1355 Final review questions

A patient who has smoked 1.5 packs per day for 35 years has a pack year history of: A. 61.5 pack years B. 52.5 pack years C. 25 pack years D. 35 pack years

B. 52.5 pack years

A nurse is assessing a patient who is recovering from a lung biopsy . Which assessment finding requires immediate action ? A. Increased temperature B. Absent breath sounds C. Productive cough D. Incisional discomfort

B. Absent breath sounds

What would be the priority goal established for a patient with newly diagnosed asthma being discharged from the hospital? A. Is able to obtain pulse oximetry readings B. Demonstrates use of a metered-dose inhaler C. Knows the primary care provider's office hours D. Can identify the foods that may cause wheezing

B. Demonstrates use of a metered-dose inhaler

A patient who has smoked 2 packs per day for 50 years has a pack year history of: A. 25 B. 50 C. 100 D. 125

C. 100 (50 x 2 = 100)

The respiratory defense mechanism most impaired by smoking is which of the following? A. Filtration of air. B. The cough reflex. C. Ciliary clearance of mucous D. Sneezing

C. Ciliary clearance of mucous

The nurse is completing the admission assessment on a patient diagnosed with asthma. Which signs or symptoms would the nurse expect to find? A. Fever and crepitus B. Crackles and hives C. Dyspnea and wheezing D. Barrel chest and hyperventilation

C. Dyspnea and wheezing

A COPD patient has a barrel chest. The nurse expects results of a chest x-ray to reveal: A. fluid in the alveoli B. air in the pleural space C. over inflation of the alveoli with air D. consolidation of lung tissue with mucous

C. over inflation of the alveoli with air

While obtaining a patient's health history, the patient states, "I am allergic to shrimp.", Which responses by the nurse are best? (Select all that apply) A. "When was the last time you ate foods containing shrimp?" B. "Have you ever been treated for this allergic reaction?" C. "I will document this in your record so all of your providers will know." D. "I will remove any avocados that are on your lunch tray." E. "What response do you have when you eat shrimp?"

B. "Have you ever been treated for this allergic reaction?" C. "I will document this in your record so all of your providers will know." E. "What response do you have when you eat shrimp?"

What statement made by the patient with chronic bronchitis indicates to the nurse that more teaching is needed? A. "I should contact my doctor if my sputum changes in color or amount." B. "I should continue to eat a high carbohydrate, high fat diet." C. "I will take my bronchodilator regularly to prevent having bronchospasms." D. "My metered-dose inhaler gives me a precise amount of medication with each dose."

B. "I should continue to eat a high carb and high fat diet"

Which patient statement indicates potential obstructive sleep apnea? A. "I have so much trouble getting to sleep at night." B. "I wake up feeling just as tired as I did when I went to bed." C. "I can't breathe when I lie flat in bed." D. "I wake up several times a night to go to the bathroom"

B. "I wake up feeling just as tired as I did when I went to bed."

Which of the following statements by the patient demonstrates an understanding regarding the use of Becomethasone (Vanceril) inhalers? A. "I will take two puffs to treat an acute asthma attack." B. "I will rinse my mouth with water after each use." C. "I will immediately stop taking my oral prednisone as soon as I start using my Vanceril D. "I will not use my albuterol inhaler while I am using Vanceril."

B. "I will rinse my mouth with water after each use."

A patient is 4 hours post lobectomy for lung cancer. Which assessment data warrants immediate intervention by the nurse? A. 1500 cc. IV intake & 1000 cc. output B. 450 cc. bright red drainage in chest tube C. c/o pain of 10 on 1/10 scale D. absent lung sounds on surgical side

B. 450 cc bright red drainage in chest tube

A nurse is caring for a patient experiencing excessive vomiting. The nurse receives the arterial blood gas analysis of pH 7.55, PaCO2 40 mm Hg, PaO2 102 mm Hg, HCO3 39mEq/L. What intervention(s) will the nurse apply in the plan of care? Select all that apply. A. Encourage client to breathe into a closed container. B. Administer intravenous fluids containing potassium salts. C. Assess for cardiac dysrhythmias. D. Assess neurological status. E. All of them are correct

B. Administer intravenous fluids containing potassium salts. C. Assess for cardiac dysrhythmias. D. Assess neurological status.

A patient is scheduled for a total laryngectomy. Which of the following interventions on the care plan will be most important for the nurse to accomplish prior to the surgery? A. Discuss what clothing to wear that covers the stoma and decreases social isolation B. Establish a method to communicate during the immediate postop period (magic slate) C. Teach the patient and significant others how to suction the trache and perform stoma care D. Educate the patient about ways to avoid aspiration when swallowing after surgery

B. Establish a method to communicate during the immediate postop period (magic slate, etc.)

The nurse is monitoring a patient who is experiencing an acute asthma attack. What observations would indicate an improvement in the patient's condition? A. Pulse oximetry of 88% B. Respiratory rate of 18 breaths/minute C. Pulse rate of 110 beats/minute D. Productive cough with expectoration of sputum

B. Respiratory rate of 18 breaths/minute

Which assessment data would support that the patient has experienced a PE? A. Calf pain with dorsiflexion of the foot B. Sudden onset of chest pain and dyspnea C. Left-sided chest pain and diaphoresis D. Bilateral crackles and low-grade fever

B. Sudden onset of chest pain and dyspnea

A patient is diagnosed with laryngeal cancer and has had 4 weeks of radiation therapy to the neck and is c/o in severe pain when swallowing. What rationale explains the pain? A. The cancer has grown to obstruct the esophagus. B. The treatments are affecting the esophagus, causing ulcerations. C. Cancers are painful and this is expected. D. The treatments are working on the cancer and the throat is edematous.

B. The treatments are affecting the esophagus, causing ulcerations.

When assessing the respiratory system of an 82 year old patient, the nurse expects to find: A. increased respiratory excursion B. decreased chest wall compliance C. decreased AP diameter D. bronchvesicular sounds at the apex

B. decreased chest wall compliance

A patient with an MVA underwent a rhinoplasty to correct nasal deformities. The most important nursing intervention post op is: A. Reassure the patient that her appearance will return to normal when swelling subsides B. Instruct patient to maintain a semi-Fowler's position for 48 hours to prevent an ↑ in edema C. Teach the patient that she may use aspirin to control pain & inflammation D. Remind the patient that nasal packing will not be removed for weeks since it helps shape the nose

B. instruct the patient to maintain a semi-Fowlers position for 48 hours to prevent an increase in edema.

A patient with aa chronic cough has a bronchoscopy. Following this procedure, the nurse should: A. keep the patient on bedrest for 8 hours B. keep the patient NPO until the gag reflex returns C. check vital signs every 15 minutes for 6 hours D. encourage fluid intake to promote elimination of contrast media

B. keep the patient NPO until gag reflex returns

While caring for a patient with a smoking history, the patient nurse knows the patient has decreased respiratory defenses due to impaired: A. cough reflex B. mucociliary clearance C. reflex bronchoconstriction D. ability to filter particles from the air

B. mucociliary clearance

The nurse encourages a patient to deep breathe periodically knowing that this exercise helps maintain respiratory function by: A. stimulating ciliary activity promoting bronchiole clearance B. stretching the alveoli stimulating surfactant production C. increasing the strength of the diaphragm and intercostal muscles D. stimulating the reflex that increases respiratory rate

B. stretching the alveoli stimulating surfactant production

A nurse observes that a patient's anteroposterior (AP) chest diameter is the same as the lateral chest diameter. Which question should the nurse ask the patient in response to this finding? A. "How often do you perform aerobic exercise?" B. "What is your occupation and what are your hobbies?" C. "Do you have any chronic breathing problems?" D. "Are you taking any medications or herbal supplements?"

C. "Do you have any chronic breathing problems?"

A patient admitted with pneumonia has a history of lung cancer and heart failure. A nurse caring for this client recognizes that they should maintain adequate fluid intake to keep secretions thin for ease in expectoration. The amount of fluid intake this client should maintain is A. 2L B. 2.5L C. 1.4L D. 3L

C. 1.4L

A nurse cares for a patient with arthritis who reports frequent asthma attacks. Which action should the nurse take first? A. Assess how frequently the patient uses a bronchodilator. B. Review the patient's pulmonary function test results. C. Ask about medications the patient is currently taking. D. Consult the provider and request arterial blood gases.

C. Ask about medications the patient is currently taking.

The patient with ARDS is in ICU and on a ventilator. Which intervention should the nurse implement first? A. Confirm that the ventilator settings are correct B. Verify that the ventilator alarms are functioning properly C. Assess the patient's respiratory status and pulse ox reading D. Monitor the patient's ABG results

C. Assess the patient's respiratory status and pulse ox reading

Which instructions should the nurse give to a patient who is develops an asthmatic episode when eating Chinese food? A. Only eat Chinese food once a month B. Use your inhalers before eating Chinese food C. Avoid Chinese food because this is a trigger for you D. Determine another cause of the attack because Chinese food would not cause it

C. Avoid Chinese food because this is a trigger for you

The patient had a chest tube inserted 2 hours ago for a pneumothorax. Which action should the nurse take if there is no fluctuation in the water-seal compartment? A. Obtain an order for a stat chest x-ray B. Increase the amount of wall suction C. Check the tubing for kinks or clots D. Monitor the patient's pulse ox reading

C. Check the tubing for kinks or clots

The patient has just returned to the nursing unit following bronchoscopy. Which of the following is the most important nursing intervention for this patient? A. Administering medication for post-procedure pain B. Determining level of consciousness C. Checking a gag reflex before allowing her to eat D. Assessing for nausea

C. Checking a gag reflex before allowing her to eat

A nurse assesses a patient who has developed epistasis. Which conditions in the patient's history would the nurse identify as potential contributors to the problems? (select all that apply) A. Migraine B. Elevated platelets C. Cocaine use D. Hypertension E. Diabetes mellitus. F. Clotting disorder

C. Cocaine use D. Hypertension F. Clotting disorder

While assessing a patient who has facial trauma, the nurse auscultates stridor. The patient is anxious and restless. Which action should the nurse take first? A. Place the patient in high-Fowler's position. B. Ask the client to perform deep-breathing exercises. C. Contact the provider and prepare for intubation D. Administer prescribed albuterol nebulizer therapy.

C. Contact the provider and prepare for intubation

A client is admitted to the emergency department with a broken humorous after a motor vehicle collision. Significant assessment findings include a respiratory rate of 28 breaths/min and arterial blood gas (ABG) readings of of pH 7.51, PaCO2 30 mmHg, PaO2 90 mmHg, HCO3 23 mEq/L. Which nursing action would be a priority? A. Continuously assess post oximetry B. Administer lorazepam, sublingually C. Offer reassurance and treat the clients pain. D. Administer albuterol inhaler.

C. Offer reassurance and treat the clients pain.

The ER nurse will attempt to stop a patient's nosebleed by which of the following methods? A. Administer sedation medication, lie patient down, applying ice packs/pressure to the nose B. Pack nose, apply heat packs, have patient sit with head forward C. Relax patient, positioning them upright with head neutral/forward; apply lateral pressure to nose D. Reassure patient. have them lie down. apply ice pack and pressure to nose

C. Relax patient, positioning them upright with head neutral/forward; apply lateral pressure to nose

The nurse is caring for a patient with end-stage COPD. What patient data warrants immediate intervention by the nurse? A. Pulse ox reading of 92% B. ABG pO2 level of 74% C. SOB when walking to the bathroom D. Sputum is rusty colored

C. SOB when walking to the bathroom.

A patient has a right pleural effusion, and the physician performs a thoracentesis. Which position should the nurse have the patient assume during the procedure? A. Supine with the head of the bed elevated 45 degrees B. Left lateral with his right arm extended above his head C. Sitting upright with his arms supported on an over the bed table D. Trendelenburg position with both arms extended over the head

C. Sitting upright with his arms supported on an over the bed table

Which medication should the nurse discuss with the patient who has mild persistent asthma? A. Daily inhaled steroids B. Use of a rescue inhaler C. Use of systemic steroids D. Leukotriene agonist

C. Use of systemic steroids

During morning assessment, a nurse assesses four clients. Which client is the priority for follow up? A. an 84-year-old client with heart failure who's on telemetry and 2 L/minute of oxygen B. a 42-year-old client who has left lower lobe pneumonia and an I.V. line C. a 73-year-old client who has pneumonia with coarse crackles. is receiving 2 L/minute of oxygen, and has an I.V. line D. a 48-year-old client with chronic obstructive pulmonary disease with occasional atrial fibrillation

C. a 73-year-old client who has pneumonia with coarse crackles. is receiving 2 L/minute of oxygen, and has an I.V. line

The nurse is admitting a patient with a diagnosis of R/O laryngeal cancer. Which information would the nurse teach? A. demonstrate proper gargling with normal saline B. perform voice exercises for 30 minutes 3 times/day C. explain that a lighted instrument will be used to biopsy the area D. teach the patient to self-examine the larynx monthly

C. explain that a lighted instrument will be used to biopsy the area.

Which of the following ABG values are normal for a 90-year-old patient on room air? A. рН 7.30, pO2 95 mmHg, pCO2 50 mmg. B. pH 7.46, PO2 85 mmg, pCO2 34 mmHg. C. pH 7.38, pO2 82 mmHg, pCO2 42 mmHg D. pH 7.50, pO2 60 mmHg, pCO2 30 mmHg.

C. pH 7.38, pO2 82 mmHg, pCO2 42 mmHg

Upon entering the room of a total laryngectomy patient who just returned from the OR, the nurse needs to intervene upon finding: A. A gastrostomy tube that is clamped B. blood-tinged secretions from the trache C. patient is in a lateral position with the head of bed flat D. 200 ml. of sero-sanguineous drainage in the JP

C. patient is in a lateral (flat) position with the head of the bed flat

The nurse knows that teaching regarding mast cell stabilizers is effective when the patient makes which statement: A. "I should take 2 puffs when I begin to have an attack." B. "I must taper off the medications and stop taking them abruptly." C. "These drugs are most effective when taken at bedtime." D. "These drugs are not good at the time of an attack."

D. "These drugs are not good at the times of an attack"

How many pack years are recorded on a patients chart who smoked 1 ½ packs/day for 30 years? A. 20 pack years B. 25 pack years C. 35 pack years D. 45 pack years

D. 45 pack years

During assessment of a very elderly respiratory patient, the patient might expect to find a pO2 level of: A. 95 mmHg. B. 89 mmHg. C. 81 mgHg. D. 78 mmHg.

D. 78 mmHg.

A nurse assesses several patients who have a history of asthma. Which patient should the nurse assess first? A. A 66 year old patient with barrel chest and clubbed fingernails. B. A 48 year old patient with an oxygen saturation level of 92% at rest. C. A 35 year old patient who has a longer expiratory phase than an inspiratory phase. D. A 27 year old patient with a heart rate of 120/BPM.

D. A 27 year old patient with a heart rate of 120/BPM.

A respiratory disorder is suspected if a patient complains of which of the following symptoms? A. Chest pain, edema, shortness of breath B. Headache, palpitations, blurred vision C. Hemoptysis, fever, hematuria D. Cough, dyspnea, sputum production

D. Cough, dyspnea, sputum production

The nurse is evaluating the effectiveness of a teaching plan for a client recovering from an upper respiratory tract infection . Which is an expected outcome of the plan ? The client will: A. cough productively without chest discomfort . B. maintain a fluid intake of 800 ml every 24 hours . C. have a temperature below 100 ° F ( 37.8 ° C ) . D. experience less nasal obstruction and discharge .

D. experience less nasal obstruction and discharge .

The nurse is taking a social history from a patient diagnosed with small cell lung cancer. Which information about the patient is significant for this disease? A. worked with asbestos for a short time many years ago. B. has no family history for this type of lung cancer. C. has numerous tattoos covering both upper and lower arms. D. has smoked 2 packs of cigarettes a day for 20 years.

D. has smoked 2 packs of cigarettes a day for 20 years.

The nurse administers two 325-mg aspirin every 4 hours to a client with pneumonia. The nurse should evaluate the outcome of administering the drug by assessing which findings? Select all that apply: A. Decreased temperature B. Decreased respiratory rate C. Prolonged clotting time D. Decreased pain when breathing E.Increased ability to expectorate secretions

A. Decreased temperature D. Decreased pain when breathing

Which statement indicates a need for further teaching for the patient diagnosed with sleep apnea? A. "If I lose weight and stop smoking, I may not need treatment for sleep apnea." B. "The CPAP holds my airway open with pressure." C. "The CPAP will help me stay awake during the day while I am at work." D. "It is all right to have a few beers at night because I have this CPAP machine."

D. "It is alright to have a few beers at night because I have this CPAP machine"

The nurse is caring for several clients on the respiratory unit who are receiving the B-adrenergic agonist bronchodilator albuterol in the prescrived nebulizer treatments. Which side effects would the nurse expect to asses following administration? Select all that apply. A. Irritability and nervousness B. Increased tachypnea C. Increased somnolence D. Insomnia E. Tachycardia

A. Irritability and nervousness D. Insomnia E. Tachycardia

What advice might a sleep apnea patient be given in order to avoid using a nasal CAP device? A. Lose excess weight B. Take naps during the day C. Eat a high protein snack at bedtime D. Use mild sedatives or alcohol at bedtime

A. Lose excess weight

What is the main nursing priority for a postop laryngectomy/ radical neck patient? A. Maintaining a patent airway B. Changing the surgical dressing C. Ensuring the gastrostomy tube is patent D. Emptying the Jackson-Pratt drain near the incision line

A. Maintaining a patent airway

Which intervention should the nurse implement for a patient who had a chest tube placed 6 hours ago and will not take deep breaths because "it hurts too much?" A. Medicate the patient; then have them deep breathe B. Encourage the patient to take shallow breaths to help with the pain C. Explain that deep breaths do not have to be taken at this time D. Tell the patient that if they don't deep breathe, they could die.

A. Medicate the patient; then have them deep breathe

Which assessment information obtained by the nurse when caring for a patient who has just had a thoracentesis is most important to communicate to the health care provider? A. Oxygen saturation is 89% B. BP is 150/90 mm. Hg C. Pain level is 7/10 with a deep breath D. Respiratory rate is 26 breaths/minute when lying flat

A. Oxygen saturation is 89%

During an assessment of a patient with pneumonia, the nurse expects the development of a pleural effusion upon finding: A. A barrel chest. B. Paradoxical respirations. C. Hyperresonance on percussion. D. Localized absence of breath sounds.

D. Localized absence of breath sounds.

A nurse should interpret which finding as an early sign of tension pneumothorax in a client with chest trauma. A. Diminished bilateral breast sounds B. Tracheal deviation C. Muffled heart sounds D. Respiratory distress

D. Respiratory distress

The patient has a chest tube and as he is getting out of bed, the tube is accidentally pulled out? Which action should the nurse implement first? A. Notify the physician to have the chest tube reinserted STAT B. Instruct the patient to take slow, shallow breaths until the tube is reinserted C. Take no action and assess the patient's respiratory status every 15 minutes D. Tape a sterile petroleum occlusive dressing over the insertion site

D. Tape a sterile petroleum occlusive dressing on over the insertion site

During inspiration, air enters the thoracic cavity as a result of: A. contraction of accessory abdominal muscles B. ↑ CO2 and ↓ O2 in the blood C. stimulation of respiratory muscles by chemoreceptors D. decreased intrathoracic pressure relative to airway pressure

D. decreased intrathoracic pressure relative to airway pressure

While caring for a patient with a smoking history, the nurse knows the patient has decreased respiratory defenses due to impaired: A. Cough reflex B. Mucociliary clearance C. Reflex bronchoconstriction D. Ability to filter particles from the air

B. Mucociliary clearance

The nurse is caring for a client who is in status asthmaticus. What is the nurse's priority action? A. Administer Magnesium sulphate intravenously B. Place the client on oxygen C. Administer albuterol D. Call the healthcare provider

B. Place the client on oxygen

The nurse is providing discharge terching for a patient who had a laryngectomy. Which instruction should the nurse includes her discharge teaching with this patient? A. "Wear a tight cloth at the stoma to prevent anything from entering it." B. "Keep the humidity in your house low' C. "Cover the stoma whenever you shower or bathe." D. "Swimming is good exercise after this surgery

A. "Wear a tight cloth at the stoma to prevent anything from entering it."

A reference on a chart to a "T3 - N1 - M0? stage malignancy means the patient has: A. A large tumor with a positive lymph node and no metastases B. A small tumor with negative lymph nodes and no metastases C. A large tumor and status of lymph nodes and metastases is unknown D. A small tumor with multiple lymph nodes involved and widespread metastases

A. A large tumor with a positive lymph node and no metastases

A 56-year-old normally healthy patient at the clinic is diagnosed with CAP. Before treatment is prescribed, the nurse asks the patient about an allergy to: A. Amoxicillin. B. Erythromycin. C. Sulfonamides. D. Cephalosporins.

A. Amoxicillin

When assessing a patient brought to the ER with chest trauma, which signs/symptoms would the nurse expect to find in a suspected pneumothorax? A. Bronchovesicular lung sounds and bradypnea B. Dyspnea and diminished breath sounds on the affected side C. Frothy bloody sputum and consolidation D. Barrel chest and polycythemia

A. Bronchovesicular lung sounds and bradypnea

A nurse assesses a patient who is recovering from a thoracentesis. Which assessment findings would alert the nurse to a potential pneumothorax? (select all that apply) A. Tachypnea B. New-onset cough C. Bradycardia D. Purulent sputum E. Pain with respirations

A. Tachypnea B. New-onset cough E. Pain with respirations

An emphysema patient is in the hospital with dyspnea and cough. While palpating the thorax, the nurse would expect to find: A. diminished expansion B. asymmetric expansion C. normal expansion of 1 inch D. unequal, diminished expansion

A. diminished expansion

While assessing the health patterns in a patient with respiratory problems, the nurse asks specifically about: (select all that apply) A. smoking habits B. alterations in sexual activity C. the course of the patient's illness D. occupational exposure to respiratory irritants

A. smoking habits D. occupational exposure to respiratory irritants

A diagnostic procedure done to remove pleural fluid for analysis is: A. thoracentesis B. bronchoscopy C. pulmonary angiography D. sputum C & S

A. thoracentesis

The nurse is preparing a patient for a total laryngectomy in the morning for laryngeal cancer. Which intervention would have priority? A. Take the patient to the ICU for a visit B. Explain that the patient will need to ask for pain medication C. Demonstrate the use of TED hose D. Determine if the patient can read and write

D. Determine if the patient can read or write

A patient diagnosed with laryngeal cancer has had 4 weeks of radiation therapy to the neck and is c/o severe pain with swallowing. What rational explains the pain? A. The cancer has grown to obstruct the esophagus B. The treatments are working on the cancer and the throat is edematous C. Cancers are painful and this is expected D. The treatments are affecting the esophagus causing ulcerations

D. The treatments are affecting the esophagus causing ulcerations.

Which assessments would provide the nurse with the most valuable information to assess the breathing of a patient with chronic obstructive pulmonary disease (COPD)? Select all that apply. A. Exertional effects on breathing B. Palpation of peripheral pulses C. Inspection and palpation for vibrations D. Auscultation and percussion E. Inspection for pursed-lip breathing technique F. All of them are correct

F. All of them are correct