range of motion e. Vision
A B D E
A nurse plans care for a client who is at high risk for a pulmonary infection. Which interventions should the nurse include in this client's plan of care? (Select all that apply.) a. Encourage deep breathing and coughing. b. Implement an air mattress overlay. c. Ambulate the client three times each day. d. Provide a diet high in protein and vitamins. e. Administer acetaminophen (Tylenol) twice daily.
A C D
A nurse assesses a client who is prescribed varenicline (Chantix) for smoking cessation. Which manifestations should the nurse identify as adverse effects of this medication? (Select all that apply.) a. Visual hallucinations b. Tachycardia c. Decreased cravings d. Impaired judgment e. Increased thirst
A D
A nurse is caring for a client who has a tracheostomy tube. What actions may the nurse delegate to unlicensed assistive personnel (UAP)? (Select all that apply.) a. Applying water-soluble lip balm to the client's lips b. Ensuring the humidification provided is adequate c. Performing oral care with alcohol-based mouthwash d. Reminding the client to cough and deep breathe often e. Suctioning excess secretions through the tracheostomy
A D
the nurse is positioning the patient who has an oxygen saturation rate of 88% and is receiving oxygen at 50% via CPAP. for optimal absorption, the nurse plans to position this patient Select all that apply a. Prone b. Flat in bed c. In semi-Fowler's position on the left side d. In semi-Fowler's position on the right side e. Supine with the head elevated enough for comfort
A D
A client is being discharged home after having a tracheostomy placed. What suggestions does the nurse offer to help the client maintain self-esteem? (Select all that apply.) a. Create a communication system. b. Don't go out in public alone. c. Find hobbies to enjoy at home. d. Try loose-fitting shirts with collars. e. Wear fashionable scarves.
A D E
A nurse collaborates with a respiratory therapist to complete pulmonary function tests (PFTs) for a client. Which statements should the nurse include in communications with the respiratory therapist prior to the tests? (Select all that apply.) a. "I held the client's morning bronchodilator medication." b. "The client is ready to go down to radiology for this examination." c. "Physical therapy states the client can run on a treadmill." d. "I advised the client not to smoke for 6 hours prior to the test." e. "The client is alert and can follow your commands."
A D E
A nurse teaches a client who is interested in smoking cessation. Which statements should the nurse include in this client's teaching? (Select all that apply.) a. "Find an activity that you enjoy and will keep your hands busy." b. "Keep snacks like potato chips on hand to nibble on." c. "Identify a punishment for yourself in case you backslide." d. "Drink at least eight glasses of water each day." e. "Make a list of reasons you want to stop smoking."
A D E
While obtaining a client's health history, the client states, "I am allergic to avocados." Which responses by the nurse are best? (Select all that apply.) a. "What response do you have when you eat avocados?" b. "I will remove any avocados that are on your lunch tray." c. "When was the last time you ate foods containing avocados?" d. "I will document this in your record so all of your providers will know." e. "Have you ever been treated for this allergic reaction?"
A D E
A student nurse is preparing to administer enoxaparin (Lovenox) to a client. What action by the student requires immediate intervention by the supervising nurse? a.Assessing the client's platelet count b.Choosing an 18-gauge, 2-inch needle c.Not aspirating prior to injection d.Swabbing the injection site with alcohol
B
A client is being discharged soon on warfarin (Coumadin). What menu selection for dinner indicates the client needs more education regarding this medication? a.Hamburger and French fries b.Large chef's salad and muffin c.No selection; spouse brings pizza d.Tuna salad sandwich and chips
B
A nurse is caring for a client using oxygen while in the hospital. What assessment finding indicates that goals for a priority diagnosis are being met? a. 100% of meals being eaten by the client b. Intact skin behind the ears c. The client understanding the need for oxygen d. Unchanged weight for the past 3 days
B
A nurse is teaching a client about warfarin (Coumadin). What assessment finding by the nurse indicates a possible barrier to self-management? a.Poor visual acuity b.Strict vegetarian c.Refusal to stop smoking d.Wants weight loss surgery
B
A nurse observes that a client's anteroposterior (AP) chest diameter is the same as the lateral chest diameter. Which question should the nurse ask the client in response to this finding? a. "Are you taking any medications or herbal supplements?" b. "Do you have any chronic breathing problems?" c. "How often do you perform aerobic exercise?" d. "What is your occupation and what are your hobbies?"
B
A nursing student caring for a client removes the client's oxygen as prescribed. The client is now breathing what percentage of oxygen in the room air? a. 14% b. 21% c. 28% d. 31%
B
A client has a pulmonary embolism and is started on oxygen. The student nurse asks why the client's oxygen saturation has not significantly improved. What response by the nurse is best? a."Breathing so rapidly interferes with oxygenation." b."Maybe the client has respiratory distress syndrome." c."The blood clot interferes with perfusion in the lungs." d."The client needs immediate intubation and mechanical ventilation."
C
A client has been brought to the emergency department with a life-threatening chest injury. What action by the nurse takes priority? a.Apply oxygen at 100%. b.Assess the respiratory rate. c.Ensure a patent airway. d.Start two large-bore IV lines
C
A client is admitted with a pulmonary embolism (PE). The client is young, healthy, and active and has no known risk factors for PE. What action by the nurse is most appropriate? a.Encourage the client to walk 5 minutes each hour b.Refer the client to smoking cessation classes. c.Teach the client about factor V Leiden testing. d.Tell the client that sometimes no cause for disease is found.
C
A client is on a ventilator and is sedated. What care may the nurse delegate to the unlicensed assistive personnel (UAP)? a.Assess the client for sedation needs. b.Get family permission for restraints. c.Provide frequent oral care per protocol. d.Use nonverbal pain assessment tools.
C
A nurse assesses a client after an open lung biopsy. Which assessment finding is matched with the correct intervention? a. Client states he is dizzy. - Nurse applies oxygen and pulse oximetry. b. Client's heart rate is 55 beats/min. - Nurse withholds pain medication. c. Client has reduced breath sounds. - Nurse calls physician immediately. d. Client's respiratory rate is 18 breaths/min. - Nurse decreases oxygen flow rate.
C
A nurse is providing care after auscultating clients' breath sounds. Which assessment finding is correctly matched to the nurse's primary intervention? a. Hollow sounds are heard over the trachea. - The nurse increases the oxygen flow rate. b. Crackles are heard in bases. - The nurse encourages the client to cough forcefully. c. Wheezes are heard in central areas. - The nurse administers an inhaled bronchodilator. d. Vesicular sounds are heard over the periphery. - The nurse has the client breathe deeply.
C
A student nurse is providing tracheostomy care. What action by the student requires intervention by the instructor? a. Holding the device securely when changing ties b. Suctioning the client first if secretions are present c. Tying a square knot at the back of the neck d. Using half-strength peroxide for cleansing
C
The nurse assesses the client using the device pictured below to deliver 50% O2: The nurse finds the mask fits snugly, the skin under the mask and straps is intact, and the flow rate of the oxygen is 3 L/min. What action by the nurse is best? a. Assess the client's oxygen saturation. b. Document these findings in the chart. c. Immediately increase the flow rate. d. Turn the flow rate down to 2 L/min.
C
A student nurse asks for an explanation of "refractory hypoxemia." What answer by the nurse instructor is best? a."It is chronic hypoxemia that accompanies restrictive airway disease." b."It is hypoxemia from lung damage due to mechanical ventilation." c."It is hypoxemia that continues even after the client is weaned from oxygen." d."It is hypoxemia that persists even with 100% oxygen administration."
D
