acute Quiz 3

A nurse assesses a 66-year-old patient who is attempting to quit smoking. The patient states, "I started smoking at age 16, and smoked one pack each day until 10 years ago. Then I decreased to a half of a pack per day." How many pack-years would the nurse document for this patient? (Record your answer using a whole number.) ___ pack-years Blank 1. Fill in the blank, read surrounding text.

45 66-16 =50 years 40 year 1 pack/day 10year .5 pack/day =5 pack years 40+5= 45 pack years

The emergency department (ED) manager is reviewing patient charts to determine how well the staff performs when treating patients with community-acquired pneumonia. What outcome demonstrates that goals for this patient type have been met? A. Antibiotics started before admission B. Blood cultures obtained within 20 minutes C. Chest x-ray obtained within 30 minutes D. Pulse oximetry obtained on all patients

A. Antibiotics started before admission

A student is practicing suctioning a tracheostomy in the skills laboratory. What action by the student demonstrates that more teaching is needed? A. Applying suction while inserting the catheter B. Preoxygenating the patient prior to suctioning C. Suctioning for a total of three times if needed D. Suctioning for only 10 to 15 seconds each time

A. Applying suction while inserting the catheter

A patient appears dyspneic, but the oxygen saturation is 97%. What action by the nurse is best? A. Assess for other manifestations of hypoxia. B. Change the sensor on the pulse oximeter. C. Obtain a new oximeter from central supply. D. Tell the patient to take slow, deep breaths.

A. Assess for other manifestations of hypoxia.

An older adult is brought to the emergency department by a family member, who reports a moderate change in mental status and mild cough. The patient is afebrile. The healthcare provider orders a chest x-ray. The family member questions why this is needed since the manifestations seem so vague. What response by the nurse is best? A. "Chest x-rays are always ordered when we suspect pneumonia." B. "Older people often have vague symptoms, so an x-ray is essential." C. "The x-ray can be done and read before laboratory work is reported." D. "We are testing for any possible source of infection in the patient."

B. "Older people often have vague symptoms, so an x-ray is essential."

A nursing student caring for a patient removes the patient's oxygen as prescribed. The patient is now breathing what percentage of oxygen in the room air? A. 14% B. 21% C. 28% D. 31%

B. 21%

A patient is on intravenous heparin to treat a pulmonary embolism. The patient's most recent partial thromboplastin time (PTT) was 25 seconds. What order should the nurse anticipate? A. Decrease the heparin rate. B. Increase the heparin rate. C. No change to the heparin rate. D. Stop heparin; start warfarin (Coumadin).

B. Increase the heparin rate.

A nurse cares for a patient who had a bronchoscopy 2 hours ago. The patient asks for a drink of water. What action would the nurse take next? A. Call the physician and request a prescription for food and water. B. Provide the patient with ice chips instead of a drink of water. C. Assess the patient's gag reflex before giving any food or water. D. Let the patient have a small sip to see whether he or she can swallow.

C. Assess the patient's gag reflex before giving any food or water.

A nurse is caring for several older patients in the hospital that the nurse identifies as being at high risk for healthcare-associated pneumonia. To reduce this risk, what activity should the nurse delegate to the unlicensed assistive personnel (UAP)? A. Encourage between-meal snacks. B. Monitor temperature every 4 hours. C. Provide oral care every 4 hours. D. Report any new onset of cough.

C. Provide oral care every 4 hours.

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

A student nurse asks for an explanation of "refractory hypoxemia." What answer by the nurse instructor is best? A. "It is chronic hypoxemia that accompanies restrictive airway disease." B. "It is hypoxemia from lung damage due to mechanical ventilation." C. "It is hypoxemia that continues even after the patient is weaned from oxygen." D. "It is hypoxemia that persists even with 100% oxygen administration."

D. "It is hypoxemia that persists even with 100% oxygen administration."

A patient is on mechanical ventilation and the patient's spouse wonders why ranitidine (Zantac) is needed since the patient "only has lung problems." What response by the nurse is best? A. "It will increase the motility of the gastrointestinal tract." B. "It will keep the gastrointestinal tract functioning normally." C. "It will prepare the gastrointestinal tract for enteral feedings." D. "It will prevent ulcers from the stress of mechanical ventilation."

D. "It will prevent ulcers from the stress of mechanical ventilation."

A nurse cares for a patient who had a chest tube placed 6 hours ago and refuses to take deep breaths because of the pain. What action would the nurse take? A. Ambulate the patient in the hallway to promote deep breathing. B. Auscultate the patient's anterior and posterior lung fields. C. Encourage the patient to take shallow breaths to help with the pain. D. Administer pain medication and encourage the patient to take deep breaths.

D. Administer pain medication and encourage the patient to take deep breaths.

A nurse evaluates the following arterial blood gas and vital sign results for a patient with chronic obstructive pulmonary disease (COPD): Arterial Blood Gas Results pH = 7.32 PaCO2 = 62 mm Hg PaO2 = 46 mm Hg HCO3- = 28 mEq/L (28 mmol/L) Vital Signs Heart rate = 110 beats/min Respiratory rate = 12 breaths/min Blood pressure = 145/65 mm HgOxygen saturation = 76% What action would the nurse take first? A. Administer a short-acting beta2 agonist inhaler. B. Document the findings as normal for a patient with COPD. C. Teach the patient diaphragmatic breathing techniques. D. Initiate oxygenation therapy to increase saturation to 92%.

D. Initiate oxygenation therapy to increase saturation to 92%.

A nurse cares for a patient who has a pleural chest tube. What action would the nurse take to ensure safe use of this equipment? A. Strip the tubing to minimize clot formation and ensure patency. B. Secure tubing junctions with clamps to prevent accidental disconnections. C. Connect the chest tube to wall suction at the level prescribed by the provider. D. Keep padded clamps at the bedside for use if the drainage system is interrupted.

D. Keep padded clamps at the bedside for use if the drainage system is interrupted.

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. Bradycardia B. New-onset cough C. Purulent sputum D. Tachypnea E. Pain with respirations

D. Tachypnea E. Pain with respirations

A nurse cares for a patient who has a chest tube. When would this patient be at highest risk for developing a pneumothorax? A. When the insertion site becomes red and warm to the touch B. When the tube drainage decreases and becomes sanguineous C. When the patient experiences pain at the insertion site D. When the tube becomes disconnected from the drainage system

D. When the tube becomes disconnected from the drainage system