CLS Oxygenation Quiz

TB

Risk Factors: - < 5 years old - drinking unpasteurized milk if cow has bovine TB - homeless, low SES, refugees, minorities - living in crowded facility - immunocompromised, malnourished - alcohol abuse, IV Drug users Transmission: - via the airborne route by droplet infection - after having meds fro 2-3 weeks, < infective Manifestations: - none - fatigue - lethargy - anorexia - weight loss - low-grade fever - chills - night sweats - persistent cough and mucopurulent sputum - chest tightness and dull, aching chest pain TB Skin Test: - positive reaction can mean previous exposure or inactive (dormant) TB - a positive result depends on induration and the person's risk of being infected Hospitalized patient: - needs a surgical mask when out of room - RN wear N95 - negative pressure room - need chest x-ray after positive test

The herpes simplex virus type 1 (HSV-1), which produces a cold sore (fever blister), has an incubation period of a. 2 to 12 days. b. 20 to 30 days. c. 1 to 3 months. d. 3 to 6 months.

a. 2 to 12 days.

A client is receiving rifampin and isoniazid in combination for treatment of tuberculosis. What would the nurse need to monitor closely? a. Liver function studies b. Urine culture c. Audiometric studies d. Pulmonary function studies

a. Liver function studies

In which grade of COPD is the forced expiratory volume (FEV) less than 30%? a. I b. II c. III d. IV

d. IV

Beta Blockers

tenormin (atenolol), lopressor (metoprolol), coreg (carvedilol)

1. Which of the following pieces of data would indicate respiratory improvement after nebulizer treatment? SATA A. O2 sat 97% B. Respirations 26 breaths per min C. Decreased wheezing upon inspiration D. Decreased ​reddening of oropharynx E. Use of accessory muscles

A, C

1. A patient arrives to the ED with a history of heart failure, hyperlipidemia, diabetes and pneumonia with a pleural effusion. Which of the following is the priority finding specifically related to the patient's pneumonia? a. Cough with sputum b. Using 2 pillows to sleep c. Oxygen saturation 93% on RA d. 24 breaths per minute

"A" because the other options are not directly linked to pneumonia. They are likely related to other diagnosis history

1. Question: Match the drug with what the nurse should monitor for most? A. Lisinopril B. Carvedilol C. Hydrochlorothiazide D. Lorazepam ___ Monitor for muscle weakness or spasms ___ Monitor for respiratory depression ___ Check patient's pulse ___ Monitor for hypotension

C B D A

TB Pharm

First Line: - Isoniazid - Rifampin: red-orange body secretions - Ethambutol - Pyrazinamide

COPD Assessment

- Cough - exertional dyspnea - wheezing and crackles - sputum production - weight loss - barrel chest (emphysema) - use of accessory muscles - prolonged expiration - orthopnea - cardiac dysrhythmias - congestion and hyperinflation seen on chest x-ray - ABG levels that indicate respiratory acidosis and hypoxemia - pulmonary function tests that demonstrate decreased vital capacity

A patient presents with a temperature 101.6F, O2sat. of 88%, RR of 26, HR of 110. The patient's lab values reveal a WBC count of 17,000, a RBC count of 5.1, a platelet count of 250,000, and an elevated sedimentation rate. The patient's breath sounds are diminished and include rhonchi and wheezes. The patient shows use of accessory muscles for breathing, and has increased sputum production when coughing. Results from TST are negative. Based on the data, rank the likelihood of: Pneumonia, Tuberculosis, and COPD

- Highly likely: Pneumonia - Somewhat likely: COPD - Least likely: Tuberculosis Rationale: Pneumonia presents with signs of infection including elevated temperature, increased WBC, and an elevated sedimentation rate. Abnormal breath sounds are found in pneumonia. Although Tuberculosis also shows signs of infection, it would not present with rhonchi or wheezes. There may be increased respiratory effort and sputum production, but a TST would come back positive. COPD is a respiratory condition that puts a patient at risk for infection, but is not directly associated with signs of infection. COPD is likely to be more rapid and have crackles at the base of lungs. COPD would have a negative TST

HF Nutrition

- Low sodium, low fat, low cholesterol - give client list of potassium-rich foods because diuretics can cause hypokalemia

DVT

- extremity appears red, edematous, and painful - traditional heparin sodium therapy may be initiated - bed rest with leg elevation - clients with low-molecular heparin can be out of bed after 24 hours if pain level permits

Epiglottitis Interventions

- maintain a patent airway - assess respiratory status and breath sounds, noting nasal flaring, the use of accessory muscles, retractions, and the presence of stridor - NPO; do not measure temp orally - avoid supine position - administer IV fluids, antibiotics, antipyretics, analgesics, corticosteroids - Heliox (mixture of Helium and O2): reduces work of breathing, reduces airway turbulence, helps relieve obstruction - provide cool mist O2: high humidification decreases swelling - have resuscitation equipment available

Respiratory Distress

- nasal flaring - increasingly severe retractions - grunting - cyanosis - bradycardia and periods of apnea lasting > 15 seconds

Pneumonia Assessment

-Chills -Elevated temperature -Pleuritic pain -Tachypnea -Rhonchi and wheezes -Use of accessory muscles for breathing -Mental status changes -Sputum production

Hypoxia Assessment

-skin color changes (pallor to cyanosis) -tachycardia -tachypnea -dyspnea -LOC changes -Altered mental status -Anxiety -restlessness -other clinical signs dependent on body tissue that is oxygen deprived

1. What outcomes are indicative that interventions for treating pneumonia are effective? a. O2 stat of 97% b. Temp 98.9 c. Decreased edema in lower extremities d. skin is clear of ecchymosis

A

A 75 y/o Caucasian female is complaining of SOB, not improving since starting antibiotics 4 days ago, and says her muscles next to her ribs hurt with coughing. Upon assessment, you find rhonchi and diminished lung sounds. You suspect pneumonia. What intervention will the nurse implement next? a. Obtain a chest x-ray & sputum culture b. Administer levofloxacin c. Start the pt on continuous fluids d. Refer to primary provider after antibiotics are finished

A

1. Patient comes into the ED experiencing fluid volume overload. Which of the following s/s would support this diagnosis? SATA a. Urine specific gravity 1.002 b. Urine specific gravity 1.042 (deficit) c. JVD d. BP of 90/44 (deficit) e. SOB f. Peripheral Edema g. 5 lb. weight gain in two days .

A C E F G

1. The patient comes into the ED after a house fire. The patient's respirations are 24, blood pressure is 140/90 and Pulse is 89. Upon assessment which of the findings below are highly likely for this patient? SATA A. Wheezing B. 02 sat 98% C. Kussumal Respirations D. Stridor E. Shortness of breath

A D E

1. Match the medications to indication for why we use the med a. ACE inhibitors b. Beta Blockers c. Diuretic d. Digoxin __ hypertension __A Fib __peripheral edema __Heart Failure

ACE Inhibitors__ hypertension Beta Blockers__A Fib Diuretic__peripheral edema Digoxin__Heart Failure

1. Which of the following patients would be the most likely candidate to receive a thoracentesis? A. an 80 year old with right leg swelling and pain B. a 75 year old who reports SOB, coughing and a CXR that indicates a pleural effusion. C. a 65 year old with SOB and tracheal deviation D. an 85 year old with SOB and increased abdominal girth

B

1. The nurse is educating a patient with heart failure about appropriate dietary choices. Which of the following statements indicates a need for further teaching? a. "I will drink less than 2 L of water a day " b." I will cook with olive oil" c. "Black licorice is a healthier dessert option" d. "I will eat fresh vegetables instead of canned "

C

Patient presents to the ED with shortness of breath and bilateral diminished lung sounds upon assessment and needs immediate thoracentesis. What assessment finding indicates a complication as a result of the thoracentesis? A) Potassium of 6 B) Oxygen saturation of 97% C) Tracheal deviation D) Heart rate of 95

C

1. A client comes into the ED reporting congestion, yellow sputum, and other flu-like symptoms. The client has an extensive medical history including HF, HTN, hyperlipidemia, heart disease with a pacemaker, T2DM, and CKD. The client's most recent breath sounds were bilateral crackles. Which data within the medical history is most likely contributing to crackles? A. Type II Diabetic B. CKD C. HF D. Hyperlipidemia

C. Heart Failure

1. A patient with a history of Heart Failure presents to the E.R. with shortness of breath and anxiety. Which nursing action will the nurse perform first? A.) Assess lung sounds B.) Give IV Furosemide C.) Raise the HOB D.) Call the Provider

C. Raise HOB

1. A patient arrived in the ED 60 minutes ago with SOB and a fever of 102.7 F. After labs and diagnostics, the patient was diagnosed with pneumonia. The provider prescribed penicillin. 10 minutes after the first dose, the patient becomes light-headed and oxygen saturation drops to 78%. What is the priority intervention? A) Call provider. B) Raise the head of the bed. C) Update the client's allergies in the chart. D) Administer Epinephrine. E) Apply supplemental oxygen.

D

1. A patient arrives to the ED with a history of heart failure, hyperlipidemia, diabetes and pneumonia with a pleural effusion. Which assessment data from this patient is the most concerning to the nurse? A. A wet cough B. Use of accessory muscles C. Dyspnea with excretion O2 sat of 89%

D

Pulmonary Embolus

Description: - Occurs when a thrombus forms (most commonly in a deep vein), detaches, travels to the right side of the heart, and then lodges in a branch of the pulmonary artery - at risk population: ppl w/ DVT, prolonged immobilization, surgery, obesity, pregnancy, heart failure, advanced age, Hx of Thromboembolism - Fat emboli can occur as a complication following a long-bone fracture Assessment: - apprehension and restlessness - blood-tinged sputum - chest pain - cough - crackles and wheezes - cyanosis - distended neck veins - dyspnea accompanied by anginas and pleuritic pain, exacerbated on inspiration - feeling of impending doom - hypotension - petechiae over the chest and axilla - shallow respirations - tachypnea and tachycardia Interventions: - Rapid Response/notify provider - reassure patient, elevate HOB - give O2 - obtain VS and auscultate - Obtain ABG - administer Heparin or other therapy - Document event, interventions, and client response to Tx

HTN Pharm (ARB, Diuretic, BB, ACE)

Diuretics: - Thiazides (Ex: Chlorothiazide), Potassium-sparing (Ex: Spironolactone), Loop (Bumetanide, Furosemide), osmotic (Mannitol) - Monitor electrolytes ARBs: - "sartens" - prevent peripheral vasoconstriction and secretion of aldosterone - avoid use with potassium-retaining diuretics ACEs: - "prils" - prevent peripheral vasoconstriction by blocking angiotensin conversion -avoid use with K+ sparing diuretics - persistent dry cough and diminished taste Beta Blockers: - "lols" - < CO -Nonselective- heart + lungs; selective- heart - contraindicated with asthmatics, bradycardia, HF (w/ exceptions), severe renal/hepatic disease, hyperthyroidism, or stroke

A patient is admitted onto the medical-surgical floor for dyspnea, chills, and wheezing of unknown cause. The patient states her symptoms began 3 days ago and have gotten progressively worse. Upon assessment, the nurse notes use of accessory muscles for breathing, and rhonchi during auscultation. Patient is not oriented to time and place. Vital Signs - Temperature 102.1, Heart Rate 110 , Respiratory Rate 22 , Oxygen Saturation 93% Blood Pressure 118/76 Laboratory Data - WBC 15,000 , Hemoglobin 13% , Hematocrit 39% Based on the data, which respiratory illness is highly likely, somewhat likely, and least likely? Pneumonia, COPD, ARDS

HIGHLY LIKELY- Pneumonia causes an increase white blood cell count and fever as opposed to COPD and ARDS which do not.

A patient presents to the ER with respiratory distress. Based on the assessment data given below, which diagnosis is the patient most likely experiencing. Assessment data: Patient experiences dyspnea and coughing. He is standing in tripod position while trying to catch his breath. The nurse notices that his chest is barrel shaped. Accessory muscles are used during respiration. On auscultation, the nurse hears diminished breath sounds across all lobes of his lungs. Vital signs: HR: 98 BP: 132/82 O2: 88% Temp: 98.4 F RR: 22 Laboratory: Na 137 K 3.8 Ca 8.6 BUN 14 creatinine 1.1 Hgb 14 Hct 40% ABGs: pH 7.21 CO2 48 bicarb 24 O2 86 Based on the data, rank the likelihood of pneumothorax, pulmonary embolus, and COPD.

High likely- COPD is highly likely given the assessment data above. Somewhat likely- Pneumothorax would be somewhat likely due to the oxygen saturation and decreased breath sounds, but the patient would have unequal breath sounds and chest assessment. Least likely- Pulmonary embolus

A client present to the ED with tachypnea, tachycardia dyspnea, and diminished bilateral breath sounds. The client's O2 situation is 83 and SBP is 84. Temperature is 100.6* F oral. The client is in tripod position and has a productive cough. Sternal retractions are noted. The client is receiving 15 L O2 via non-rebreather. Lab values are as follows: ABG: ph (7.15) O2 (68) CO2 (64) HCO3- (20) White Blood Cell Count: 14 x10^9 Lactic Acid: 4.5 X - Ray: Shows signs of bilateral pneumonitis (white out lung)

Highly Likely - ARDS is the likely diagnosis because the client is showing signs of sepsis such as hypotension, tachycardia, elevated white count, elevated lactate, white out x-ray, and the client is febrile. Somewhat Likely - Pneumonia is somewhat likely and could possibly be the etiology of the client's ARDS. If the client's vital signs were more stable and the client's labs and diagnostics were not as critical, the nurse may suspect pneumonia. Least Likely - COPD Exacerbation is somewhat, yet least likely, due to the client's dyspnea, hypoxia, tripod positioning, sternal retraction, and respiratory acidosis. However, the nurse rules this out related to the client's signs of infection.

34-year-old female patient presents with: sudden chest pain, SOB, tachypnea, anxiety, abnormal breath sounds History: 36 hours post-surgical (open reduction of tibial fracture), HTN, DVT, no known food or drug allergies, seasonal allergies, smoker (8 years), denies ETOH use, oral contraception (12 years). VS: HR 102, RR 30, O2 88%, BP 145/92 Based on the data, rate the likelihood of MI, asthma, and pulmonary embolism.

Highly likely - PE Somewhat likely - MI Least likely - anxiety attack 1. PE: High risk for development of thromboembolism following orthopedic surgery, especially on lower extremities. History of deep vein thrombosis also increases this risk, as does smoking and use of oral contraceptives. S/sx & VS consistent with PE. 2. MI: Moderate risk d/t HTN, hx of DVT, smoker. Chest pain, SOB, tachypnea, anxiety consistent with MI. 3. Anxiety attack: HR, RR, BP, & anxiety consistent with anxiety attack.

A patient present to the ED with chest pain, dyspnea, crackles and wheezes, hypoxemia, cyanosis, and blood tinged sputum. The client states "I feel like I am going to die. I had pain in my left leg two days ago, but now that is gone. My chest now feels like it is going to explode, and I cannot breathe." VS: BP 80/40, Temp 101.4, RR 30, HR 120, O2 85% on RA Oxygen is applied at 12L by face mask and increases to 88%. The patient is given a breathing treatment but is ineffective. Based on the data, rank the likelihood of pneumonia, ARDS, or pulmonary embolism.

Highly likely- Pulmonary Embolism Somewhat likely- Pneumonia Least likely- ARDS What data supports your decision for each answer? Pulmonary embolism is highly likely, because chest pain, crackles and wheezes, respiratory rate, blood pressure, and blood tinged sputum. The patient is also experiencing feelings of death and despair, which are significant presentations in PE patients. The breathing treatment also being ineffective supports the PE being most likely. The major clue that indicates PE is the pain in the leg that has now subsided. Pneumonia is somewhat likely, because dyspnea, fever, and respiratory rate are the only symptoms that point towards this diagnosis. ARDS is least likely, because of dyspnea, hypoxemia, and respiratory rate are the only symptoms that would indicate this.

A 70-year old man, former military, presents to the emergency department, complaining of fatigue, weight loss, low grade fever, chills, and night sweats, although symptoms come and go. The patient has a persistent, productive cough and a sensation of chest tightness when coughing. Patient reports occasional blood-tinged sputum. According to the chart, patient recently hospitalized for influenza. Patient received chest x-ray, which displays infiltrates in upper lobes. Rales noted upon auscultation in bilateral upper lobes. Patient has sputum culture pending. Based on the data, rank the likelihood of TB, pneumonia, and COPD exacerbation.

Highly likely: TB Somewhat likely: Pneumonia Least likely: COPD exacerbation What data supports your decision for each answer? Highly likely: These are all manifestations of TB. The patient's hemoptysis differentiates their manifestations from the other two exemplars as this is indicative only of TB. Recent influenza is also a risk factor for development of TB. Somewhat likely: A patient with pneumonia would receive a chest x-ray as well, and would demonstrate respiratory difficulty, however rales would not be auscultated. Least likely: It is least likely that the patient is experiencing a COPD exacerbation because of the other symptoms noted. The patient would not have a sputum culture ordered.

Congenital Heart Disease (PDA & Tetralogy of Fallot)

Patent ductus arteriosus Description: failure of fetal ductus arteriosus (shunt connecting the aorta and the pulmonary artery) to close within first few weeks of life - machinery murmur - widened pulse pressure, bounding pulse - Indomethacin may be given to close patent ductus Tetralogy of Fallot Description: VSD, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy - characteristic murmur - tet spells: occur when the infant's O2 requirements exceed the blood supply (crying, feeding, pooping) Hypercyanotic Spell Priority Actions: - knee-chest position - 100% O2 - morphine sulfate - fluids IV - document

Thoracentesis (removal of air or fluid from the pleural space via transthoracic aspiration) Complications

Postprocedure: - monitor respiratory status - apply a pressure dressing, and assess puncture site for bleeding and crepitus - monitor for signs of pneumothorax, air embolism, and pulmonary embolism

The health care provider is preparing to order rifampin and pyrazinamide for a female client with active tuberculosis. What question should the provider ask this client before confirming this order? a. "Are you pregnant?" b. "Have you ever experienced a miscarriage?" c. "Do you have a family history of diabetes?" d. "Are you allergic to penicillin?"

a. "Are you pregnant?"

A new ICU nurse is observed by her preceptor entering a patient's room to suction the tracheostomy after performing the task 15 minutes before. What should the preceptor educate the new nurse to do to ensure that the patient needs to be suctioned? a. Auscultate the lung for adventitious sounds. b. Have the patient inform the nurse of the need to be suctioned. c. Assess the CO2 level to determine if the patient requires suctioning. d. Have the patient cough.

a. Auscultate the lung for adventitious sounds.

For a client with an endotracheal (ET) tube, which nursing action is the most important? a. Auscultating the lungs for bilateral breath sounds b. Turning the client from side to side every 2 hours c. Monitoring serial blood gas values every 4 hours d. Providing frequent oral hygiene

a. Auscultating the lungs for bilateral breath sounds

Which of the following is the most effective treatment for obstructive sleep apnea (OSA)? a. Continuous positive airway pressure (CPAP) b. Bilevel positive airway pressure (BiPAP) c. Mechanical ventilation d. Oxygen by nasal cannula

a. Continuous positive airway pressure (CPAP)

An emergency room nurse is assessing a client who is complaining of dyspnea. Which sign would indicate the presence of a pleural effusion? a. Decreased chest wall excursion upon palpation b. Wheezing upon auscultation c. Resonance upon percussion d. Mottled skin seen during inspection

a. Decreased chest wall excursion upon palpation

A nurse has established a nursing diagnosis of ineffective airway clearance. The datum that best supports this diagnosis is that the client a. Has wheezes in the right lung lobes b. Has a respiratory rate of 28 breaths/minute c. Reports shortness of breath d. Cannot perform activities of daily living

a. Has wheezes in the right lung lobes

A newly admitted patient to the respiratory floor is being given the following medications: Isoniazid, Rifampin, pyrazinamide and bronchodilators The patient presents with SOB, a productive cough, a low-grade fever and is under precautions. Based on the data, rank the likelihood of the follow conditions: Pneumonia, TB, COPD.

a. High likely TB b. Somewhat likely Pneumonia c. Least likely COPD

After a traumatic car accident, a 46-year-old male presents with SOB, dyspnea, unequal breath sounds and chest pain. The patient is also tachypneic and has paradoxical respirations. ABG results are pending. Vital signs are as follows: BP 134/78, Temperature of 98.3, Oxygen Sat. 86%, respiratory rate of 28. Based on the data, rank the likelihood of the follow respiratory emergencies: ARDs, flail chest, and pneumothorax

a. Highly likely flail chest b. Somewhat likely pneumothorax c. Least likely ARDs

A nurse is caring for a client with chest trauma. Which nursing diagnosis takes the highest priority? a. Impaired gas exchange b. Anxiety c. Decreased cardiac output d. Ineffective tissue perfusion (cardiopulmonary)

a. Impaired gas exchange

For a client who has a chest tube connected to a closed water-seal drainage system, the nurse should include which action in the care plan? a. Measuring and documenting the drainage in the collection chamber b. Maintaining continuous bubbling in the water-seal chamber c. Keeping the collection chamber at chest level d. Stripping the chest tube every hour

a. Measuring and documenting the drainage in the collection chamber

A nurse administers albuterol (Proventil), as ordered, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect? a. Respiratory rate of 22 breaths/minute b. Dilated and reactive pupils c. Urine output of 40 ml/hour d. Heart rate of 100 beats/minute

a. Respiratory rate of 22 breaths/minute

A client is admitted to hospital to rule out Legionnaire disease following a canoe trip where he was sprayed in the face with a lot of "creek" water. Which manifestations are characteristic of Legionnaire pneumonia? Select all that apply. a. Temperature of 103.5°F (39.7°C), pulse 80 b. "Talking but not making a lot of sense" (confusion) c. Decreased abdominal bowel sounds d. Productive cough with thick, yellow secretions e. Chest x-ray that reveals areas of consolidation suggestive of pneumonia

a. Temperature of 103.5°F (39.7°C), pulse 80 b. "Talking but not making a lot of sense" (confusion) e. Chest x-ray that reveals areas of consolidation suggestive of pneumonia

The nurse caring for a client with tuberculosis anticipates administering which vitamin with isoniazid (INH) to prevent INH-associated peripheral neuropathy? a. Vitamin B6 b. Vitamin C c. Vitamin D d. Vitamin E

a. Vitamin B6

The nurse is caring for a patient who had a total laryngectomy and has drains in place. When does the nurse understand that the drains will most likely be removed? a. When the patient has less than 30 mL for 2 consecutive days b. When the patient states that there is discomfort and requests removal c. When the drainage tube comes out d. In 1 week when the patient no longer has serous drainage

a. When the patient has less than 30 mL for 2 consecutive days

A nurse is assisting with a subclavian vein central line insertion when the client's oxygen saturation drops rapidly. He complains of shortness of breath and becomes tachypneic. The nurse suspects the client has developed a pneumothorax. Further assessment findings supporting the presence of a pneumothorax include: a. diminished or absent breath sounds on the affected side. b. paradoxical chest wall movement with respirations. c. tracheal deviation to the unaffected side. d. muffled or distant heart sounds.

a. diminished or absent breath sounds on the affected side.

A nurse is taking stock of the equipment in the room of an older adult client with pneumonia who has been on parenteral nutrition for a long time. Which equipment can transmit infection to older adult clients? a. indwelling catheter b. bath blanket c. face shields d. specimen containers

a. indwelling catheter

A client who has been diagnosed with an early glottis cancer would likely undergo which type of surgery? a. laser microsurgery b. vocal cord stripping c. partial laryngectomy d. total laryngectomy

a. laser microsurgery

A patient who wears contact lenses is to be placed on rifampin for tuberculosis therapy. What should the nurse tell the patient? a. "Only wear your contact lenses during the day and take them out in the evening before bed." b. "You should switch to wearing your glasses while taking this medication." c. "The physician can give you eye drops to prevent any problems." d. "There are no significant problems with wearing contact lenses."

b. "You should switch to wearing your glasses while taking this medication."

The infection control nurse at a large hospital has instituted a new education campaign aimed at reducing the incidence of hospital-acquired pneumonia (HAP). The nurse should identify which client as being particularly susceptible to hospital-acquired pneumonia? a. A middle-aged client who donated a kidney to his brother 48 hours ago b. An intubated client who is ventilator dependent following a traumatic head injury c. An older adult client with Alzheimer disease who is administered antipsychotics to manage his behavior d. A woman who gave birth by cesarean section 24 hours ago

b. An intubated client who is ventilator dependent following a traumatic head injury

The nurse assesses a patient with a heart rate of 42 and a blood pressure of 70/46. What type of hypoxia does the nurse determine this patient is displaying? a. Anemic hypoxia b. Circulatory hypoxia c. Histotoxic hypoxia d. Hypoxemic hypoxia

b. Circulatory hypoxia

A 72-year-old patient who was admitted to the hospital for a total hip arthroplasty has developed increasing dyspnea and leukocytosis over the past 48 hours and has been diagnosed with hospital-acquired pneumonia (HAP). The choice of antibiotic therapy for this patient will be primarily based on which of the nurse's assessments? a. Auscultation and percussion of the patient's thorax b. Collection of a sputum sample for submission to the hospital laboratory c. Analysis of the patient's leukocytosis and the white blood cell (WBC) differential d. Assessment of the patient's activities of daily living

b. Collection of a sputum sample for submission to the hospital laboratory

A nurse consulting with a nutrition specialist knows it's important to consider a special diet for a client with chronic obstructive pulmonary disease (COPD). Which diet is appropriate for this client? a. Full-liquid b. High-protein c. 1,800-calorie ADA d. Low-fat

b. High-protein

A client who is malnourished and hypertensive client is being treated with losartan. Considering the client's nutritional status, how should the dose of the medication be adjusted in this client? a. Increased b. Lowered c. Prescribed according to normal dosages d. Discontinued

b. Lowered

A client is taking amiloride and lisinopril for the treatment of hypertension. What laboratory studies should the nurse monitor while the client is taking these two medications together? a. Magnesium level b. Potassium level c. Calcium level d. Sodium level

b. Potassium level

Mr. Faulkner is a 69-year-old man who has enjoyed generally good health for his entire adult life. As a result, he has been surprised to receive a new diagnosis of hypertension after a series of visits to his primary care provider. The nurse who is working with Mr. Faulkner should recognize which of the following aspects of aging and hypertension? a. The diagnostic criteria for hypertension in adults over 65 differ from those for younger adults. b. The incidence and prevalence of hypertension increase with age. c. Blood pressure remains stable throughout adulthood but tends to be assessed more often by health care providers of older adults. d. Older adults are less vulnerable to the pathophysiological effects of hypertension than are younger adults.

b. The incidence and prevalence of hypertension increase with age.

A health care center is conducting a seminar on cephalosporins drugs. During the question-and-answer period, the audience wants examples of conditions that can be treated by cephalosporins. Which of the following infections should the nurse state as examples? a. Hemolysis b. Urinary tract infections c. Nausea and diarrhea d. Jaundice

b. Urinary tract infections

A client is on a positive-pressure ventilator with a synchronized intermittent mandatory ventilation (SIMV) setting. The ventilator is set for 8 breaths per minute. The client is taking 6 breaths per minute independently. The nurse a. Consults with the physician about removing the client from the ventilator b. Changes the setting on the ventilator to increase breaths to 14 per minute c. Continues assessing the client's respiratory status frequently d. Contacts the respiratory therapy department to report the ventilator is malfunctioning

c. Continues assessing the client's respiratory status frequently

A 71-year-old male client is being treated for hypertension. Which measurement is a partial indication of effective treatment and management? a. Systolic blood pressure above 140 mm Hg b. Diastolic blood pressure below 100 mm Hg c. Diastolic blood pressure below 90 mm Hg d. Systolic blood pressure below 160 mm Hg

c. Diastolic blood pressure below 90 mm Hg

You are caring for a client who is 42-years-old and status post adenoidectomy. You find the client in respiratory distress when you enter their room. You ask another nurse to call the physician and bring an endotracheal tube into the room. What do you suspect? a. Infection b. Post operative bleeding c. Edema of the upper airway d. Plugged tracheostomy tube

c. Edema of the upper airway

A client is receiving supplemental oxygen. When determining the effectiveness of oxygen therapy, which arterial blood gas value is most important? a. pH b. Bicarbonate (HCO3-) c. Partial pressure of arterial oxygen (PaO2) d. Partial pressure of arterial carbon dioxide (PaCO2)

c. Partial pressure of arterial oxygen (PaO2)

The nurse is assigned the care of a 30-year-old client diagnosed with cystic fibrosis (CF). Which nursing intervention will be included in the client's care plan? a. Restricting oral intake to 1,000 mL/day b. Providing the client a low-sodium diet c. Performing chest physiotherapy as ordered d. Discussing palliative care and end-of-life issues with the client

c. Performing chest physiotherapy as ordered

After diagnosing a client with pulmonary tuberculosis, the physician tells family members that they must receive isoniazid (INH [Laniazid]) as prophylaxis against tuberculosis. The client's daughter asks the nurse how long the drug must be taken. What is the usual duration of prophylactic isoniazid therapy? a. 3 to 5 days b. 1 to 3 weeks c. 2 to 4 months d. 6 to 12 months

d. 6 to 12 months

A client with asthma is prescribed a short acting beta-adrenergic (SABA) for quick relief. Which of the following is the most likely drug to be prescribed? a. Ipratropium bromide b. Fluticasone propionate c. Ipratropium bromide and albuterol sulfate d. Albuterol

d. Albuterol

When caring for a client with acute respiratory failure, the nurse should expect to focus on resolving which set of problems? a. Hypotension, hyperoxemia, and hypercapnia b. Hyperventilation, hypertension, and hypocapnia c. Hyperoxemia, hypocapnia, and hyperventilation d. Hypercapnia, hypoventilation, and hypoxemia

d. Hypercapnia, hypoventilation, and hypoxemia

The nurse teaches the client which guidelines regarding lifestyle modifications for hypertension? a. Reduce smoking to no more than four cigarettes per day b. Limit aerobic physical activity to 15 minutes, three times per week c. Stop alcohol intake d. Maintain adequate dietary intake of fruits and vegetables

d. Maintain adequate dietary intake of fruits and vegetables

A 44-year-old homeless man presented to the emergency department with hemoptysis. The patient was diagnosed with tuberculosis (TB) after diagnostic testing and has just begun treatment with INH, pyrazinamide, and rifampin (Rifater). When providing patient education, what should the nurse emphasize? a. The rationale and technique for using incentive spirometry b. The correct use of a metered-dose inhaler (MDI) for bronchodilators c. The need to maintain good nutrition and adequate hydration d. The importance of adhering to the prescribed treatment regimen

d. The importance of adhering to the prescribed treatment regimen

The classification of Stage IV of COPD is defined as a. at risk for COPD. b. mild COPD. c. severe COPD. d. very severe COPD. e. moderate COPD.

d. very severe COPD.