Respiratory Quiz

1. A nurse assesses a 66-year-old client who is attempting to quit smoking. The client states, I started smoking at age 16, and smoked one pack each day until 10 years ago. Then I decreased to a half of a pack per day. How many pack-years should the nurse document for this client? (Record your answer using a whole number.) ___ pack-years

16-> 56: 40 years*1 pack.10 years*0.5= 545 pack years.

1.A 242-pound client is being mechanically ventilated. To prevent lung injury, what setting should the nurse anticipate for tidal volume? (Record your answer using a whole number.) ___ mL

A low tidal volume of 6 mL/kg is used to prevent lung injury.6ml*110 = 660 mL

The nurse is caring for a group of clients on a Telemetry unit. When providing client education, which client will the nurse determine most needs information regarding preventing pulmonary embolism (PE)?A. A woman who frequently flies to EuropeB. A man who works on a farmC. A man admitted for a myocardial infarctionD. A woman with a bleeding disorder

A. A woman who frequently flies to Europe

The nurse is providing education on preventing pulmonary disorders at a community health fair. Which of these groups does the nurse target? Select all that apply.A. BakersB. Coal minersC. ElectriciansD. Furniture refinishersE. PlumbersF. Potters

A. BakersB. Coal minersD. Furniture refinishersF. Potters

When caring for a group of clients at risk for or diagnosed with pulmonary embolism, the nurse calls the Rapid Response Team (RRT) for intervention for which client?A. Client treated for pulmonary embolism with IV heparin who has hemoptysis and tachycardiaB. Client with deep vein thrombosis who is receiving low-molecular-weight heparin and has ongoing calf painC. Client with a right pneumothorax who is being treated with a chest tube and has a pulse oximetry reading of 94%D. Client who was extubated 3 days ago and has decreased breath sounds at the posterior bases of both lungs

A. Client treated for pulmonary embolism with IV heparin who has hemoptysis and tachycardia

The nurse is caring for a group of clients on a medical surgical unit. Which clients will the nurse monitor closely for respiratory failure? Select all that apply.A. Client with a brainstem tumorB. Client with acute pancreatitisC. Client with a C5 spinal cord injuryD. Client using client-controlled analgesiaE. Client experiencing cocaine intoxication

A. Client with a brainstem tumorB. Client with acute pancreatitisC. Client with a C5 spinal cord injuryD. Client using client-controlled analgesia

The RN has received report about four clients. Which client needs the most immediate assessment?A. Client with acute asthma who has an oxygen saturation of 89% by pulse oximetryB. Client admitted 3 hours ago for a scheduled thoracentesis in 30 minutesC. Client with bronchogenic lung cancer who returned from bronchoscopy 3 hours ago

A. Client with acute asthma who has an oxygen saturation of 89% by pulse oximetry

The home health nurse is assigned to visit these clients when a change in agency staffing requires that one of the clients be rescheduled for a visit on the following day. Which client will be best to reschedule? A. Client with emphysema who has been on home oxygen for a month and has SpO2 levels of 91% to 93% B. Client with history of a cough, weight loss, and night sweats who has just had a positive Mantoux test C. Client with newly diagnosed pleural effusion who needs an admission visit and an initial intake assessment D. Client with percutaneous lung biopsy yesterday who called in to report increased dyspnea

A. Client with emphysema who has been on home oxygen for a month and has SpO2 levels of 91% to 93%

The nurse is caring for a client with heart failure and acute kidney injury. For which of these breath sounds will the nurse assess?A. CracklesB. RhonchiC. Pleural friction rubD. Wheeze

A. Crackles

The nurse is assessing a client with possible pulmonary embolism (PE). For which symptoms consistent with PE will the nurse assess?Select all that apply.A. Dizziness and syncopeB. Shortness of breath (SOB) worsening over the last 2 weeksC. Inspiratory chest painD. Productive coughE. Pink, frothy sputumF. Tachycardia

A. Dizziness and syncopeC. Inspiratory chest painF. Tachycardia

A client is admitted to the medical floor with a new diagnosis of lung cancer. How will the nurse initially assist the client in managing the anxiety associated with the new diagnosis?A. Encourage the client to ask questions and verbalize concerns.B. Provide privacy for the client to be alone to deal with his or her own feelings.C. Medicate the client with diazepam for anxiety every 8 hours.D. Provide journals about cancer treatment.

A. Encourage the client to ask questions and verbalize concerns.The best way for the nurse to initially assist the client in managing anxiety related to a new diagnosis of cancer is to encourage the client to ask questions and voice concerns. The availability of the nurse to answer questions and listen to the client's concerns will help to decrease anxiety.The client may choose to be alone, although this may be a maladaptive coping behavior. Diazepam every 8 hours will reduce the client's anxiety but not help to manage its cause such as fear of the unknown or fear of death. It is more important to work with the client to assist him or her in dealing with those issues first. Knowledge about cancer diagnosis and treatment may help relieve anxiety but the nurse must first assess the client's needs as well as the plan of care.

A client with asthma reports shortness of breath. Which of these findings does the nurse anticipate when assessing this client's chest?A. Expiratory wheezing not cleared by coughingB. Bronchial breath sounds over the tracheaC. Crackles throughout the lung fieldsD. Bronchovesicular breath sounds in the lung bases

A. Expiratory wheezing not cleared by coughing

The nurse in the medical clinic is performing an assessment on an older adult client. Which finding requires further assessment by the nurse?A. Inability to state name and date of birthB. Slight kyphoscoliosisC. Soft speaking voiceD. Need to rest after activity

A. Inability to state name and date of birth

The nurse is caring for a client who has just been extubated after receiving mechanical ventilation. Which action will the nurse delegate to unlicensed assistive personnel (UAP)?A. Keep the head of the bed elevated.B. Teach about incentive spirometer use.C. Monitor vital signs every 5 minutes.D. Adjust the nasal oxygen flow rate.

A. Keep the head of the bed elevated.

The intensive care nurse is working on a unit-based project to prevent intensive care unit (ICU) psychosis. Which intervention does the nurse recommend to best decrease the incidence of ICU psychosis?A. Providing frequent explanations and reassuranceB. Keeping the lights on to promote orientationC. Administering sedationD. Providing television or radio for stimulation

A. Providing frequent explanations and reassurance

When caring for a client with a pulmonary embolism, which priority intervention will the nurse use to reduce anxiety?A. Remain with the client and provide oxygen in a calm manner.B.Have the client breathe into a brown paper bag using pursed lips.C. Offer the client a mild sedative.D. Allow a family member to remain in the room.

A. Remain with the client and provide oxygen in a calm manner.

The nurse is preparing a client with possible pulmonary embolism for a CT scan with contrast. Prior to the scan, which of these assessment questions is essential for the nurse to ask?A. "Do you take supplements containing vitamin K?"B. "Did you take metformin today?"C. "Are you allergic to peanuts?"D. "Have you had shortness of breath recently?"

B. "Did you take metformin today?"

The nurse is overseeing a nursing student who is administering medications to a group of clients receiving treatment for pulmonary embolism. The nurse recognizes the student understands safety and administration of anticoagulant therapy when the student makes which of these statements?A. "The client will receive a dose of enoxaparin (Lovenox) intramuscularly for 3 days."B. "Therapy with warfarin (Coumadin) is effective when the INR is between 2 and 3."C. "Once the health care provider orders warfarin (Coumadin), the intravenous heparin can be discontinued."D. "If bleeding develops, we will give platelets to reverse the anticoagulant."

B. "Therapy with warfarin (Coumadin) is effective when the INR is between 2 and 3."

When receiving report on a group of clients on the step down unit, which client needs immediate attention by the nurse?A. A client who is receiving continuous positive airway pressure (CPAP) and has intermittent wheezingB. A client receiving mechanical ventilation who has tracheal deviationC. A client who was recently extubated and is reporting a sore throatD. A client who is receiving O2 by facemask and whose respiratory rate is 24 breaths/min

B. A client receiving mechanical ventilation who has tracheal deviation

The nurse is reviewing the medical record of a client with pulmonary embolism (PE). What priority does the nurse set after reviewing the blood gas result below? pH 7.46, PaCO2 30 mm Hg, HCO3- 26 mEq/L (26 mmol/L), PaO2 62 mm HgA. Have the client breathe rapidly and deeplyB. Apply oxygenC. Administer sodium bicarbonateD. Collaborate with the provider to increase the pH

B. Apply oxygen

A client in the intensive care unit (ICU) who is receiving mechanical ventilation begins to pick at the bedcovers. Which action will the nurse take next?A. Increase the sedation.B. Assess for adequate oxygenation.C. Explain that the tube in the client's throat helps with breathing.D. Request that the family leave to decrease the client's agitation.

B. Assess for adequate oxygenation

The nurse coming on shift prepares to perform an initial assessment of a client receiving sedation and mechanical ventilation through a tracheostomy. Which are priorities for the nurse to carry out? Select all that apply.A. Ask visitors to leave the room.B. Assess the client's color and respirations.C. Confirm alarms and ventilator settings.D. Ensure that the tube is in proper position.E. Auscultate for bilateral breath sounds.F. Provide routine tracheostomy and mouth care.

B. Assess the client's color and respirations.C. Confirm alarms and ventilator settings.D. Ensure that the tube is in proper position.E. Auscultate for bilateral breath sounds.

The nurse is caring for a client with impending respiratory failure who refuses intubation and mechanical ventilation. Which respiratory modality does the nurse suggest to the interdisciplinary team as an alternative to mechanical ventilation?A. Oropharyngeal airwayB. Bi-level positive airway pressure (BiPAP)C. Non-rebreather mask with 100% oxygenD. Positive end-expiratory pressure (PEEP)

B. Bi-level positive airway pressure (BiPAP)

Which assessment finding in the client with exacerbation of emphysema requires intervention by the nurse?A. Barrel-shaped chestB. Bronchial breath sounds heard at the basesC. Hyperresonance to percussion of the chestD. Ribs lying horizontal

B. Bronchial breath sounds heard at the bases

The nurse is assessing a client who is receiving mechanical ventilation with positive end-expiratory pressure. Which findings would cause the nurse to suspect a left-sided tension pneumothorax?A. The left chest caves in on inspiration and "puffs out" on expiration.B. Chest asymmetry and jugular vein distention are present.C. The left lung field is dull to percussion with crackles present on auscultation.D. The client has bloody sputum and wheezes.

B. Chest asymmetry and jugular vein distention are present.

The nurse is assessing a client with chronic bronchitis who smoked 3 packs of cigarettes daily for 32 years. How does the nurse document pack-year history of smoking in the medical record?A. Client has a 32 pack-year historyB. Client has a 96 pack-year historyC. Client smoked 3 packs for yearsD. Client was a passive smoker for 32 years

B. Client has a 96 pack-year history

The nurse is caring for a group of clients with respiratory disorders. For which of these clients does the nurse plan for immediate intubation?A. Client who requires suctioning of oral secretionsB. Client with hypoventilation and decreased breath soundsC. Client with O2 saturation of 90%D. Client with thick, purulent secretions and crackles

B. Client with hypoventilation and decreased breath sounds

When caring for the client receiving mechanical ventilation, the nurse includes which of these interventions to prevent ventilator-associated pneumonia (VAP)?Select all that apply.A. Administering antibiotic prophylaxisB. Continuous removal of subglottic secretionsC. Elevating the head of the bed at least 30 degrees whenever possibleD. Handwashing before and after contact with the clientE. Placing a nasogastric tubeF. Placing the client in a negative-airflow room

B. Continuous removal of subglottic secretionsC. Elevating the head of the bed at least 30 degreesD. Handwashing before and after contact with the client

The nurse is preparing the client for a diagnostic bronchoscopy. Which nursing intervention is essential for the nurse to perform prior to the procedure?A. Obtain informed consent.B. Ensure the client has had nothing by mouth.C. Review dietary and medication allergies.D. Perform aggressive chest physiotherapy.

B. Ensure the client has had nothing by mouth

A client has been admitted with a diagnosis of pulmonary embolism and is receiving heparin infusion. What safety priority does the nurse include in the plan of care?A. Teach the client to avoid using dental floss.B. Monitor the platelet count daily.C. Ensure adequate staffing for the unit.D. Notify radiology of an impending scan.

B. Monitor the platelet count daily.

When caring for a client who has just undergone thoracentesis, which of these interventions does the nurse perform first?A. Encourage coughing and deep breathing.B. Schedule an immediate chest x-ray.C. Document the volume of removed fluid in the medical record.D. Set up a water seal drainage unit.

B. Schedule an immediate chest x-ray.

The emergency department nurse is assessing a client who believes he has sustained a pneumothorax after an outpatient thoracentesis earlier today. For which of these symptoms will the nurse assess?Select all that apply.A. Slowing heart rateB. Sensation of air hungerC. Tracheal deviationD. Pain on the unaffected sideE. Blue discoloration of the lips

B. Sensation of air hungerC. Tracheal deviationE. Blue discoloration of the lips

The nurse in a life care community for geriatric clients is providing education to a group of residents on expected changes during aging. Which of these activities does the nurse encourage the older adult to perform to maintain respiratory function?A. Stay in bed to prevent fatigue.B. Walk as tolerated each day.C.Consume adequate calcium.D. Perform oral hygiene twice daily.

B. Walk as tolerated each day.

A client is admitted to the surgical floor with chest pain, shortness of breath, and hypoxemia after having a knee replacement. What primary assessment will the nurse make while preparing the client for a computed tomography (CT) scan?A. "Do you have any metal anywhere in your body?"B. "Do you have diabetes?"C. "Are you allergic to iodine or shellfish?"D. "Do you drink alcohol regularly?"

C. "Are you allergic to iodine or shellfish?"

The nurse is providing education about the management of respiratory failure to the family of a client who is receiving mechanical ventilation. Which statement reflects appropriate information that the nurse will communicate?A. "Sedation is needed so your loved one does not rip the breathing tube out."B. "Suctioning is important to remove organisms from the lower airway."C. "Paralytics and sedatives help decrease the demand for oxygen."D. "We are encouraging oral and IV fluids to keep your loved one hydrated."

C. "Paralytics and sedatives help decrease the demand for oxygen."

The nurse is caring for a group of clients on a medical surgical unit. For which of these individuals does the nurse provide immediate interventions to reduce the risk for pulmonary embolism (PE)?A. A client with diabetes and cellulitis of the legB. A client receiving IV fluids through a peripheral lineC. A client returning from an open reduction and internal fixation of the tibiaD. A client with fluid volume deficit and hypokalemia receiving potassium supplements

C. A client returning from an open reduction and internal fixation of the tibia

The charge nurse in the intensive care unit is overseeing care for a group of clients. The nurse is especially vigilant in collaboration with the primary nurse and interprofessional team in assessing for acute respiratory distress syndrome (ARDS) in which of these clients?A. Client with diabetic ketoacidosis (DKA)B. Client with atrial fibrillationC. Client with aspiration pneumoniaD. Client with acute kidney failure

C. Client with aspiration pneumonia

The nurse is caring for a client who just returned from an open lung biopsy and has a prescription for morphine by client controlled analgesia (PCA). Which of these actions to detect early opioid induced respiratory depression does the nurse recommend?A. Continuous pulse oximetryB. Serial arterial blood gas measurementsC. Continuous capnographyD. Apnea monitoring

C. Continuous capnography

The nurse in the outpatient clinic is scheduling a client for pulmonary function tests. When teaching the client about pulmonary function testing (PFT), which point is essential for the nurse to emphasize?A. Administer bronchodilator medication on call.B. Encourage clear fluid intake 12 hours before the procedure.C. Ensure the client does not smoke for 6 hours before the test.D. Provide supplemental oxygen.

C. Ensure the client does not smoke for 6 hours before the test.

The nurse is developing a plan of care for a client with pulmonary embolism (PE). Which client problem does the nurse establish as the priority?A. Inadequate nutrition related to food-drug interactions with anticoagulant therapyB. Risk for infection related to leukocytosisC. Hypoxemia related to ventilation-perfusion mismatchD. Insufficient knowledge related to the cause of PE

C. Hypoxemia related to ventilation-perfusion mismatch

The nurse is caring for a client who is receiving mechanical ventilation and hears the high-pressure alarm. Which action will the nurse take first?A. Check the ventilator alarm settings.B. Assess the set tidal volume.C. Listen to the client's breath sounds.D. Call the respiratory therapist.

C. Listen to the client's breath sounds.

The nurse is caring for four clients who came to the emergency department with a productive cough. Which of these clients requires immediate intervention by the nurse?A. The client with blood in the sputumB. The client with mucoid sputumC. The client with pink, frothy sputumD. The client with yellow sputum

C. The client with pink, frothy sputum

The nurse is caring for a client who developed GI bleeding 3 weeks after a diagnosis of pulmonary embolism (PE). The international normalized ratio (INR) is 6.9. Which one of these questions is most appropriate for the nurse to ask at this time?A. "Have you eaten a lot of green leafy vegetables?"B. "Have you experienced swelling of your legs?"C. "Were you massaging your calves?"D. "Have you taken any aspirin or salicylates?"

D. "Have you taken any aspirin or salicylate?"

A client was intubated 30 minutes ago for acute respiratory distress syndrome (ARDS) and possible sepsis. The following prescriptions have been given for the client. In what sequence will the nurse perform these actions? 1. Infuse levofloxacin (Levaquin) 500 mg IV. 2. Obtain baseline aerobic and anaerobic sputum cultures. 3. Teach the client and family methods of communicating. 4. Analyze post-intubation arterial blood gases (ABGs).A. 2, 1, 3, 4B. 4, 3, 1, 2C. 3, 4, 2, 1D. 4, 2, 1, 3

D. 4, 2, 1, 3

Which client does the charge nurse on the medical-surgical unit assign to an RN who has floated from the postanesthesia care unit (PACU)?A. Client with possible ulcer who just returned from an endoscopyB. Client with emphysema who needs teaching about pulmonary function testingC. Client with pancreatitis who needs a preoperative chest x-rayD. Client who had 1200 mL of pleural fluid removed by thoracentesis

D. Client who had 1200 mL of pleural fluid removed by thoracentesis

The nurse is working in an urgent care clinic where four clients are waiting to be seen. Which client needs to be evaluated first by the nurse?A. Client who is short of breath after walking up two flights of stairsB. Client with a 10 mm area of redness on the arm after receiving purified protein derivative (Mantoux) skin testC. Client with sore throat and fever of 102.2°F (39°C) oralD. Client who is speaking in three-word sentences and has an SpO2 of 90%

D. Client who is speaking in three-word sentences and has an SpO2 of 90%

A client has returned to the medical surgical unit after a bronchoscopy. Which nursing task is best for the charge nurse to delegate to the experienced unlicensed assistive personnel (UAP)?A. Assess breath sounds.B. Offer clear liquids when gag reflex returns.C. Determine level of consciousness.D. Monitor blood pressure and pulse

D. Monitor blood pressure and pulse.

The RN and the LPN/LVN are working together to provide care for a group of clients on a medical surgical unit. Which of these actions is most appropriate for the RN to perform?A. Administer purified protein derivative (PPD) for tuberculosis testing.B. Assess vital signs and the puncture site one day post thoracentesis.C. Monitor oxygen saturation using pulse oximetry every 4 hours.D. Plan client and family teaching regarding upcoming pulmonary function testing.

D. Plan client and family teaching regarding upcoming pulmonary function testing.

3.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. 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.e. Stay with the client and speak in a quiet, calm voice.

4.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 hygieneb. Administering anti-ulcer medicationc. Elevating the head of the bedd. Providing oral care per protocole. Suctioning the client on a regular schedule

a. Adherence to proper hand hygieneb. Administering anti-ulcer medicationc. Elevating the head of the bedd. Providing oral care per protocol

5.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 clients 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. Allow visitors at the clients bedside.b. Ensure the client can communicate if awake.d. Provide back and hand massages when turning.e. Turn the client every 2 hours or more.

19.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 bedb. Humidifying the supplemental oxygenc. Offering frequent, small drinks of waterd. Providing warmed blankets

a. Allowing the client to choose the position in bed

20.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 heparind. Warfarin sodium (Coumadin)

a. Alteplase (Activase)

7.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. Assess for other manifestations of hypoxia

12.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 clients hands.d. Sedate the client immediately.

a. Assess the cause of the agitation.

11. 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 clients plan of care?a. Assistance with activities of daily livingb. Physical therapy activities every dayc. Oxygen therapy at 2 liters per nasal cannulad. Complete bedrest with frequent repositioning

a. Assistance with activities of daily living

6.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 stiffnessb. Decreased muscle strengthc. Inability to cooperated. Less lung elasticitye. Poor vision and hearing

a. Chest wall stiffnessb. Decreased muscle strengthd. Less lung elasticity

14. A nurse auscultates a harsh hollow sound over a clients trachea and larynx. Which action should the nurse take first?a. Document the findings.b. Administer oxygen therapy.c. Position the client in high-Fowlers position.d. Administer prescribed albuterol.

a. Document the findings.

2. A nurse plans care for a client who is at high risk for a pulmonary infection. Which interventions should the nurse include in this clients 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. Encourage deep breathing and coughing.c. Ambulate the client three times each day.d. Provide a diet high in protein and vitamins.

5. A nurse teaches a client who is interested in smoking cessation. Which statements should the nurse include in this clients 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. Find an activity that you enjoy and will keep your hands busy.d. Drink at least eight glasses of water each day.e. Make a list of reasons you want to stop smoking.

4. 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 clients 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. I held the clients morning bronchodilator medication.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.

1. 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 hallucinationsb. Tachycardiac. Decreased cravingsd. Impaired judgmente. Increased thirst

a. Visual hallucinationsd. Impaired judgment

3. While obtaining a clients 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. What response do you have when you eat 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?

7. A nurse is assessing a client who is recovering from a lung biopsy. Which assessment finding requires immediate action?a. Increased temperatureb. Absent breath soundsc. Productive coughd. Incisional discomfort

b. Absent breath sounds

4. 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 clients level of consciousness.c. Raise the head of the bed to at least 45 degrees.d. Provide the client with humidified oxygen.

b. Assess the clients level of consciousness.

18.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 clients platelet countb. Choosing an 18-gauge, 2-inch needlec. Not aspirating prior to injectiond. Swabbing the injection site with alcohol

b. Choosing an 18-gauge, 2-inch needle

1.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 yesterdayb. Client with a new spinal cord injury on a rotating bedc. Middle-aged man with an exacerbation of asthmad. Older client who is 1-day post hip replacement surgerye. Young obese client with a fractured femur

b. Client with a new spinal cord injury on a rotating bedd. Older client who is 1-day post hip replacement surgerye. Young obese client with a fractured femu

6. A nurse observes that a clients 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. Do you have any chronic breathing problems?

13.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 correctb. Ensuring there is a bag-valve-mask in the roomc. Obtaining personal protective equipmentd. Planning to suction the client upon arrival to the room

b. Ensuring there is a bag-valve-mask in the room

23.A nurse is caring for a client on the medical stepdown unit. The following data are related to this client:Subjective Information:Shortness of breath for 20 minutesFeels frightenedCant catch my breathLaboratory Analysis:pH: 7.12PaCO2: 28 mm HgPaO2: 58 mm HgSaO2: 88%Physical Assessment:Pulse: 120 beats/minRespiratory rate: 34 breaths/minBlood pressure 158/92 mm HgLungs have cracklesWhat 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. Facilitate a STAT pulmonary angiography.

4.A client is on intravenous heparin to treat a pulmonary embolism. The clients 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. Increase the heparin rate.

16.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 friesb. Large chefs salad and muffinc. No selection; spouse brings pizzad. Tuna salad sandwich and chips

b. Large chefs salad and muffin

1.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 clients lung sounds.b. Notify the Rapid Response Team.c. Provide reassurance to the client.d. Take a full set of vital signs.

b. Notify the Rapid Response Team.

6.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/dLb. Platelet count: 82,000/Lc. Red blood cell count: 4.8/mm3d. White blood cell count: 8.7/mm3

b. Platelet count: 82,000/L

5.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. Prepare preoperative teaching for an inferior vena cava (IVC) filter.

17.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 acuityb. Strict vegetarianc. Refusal to stop smokingd. Wants weight loss surgery

b. Strict vegetarian

10. 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 clients 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. Assess the clients gag reflex before giving any food or water.

2. 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. Clients heart rate is 55 beats/min. Nurse withholds pain medication.c. Client has reduced breath sounds. Nurse calls physician immediately.d. Clients respiratory rate is 18 breaths/min. Nurse decreases oxygen flow rate

c. Client has reduced breath sounds. Nurse calls physician immediately.

15.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. Ensure a patent airway.

2.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. Exercise on a regular basis.d. Maintain a healthy weight.e. Stop smoking cigarettes.

8.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 clients oxygen saturation.

c. Interrupt the procedure to give oxygen.

9.An intubated clients 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 clients lung sounds.d. Suction the endotracheal tube.

c. Listen to the clients lung sounds.

1. A nurse obtains the health history of a client who is recently diagnosed with lung cancer and identifies that the client has a 60pack-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. Maintain a nonjudgmental attitude to avoid causing the client to feel guilty.

10.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. Provide frequent oral care per protocol.

12. A nurse teaches a client who is prescribed nicotine replacement therapy. Which statement should the nurse include in this clients 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. Smoking while taking this medication will increase your risk of a stroke.

2.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. Teach the client about factor V Leiden testing.

3.A client has a pulmonary embolism and is started on oxygen. The student nurse asks why the clients 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. The blood clot interferes with perfusion in the lungs.

5. A nurse is providing care after auscultating clients breath sounds. Which assessment finding is correctly matched to the nurses 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. Wheezes are heard in central areas. The nurse administers an inhaled bronchodilator.

22.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. It is hypoxemia that persists even with 100% oxygen administration.

14.A client is on mechanical ventilation and the clients 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. It will prevent ulcers from the stress of mechanical ventilation.

3. A nurse assesses a clients respiratory status. Which information is of highest priority for the nurse to obtain?a. Average daily fluid intakeb. Neck circumferencec. Height and weightd. Occupation and hobbies

d. Occupation and hobbies

21.A client is brought to the emergency department after sustaining injuries in a severe car crash. The clients 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 clients lung sounds.c. Facilitate a portable chest x-ray.d. Prepare to assist with intubation.

d. Prepare to assist with intubation

9. 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. The trachea is deviated toward the opposite side of the neck.

11.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. The upper peak airway pressure limit alarm is on.

8. 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. Validate that informed consent has been given by the client.