Respiratory Test

A nurse is providing discharge teaching to a client who has COPD regarding the influenza vaccine. Which of the following statements should the nurse make?

"You should make every effort to receive a flu vaccine every year."

A nurse is caring for a client who is dying and is having periods of deep breathing alternating with periods of apnea. The nurse should identify this as which of the following types of breathing?

Cheyne-Stokes breathing

A charge nurse is teaching a newly licensed nurse how to recognize a pleural friction rub. Which of the following descriptions should the nurse use to describe a pleural friction rub? (Select all that apply.)

Coarse grating tone Heard on inspiration and expiration Pain with breathing

A charge nurse is reviewing the documentation of a newly licensed nurse. Which of the following entries made by the newly licensed nurse is an example of correct documentation?

Inspiratory wheeze auscultated at left lateral che

A nurse in the emergency department is assessing a client who has experienced thoracic trauma from a motor-vehicle crash. Which of the following findings is an indication of a pneumothorax

The client is experiencing unequal movement of the posterior chest.

A nurse is caring for a client who is having difficulty breathing. Which of the following actions should the nurse take first?

Elevate the head of the client's bed.

A nurse is assessing a client who is dark-skinned. In which of the following areas of the client's body should the nurse assess the client for adequate oxygenation? (Select all that apply.)

Nail beds Oral mucosa Lips

A nurse is caring for a client who is experiencing episodes of hyperventilation. Which of the following manifestations should the nurse expect during hyperventilation? (Select all that apply.)

Numbness and tingling of extremities Lightheadedness Chest pain

A charge nurse is teaching a newly licensed nurse how to recognize manifestations of decreased oxygenation in a client. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

Clubbing of the fingers indicates a chronic state of impaired perfusion."

A nurse is providing teaching to a client who has a new diagnosis of asthma and reports a smoking history of 20 years. Which of the following statements should the nurse make when counseling the client about their tobacco use? (Select all that apply.)

"There are pharmacologic therapies that can help a person stop smoking "It might take several attempts to finally stop smoking" "Smoking is linked to various forms of cancer"

A charge nurse is observing a newly licensed nurse perform an anterior chest auscultation on a client. For which of the following actions should the charge nurse intervene?

The nurse is auscultating through the client's gown.

A nurse is admitting a client who has a new diagnosis of COPD. Which of the following information documented by the nurse is subjective data? (Select all that apply.)

Report from client says they sleep while propped on two pillows at night Client says they quit smoking 2 years ago Client states, "Being short of breath all of the time is making me depressed

A nurse is auscultating the breath sounds of a client who has pneumonia and hears bronchial crackles. In which of the following areas of the chest is the nurse auscultating? (You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.)

A. Bronchial breath sounds are heard to the right and left of the trachea and larynx. They can only be heard on the anterior chest.

A nurse is auscultating the lateral lobes of a client who has bronchitis. The nurse should document the sound as which of the following? (Click on the audio button to listen to the clip.)

Wheeze

A nurse is preparing to auscultate a client's posterior and lateral chest. In which order should the nurse perform the following actions? (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)

Expose the posterior chest with the client sitting with their arms folded across their chest is the first step Auscultate 8 cm (3 in) to one side of the spine around C7, then auscultate the other side of the spine in the same location is the second step. Auscultate down the spine, moving the stethoscope from one side to the other until the lower thoracic spine is reached is the third step Auscultate the lateral sides slightly below the axillary area, then down to the seventh or eighth rib is the fourth step.

A nurse is reviewing the medical record of a client who was assessed as having a barrel chest resulting from COPD. Which of the following images shows a client who has a barrel chest?

The anterior/posterior to transverse diameter is equal, and the ribs,

A nurse is performing a head-to-toe assessment of a client. Which of the following findings indicate the client might be experiencing respiratory difficulty? (Select all that apply.)

The client is sitting in a tripod position The client is using pursed lipped breathing The client appears confused