Respiratyory practice questions
Which action will the nurse take first for a client being mechanically ventilated who begins to pick at the bedcovers? a. Administering the prescribed sedating drug b. Explaining to the client that the tube helps with breathing c. Requesting that the family leave to decrease the client's agitation d. Assessing for adequate oxygenation
d
Which action will the nurse take first while caring for a client being mechanically ventilation when the high-pressure alarm sounds? a. Comparing the ventilator settings with the prescribed settings b. Turning off the alarm then assess the need for suctioning c. Notifying the respiratory therapist d. Auscultating the client's breath sounds
d
Drugs from which class will the nurse prepare to administer as first-line therapy for a client just diagnosed with pulmonary embolism (PE)? a. Anticoagulants b. Antihypertensives c. Antidysrhythmics d. Antibiotics
a
For which problem in a client with a tracheostomy will the nurse collaborate with the speech-language pathologist (SLP) member of the interprofessional team? a. Ensuring effective communication b. Determining the proper cuff pressure c. Identifying early indications of infection d. Assessing for vocal cord damage
a
What is the best first action when the nurse assesses that the respirations of a sedated client with a new tracheostomy have become noisy, and the ventilator alarms indicate high peak pressures but the ventilator tubing is clear? a. Suctioning the tracheostomy tube b. Remove the inner cannula of the tracheostomy c. Humidifying the oxygen source d, Increasing the percentage of oxygen
a
What is the nurse's best first action when a client receiving continuous oxygen therapy by nasal cannula for an acute respiratory problem is becoming increasingly confused? a. Increasing the oxygen flow rate b. Documenting the observation as the only action c. Notifying the primary health care provider immediately d. Repositioning the client from a high-Fowler to a low-Fowler position
a
What is the primary emphasis for the nurse who is providing care to a client with acute respiratory distress syndrome (ARDS) currently in the exudative management stage of the disorder? a. Assessing the client at least hourly for tachypnea and dyspnea b. Performing meticulous mouth during mechanical ventilation c. Assessing for abnormal lung sounds d. Monitoring urine output to identify multiple organ dysfunction syndrome early
a
What type of acid-base problem will the nurse expect in a client who is being insufficiently mechanically ventilated for the past 4 hours and whose most recent arterial blood gas results include a pH of 7.29? a. Respiratory acidosis with an acid excess b. Metabolic acidosis with an acid excess c. Respiratory acidosis with a base deficit d. Metabolic acidosis with a base deficit
a
What type of percussion note or sound will the nurse expect on the affected chest side of a client who has a hemothorax? a. Dull b. Hyperresonant c. Crackling d. Hypertympanic
a
Which action has the highest priority for the nurse to take to prevent harm for a client being mechanically ventilated with 100% oxygen for the past 24 hours who now has new-onset crackles, decreased breath sounds, and a PaO2 level of 95 mm Hg? a. Collaborating with the pulmonary health care provider to lower the FiO2 level b. Assessing cognition c. Placing the client in the prone position d. Preparing to suction the client
a
Which assessment findings in a postoperative client suggest to the nurse the possibility of a pulmonary embolism (PE) and pulmonary infarction? a. Hemoptysis and shortness of breath b. Fever and tracheal deviation c. Audible wheezing on inhalation and exhalation d. Paradoxical chest movements
a
Which associated health problems will the nurse expect a client with long-term obstructive sleep apnea (OSA) to have? a. Hypertension and weight gain b. Cancer and autoimmune disorders c. Hypotension and chronic hypoglycemia d. Asthma and chronic obstructive pulmonary disease
a
Which change in the condition of a client with chronic obstructive pulmonary disease (COPD) who is receiving supplemental oxygen indicates to the nurse that an increase in the fraction of inspired oxygen (FiO2) may need to be increased? a. Restlessness has increased over the past hour. b. Client reports increased mouth dryness. c. Heart rate has decreased from 90 to 82 beats/min. d. Blood pressure has changed from 106/80 to 110/70.
a
Which oxygen delivery device will the nurse consider best to meet the needs to apply for a newly admitted client who requires high-flow oxygen therapy after suffering facial burns and smoke inhalation? a. Face tent b. Nasal cannula c. Venturi mask d. Nonrebreather mask
a
Which statements made by a client going home with a tracheostomy indicate to the nurse the need for further teaching about correct tracheostomy care? (Select all that apply.) a. "I can only take baths, but no showers." b. I will be unable to wear a necklace." c. "I should put cotton or foam over the tracheostomy hole." d. "I will have to learn to suction myself." e. "I will notify my primary health care provider if my secretions develop a foul odor." f. "I can put normal saline in my tracheostomy to keep the secretions from getting thick."
a, b, c, f
Which clients will the nurse monitor most closely for respiratory failure? (Select all that apply.) a. A 30 year old with a C-5 spinal cord injury b. A 55 year old with a brainstem tumor c. A 50 year old experiencing cocaine intoxication d. A 65 year old with COVID-19 pneumonia e. A 35 year old using client-controlled analgesia f. A 40 year old with acute pancreatitis
a, b, d, e, f
Which assessment findings in a client at high risk for pulmonary embolism (PE) indicates to the nurse the probably presence of a PE? (Select all that apply.) a. Inspiratory chest pain b. Dizziness and syncope c. Pink, frothy sputum d. Worsening dyspnea for 3 days e. Tachycardia f. Productive cough
a, b, e
For which problem does the nurse assess the client who cannot breathe through the nose because of a severe septal deviation? a. Difficulty swallowing b. Dry respiratory tract membranes c. Development of nasal polyps d. Frequent episodes of tonsillitis
b
For which situation will the nurse take immediate action to prevent harm for a client with pneumonia who is receiving 100% oxygen via a nonrebreather mask? a; Sputum is now rust-colored. b. Oxygen reservoir deflates during inspiration. c. Crackles are present in the lung bases. d. Skin is pink and flushed.
b
In addition to the pulmonary health care provider, which other member of the interprofessional team will the nurse expect to collaborate with most frequently when providing care to a client with a pulmonary embolism (PE)? a. Registered dietitian nutritionist b. Respiratory therapist c. Occupational therapist (OT) d. Pharmacist
b
The nurse has just received report on a group of clients. Which client is the nurse's first priority? a. A 60 year old who was recently extubated and reports a sore throat. b. A 50 year old being mechanically ventilated who has tracheal deviation. c. A 30 year old receiving continuous positive airway pressure (CPAP) and has intermittent wheezing. d. A 40 year old receiving oxygen facemask and whose respiratory rate is 24 breaths/min.
b
Which action is a priority for the nurse to prevent harm for a client with a pulmonary embolism who is receiving a continuous heparin infusion? a. Assessing gums daily for indications of bleeding b. Monitoring the platelet count daily c. Assessing breath sounds d. Comparing pedal pulses bilaterally
b
Which action will the nurse take to prevent harm from tracheal stenosis in a client after tracheostomy? a. Using commercial tube holders instead of standard tracheostomy ties b. Securing the tube in a midline position c. Assessing bilateral breath sound every 2 hours d. Ensuring maximum cuff pressure
b
Which best practice technique will the nurse use when suctioning a client's tracheostomy tube place earlier today? a. Applying suction only during insertion of the catheter b. Hyperoxygenating the client before and after suctioning c. Ensuring each suction pass lasts no longer 30 seconds d. Suctioning repeatedly until the secretions are is clear
b
Which changes in a client receiving oxygen therapy at 60% for more than 24 hours alert the nurse to the possibility of oxygen toxicity? a. Decreased PaCO2 b. Client report of increased dyspnea c. Production of thick, white, frothy sputum d. Client demand to remove the mask
b
Which nursing action will the nurse take to prevent harm from disruption of oxygen therapy for the client receiving low-flow oxygen by simple facemask? a. Keeping a small cylinder of oxygen at client's bedside stand for emergency use in case the central oxygen delivery system fails b. Changing to a nasal cannula during meals c. Sealing the edges of the mask to the client's skin with a water-soluble lubricant. d. Ensuring that the flaps are closed over the exhalation ports
b
Which problem does the nurse suspect when a client who has been receiving 50% oxygen by Venturi mask for 2 days now has crackles and decreased breath sounds on auscultation? a. New-onset asthma b. Absorptive atelectasis c. Bronchiolar infection d. Stasis pneumonia
b
Which sign or symptom will the nurse report immediately to the pulmonary health care provider to prevent harm for a client who had a percutaneous lung biopsy 2 hours ago? a. Bruising at the puncture site b. Lateral displacement of the trachea c. Oxygen saturation of 97% d. Pink-tinged sputum
b
With which client will the nurse take immediate actions to reduce the risk for developing a pulmonary embolism (PE)? a. A 50 year old with type 2 diabetes mellitus and cellulitis of the leg b. A 36 year old who had open reduction and internal fixation of the tibia c. A 25 year old receiving IV antibiotics through a peripheral line d. A 72 year old with dehydration and hypokalemia taking oral potassium supplements
b
Which ventilator mode does the nurse expect will be set for a client with a tracheostomy who is beginning to take spontaneous breaths at his own rate and tidal volume between set ventilator breaths? a. Assist-control (AC) ventilation b. Continuous positive airway pressure (CPAP) c. Synchronized intermittent ventilation (SIMV) d. Bi-level positive airway pressure (BiPAP)
c
For which problems will the nurse specifically assess when the low-pressure alarm of a client's mechanical ventilator sounds? (Select all that apply.) a. Mucous plugs are in the endotracheal tube. b. Leak in the ventilator tubing circuit. c. Client is not breathing. d. Cuff leak in the endotracheal or tracheostomy tube. e. Ventilator tubing is under the client. f. Client is attempting to breathe against the ventilator.
b, c, d
For which symptoms would a nurse assess a client who worries a thoracentesis earlier today may have caused a pneumothorax? (Select all that apply.) a. Slowing heart rate b. Sensation of air hunger c. Pain at the insertion site d. Cyanosis of oral mucous membranes e. Wheezing on inhalation and exhalation f. Tracheal deviation
b, d, f
What is the nurse's best response when a client who is concerned about getting a tracheostomy says, "I will be ugly, with a hole in my neck?" a. "Your family and those who love you won't care." b. "It won't take you long to learn to manage." c. "But you know you need this to breathe, right?" d. "The hole can be hidden with a light scarf."
d
How will the nurse document the pack-year smoking history for a client who reports smoking 3 packs of cigarettes per day for 25 years and then smoking 2 packs per day for the past 20 years? a. 45-pack-year b. 90-pack-year c. 115-pack-year d. 80-pack-year
c
How will the nurse expect a client's age-related decreased skeletal muscle strength to affect gas exchange? a. Reduced gas exchange as a result of decreased alveolar surface b. Reduced gas exchange as a result of longer relaxation of bronchiolar smooth muscles c. Reduced gas exchange as a result of decreased changes in pressures of the chest cavity d. Reduced gas exchange as a result of failure of pulmonary circulation to fully perfuse lung tissue
c
The nurse has just received report on a group of clients. Which client is the nurse's first priority? a. A 40 year old admitted 3 hours ago for a scheduled thoracentesis in 30 minutes. b. A 55 year old with bronchogenic lung cancer who returned from bronchoscopy 4 hours ago. c. A 30 year old with acute asthma who has an oxygen saturation of 89% by pulse oximetry. d. A 68 year old with pleural effusion who has decreased breath sounds at the right base.
c
What action does the nurse take first when a client who has a "do not resuscitate" (DNR) order and a nonrebreather oxygen mask, has labored breathing? a. Only provide comfort to the client. b. Notify the chaplain and the family member of record. c. Ensure that the tubing is patent and that oxygen flow is high. d. Initiate the Rapid Response Team (RRT).
c
What is the nurse's best first action when assessing a client who was intubated a few minutes ago and finds the end-tidal carbon dioxide level is 0 and the SpO2 is 38%? a. Documenting the finding in the electronic health record as the only action b. Initiating the Rapid Response Team c. Removing the endotracheal tube and ventilating the client with a bag-valve-mask d. Obtaining a different monitor and rechecking the end-tidal carbon dioxide level
c
What is the nurse's best next question after observing that a 60-year-old client's anteroposterior (AP) chest diameter is the same as the lateral chest diameter? a. "What are your hobbies?" b. No questions are needed regarding this normal finding. c. "Do you have any chronic breathing problems?" d. "How often do you perform aerobic exercise?"
c
What is the nurse's interpretation of a 50-year-old client's respiratory assessment findings when hearing bronchial breath sounds over the left lower lobe and noting decreased fremitus and dullness to percussion in the same area? a. Obstruction of the larger airways b. Normal physical exam for a 50 year old c. An area of increased density d. Subcutaneous emphysema
c
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 with a right pneumothorax who is being treated with a chest tube and has a pulse oximetry reading of 94%. b. Client who was extubated 3 days ago and has decreased breath sounds at the posterior bases of both lungs. c. Client treated for pulmonary embolism with IV heparin who has hemoptysis and tachy-cardia. d. Client with deep vein thrombosis who is receiving low-molecular-weight heparin and has ongoing calf pain.
c
When performing an assessment on an older client, which finding is most important for the nurse to assess further? a. Soft speaking voice b.Slight kyphoscoliosis c. Inability to state name and date of birth d. Need to rest after activity
c
Which action will the nurse take first when a client has just arrived in the postanesthesia care unit (PACU) following a successful tracheostomy procedure? Which nursing action must be taken first? a. Cleaning the tracheostomy inner cannula and stoma b. Observing for indications that suctioning is needed c. Auscultating lung sounds d. Changing the tracheostomy dressing immediately
c
Which assessment has the highest priority for the nurse to make when caring for a client who had a tracheostomy placed yesterday? Which of these assessments is essential for the nurse to make? a. Examining the color and consistency of secretions b. Measuring the cuff pressure c. Observing for tachypnea d. Checking arterial blood gas values
c
Which client will the nurse consider to be at greatest risk for an airway obstruction? a. A 25 year old with a sinus infection b. A 65 year old who has chronic mouth dryness and many dental caries c. A 35 year old with a traumatic brain injury d. A 55 year old who wears upper and lower dentures
c
Which actions will the nurse take to reduce risk for aspiration for a client with a tracheostomy? (Select all that apply.) a. Inflating the tracheostomy cuff during meals b. Encouraging water with meals c. Teaching the client to "tuck" the chin down in the forward position to swallow d. Maintaining the client upright for 30 minutes after eating e. Encouraging frequent sipping from a cup f. Providing small, frequent meals
c, d, f
Which action will the nurse instruct a client with an endotracheal tube to perform during the time the tube is being removed? a. Hold his or her breath b. Inhale c. Cough d, Exhale
d
How will the nurse document the client's respiratory assessment findings on auscultation that are heard as popping, discontinuous, high-pitched sounds at the end of exhalation? a.Coarse crackles b. Rhonchi c. Wheezes d. Fine crackles
d
In addition to notifying the pulmonary health care provider, what is the most important action for the nurse to take first for a client with a pulmonary embolism (PE) whose arterial blood gas (ABG) values are pH 7.28, PaCO250 mm Hg, PaO2 62 mm Hg, and HCO3− 24 mEq/L (24 mmol/L)? a. Administering sodium bicarbonate b. Having the client breathe rapidly and deeply into a paper bag c. Assessing for the presence of adventitious lung sounds d. Increasing the oxygen flow rate
d
The nurse has just received report on a group of clients. Which client is the nurse's first priority? a. A 50 year old who is 1 day postoperative from abdominal surgery and is receiving 2 L oxygen by nasal cannula. b. A 55 year old was admitted yesterday with pneumonia and is receiving antibiotics and oxygen through a nasal cannula. c. A 45 year old who is being discharged with a new prescription for home oxygen therapy by nasal cannula. d. A 60 year old admitted 2 hours ago who has a 90-pack-year smoking history and is receiving 50% oxygen by Venturi mask.
d
The nurse is caring for a client who underwent a bronchoscopy performed under moderate sedation an hour ago. Which action will the nurse delegate to an assistive personnel (AP) at this time? a. Determine level of consciousness b. Offer clear liquids to moisten mucous membranes c. Auscultate breath sounds d. Assist with urinal or bedpan use for elimination
d
What is the basis for the decreased oxygen saturation the nurse assesses in a client with a pulmonary embolism (PE)? a. Partial bronchial airway obstruction b. Thickened alveolar membranes and poor gas exchange c. Increased oxygen need resulting from a septic clot PE d. Shunting of deoxygenated blood to the left side of the heart
d
What is the most relevant technique for the nurse to use when assessing a client for dyspnea? a. Checking oxygen saturation by pulse oximetry b. Observing the client's rate, depth, and ease of inhalation and exhalation c. Comparing previous respiratory assessment information with current data d. Asking the client about whether any breathlessness is present
d
What is the nurse's best first action on finding the client's oxygen saturation by pulse oximetry on the finger is 84%? a. Apply supplemental oxygen by mask or nasal cannula. b. Notify the Rapid Response Team immediately. c. Assess the client's cognitive function. d. Recheck the value on the forehead.
d
What is the nurse's best response to a client who smokes and is being discharged home on oxygen states, "My lungs are already damaged, so I'm not going to quit smoking?" a. "Tell me more about why you think quitting wont's help you." b. "For safety, lower your oxygen flow rate when you smoke." c. "The progression to damage to your lungs can be slowed if you stop smoking now." d. "For now, let's discuss why smoking around oxygen is dangerous."
d
Which assessment finding on a client who is being mechanically ventilated with positive end-expiratory pressure indicates to the nurse a possible left-sided tension pneumothorax? a. Left chest caves in on inspiration and "puffs out" on expiration. b. The left lung field is dull to percussion and crackles are present on auscultation. c. The client has bloody sputum and wheezes. d. Chest is asymmetrical and trachea deviates toward the right side.
d
Which blood gas value indicates to the nurse that a client is experiencing hypercarbia? a. Bicarbonate = 20 mEq/L b. pH = 7.33 c. PaO2 = 80 mm Hg d. PaCO2 = 60 mm Hg
d
Which client will the nurse consider to be at the greatest risk for developing acute respiratory distress syndrome (ARDS)? a. A 22 year old with a fractured clavicle b. A 39 year old with uncontrolled diabetes c. A 56 year old with chronic kidney disease d. A 74 year old who aspirates a tube feeding
d
Which new assessment finding in a client being managed for a pulmonary embolism (PE) indicates to the nurse that the client's condition is worsening? a. Increasing temperature b. Abdominal cramping c. Hand tremors d. Distended neck veins in the high-Fowler position
d
Which type of ADL assistance will the nurse plan for a client with long-standing pulmonary problems who has Class IV dyspnea? a. Dyspnea is minimal and no assistance is required. b. The client is severely dyspneic at rest and cannot participate in any self-care. c. The client may complete ADLs without assistance but requires rest periods during performance. d. The client is severely dyspneic with activity and requires assistance for bathing and dressing.
d
