Respiratory TB and others

D. covers the mouth and nose when coughing.

1. The nurse recognizes that the goals of teaching regarding the transmission of TB have been met when the patient with TB A. demonstrates correct use of a nebulizer. B. reports daily to the public health department. C. washes dishes and personal items after use. D. covers the mouth and nose when coughing.

Chest pain or tightness Shortness of breath Wheezing Purulent sputum

10. What are the later signs and symptoms associated with the progression of lung cancer? (Select all that apply.) White sputum Chest pain or tightness Shortness of breath Wheezing Weight gain Recurrent attacks of asthma Purulent sputum

C. Difficulty swallowing solid food

11. The client with lung cancer who is receiving radiation therapy tells you that she has all the following health problems. Which one is most likely a result of the radiation therapy? A. Thinning scalp hair B. Pain in the left shoulder C. Difficulty swallowing solid food D. Heart palpitations and night sweats

D. Acute Pain related to metastasis

12. The client is a 64-year-old man with late-stage small cell lung cancer being cared for in the home by his 63-year-old wife. Which nursing diagnosis has the highest priority for you as the home care nurse in teaching the wife how to manage symptoms? A. Imbalanced Nutrition: Less than Body Requirements related to fatigue and increased metabolism B. Constipation related to decreased activity and medication regimen C. Activity Intolerance related to dyspnea and fatigue D. Acute Pain related to metastasis

C. Percussion is dull in left lower lobe

13. Which assessment finding alerts the nurse to the possibility of pneumonia in a client with chronic bronchitis? A. Pulse oximetry reading of 92% B. Shallow respirations of 32/min C. Percussion is dull in left lower lobe D. Wheezes are audible over right and left bronchi

A. An air leak is present at the chest tube insertion site or in the thoracic cavity.

14. The chest tube drainage system of the client 36 hours after a pneumonectomy has continuous bubbling in the water seal chamber (chamber 2). When you clamp the chest tube close to the client's dressing, the bubbling stops. What is your interpretation of this finding? A. An air leak is present at the chest tube insertion site or in the thoracic cavity. B. An air leak is present somewhere in the drainage system. C. The suction pressure applied to the system is too high. D. The suction pressure applied to the system is too low.

A. yellow-tinged skin.

15. When teaching the patient who is receiving standard multidrug therapy for TB about possible toxic effects of the antitubercular medications, the nurse will give instructions to notify the health care provider if the patient develops A. yellow-tinged skin. B.changes in hearing. C. orange-colored urine. D. thickening of the nails.

B. "Tell me what you know about the various treatments available."

16. A lobectomy is scheduled for a patient with stage I non-small cell lung cancer. The patient tells the nurse, "I would rather have radiation than surgery." Which response by the nurse is most appropriate? A. "Are you afraid that the surgery will be very painful?" B. "Tell me what you know about the various treatments available." C. "Surgery is the treatment of choice for stage I lung cancer." D. "Did you have bad experiences with previous surgeries?"

B. Cover the insertion site with sterile gauze.

17. The client is 12 hours postoperative after a thoracotomy for lung cancer. During a portable chest x-ray at the bedside, the lower chest tube tubing is accidentally pulled out. What is your best first action? A.Clamp the tubing with padded clamps. B. Cover the insertion site with sterile gauze. C. Clamp and close the skin at the insertion site. D. Reinsert the chest tube, using sterile technique.

B. Increase the oxygen flow rate.

19. The client with lung cancer is scheduled for surgery and is receiving oxygen for hypoxia. The client tells you that the sensation of air hunger is worse. What is your best first action? A. Notify the physician. B. Increase the oxygen flow rate. C. Document the observation as the only action. D. Attempt to calm the client using guided imagery.

B. Obtain an oxygen saturation.

2. The nurse notes new-onset confusion in an 89-year-old patient in a long-term-care facility; the patient is normally alert and oriented. Which action should the nurse take next? A. Check the patient's pulse rate. B. Obtain an oxygen saturation. C. Notify the health care provider. D. Document the change.

A. Azithromycin (Zithromax)

3. A patient who was admitted to the hospital with pneumococcal pneumonia has a temperature of 101.6° F with a frequent cough and is complaining of chest pain rated 7 on a 10-point scale with deep inspiration. Which of these ordered medications should the nurse give first? A. Azithromycin (Zithromax) B. Acetaminophen (Tylenol) C. Guaifenesin (Robitussin) D. Codeine phosphate (Codeine)

C. Using standard and airborne precautions until a chest x-ray shows no evidence of tuberculosis

4. The client has a productive cough, fever, and chills and a history of night sweats. The client's PPD test is negative. Which is the nurse's best intervention related to infection prevention? A. Using standard precautions alone because the client does not have tuberculosis B. Using standard and airborne precautions because the client has tuberculosis C. Using standard and airborne precautions until a chest x-ray shows no evidence of tuberculosis D. Using only airborne precautions because the client is taking penicillin for another infection

B. puts on a surgical face mask before visiting the patient.

5. When caring for a patient who is hospitalized with active TB, the nurse observes a family member who is visiting the patient. The nurse will need to intervene if the family member A. washes the hands before entering the patient's room. B. puts on a surgical face mask before visiting the patient. C. brings food from a "fast-food" restaurant to the patient. D. hands the patient a tissue from the box at the bedside.

B. increased vocal fremitus on palpation.

6. During assessment of the chest in a patient with pneumococcal pneumonia, the nurse would expect to find A. hyperresonance on percussion. B. increased vocal fremitus on palpation. C. fine crackles in all lobes on auscultation. D. asymmetric chest expansion on inspection.

C. "Early symptoms are nonspecific, consisting of cough and shortness of breath on moderate exertion."

7. The client, a 63-year-old man who has smoked 2 packs of cigarettes per day for 45 years, has just had his brother die of small cell lung cancer. Knowing that cancer is easier to cure in the early stages, the client asks you about early symptoms of lung cancer. What is your best response? A. "There are no early symptoms of lung cancer." B. "Early symptoms of lung cancer include bloody sputum and nagging chest pain." C. "Early symptoms are nonspecific, consisting of cough and shortness of breath on moderate exertion." D. "Wheezing on exhalation should always be considered a positive sign of lung cancer until proven otherwise."

D. Weak, nonproductive cough effort

8. Following assessment of a patient with pneumonia, the nurse identifies a nursing diagnosis of ineffective airway clearance. Which information best supports this diagnosis? A. Resting pulse oximetry (SpO2) of 85% B. Respiratory rate of 28 C. Large amounts of greenish sputum D. Weak, nonproductive cough effort

A. turns the patient over to the right side

9. The nurse observes a nursing assistant doing all the following activities when caring for a patient with right lower-lobe pneumonia. The nurse will need to intervene when the nursing assistant A. turns the patient over to the right side. B. splints the patient's chest during coughing. C. elevates the patient's head to 45 degrees. D. assists the patient to get up to the bathroom.

C. Medicate the patient with the ordered morphine.

An hour after a left upper lobectomy, a patient complains of incisional pain at a level 7 out of 10 and has decreased left-sided breath sounds. The pleural drainage system has 100 ml of bloody drainage and a large air leak. Which action should the nurse take first? A. Assist the patient to deep breathe and cough. B. Milk the chest tube gently to remove any clots. C. Medicate the patient with the ordered morphine. D. Notify the surgeon about the large air leak.