Respiratory

Which nursing interventions are recommended when caring for a client who is diagnosed with influenza? Select all that apply. Placing client in supine position Administering humidified oxygen Encouraging frequent ambulation Increasing fluid intake Obtaining cultures after antibiotics given

Administering humidified oxygen Increasing fluid intake

During an acute asthma attack, the nurse should expect which finding? Increased peak flow reading Increased incentive spirometer reading Client able to breathe comfortably Wheezing on auscultation

Wheezing on auscultation

A client is scheduled for a polysomnography and asks the nurse what he should expect. Which item should the nurse include? You will come to the sleep center and take an afternoon nap. You will be connected to several monitoring devices. You will have the procedure in the doctor's office. You will be placed on a machine that breathes for you.

You will be connected to several monitoring devices.

Your 75 year old patient is not planning to receive "flu shot" this year because he had one just one year ago. What is best response? •A. Because of your age, you should have a booster this year as well •B. The virus causing influenza often changes each year and a new influenza vaccine is needed every flu season •C. The shot you received last year should still protect you for seasonal influenza •D. The fact that you received an injection last year makes you a good candidate for the nasal vaccination this year

•B. The virus causing influenza often changes each year and a new influenza vaccine is needed every flu season

Which discharge teaching should the nurse include in the teaching plan for a client who was treated for tuberculosis? Select all that apply. "Family members should have chest x-rays done." "Stop medication when coughing subsides." "Persons living with you should have skin testing." "Use your best judgment in terms of your daily medications." "Maintain adequate nutrition."

"Persons living with you should have skin testing." "Maintain adequate nutrition."

The nurse is instructing a client newly diagnosed with chronic bronchitis about his disease. He says a friend has this disease and he calls himself a "blue bloater." The client asks the nurse why. How should the nurse reply? "That's a term used for someone who smokes a lot." "It has to do with the color of the phlegm." "That's from the 'puffing' breathing pattern." "The lack of oxygen in the blood gives the skins a blue appearance."

"The lack of oxygen in the blood gives the skins a blue appearance."

A client with obstructive sleep apnea (OSA) has been newly diagnosed with atherosclerosis. He questions whether this could be a result of his apnea. How should the nurse respond? "Atherosclerosis is always a result of OSA." "No correlation exists between OSA and atherosclerosis." "The physiological changes from OSA can lead to atherosclerosis." OSA results in other heart conditions, but not atherosclerosis.

"The physiological changes from OSA can lead to atherosclerosis."

A client asks the nurse if it is safe to return to work after suffering from influenza. Which questions should the nurse ask the client? Select all that apply. "When was the last time you had any fever?" "Are you having any difficulty breathing?" "How much do you weigh now?" "Have you used a bleach solution on all household and personal items?" "Are any of your family members sick?"

"When was the last time you had any fever?" "Are you having any difficulty breathing?"

22 year old patient who has had asthma since childhood. She is being managed with daily fluticasone (FLovent) 50 mcg/puff 1 puff twice daily; salmeterol (Serevent) 1 puff twice daily; albuterol (Ventolin) 1-2 puffs q 4-6 hrs prn wheezing. She reports she has been using daily prescribed medications as directed but has had to use the albuterol q 2 hrs. She reports feeling like her heart is racing. Oxygen saturation is 92%, she has slight wheeze with exhalation. 1.What additional questions need to be asked? 2.Should you administer oxygen? Why/why not? 3.Is her treatment/step effective or ineffective?

1.What additional questions need to be asked? 1.What has her environment been, has it been different from ususal? Triggers? Allergies? 2.How have you been administering medication? Proper use of inhaler? 2.Should you administer oxygen? Why/why not? 1.Should take PFT ● 3.Is her treatment/step effective or ineffective? Ineffective

The nurse should identify which high-risk clients in the absence of a positive influenza laboratory test? Select all that apply. 86-year-old female with diabetes 39-year-old male construction worker 41-year-old male university professor 26-year-old daycare employee 50-year-old client who is positive for human immunodeficiency virus

86-year-old female with diabetes 26-year-old daycare employee 50-year-old client who is positive for human immunodeficiency virus

The patient's oxygen saturation by pulse oximetry on the finger is 84%. What is the nurse's best first action? A. Recheck the value on the forehead B. Assess the patient's cognition C.Notify the Rapid Response Team immediately D. Apply supplemental oxygen by mask or nasal cannula

A. Recheck the value on the forehead

Which expected outcomes should the nurse include in the plan of care for a client treated for tuberculosis? Select all that apply. Oxygen saturation 90% on room air. Night sweats once per week. Ability to maintain stable body weight. Exhibits even and unlabored respirations. Absence of cough and sputum production.

Ability to maintain stable body weight. Exhibits even and unlabored respirations. Absence of cough and sputum production.

Which type of medication is used to maintain daily control of asthma? Anti-inflammatories Anticholinergics Bronchodilators Vasodilators

Anti-inflammatories

The nurse is providing care to William Parish, who presents in the emergency department with symptoms indicative of tuberculosis (TB).Which action should the nurse take when triaging William upon his arrival to the emergency department? Ask William to wear a gown while in the waiting area. Ask William to wear gloves until transferred to a room. Ask William to place a face mask over his mouth and nose. Ask William to use hand sanitizer after using the restroom.

Ask William to place a face mask over his mouth and nose.

Which of these assessment findings would the nurse most likely expect when a client is diagnosed with latent tuberculosis infection? Cough Fever Fatigue Asymptomatic

Asymptomatic

The nurse is preparing to conduct the admission assessment now that William is settled into the room after transport. Which findings should the nurse anticipate when conducting the client's respiratory assessment? Select all that apply. Clear breath sounds Audible wheezing Eupnea Rales (discontinuous crackle and pop sounds) Rhonchi (rattling sounds)

Audible wheezing Rales (discontinuous crackle and pop sounds) Rhonchi (rattling sounds)

Which of the following is expected with a patient who has a chest tube and drainage system in place? (Select all that apply) A.Continuous bubbling in water seal chamber B.Gentle constant bubbling in the suction control chamber C.Rise and fall in the level of water in the water seal chamber with inspiration and expiration D.Exposed sutures without dressing E.Drainage system upright at chest level

B.Gentle constant bubbling in the suction control chamber C.Rise and fall in the level of water in the water seal chamber with inspiration and expiration

A nurse is caring for a patient with new Rx for heparin therapy. Which of the following statement is an immediate concern for the nruse? A.I am allergic to morphine B.I take antacids several times a day C.I had a blood clot in my legs several years ago D.It hurts to take a deep breath

B.I take antacids several times a day

The client with emphysema comes to the emergency department with difficulty breathing. What assessment finding should the nurse anticipate? Excess mucous production Barrel shaped chest Hypoventilation Blueish skin tones

Barrel shaped chest

The nurse is providing discharge education for a patient with COPD who has a new prescription for albuterol (Proventil). Which statement indicates understanding of teaching? A.This medication can increase blood sugar levels B.This medication can decrease my immune response C.I can have an increase in my heart rate while taking this medication D.I can have mouth sores while taking this medication

C.I can have an increase in my heart rate while taking this medication

The nurse encourages a client with COPD to eliminate risk factors for exacerbation. What is considered a risk factor? Select all that apply. Chemicals Dust Air pollutants Secondhand smoke Cigarette smoking

Chemicals Dust Air pollutants Secondhand smoke Cigarette smoking

A nurse caring for a client diagnosed with tuberculosis requires further teaching when the charge nurse makes which observation? Nurse wears N95 mask during client care. Client transported to radiology while wearing a mask. Visitors wear snug-fitting surgical masks. Client wears mask when visiting family in waiting area.

Client wears mask when visiting family in waiting area.

A client comes to the clinic with a 5-year history of COPD. The nurse provides a focused assessment. What should be included? Select all that apply. Cough Sputum Confusion Use of accessory muscles Bowel sounds

Cough Sputum Confusion Use of accessory muscles

The nurse is caring for a hospitalized client being treated with heparin for a pulmonary embolism. The most recent activated partial thromboplastin time (aPTT) is 3.0 times the normal value. What is the nurse's best action? Administer an additional heparin bolus Increase the rate of infusion Continue the current rate of infusion Decrease the rate of infusion

Decrease the rate of infusion

Which is the primary risk factor for pulmonary embolism? Smoking Heart disease Deep vein thrombosis Malignancy

Deep vein thrombosis

Diagnostic Testing for PE

Electrocardiogram (ECG) Pulmonary angiography Ventilation/perfusion scan (V/Q scan)Plasma D-dimer level CORRECT. Diagnostic testing for PE includes imaging and laboratory studies. Diagnostic studies include an ECG, a chest CT with contrast (not without), a V/Q scan, and pulmonary angiography. Laboratory studies include arterial blood gas analysis (not venous) and a plasma D-dimer level.

A client treated for a pulmonary embolism is being discharged from the hospital. Which client teaching should the nurse include in the teaching plan? Select all that apply. Lab tests to check oral heparin effectiveness Exercise regimen recommended by provider Smoking cessation therapies or support group Diet rich in saturated fat Take prescribed medication at appropriate time

Exercise regimen recommended by provider Smoking cessation therapies or support group Take prescribed medication at appropriate time

The nurse suspects a client may be suffering from primary progressive tuberculosis infection when the client exhibits which symptoms? Select all that apply. Fatigue Sore throat Weight loss Nonproductive cough Night sweats

Fatigue Weight loss Night sweats

A client, newly diagnosed with asthma, has recovered from an acute attack. The nurse analyzes possible triggers in the environment. Which triggers could have caused the exacerbation? Select all that apply. Client walking in hallway two times today Gift basket in room containing boxed food items Fellow staff nurse in hallway wearing perfume Flower arrangement on client's bedside table Visitor who smells of cigarette smoke

Fellow staff nurse in hallway wearing perfume Flower arrangement on client's bedside table Visitor who smells of cigarette smoke

The nurse is caring for a client with a diagnosis of active tuberculosis. Which symptoms does the nurse expect this client to exhibit? Select all that apply. Fever Abdominal rigidity Abnormal breathing sounds Hypothermia Decreased oxygen saturation

Fever Abnormal breathing sounds Decreased oxygen saturation

The nurse should include which preventive measures when teaching a group of adults about prevention of influenza? Select all that apply. Handwashing Vigorous exercise while ill Annual vaccination Covering mouth when coughing Avoiding playgrounds

Handwashing Annual vaccination Covering mouth when coughing

The nurse suspects a client to have a pulmonary embolism. Which signs and symptoms would support the nurse's belief? Select all that apply. Hemoptysis Decreased heart rate Dyspnea with accessory muscle use Unilateral lower extremity edema Cough

Hemoptysis Dyspnea with accessory muscle use Unilateral lower extremity edema Cough

Drug Therapy to Treat PE

Heparin drip Altapase Warfarin CORRECT. Drug therapy prescribed to treat PE includes heparin (single dose followed by a continuous infusion). Anticoagulation will continue after discharge with warfarin. Thrombolytic therapy with altaplase may be prescribed for patients who are hemodynamically unstable as thrombolysis actively reduces the clot. Protamine sulfate should be on standby to treat active bleeding; however, this is not prescribed to treat the PE itself but a complication associated with heparin therapy. Vitamin K is used to treat active bleeding for a patient who has transitioned to warfarin. Vitamin K, like protamine sulfate, is not prescribed to treat the PE but to treat complications associated with warfarin therapy.

Which assessment findings would the nurse most likely expect in a client diagnosed with a pulmonary embolism? Select all that apply. High ventilation/low perfusion Increased cardiac output Decreased pulmonary vascular resistance Pulmonary hypertension Reduced left ventricular preload

High ventilation/low perfusion Pulmonary hypertension Reduced left ventricular preload

Which nursing actions are appropriate when caring for a client diagnosed with tuberculosis? Select all that apply. Place on droplet precautions. Humidify oxygen when administered. Request dietary consult. Offer family members N95 masks. Medication teaching.

Humidify oxygen when administered. Request dietary consult. Medication teaching.

The nurse should include which priority preventive measure when teaching a group of adults about preventing the spread of tuberculosis? Handwashing Annual vaccination Isolation Covering mouth when coughing

Isolation

The nurse is offering a community teaching session on obstructive sleep apnea (OSA). Which life-threatening occurrences can result from untreated OSA? Select all that apply. Motor vehicle accidents Heart failure Diabetes mellitus Myocardial infarction Stroke

Motor vehicle accidents Heart failure Myocardial infarction Stroke

A client diagnosed with a pulmonary embolism is receiving a heparin infusion. Which lab should the nurse monitor in order to adjust the rate of infusion? Prothrombin time Partial thromboplastin time Platelet count Hemoglobin and hematocrit

Partial thromboplastin time

A client has diminished breath sounds after receiving an albuterol nebulizer treatment for asthma. What are the nurse's priority actions? Select all that apply. Obtain a 12-lead ECG. Request a beta blocker. Document the finding. Notify the healthcare provider. Provide mechanical ventilation, if ordered.

Notify the healthcare provider. Provide mechanical ventilation, if ordered.

Risk Factors for PE

Obesity Deep vein thrombosis (DVT) Cigarette smoking CORRECT. Risk factors for PE include DVT, obesity, and cigarette smoking. A hip or leg, not wrist, fracture is a risk factor for PE. Chronic heart disease is also a risk factor for PE, but transient heart disease is not.

The nurse is caring for a client admitted with COPD who is having difficulty breathing. Which actions can the nurse take to provide support? Select all that apply. Place client in semi-Fowler's position Provide bronchodilators, if ordered Offer small, frequent meals Encourage smoking cessation Wean from oxygen

Place client in semi-Fowler's position Provide bronchodilators, if ordered Offer small, frequent meals Encourage smoking cessation

What is the nurse's first action when admitting a client experiencing night sweats and rust-colored sputum to the hospital? Place the client in a private room. Prepare client for chest x-ray. Perform PPD (purified protein derivative) skin test. Fit the client for an N95 mask respirator.

Place the client in a private room.

Which lab study indicates the presence of a thrombus in the body? Arterial blood gas Prothrombin time B-type natriuretic peptide Plasma d-dimer

Plasma d-dimer

The nurse should closely monitor for signs and symptoms of a pulmonary embolism in a client with which risk factors? Select all that apply. Post-knee surgery Underweight Smoker Chronic heart disease Hypertension

Post-knee surgery Smoker Chronic heart disease

The nurse should ensure that which reversal agent is readily available in case of active bleeding while a client is receiving a heparin infusion? Vitamin K Protamine sulfate Flumazenil Naloxone

Protamine sulfate

A client presents to the emergency department with symptoms of a pulmonary embolism. What is the nurse's first action? Obtain 12-lead ECG. Administer IV saline. Provide oxygen. Start heparin infusion.

Provide oxygen.

Which topics should the nurse include in the discharge teaching plan of a client newly diagnosed with asthma? Select all that apply. Pursed-lip breathing Possible triggers Signs and symptoms Using the incentive spirometer Using a peak flow meter

Pursed-lip breathing Possible triggers Signs and symptoms Using a peak flow meter

Which instruction should the nurse provide to a client who has just received a PPD (purified protein derivative)? Return to the clinic in 48-72 hours to have the test read. Take antiviral medication as prescribed. Massage the subcutaneous injection site. There may be a very small amount of bleeding on the forearm.

Return to the clinic in 48-72 hours to have the test read.

The client states he is "tired all the time." What assessment is the priority for the nurse? Vital signs Breath sounds Sleep pattern assessment Polysomnography

Sleep pattern assessment

Patient Education to Prevent Recurrence of PE

Smoking cessation Exercise regimen to include aerobic exercise Take prescribed medication, such as warfarin, at the appropriate time CORRECT. Patient teaching to prevent the recurrence of PE includes implementation of an exercise regimen to include aerobic exercise. The exercise will strengthen the patient's heart and cardiovascular system, improve venous return to the heart, and assist with weight loss. Smoking cessation is encouraged during hospitalization and at every subsequent visit to the patient's primary care provider. Teaching to prevent recurrence of PE should also include the importance of taking all prescribed medication, such as warfarin, at the appropriate time. Follow-up visits to monitor laboratory values are required for patients who are prescribed warfarin therapy. While a cardiac prudent diet is important and should be encouraged, it is important to minimize saturated, not unsaturated, fat.

The client is at risk of developing obstructive sleep apnea (OSA). What factor can the client change to prevent the onset of this condition? Stop taking sleep medications Stop cigarette smoking Stop sleeping on the back Stop sleeping less than 6 hours each night

Stop cigarette smoking

A client is diagnosed with influenza in the clinic and is sent home to recover. Which client teaching should the nurse provide to the client? Select all that apply. Take an antipyretic for fever. An analgesic can be taken for body aches. Take antivirals if symptoms are not improved in 1 week. You may return to work if fever is below 101.5°F. Avoid contact with others for up to 48 hours.

Take an antipyretic for fever. An analgesic can be taken for body aches.