EVOLVE EAQ respiratory questions

Which key feature would the nurse explain indicates malignancy in an acute immunodeficiency syndrome (AIDS) client? 1 Dry skin 2 Weight loss 3 Kaposi sarcoma 4 Opportunistic infections

Kaposi sarcoma

The nurse understands that clients with emphysema experience which pathophysiologic change in the alveolar sacs? 1 They collapse. 2 They retain CO2. 3 They become fluid filled. t4 They become overdistended

They become overdistended

A client is admitted to the hospital with a diagnosis of emphysema and dyspnea. The nurse should encourage the client to assume what position? 1 Supine 2 Contour 3 Orthopneic

orthopenic

When planning discharge teaching for the parents of a child with asthma, what information should the nurse include? 1 Avoid foods high in fat. 2 Stay at home for 2 weeks. 3 Increase protein and calorie intake. 4 Minimize exertion and exposure to cold

Minimize exertion and exposure to cold

The nurse instructs the client admitted for an acute exacerbation of chronic obstructive pulmonary disease (COPD) about the importance of assessing for right-sided heart failure after discharge. What does the nurse instruct the client to assess for? 1 Increased appetite 2 Clubbing of the nail beds 3 Hypertension 4 Weight gain

weight gain

While caring for a client with asthma, the nurse auscultates a bilateral high-pitched, continuous whistling sound in the anterior lung fields. What finding does the nurse document in the medical record? 1 Crackles 2 Wheezes 3 Rhonchus 4 Pleural friction rub

wheezes

A child with a history of asthma is brought to the emergency department experiencing an acute exacerbation of asthma. Which nursing assessment findings support this conclusion? Select all that apply. 1 Fever 2 Stridor 3 Wheezing 4 Tachycardia 5 Hypotension

wheezing tachycardia

A client newly diagnosed with human immunodeficiency virus (HIV) comments to a nurse, "There are so many rotten people around. Why couldn't one of them get HIV instead of me?" What is the nurse's best response? 1 "I can understand why you're afraid of dying." 2 "It seems unfair that you contracted this disorder." 3 "Do you really wish this disorder on someone else?" 4 "Have you thought of speaking with your religious advisor?"

"It seems unfair that you contracted this disorder." -The client is in the anger or "why me" stage; encouraging the expression of feelings will help the client resolve them and move toward acceptance

A nurse is educating a client with human immunodeficiency virus (HIV) about self-management. Which suggestion by the nurse benefits the client? 1 "Limit your daily fluid intake." 2 "Eat more roughage." 3 "Rinse your mouth with normal saline after every meal." 4 "Maintain a 4-to-5-hour gap in between meals."

"Rinse your mouth with normal saline after every meal."

A patient with COPD who has been receiving oxygen therapy for an extended time on high flow may be at risk for which of the following acid-base imbalances? A) Respiratory acidosis B) Respiratory alkalosis C) Metabolic acidosis D) Metabolic alkalosis

A) Respiratory acidosis

A client with a history of chronic obstructive pulmonary disease (COPD) is admitted with acute bronchopneumonia. The client is in moderate respiratory distress. The nurse should place the client in what position to enhance comfort? 1 Side-lying with head elevated 45 degrees 2 Sims with head elevated 90 degrees 3 Semi-Fowler with legs elevated 4 High Fowler using the bedside table as an arm res

High Fowler using the bedside table as an arm rest

What statement by the nursing student indicates understanding of the precautions needed in the provision of care to a 7-year-old child who is HIV positive? 1 "I'll put on a mask." 2 "I'll put on an N-95 mask." 3 "I'll put on a gown and gloves." 4 "I'll put on gloves if I'm going to be in contact with body fluids."

"I'll put on gloves if I'm going to be in contact with body fluids." The Centers for Disease Control and Prevention (Canada: Public Health Agency of Canada) recommends standard precautions for the care of individuals with HIV infection or AIDS without opportunistic infections.

The laboratory report of a client reveals the presence of 350 cells/mm3 (350 cells/uL) of CD4+ T-cell count. According to the Centers for Disease Control and Prevention (CDC), which stage of human immunodeficiency virus (HIV) disease is present in the client? 1 Stage 1 2 Stage 2 3 Stage 3 4 Stage 4

stage 2

Which statement will the nurse include when teaching the family of a school-aged child with asthma about peak flow meters (PFMs)? 1 "This device measures the peak amount of air that your child can inhale." 2 "This device will improve medication delivery to the lungs when it's used with an inhaler." 3 "Your child should make sure to use a short-acting bronchodilator before using the peak flow meter." 4 "A peak flow meter can help you identify when asthma is getting worse even before your child has symptoms."

"A peak flow meter can help you identify when asthma is getting worse even before your child has symptoms." -The PFM is used to measure the maximal amount of exhalation. In doing this, it can identify when airway obstruction is occurring before the obstruction is sufficient to cause symptoms. PFMs are used to measure exhalation, not inhalation. PFMs are not used for medication administration. The use of a PFM should not be preceded by administration of a bronchodilator.

A nurse is teaching a client about human immunodeficiency virus (HIV). What are the various ways HIV is transmitted? Select all that apply. 1 Mosquito bites 2 Sharing syringe needles 3 Breastfeeding a newborn 4 Dry kissing the infected partner 5 Anal intercourse

sharing syringe needles breastfeeding newborn anal intercourse

What is the priority goal for a client with asthma who is being discharged from the hospital with prescriptions for inhaled bronchodilators? 1 Is able to obtain pulse oximeter readings 2 Demonstrates use of a metered-dose inhaler 3 Knows the healthcare provider's office hours 4 Can identify the foods that may cause wheezing

Demonstrates use of a metered-dose inhaler

What breathing exercises should the nurse teach a client with the diagnosis of emphysema? 1 An inhalation that is prolonged to promote gas exchange. 2 Abdominal exercises to limit the use of accessory muscles. 3 Sit-ups to help strengthen the accessory muscles of respiration. 4 Diaphragmatic exercises to improve contraction of the diaphragm

Diaphragmatic exercises to improve contraction of the diaphragm

A nurse is teaching breathing exercises to a client with emphysema. What is the reason the nurse should include in the teaching as to why these exercises are necessary to promote effective use of the diaphragm? 1 The residual capacity of the lungs has been increased. 2 Inspiration has been markedly prolonged and difficult. 3 The client has an increase in the vital capacity of the lungs. 4 Abdominal breathing is an effective compensatory mechanism and is spontaneously initiated.

The residual capacity of the lungs has been increased.

A nurse in the pediatric clinic is assessing an 8-year-old child who has had asthma since infancy. What clinical finding requires immediate intervention? 1 Barrel chest 2 Audible wheezing 3 Heart rate of 105 beats/min 4 Respiratory rate of 30 breaths/min

audible wheezing

A client who is receiving a screening test for tuberculosis (TB) asks the nurse what a positive reaction will mean. What should the nurse explain that a positive reaction indicates? 1 A depressed immune system 2 An active tuberculosis infection 3 A previous exposure to the organism 4 An imminent tuberculosis infection

A previous exposure to the organism -The presence of antibodies indicates past exposure to or infection with an organism that may be presently dormant.

A client has chronic obstructive pulmonary disease (COPD) and cor pulmonale. When teaching about nutrition, what does the nurse instruct the client? 1 Eat small meals six times a day to limit oxygen needs. 2 Drink large amounts of fluid to help liquefy secretions. 3 Lie down after eating to conserve energy needed for digestion. 4 Increase the intake of protein to decrease intravascular hydrostatic pressure

Eat small meals six times a day to limit oxygen needs.

Which positioning should be avoided while assessing a client with a history of asthma? 1 Sitting 2 Supine 3 Dorsal recumbent 4 Lateral recumbent

Lateral recumbent -The lateral recumbent position is used to assess heart function. A client with asthma or other respiratory problems may not tolerate the lateral recumbent position.

The nurse is assessing a client with severe nodule-forming rheumatoid arthritis for possible Felty syndrome. Which assessment findings are consistent with Felty syndrome? Select all that apply. 1 Itchy eyes 2 Dry mouth 3 Leukopenia 4 Splenomegaly 5 Photosensitivity

Leukopenia Spelomegaly -Felty syndrome occurs most commonly in clients with severe nodule-forming rheumatoid arthritis; it is characterized by splenomegaly and leukopenia. Itchy eyes, dry mouth, and photosensitivity are all signs of Sjögren syndrome

The nurse is caring for a client with human immunodeficiency virus (HIV) infection. Which clinical manifestations in the client should be immediately reported to the primary healthcare provider? 1 Blood in the urine 2 New or productive cough 3 Vomiting accompanied by fever 4 Burning, itching, and discharge from the eyes

Blood in the urine

A client is diagnosed with emphysema. What long-term problem should the nurse monitor in this client? 1 Localized tissue necrosis 2 Carbon dioxide retention 3 Increased respiratory rate 4 Saturated hemoglobin molecules

Carbon dioxide retention

A spontaneous pneumothorax is suspected in a client with a history of emphysema. In addition to calling the healthcare provider, which action should the nurse take? 1 Place the client on the unaffected side 2 Administer 60% oxygen via a Venturi mask 3 Give oxygen at 2 L per minute via nasal cannula 4 Prepare for intravenous (IV) administration of electrolytes

Give oxygen at 2 L per minute via nasal cannula

A client who abused intravenous drugs was diagnosed with the human immunodeficiency virus (HIV) several years ago. What does the nurse explain to the client regarding the diagnostic criterion for acquired immunodeficiency syndrome (AIDS)? 1 Contracts HIV-specific antibodies 2 Develops an acute retroviral syndrome 3 Is capable of transmitting the virus to others 4 Has a CD4+T-cell lymphocyte level of less than 200 cells/µL (60%)

Has a CD4+T-cell lymphocyte level of less than 200 cells/µL (60%)

A nurse is caring for a client who is human immunodeficiency virus (HIV) positive. Which complication associated with this diagnosis is most important for the nurse to teach prevention strategies? 1 Infection 2 Depression 3 Social isolation 4 Kaposi sarcoma

Infection

A nurse observes a client with acute bronchitis and emphysema sitting up in bed, appearing anxious and dyspneic. What should the nurse do first? 1 Provide oxygen at 2 L per minute 2 Encourage deep breathing and coughing 3 Administer the prescribed sedative and encourage rest 4 Suggest breathing into a paper bag for several minutes

Provide oxygen at 2 L per minute

A client who is negative for human immunodeficiency virus (HIV) but who has a history of chronic obstructive pulmonary disease (COPD) requests the nurse to read the results of the client's Mantoux test for tuberculosis. The test site has a 10-mm area of induration with 5 mm of erythema. How should the nurse interpret the finding? 1 The erythema does not meet the criterion for a diagnosis of tuberculosis; the results are negative. 2 The clinical manifestations indicate that the client has tuberculosis; the results are positive. 3 The results are indeterminate because of the client's history of COPD. 4 The client has been exposed to the pathogen that causes tuberculosis.

The client has been exposed to the pathogen that causes tuberculosis.

What are the symptoms of tuberculosis? Select all that apply. 1 Diarrhea 2 Anorexia 3 Weight gain 4 Hemoptysis 5 Night sweats

anorexia hemoptysis night sweats

A client has chronic asthma. Which complication should the nurse monitor in this client? 1 Atelectasis 2 Pneumothorax 3 Pulmonary edema 4 Respiratory alkalosis

atelectasis

A client is admitted to the emergency department with joint pain and swelling. Upon assessment the nurse suspects rheumatoid arthritis. Which findings support the nurse's conclusion? Select all that apply. 1 Obesity 2 Antinuclear antibodies 3 Inflammatory disease pattern 4 Disease in the bilateral symmetric joints 5 Disease in the distal intrapharyngeal joints

Antinuclear antibodies Inflammatory disease pattern Disease in the bilateral symmetric joints

Which type of allergic skin condition in a client is associated with immunological irregularity, asthma, and allergic rhinitis? 1 Urticaria 2 Psoriasis 3 Acne vulgaris 4 Atopic dermatitis

Atopic dermatitis -Atopic dermatitis is an allergic skin condition that is a genetically influenced, chronic, relapsing disease. It is associated with immunologic irregularity involving inflammatory mediators associated with allergic rhinitis and asthma.

A nurse is caring for a client with chronic obstructive pulmonary disease (COPD). Which clinical finding supports the nurse's suspicion that the client is developing cor pulmonale? 1 Peripheral edema 2 Productive coughing 3 Twitching of the extremities 4 Lethargy progressing to coma

Peripheral edema

A client with a 10-year history of emphysema is admitted in acute respiratory distress. During assessment, what does the nurse expect to identify? 1 Chest pain on inspiration 2 Prolonged expiration with use of accessory muscles 3 Signs and symptoms of respiratory alkalosis 4 Decreased respiratory rate

Prolonged expiration with use of accessory muscles

A client is experiencing an exacerbation of systemic lupus erythematosus. To reduce the frequency of exacerbations, what would be important for the nurse to include in the client's teaching plan? 1 Basic principles of hygiene 2 Techniques to reduce stress 3 Measures to improve nutrition 4 Signs of an impending exacerbation

Techniques to reduce stress -Systemic lupus erythematosus is an autoimmune disorder, and physical and emotional stresses have been identified as contributing factors to the occurrence of exacerbations. Although basic principles of hygiene should be performed, inadequate hygiene is not known to produce exacerbations. Although measures to improve nutrition should be done, nutritional status is not significantly correlated to exacerbations. Knowledge of the symptoms will not decrease the occurrence of exacerbations

What clinical manifestations does a nurse expect a client with systemic lupus erythematosus (SLE) most likely to exhibit? Select all that apply. 1 Joint pain 2 Facial rash 3 Pericarditis 4 Weight gain 5 Hypotension

joint pain facial rash pericaditis

Which of the following assessment findings would the nurse state are common integumentary manifestations in clients with acquired immunodeficiency syndrome (AIDS)? 1 Weight loss 2 Lymphadenopathy 3 Poor wound healing 4 Low white blood cell counts

poor wound healing

A client with a history of emphysema is admitted with a diagnosis of acute respiratory failure with respiratory acidosis. Oxygen is being administered at 3 L/min nasal cannula. Four hours after admission, the client has increased restlessness and confusion followed by a decreased respiratory rate and lethargy. What should the nurse do? 1 Question the client about the confusion. 2Change the method of oxygen delivery. 3 Percuss and vibrate the client's chest wall. 4 Discontinue or decrease the oxygen flow rate.

Discontinue or decrease the oxygen flow rate.

A client with chronic asthma is being cared for in the inpatient care unit. To assess the client on a regular basis would be delegated to which healthcare team member? 1 Charge nurse 2 Registered nurse 3 Patient care associate 4 Licensed practical nurse

Registered nurse -The registered nurse is a licensed nursing professional and is responsible for assessing the asthmatic symptoms of the client for providing care.

What are the symptoms of tuberculosis? Select all that apply. 1 Fatigue 2 Nausea 3 Weight gain 4 Low-grade fever 5 Increased appetite

fatigue nausea low-grade fever

A 16-year-old client has a steady boyfriend with whom she is having sexual relations. She asks the nurse how she can protect herself from contracting human immunodeficiency virus (HIV). Which guidance is most appropriate for the nurse to provide? 1 Ask her partner to withdraw before ejaculating. 2 Make certain their relationship is monogamous. 3 Insist that her partner use a condom when having sex. 4 Seek counseling about various contraceptive methods.

Insist that her partner use a condom when having sex.

The nurse is caring for clients in the pulmonary unit and suspects that one has tuberculosis. What is the priority nursing intervention in this situation? 1 Move the client to an airborne isolation unit 2 Emphasize hand washing after handling soiled tissues 3 Inform the client about adherence with the prescribed regimen 4 Report the client's condition to the primary healthcare provider

Move the client to an airborne isolation unit

A nurse is teaching a group of healthcare workers about the prevention of human immunodeficiency virus (HIV) transmission by healthcare workers. Which statements made by a healthcare worker indicate the need for the further teaching? Select all that apply. 1 "I should never re-use equipment used in invasive procedures." 2 "If I perform exposure-prone procedures, I should know my HIV antibody status." 3 "I should identify exposure-prone procedures by institutions where they are performed." 4 "If I am infected with HIV, I am restricted from practice of non-exposure-prone procedures." 5 "If I have exudative lesions or weeping dermatitis, I should not perform direct client care or handle client care equipment."

"I should never re-use equipment used in invasive procedures." "If I am infected with HIV, I am restricted from practice of non-exposure-prone procedures."

The nurse is caring for a 4-year-old child who has been hospitalized with an acute asthma exacerbation. Which assessment finding requires action by the nurse? 1 Diminished breath sounds 2 Pulse rate of 110 beats/min 3 Pulse oximetry reading of 95% 4 Respiratory rate of 24 breaths/min

Diminished breath sounds

A client who is human immunodeficiency virus (HIV) positive is admitted to a surgical unit after an orthopedic procedure. The nurse should institute appropriate precautions with the awareness that HIV is highly transmissible through what means? Select all that apply. 1 Feces 2 Blood 3 Semen 4 Urine 5 Sweat 6 Tears

blood semen

A client has been admitted for an upper respiratory tract infection secondary to chronic obstructive pulmonary disease (COPD). The nurse should expect which findings when auscultating the client's breath sounds? 1 Coarse crackles 2 Prolonged inspiration 3 Short, rapid inspiration 4 Normal breath sounds

Coarse crackles

A nurse administers oxygen at 2 L/min via nasal cannula to a client with chronic obstructive pulmonary disease (COPD). By administering a low concentration of oxygen to this client, the nurse is preventing which physiologic response? 1 Decrease in red cell formation 2 Rupture of emphysematous bullae 3 Depression in the respiratory center 4 Excessive drying of the respiratory mucosa

Depression in the respiratory center

A client's laboratory report reveals a CD4+ T-cell count of 520 cells/mm3. According to the Centers for Disease Control and Prevention (CDC), which stage of human immunodeficiency virus (HIV) disease is present in the client? 1 Stage 1 2 Stage 2 3 Stage 3 4 Stage 4

stage 1

Which medication class helps to prevent human immunodeficiency virus (HIV) incorporating its genetic material into the client's cell? 1 Entry inhibitors 2 Protease inhibitors 3 Integrase inhibitors 4 Reverse transcriptase inhibitors

Integrase inhibitors

The nursing staff has a team conference on acquired immunodeficiency syndrome (AIDS) and discusses the routes of transmission of the human immunodeficiency virus (HIV). The discussion reveals that there is no risk of exposure to HIV when an uninfected individual does what? 1 Has intercourse with just the spouse 2 Makes a donation of a pint of whole blood 3 Uses a condom each time there is sexual intercourse 4 Limits sexual contact to those without HIV antibodies

Makes a donation of a pint of whole blood -Equipment used in blood donation is disposable; the donor does not come into contact with anyone else's blood.

The school nurse recommends suitable physical activity for a child with exercise-induced asthma. Which statement by a parent indicates the need for additional teaching? 1 "I'll sign him up for swimming lessons." 2 "She'd really enjoy being on a bowling team." 3 "I'll encourage him to join a youth running club." 4 "I know she'd enjoy going to the gym and lifting weights."

"I'll encourage him to join a youth running club." -Exercise-induced asthma is triggered by rapid mouth breathing of large volumes of dry cool air, so running increases the risk of an attack. Recommended exercises for people with asthma include swimming, weight lifting, and similar activities that do not necessitate rapid breathing through the mouth.

The nurse provides discharge teaching to a client with tuberculosis. Which treatment measure does the nurse reinforce as the highest priority? 1 Getting sufficient rest 2 Getting plenty of fresh air 3 Changing the current lifestyle 4 Consistently taking prescribed medication

Consistently taking prescribed medication

What type of hypersensitivity reaction is the cause of systemic lupus erythematosus? 1 Type I 2 Type II 3 Type III 4 Type IV

Type III -Systemic lupus erythematosus is an example of an immune complex-mediated, or type III, hypersensitive reaction.

A client with chronic obstructive pulmonary disease (COPD) reports a 5-pound (2.3 kg) weight gain in one week. What does the nurse recall is the complication that may have precipitated this weight gain? 1 Polycythemia 2 Cor pulmonale 3 Compensated acidosis 4 Left ventricular failure

Cor pulmonale

A client is admitted to the hospital with a diagnosis of an exacerbation of asthma. What should the nurse plan to do to best help this client? 1 Determine the client's emotional state. 2 Give prescribed drugs to promote bronchiolar dilation. 3 Provide education about the impact of a family history. 4 Encourage the client to use an incentive spirometer routinely.

Give prescribed drugs to promote bronchiolar dilation. -Asthma involves spasms of the bronchi and bronchioles as well as increased production of mucus; this decreases the size of the lumina, interfering with inhalation and exhalation. Bronchiolar dilation will reduce airway resistance and improve the client's breathing.

A client with acquired immunodeficiency syndrome (AIDS) is suspected to be infected with Cryptococcus neoforman. Which symptoms in the client support the nurse's suspicion? Select all that apply. Correct 1 Fever Correct 2 Seizures 3 Diarrhea Correct 4 Confusion 5 Persistent dry cough

fever seizures confusion

A client presenting with an acute asthma attack is being assessed in the emergency room. The client's spouse reports that the client currently is being treated for an upper respiratory infection. The nurse should understand that the client most likely has which type of asthma? 1 Allergic 2 Emotional 3 Extrinsic 4 Intrinsic

intrinsic

Which statement indicates that a client understands the ways HIV is transmitted? Select all that apply. 1 "I can contract HIV by participating in oral sex." 2 "I can contract HIV by eating from used utensils." 3 "HIV is contracted by using contaminated needles." 4 "I can contract HIV by using the bathroom of a person who is HIV positive." 5 "Babies can contract HIV because of contact with maternal blood during birth."

"I can contract HIV by participating in oral sex." "HIV is contracted by using contaminated needles." "Babies can contract HIV because of contact with maternal blood during birth."

A client with asthma and depression is admitted to the hospital. Which tasks delegated by the delegator would indicate the task is applicable for the registered nurse? 1 "Administer oral antidepressants." 2 "Administer a pain killer intramuscularly." 3 "Teach the client how to use a meter dose inhaler." 4 "Reinforce tips for stress management with the client."

"Teach the client how to use a meter dose inhaler."

A client is admitted to the hospital with a tentative diagnosis of pneumonia. The client has a high fever and is short of breath. Bed rest, oxygen via nasal cannula, an intravenous antibiotic, and blood and sputum specimens for culture and sensitivity (C & S) are prescribed. Place these interventions in the order in which they should be implemented.

1.Bed rest 2. Oxygen via nasal cannula 3.Specimens for C & S 4. Administration of an antibiotic

The registered nurse is caring for an elderly client who is admitted with severe asthma. Which task delegated by the nurse is most suitable to be performed by the client attendant? 1 Assessing the vital signs 2 Monitoring respiratory rate 3 Administering inhalational medications 4 Assisting the client during nebulization

Assisting the client during nebulization -The client attendant is the unlicensed assistive personnel whose scope of practice is limited to providing basic care and comfort to the client. Assisting the client during nebulization is considered basic care and comfort and can be safely carried out by the client attendant.

A goal in the plan of care of a patient with COPD includes prevention of pulmonary hypertension. The nurse knows that which of the following is a common manifestation of pulmonary hypertension? A) Left-sided heart failure B) Right-sided heart failure C) Clubbing of extremities D) Increased A-P diameter

B) Right-sided heart failure

The nurse is planning to assist a patient who has COPD and limited energy with ADLs. When is the best time for the nurse to schedule the patient's activities? A) 1 hour before bed B) First thing in the morning C) 1 hour after the patient has been awake D) Late afternoon following visiting hours

C) 1 hour after the patient has been awake

The nurse is planning to assess the effectiveness of a patient's coughing and deep breathing exercises. What assessment will provide the nurse with information on the effectiveness of the patient's coughing and deep breathing? A) Assessing activity tolerance B) Checking nail bed perfusion C) Auscultating the lungs D) Monitoring pulse

C) Auscultating the lungs

The patient having pulmonary function studies performed has a spirometry test and a FEV1/FVC ratio of 60%. What does this indicate? A) Strong exercise tolerance B) Exhalation volume is normal C) Healthy lung volumes D) Obstructive lung disease

D) Obstructive lung disease -Obstructive lung disease is characterized by a FEV1/FVC ratio less than 70%.

An adolescent has been admitted with symptoms of fatigue, intermittent fever, weight loss, and arthralgia, and the diagnosis is systemic lupus erythematosus. What is the best intervention at this time? 1 Implementation of corticosteroids 2 Education about diet, rest, and exercise 3 Sun avoidance and calcium supplements 4 Avoidance of destructive coping mechanisms

Education about diet, rest, and exercise -Client education about the integrative interventions of diet, rest, and exercise will be of the most help to the adolescent client with newly diagnosed lupus. These are interventions that the client has some control over, and this is important to the adolescent.

Place the pathophysiologic process of tuberculosis infection in its correct order. 1. Necrotic areas calcify or liquefy. 2. Caseation necrosis occurs in the center of the lesion. 3. Areas of caseation undergo resorption, degeneration, and fibrosis. 4. Granulomatous inflammation is created by tuberculosis bacillus in lungs. 5. Granulomatous inflammation becomes surrounded by collagen, fibroblasts, and lymphocytes.

Granulomatous inflammation is created by tuberculosis bacillus in lungs. Granulomatous inflammation becomes surrounded by collagen, fibroblasts, and lymphocytes. Caseation necrosis occurs in the center of the lesion. Areas of caseation undergo resorption, degeneration, and fibrosis. Necrotic areas calcify or liquefy.

A client with asthma is pregnant. Which nursing intervention is advisable to ensure the safe delivery of the baby? 1 Have the client stop taking her medication 2 Advise the client to abort the pregnancy 3 Have the client continue the asthma treatment 4 Have the client reduce the dose of the medication

Have the client continue the asthma treatment

A nurse in the pediatric unit is admitting an 8-year-old child with asthma after an exacerbation at home. The child is short of breath. In what position should the child be placed to facilitate breathing and to promote respiratory drainage? 1 Supine 2 Left lateral 3 High-Fowler 4 Trendelenburg

High-Fowler

A nurse is counseling the family of an infant who is HIV positive. Where is the best place for this infant to receive long-term care? 1 Pediatric unit 2 Critical care unit 3 Home environment 4 Extended-care facility

Home environment

Which type of hypersensitivity reaction is associated with rheumatoid arthritis? 1 Delayed 2 Cytotoxic 3 IgE-mediated 4 Immune-complex

Immune-complex

A client with human immunodeficiency virus (HIV) infection is diagnosed with tuberculosis. Before starting antitubercular pharmacotherapy, what essential test results should the nurse review? 1 Liver function studies 2 Pulmonary function studies 3 Electrocardiogram and echocardiogram 4 White blood cell counts and sedimentation rate

Liver function studies

When assessing the breath sounds of a client with chronic obstructive pulmonary disease (COPD), the nurse hears coarse rhonchi. Which type of lung sounds will the nurse hear? 1 Snorting sounds during the inspiratory phase 2 Moist rumbling sounds that clear after coughing 3 Musical sounds more pronounced during expiration 4 Crackling inspiratory sounds unchanged with coughing

Moist rumbling sounds that clear after coughing

A client is admitted to the hospital with a diagnosis of emphysema. What should the nurse include when teaching the client breathing exercises? 1 Spend more time inhaling than exhaling to blow off carbon dioxide 2 Perform diaphragmatic exercises to improve contraction of the diaphragm 3 Perform sit-ups to strengthen abdominal muscles to improve breathing 4 Use abdominal exercises to limit the use of accessory muscles of respiration

Perform diaphragmatic exercises to improve contraction of the diaphragm

Which parameter should the nurse consider while assessing the psychologic status of a client with acquired immune deficiency syndrome (AIDS)? 1 Sleep pattern 2 Severity of pain 3 Cognitive changes 4 Presence of anxiety

Presence of anxiety

Before discharge, the nurse is planning to teach the client with emphysema pursed-lip breathing. What should the nurse instruct the client about the purpose of pursed-lip breathing? 1 Decreases chest pain 2 Conserves energy 3 Increases oxygen saturation 4 Promotes elimination of CO2

Promotes elimination of CO2

What should be a priority of nursing care for a client with dementia resulting from acquired immune deficiency syndrome (AIDS)? 1 Frequent assessments for pain 2 Planning for remotivational therapy 3 Arranging for long-term custodial care 4 Providing basic intellectual stimulation

Providing basic intellectual stimulation -Providing basic intellectual stimulation maintains, for as long as possible, the client's remaining intellectual functions by providing an opportunity to use them.

While assessing a client with acquired immunodeficiency syndrome (AIDS), the nurse suspects that the client has developed cryptococcosis. Which clinical manifestations support the nurse's suspicion of a cryptococcosis infection? Select all that apply. 1 Seizures 2 Dyspnea 3 Blurred vision 4 Neurologic deficits 5 Enlarged lymph nodes

Seizures blurred vision neurological deficits -also fever

What is the role of shark cartilage in the management of human immunodeficiency (HIV) and acquired immunodeficiency syndrome (AIDS)? 1 Shark cartilage enhances immunity 2 Shark cartilage reduces oral thrush 3 Shark cartilage is a complementary therapy 4 Shark cartilage is a nutritional supplement

Shark cartilage is a complementary therapy

A woman with chronic asthma discontinues her medication during pregnancy. Which condition is likely to occur in the newborn? 1 Stillbirth 2 Down's syndrome 3 Ebstein's anomaly 4 Gray baby syndrome

Stillbirth

A client with an acute emphysemic episode is dyspneic and anxious. To decrease the dyspnea, what is the nurse's first action? 1 Increase the client's oxygen intake. 2 Have the client breathe into a paper bag. 3 Teach the client to do rhythmic breathing. 4 Check the client's vital signs.

Teach the client to do rhythmic breathing.

After assessing a client with rheumatoid arthritis, the nurse suspects Sjögren's syndrome. Which manifestations are consistent with Sjögren's syndrome? Select all that apply. 1 Iritis 2 Scleritis 3 Xerostomia 4 Baker's cyst 5 Keratoconjunctivitis sicca

Xerostomia Keratoconjunctivitis sicca -Sjögren's syndrome, commonly associated with advanced rheumatoid arthritis, includes such symptoms as xerostomia (dry mouth) and keratoconjunctivitis sicca (dry eyes). Iritis and scleritis are eye complications and do not indicate Sjögren's syndrome. A Baker's cyst is an enlargement of a popliteal bursa (behind the knee); it is commonly found in people with rheumatoid arthritis but does not indicate Sjögren's syndrome

A nurse caring for a 68-year-old patient diagnosed with mycoplasmal pneumonia observes that the patient has difficulty breathing due to copious tracheobronchial secretions. The patient should be encouraged to do which of the following? A) Increase oral fluids unless contraindicated. B) Call the nurse for deep suctioning. C) Lie in a low-Fowler's position. D) Increase activity.

A) Increase oral fluids unless contraindicated.

What is the best position for the patient experiencing orthopnea for relief of symptoms? A) Sitting upright leaning forward slightly B) Low-Fowler's C) Prone D) Trendelenburg

A) Sitting upright leaning forward slightly

A client admitted to the hospital with an acute episode of rheumatoid arthritis (RA) asks why physical therapy has not been prescribed. What is the most appropriate nursing response? 1 "Your primary healthcare provider must have forgotten to prescribe it." 2 "Your condition is not severe enough to have physical therapy approved." 3 "Your joints are still inflamed, and physical therapy can be harmful." 4 "Physical therapy is not helpful for persons who suffer from RA."

"Your joints are still inflamed, and physical therapy can be harmful."

Why would a client with acquired immunodeficiency syndrome (AIDS) be prescribed diphenoxylate hydrochloride? 1 To manage pain 2 To manage diarrhea 3 To manage candidal esophagitis 4 To manage behavioral problems

to manage diarrhea

A healthcare provider prescribes a medication to be administered via a metered-dose inhaler (MDI) for a young adult with asthma. List in order the steps the nurse teaches the client to follow when using the inhaler. 1. Shake the inhaler for 30 seconds. 2. Exhale slowly and deeply to empty the air from the lungs. 3. Hold the inhaler upright in the mouth. 4. Start breathing in and press down on the inhaler once

1. Shake the inhaler for 30 seconds. 2. Exhale slowly and deeply to empty the air from the lungs. 3. Hold the inhaler upright in the mouth. 4. Start breathing in and press down on the inhaler once

On reviewing the x-ray report of a client with rheumatoid arthritis, the nurse learns that three small joints are involved. According to the diagnostic criteria for rheumatoid arthritis, which score will the nurse assign the client for joint involvement? 1 1 2 2 3 3 4 5

2 -According to the diagnostic criteria for rheumatoid arthritis, involvement of one to three small joints (with or without large-joint involvement) is given a score of 2. Involvement of two to ten large joints is given a score of 1. Involvement of four to ten small joints (with or without large-joint involvement) is given a score of 3. Involvement of more than ten joints (and at least one small joint) is given a score of 5

What determines if a client will develop AIDS from an HIV infection? 1 Level of IgM in the blood 2 The number of CD4+ T-cells available 3 Presence of antigen-antibody complexes 4 Speed with which the virus invades the RNA

The number of CD4+ T-cells available

An HIV-infected pregnant adolescent does not want a cesarean birth. Which finding would indicate the increased risk of perinatal transmission via vaginal birth? 1 A viral load of 800 copies/mL 2 A viral load of 1,200 copies/mL 3 Ruptured membranes and rapidly progressing labor 4 History of receiving combination antiretroviral therapy and having a viral load less than 400 copies/m

A viral load of 1,200 copies/mL

Which nursing action takes priority when admitting a patient with right lower lobe pneumonia? A) Elevating the head of the bed 45 to 90 degrees B) Auscultating the chest for adventitious sounds C) Obtaining a sputum specimen for culture D) Notifying the physician of the patient's admission

A) Elevating the head of the bed 45 to 90 degrees

A client has chronic obstructive pulmonary disease (COPD). To decrease the risk of CO2 intoxication (CO2 narcosis), what should the nurse do? 1 Initiate pulmonary hygiene to clear air passages of trapped mucus 2 Instruct to deep breathe slowly with inhalation longer than exhalation 3 Encourage continuous rapid panting to promote respiratory exchange 4 Administer oxygen at a low concentration to maintain respiratory drive

Administer oxygen at a low concentration to maintain respiratory drive

A client diagnosed with asthma has received a prescription for an inhaler. The nurse teaches the client how to determine when the inhaler is empty, instructing the client to do what? 1 Count the number of doses taken. 2 Taste the medication when sprayed into the air. 3 Shake the canister. 4 Place the canister in water to see if it floats

Count the number of doses taken. -The only way to determine if the canister is empty is to count the number of doses taken. The client is tracking the number of daily doses.

A client is admitted to the hospital for medical treatment of bronchopneumonia. Which test result should the nurse examine to help determine the effectiveness of the client's therapy? Bronchoscopy Pulse oximetry Pulmonary function studies Culture and sensitivity tests of sputum

Culture and sensitivity tests of sputum

When preparing a child with asthma for discharge, what instructions must the nurse emphasize to the family? Select all that apply. 1 Eliminate allergens in the home. 2 Maintain a dry home environment. 3 Avoid placing limits on the child's behavior. 4 Continue the medications even if the child is asymptomatic. 5 Prevent exposure to infection by having the child tutored at home

Eliminate allergens in the home. Continue the medications even if the child is asymptomatic.

A client with asthma is being taught how to use a peak flow meter to monitor how well the asthma is being controlled. What should the nurse instruct the client to do? 1 Perform the procedure once in the morning and once at night. 2 Move the trunk to an upright position and then exhale while bending over. 3 Inhale completely and then blow out as hard and as fast as possible through the mouthpiece. 4 Place the mouthpiece between the lips and in front of the teeth before starting the procedure

Inhale completely and then blow out as hard and as fast as possible through the mouthpiece.

A client at term is admitted in active labor. She has tested positive for human immunodeficiency virus (HIV). Which intervention in the standard prescriptions should the nurse question? 1 Sonogram 2 Nonstress test 3 Sterile vaginal examination 4 Internal fetal scalp electrode

Internal fetal scalp electrode

A 6-year-old child with status asthmaticus is admitted to the pediatric intensive care unit. What should the nurse include in the plan of care as the child starts to recover from the episode? 1 Maintain the high-Fowler position. 2 Restrict fluids to two-thirds of the usual intake. 3 Keep droplet precautions in place for 24 hours. 4 Administer the prescribed prophylactic antibiotic.

Maintain the high-Fowler position.

A client comes to the emergency department reporting symptoms of the flu. When the health history reveals intravenous drug use and multiple sexual partners, acute retroviral syndrome is suspected, and a test for the human immunodeficiency virus (HIV) is performed. Which clinical responses are associated most commonly with this syndrome? Select all that apply. 1 Malaise 2 Confusion 3 Constipation 4 Swollen lymph glands 5 Oropharyngeal candidiasis

Malaise confusion

Which medications will prevent the binding of human immunodeficiency virus (HIV) to a client's cells? Select all that apply. 1 Rilpivirine 2 Maraviroc 3 Saquinavir 4 Raltegravir 5 Enfuvirtide

Maraviroc Enfuvirtide

A client with pneumonia now requires use of a nonrebreathing mask to maintain adequate oxygen saturation levels. How does the nurse interpret this information?

Mechanical ventilator may be required next

The arterial blood gases of a client with chronic obstructive pulmonary disease (COPD) deteriorate, and respiratory failure is impending. Which clinical indicator should the nurse assess first? 1 Cyanosis 2 Bradycardia 3 Mental confusion 4 Distended neck veins

Mental confusion

A nurse is caring for a client experiencing an acute episode of bronchial asthma. What should nursing interventions achieve? 1 Curing the condition permanently 2 Raising mucous secretions from the chest 3 Limiting pulmonary secretions by decreasing fluid intake 4 Convincing the client that the condition is emotionally based

Raising mucous secretions from the chest

A nurse is caring for a client with a history of chronic obstructive pulmonary disease (COPD) who develops a pneumothorax and has a chest tube inserted. Which primary purpose of the chest tube will the nurse consider when planning care? 1 Lessens the client's chest discomfort 2 Restores negative pressure in the pleural space t3 Drains accumulated fluid from the pleural cavity 4 Prevents subcutaneous emphysema in the chest wal

Restores negative pressure in the pleural space

What observation caused the nurse to provide additional teaching to a client with AIDS during a home visit? Select all that apply. 1 Snacked on apple slices 2 Soaked toothbrush in laundry bleach 3 Picked up a sandwich after petting the cat 4 Rinsed dishes with cold water before using 5 Applied gloves before weeding a house plant

Snacked on apple slices Picked up a sandwich after petting the cat Rinsed dishes with cold water before using

A nurse is interviewing a client who was diagnosed with systemic lupus erythematosus (SLE). Which common responses to this disease can the nurse expect the client to exhibit? Select all that apply. 1 Butterfly facial rash 2 Firm skin fixed to tissue 3 Inflammation of the joints 4 Muscle mass degeneration 5 Inflammation of small arteries

butterfly facial rash inflammation of joints

The nurse is providing discharge teaching to a 30-year-old client who was hospitalized for exacerbation of rheumatoid arthritis. Which statement by the client indicates correct understanding of the treatment plan? 1 "I will plan to rest in bed for the next 2 weeks." 2 "I will only take my medications when I am having joint pain." 3 "When I exercise, I will reduce the number of repetitions when I have pain." 4 "When I get out of bed, I will push off with my fingers rather than the palms of my hands."

"When I exercise, I will reduce the number of repetitions when I have pain."

The nurse is providing education to a client with systemic lupus erythematosus. Which education will the nurse consider as high priority? 1 Instructing about ways to protect the skin 2 Helping the client to identify coping strategies 3 Teaching methods to monitor body temperature 4 Teaching about the effects of the disease on lifestyle

Instructing about ways to protect the skin -A client with systemic lupus erythematosus is first taught to protect the skin to prevent infections. Helping the client with identifying coping strategies is given low priority. Different methods are taught to monitor body temperature because fever is a major sign of exacerbation. Teaching about the effects of the disease on lifestyle occurs after teaching ways to protect the skin

A client with acquired immunodeficiency syndrome (AIDS) reports painless, white, raised lesions on the lateral aspect of the tongue. Which disease does the nurse suspect? 1 Oral thrush 2 Genital herpes 3 Kaposi sarcoma 4 Oral hairy leukoplakia

Oral hairy leukoplakia` -Oral hairy leukoplakia is found in a client with AIDS. The symptoms of oral hairy leukoplakia are painless, white, raised lesions on the lateral aspect of the tongue. The symptoms of oral thrush are white lesions in the mouth

Indicate the first step involved in the disposal of sharp wastes of a client with acquired immunodeficiency syndrome (AIDS). 1 Place tape over the container 2 Place the container in a paper bag 3 Place the waste in a puncture-resistant container Incorrect4 Pour a 1:10 bleach solution in the container

Place the waste in a puncture-resistant container -The sharp wastes of a client with AIDS should first be placed in a puncture-resistant container and labelled. Then a 1:10 bleach solution should be poured into the container for disinfection. Next the container should be taped to prevent leakage. The container should be then placed into a paper bag and subsequently disposed of in the regular trash.

What does the nurse explain to a client that a positive diagnosis for human immunodeficiency virus (HIV) infection is based on? 1 Performance of high-risk sexual behaviors 2 Evidence of extreme weight loss and high fever 3 Identification of an associated opportunistic infection 4 Positive enzyme-linked immunosorbent assay (ELISA) and Western blot tests

Positive enzyme-linked immunosorbent assay (ELISA) and Western blot tests

A client with a human immunodeficiency virus (HIV) infection reports genital discharge associated with irritation, pain, and itching. Which actions of the client might have lead to this condition? Select all that apply. 1 Taking diethylstilbestrol 2 Taking iron supplements 3 Wearing tight jean pants 4 Performing Kegel exercises 5 Using antibiotic medications

Wearing tight jean pants Using antibiotic medications

The nurse is taking care of four clients with human immunodeficiency virus (HIV) infections. Which client's condition should the nurse report to the primary healthcare provider within 24 hours after observation? 1 Client A * burning itching discharge from eye* 2 Client B *blood in urine* 3 Client C *yellow skin discoloration* 4 Client D *nausea, vomit, abdominal pain*

client A (with burning itching discharge from eye) blood in urine, yellow skin discoloration, and nausea vomittus and abdominal pain are to be reported immediately

The nurse is caring for a client with tuberculosis. Which suggestions from the nurse will be beneficial for the client? Select all that apply. 1 "Take the daily dose during daytime." 2 "Avoid exposure to any inhalation irritants." 3 "Eat foods that are rich in protein, vitamins C and B." 4 "Cover the mouth and nose with a tissue when coughing or sneezing." 5 "Avoid sputum specimens for 2 to 4 weeks once drug therapy is initiated."

"Avoid exposure to any inhalation irritants." "Eat foods that are rich in protein, vitamins C and B." "Cover the mouth and nose with a tissue when coughing or sneezing."

A 10-year-old child with recently diagnosed asthma is receiving information about the use of a peak expiratory flow meter (PEFM). The nurse knows that the child understands how to use the PEFM when she makes which statement? 1 "I have to blow out as fast and hard into the machine as I can." 2 "I can stand or sit to use the flow meter. I just can't lie down." 3 "I have to take three readings and record the average on the flow sheet." 4 "I'll use the meter whenever I can throughout the day—it doesn't really matter when."

"I have to blow out as fast and hard into the machine as I can." -A PEFM is used to measure the amount of air being exhaled. To adequately measure this, the client must blow out fast and hard. The client should use the PEFM while in a standing position to permit better expansion of the lungs. The highest of three readings, not the average, is recorded. The readings should be obtained close to the same time each day to ensure consistency.

The nurse is teaching a client who has asthma about using a peak flow meter. Which statement by the client reflects a correct understanding of the use of a peak flow meter? Select all that apply. 1 "Readings in the green zone mean that my asthma is under control." 2 "If I get a reading in the yellow zone, I need to stop what I'm doing and rest, then recheck in an hour." 3 "If I get a reading in the red zone, then I need to take my reliever drug and have my wife take me to the hospital." 4 "I should check the peak flow readings at least twice a day." 5 "I don't need to check my peak flow readings if I take a reliever drug.

"Readings in the green zone mean that my asthma is under control." "If I get a reading in the red zone, then I need to take my reliever drug and have my wife take me to the hospital." "I should check the peak flow readings at least twice a day." -Peak flow meters are used to measure how well the client's asthma is controlled. Readings in the green zone mean the asthma is under control; however, readings in the red zone indicate a serious respiratory problem that needs to be addressed immediately. The client will need to take a reliever drug and seek emergency help immediately. Peak flow readings need to be measured twice a day. If a reading in the yellow zone occurs, the client should use the reliever drug and then measure the peak expiratory flow (PEF) again in a few minutes to determine whether the drug is working. Improvement in PEF should be seen. Clients need to check the PEF any time a reliever drug is used to determine the drug's effectiveness.

A client with tuberculosis asks the nurse about the communicability of the disease. Which is the best response by the nurse? 1 "Tuberculosis is not communicable at this time." 2 "Untreated active tuberculosis is communicable." 3 "Tuberculosis is communicable during the primary stage." 4 "With the newer long-term therapies, tuberculosis is not communicable."

"Untreated active tuberculosis is communicable."

A nurse is providing counseling to a client with the diagnosis of systemic lupus erythematosus (SLE). Which recommendations are essential for the nurse to include? Select all that apply. 1 "Wear a large-brimmed hat." 2 "Take your temperature daily." 3 "Balance periods of rest and activity." 4 "Use a strong soap when washing the skin." 5 "Expose the skin to the sun as often as possible.

"Wear a large-brimmed hat." "Take your temperature daily." "Balance periods of rest and activity."

A client is diagnosed with acquired immunodeficiency syndrome (AIDS). When examining the client's oral cavity, the nurse assesses white patchy plaques on the mucosa. The nurse recognizes that this finding most likely represents what opportunistic infection? 1 Cytomegalovirus 2 Histoplasmosis 3 Candida albicans 4 Human papillomavirus

Candida albicans -White patchy plaques on the oral mucosa would most likely be a result of C. albicans, a yeastlike fungal infection. This condition is also known as "thrush."

Place the steps in the process of arthrocentesis in the correct sequence, as performed in a client with rheumatoid arthritis. 1. Apply local anesthesia 2. Cleanse the client's skin 3. Withdraw fluid from the joint 4. Insert an 18-gauge or larger needle into the joint 5. Inject corticosteroids by way of the intraarticular route

Cleanse the client's skin Apply local anesthesia Insert an 18-gauge or larger needle into the joint Withdraw fluid from the joint Inject corticosteroids by way of the intraarticular route

Which test would the client undergo to receive a diagnosis of systemic lupus erythematosus? 1 Patch test 2 Photo patch test 3 Direct immunofluorescence test 4 Indirect immunofluorescence test

Direct immunofluorescence test -A direct immunofluorescence test is used in the diagnosis of systemic lupus erythematosus. The patch test and photo patch test are used to evaluate allergic dermatitis and photo allergic reactions. An indirect immunofluorescence test is performed on a blood sample.

A school-aged child admitted to the hospital with a diagnosis of status asthmaticus appears to be improving. What is the most objective way for the nurse to evaluate the child's response to therapy? 1 Auscultating breath sounds 2 Monitoring the respiratory pattern 3 Assessing the lips for decreased cyanosis 4 Evaluating the child's peak expiratory flow rate

Evaluating the child's peak expiratory flow rate -A peak expiratory flow meter (PEFM) is used to obtain the peak expiratory flow rate (PEFR). The PEFM provides an objective measure of the maximal flow of air that can be forcefully exhaled in 1 second. The PEFM individualizes data for the child because after a personal best value is established, this baseline can be compared with current values to determine progress or lack of progress regarding the child's respiratory status.

A nurse in the health clinic is counseling a college student who recently was diagnosed with asthma. On what aspect of care should the nurse focus? 1 Teaching how to make a room allergy-free 2 Referring to a support group for individuals with asthma 3 Arranging with the college to ensure a speedy return to classes 4 Evaluating whether the necessary lifestyle changes are understood

Evaluating whether the necessary lifestyle changes are understood

A 5-year-old child is admitted to the pediatric intensive care unit with a diagnosis of acute asthma. A blood sample is obtained to measure the child's arterial blood gases. What finding does the nurse expect? 1 High oxygen level 2 Increased alkalinity 3 Decreased bicarbonate 4 Increased carbon dioxide level

Increased carbon dioxide level -Gas exchange is limited because of narrowing and swelling of the bronchi; the carbon dioxide level increases. The oxygen level will be decreased, not increased. The pH will decrease; the child is in respiratory acidosis, not alkalosis. The bicarbonate level will be increased to compensate for acidosis

What causes medications used to treat AIDS to become ineffective? 1 Taking the medications 90% of the time 2 `3 Taking medications from different classifications 4 Developing immune reconstitution inflammatory syndrome (IRIS)

Missing doses of the prescribed medications -The most important reason for the development of drug resistance in the treatment of AIDS is missing doses of drugs. When doses are missed, the blood drug concentrations become lower than what is needed to inhibit viral replication. The virus replicates and produces new particles that are resistant to the drugs.

An 8-year-old boy with asthma is being taught breathing exercises. The nurse uses several techniques in a play situation, and the child performs a repeat demonstration for the nurse. Which technique indicates that the child needs further teaching? 1 Moving a cotton ball when inhaling 2 Singing songs containing long phrases 3 Puffing through a straw to move small items 4 Blowing through a plastic pipe to make soap bubbles

Moving a cotton ball when inhaling -The goal for teaching a child with asthma breathing exercises is to lengthen expiratory time and expiratory pressure. This activity focuses on inhalation, not exhalation. Singing songs with long phrases forces the child to exhale until each phrase is completed. Activities such as puffing through a straw or blowing through a pipe encourage exhalation.

What should be included when planning care to address the nutritional status of a client with AIDS? Select all that apply. 1 Offer ice chips throughout the day 2 Instruct on the use of oral antifungal medication 3 Collaborate with the dietitian for small frequent meals 4 Emphasize an eating plan incorporating high-fat food items 5 Schedule routine mouth care, avoiding alcohol-based mouthwashes

Offer ice chips throughout the day Instruct on the use of oral antifungal medication Collaborate with the dietitian for small frequent meals Schedule routine mouth care, avoiding alcohol-based mouthwashes

A client with rheumatoid arthritis is in the convalescent stage of an exacerbation. The client states, "The only time I am without pain is when I lie perfectly still." Considering the client's statement, what should the nurse encourage the client to do? 1 Participate in active joint flexion and extension exercises. 2 Perform flexion exercises three times a day. 3 Do range-of-motion (ROM) exercises once a day. 4 Refrain from exercising until remission occurs.

Participate in active joint flexion and extension exercises.

Which dietary modifications can help improve the nutritional status of a client with acquired immunodeficiency syndrome (AIDS)? 1 Refraining from consuming fatty foods 2 Refraining from consuming frequent meals 3 Refraining from consuming high-calorie foods 4 Refraining from consuming high-protein foods

Refraining from consuming fatty foods -Many clients with AIDS become intolerant to fat due to the disease and the antiretroviral medications. Therefore the client should be instructed to refrain from consuming fatty foods. The client should be encouraged to eat small and frequent meals to improve nutritional status. High-calorie and high-protein foods are beneficial to clients with AIDS because they provide energy and build immunity.

A child has been admitted to the pediatric unit with a severe asthma attack. What type of acid-base imbalance should the nurse expect the child to develop? 1 Metabolic alkalosis caused by excessive production of acid metabolites 2 Respiratory alkalosis caused by accelerated respirations and loss of carbon dioxide 3 Respiratory acidosis caused by impaired respirations and increased formation of carbonic acid 4 Metabolic acidosis caused by the kidneys' inability to compensate for increased carbonic acid formation

Respiratory acidosis caused by impaired respirations and increased formation of carbonic acid -The restricted ventilation accompanying an asthma attack limits the body's ability to blow off carbon dioxide. As carbon dioxide accumulates in the body fluids, it reacts with water to produce carbonic acid; the result is respiratory acidosis.

Why would a primary healthcare provider recommend that a client with acquired immunodeficiency syndrome (AIDS) and Kaposi's sarcoma (KS) wear hats and long sleeves? 1 To maintain a normal appearance 2 To reduce pain 3 To promote healing 4 To prevent infection

To maintain a normal appearance -Clients with KS lesions may be advised to wear hats, makeup, or long sleeves to maintain a normal appearance. Pain associated with KS lesions is treated with analgesics and comfort measures. Modified burrow's solution soaks may promote healing in some clients with KS. The cleaning and dressing of KS lesions will prevent infections.

Why would a client with acquired immunodeficiency syndrome (AIDS) be administered pregabalin? 1 To reduce neuropathic pain 2 To reduce cognitive difficulty 3 To reduce swallowing difficulty 4 To reduce muscle and joint pain

To reduce neuropathic pain

A client is admitted to the emergency department with allergic rhinitis and asthma. The laboratory report shows histamines and prostaglandins. Which type of hypersensitivity reaction may have occurred? 1 Type I 2 Type II 3 Type III 4 Type IV

Type I -Type I hypersensitivity reactions (immediate hypersensitivity reactions) involve the immunoglobulin E (IgE)-mediated release of histamines and other mediators from mast cells and basophils. Allergic rhinitis and asthma may occur when mediators such as histamine and prostaglandins are involved as mediators of injury. Type II hypersensitivity reaction is cytotoxic mediated; it occurs in transfusion reactions. Type III reactions are immune complex-mediated hypersensitivity reactions such as rheumatoid arthritis. Type IV hypersensitivity reactions are delayed hypersensitivity reactions; an example is contact dermatitis.

A client is admitted with systemic lupus erythematosus (SLE). The laboratory report shows the presence of neutrophils and monocytes as mediators of injury. Which type of hypersensitivity reaction most likely occurred in the client? 1 Type I 2 Type II 3 Type III 4 Type IV

Type III -Systemic lupus erythematosus is an example of an immune complex-mediated, or type III, hypersensitive reaction.

The nurse instructed a client with asthma about the use of a peak flow meter at home. The client assesses the peak expiratory flow by using the peak flow meter. Which action performed by the client would be appropriate when the reading is in the yellow zone? 1 Perform the peak expiratory flow again immediately 2 Increase the prescribed drug therapy 3 Use a prescribed reliever drug therapy 4 Reassess the asthma plan and change the controller medication

Use a prescribed reliever drug therapy -Yellow is a range between 50% and 80% of personal best. When the reading is in this range, the client is recommended to use the prescribed reliever drug. After a few minutes of the intake of a prescribed reliever drug, the peak expiratory flow should be determined again to know the effect of the reliever medication. Prescribed drug therapy should not be increased without consulting the primary healthcare advisor. Reassessing the asthma plan and changing the controller medication would be required when there are frequents reading in the yellow zone.

An 11-year-old child with juvenile idiopathic arthritis will be receiving continued nonsteroidal antiinflammatory drug (NSAID) therapy at home. Which important toxic effect of NSAIDs must be included in the nurse's discharge instructions to the child and family? 1 Diarrhea 2 Hypothermia 3 Blood in the urine 4 Increased irritability

blood in urine

A 3-year-old child is admitted to the pediatric unit with a diagnosis of acute asthma. The child is short of breath, the respiratory rate is 56 breaths/min, the pulse is 102 beats/min, and there is a nonproductive cough. What does the nurse expect regarding the child's blood gas values? 1 pH of 7.32 2 Po2 of 95 mm Hg 3 Pco2 of 40 mm Hg 4 HCO3- of 26 mEq/L (26 mmol/L)

pH of 7.32

Which manifestations may indicate a client has systemic lupus erythematosus (SLE)? Select all that apply. 1 Pericarditis 2 Esophagitis 3 Fibrotic skin 4 Discoid lesions 5 Pleural effusions

pericarditis discoid lesions pleural effusions *key indicators of SLE*

Which stage of HIV would a client with a CD4+ T-cell count of 325 cells/mm3 be classified? 1 Stage 1 2 Stage 2 3 Stage 3 4 Stage 4

stage 2

A pregnant adolescent already diagnosed as HIV-positive with a viral load of more than 1,000 copies/mL is currently in her 38th week of gestation. Which is the best method of delivery in this situation? 1 Cesarean section 2 Vaginal delivery with forceps extraction 3 Vaginal delivery with vacuum extraction 4 Fetal scalp electrode

Cesarean section

When teaching a patient with asthma how to use a metered dose inhaler (MDI) correctly, it is important to emphasize which of the following? A) Rapid breathing during treatment to facilitate more medication in lungs B) Allow 5 minutes between each puff C) Hold breath as medication is released D) Position inhaler approximately 1 to 2 inches from the open mouth

D) Position inhaler approximately 1 to 2 inches from the open mouth -When using an MDI, the patient should position the inhaler approximately 1 to 2 inches from the open mouth, or use a spacer/holding chamber. Repeat puffs are given as directed, allowing 1-2 minutes between puffs. The patient should continue breathing in as medication is released (by pressing cartridge down). Then breathe in slowly and deeply for 3 to 5 seconds. After this has occurred, the patient should hold his breath for 8 to 10 seconds to allow the medication to reach down into the airways.

A client with emphysema experiences shortness of breath and uses pursed-lip breathing and accessory muscles of respiration. The nurse determines that the cause of the dyspnea is for which reason? 1 Spasm of the bronchi that traps the air 2 Increase in the vital capacity of the lungs 3 Too rapid expulsion of air from the bronchioles 4 Difficulty in expelling the air trapped in the alveoli

Difficulty in expelling the air trapped in the alveoli

While assessing a client with acquired immunodeficiency syndrome (AIDS), the nurse suspects the client has developed histoplasmosis. Which symptoms in the client support the nurse's suspicion? Select all that apply. 1 Cough 2 Seizures 3 Confusion 4 Difficulty with speech 5 Enlarged lymph nodes

cough enlarged lymph nodes -Histoplasmosis is a respiratory infection caused by Histoplasma capsulatum, which progresses to widespread infection in a client with AIDS. The symptoms of histoplasmosis are a cough and enlarged lymph nodes.

Which joint surgery is used as a prophylactic measure and as a palliative treatment for clients with rheumatoid arthritis (RA)? 1 Osteotomy 2 Arthrodesis 3 Synovectomy 4 Debridement

Arthrodesis -Synovectomy is a type of joint surgery that involves the removal of thickened synovial membrane. It is used as a prophylactic measure and as a palliative treatment for rheumatoid arthritis (RA) because it prevents the serious destruction of joint surfaces.

Which healthy snacks should the nurse teach the parents to give their 2-year-old child who has a diagnosis of acute asthma? Select all that apply. 1 Grapes 2 Ice cream 3 Apple slices 4 Oatmeal cookies 5 Sliced vegetables 6 Cold glass of milk

apple slices sliced vegetables

A nurse is teaching a health class about human immunodeficiency virus (HIV). Which basic methods are used to reduce the incidence of HIV transmission? Select all that apply. 1 Using condoms 2 Using separate toilets 3 Practicing sexual abstinence 4 Preventing direct casual contacts 5 Sterilizing the household utensil

using condoms practicing sexual abstinence

The nurse instructs a human immunodeficiency (HIV)-positive client about ways to prevent infections. During a follow-up visit, which statement made by the client indicates a need for more education? 1 "I reuse cups after washing them." 2 "I wash my hands with tap water after gardening." 3 "I rinse my toothbrush in liquid laundry bleach every week." 4 "I wash my armpits, groin, and genitals with antimicrobial soap twice a day."

"I wash my hands with tap water after gardening."

The client with emphysema complains of increased shortness of breath and becomes anxious. The healthcare provider prescribes oxygen at 1 L/min via nasal cannula. The nurse understands that this prescription is appropriate for what reason? 1 High concentrations of oxygen cause alveoli to rupture. 2 High concentrations of oxygen eliminate the respiratory drive. 3 The client does not need any more than 1 L/min. 4 The oxygen at 1 L/min should be enough to diminish the anxiety

High concentrations of oxygen eliminate the respiratory drive.

The nurse is caring for a client admitted with chronic obstructive pulmonary disease (COPD). The nurse should monitor the results of which laboratory test to evaluate the client for hypoxia? 1 Red blood cell count 2 Sputum culture 3 Arterial blood gas 4 Total hemoglobin

Arterial blood gas

The nurse is assessing a patient admitted with pulmonary tuberculosis (TB). What clinical manifestations are consistent with this diagnosis? A) High fever, fatigue, muscle aches, and cough B) Low-grade fever, night sweats, fatigue, and weight loss C) Cough, night sweats, weight gain, and fatigue D) Muscle aches, night sweats, cough, and fatigue

B) Low-grade fever, night sweats, fatigue, and weight loss

A client who has acquired human immunodeficiency syndrome (HIV) develops bacterial pneumonia. On admission to the emergency department, the client's PaO2 is 80 mm Hg. When the arterial blood gases are drawn again, the level is determined to be 65 mm Hg. What should the nurse do first? 1 Prepare to intubate the client. 2 Increase the oxygen flow rate per facility protocol. 3 Decrease the tension of oxygen in the plasma. 4 Have the arterial blood gases redone to verify accuracy.

Increase the oxygen flow rate per facility protocol. -This decrease in PaO2 indicates respiratory failure; it warrants immediate medical evaluation. Most facilities have a protocol to increase the oxygen flow rate to keep oxygen saturation greater than 92%.

A client with acquired immunodeficiency syndrome (AIDS) reports speech, gait, and vision difficulty. The nurse observes the client is confused and lethargic. Which microorganism is most likely responsible for this condition? 1 Candida albicans 2 Toxoplasma gondii 3 Pneumocystis jiroveci 4 Mycobacterium tuberculosis

Toxoplasma gondii -also confusion and lethary

A nurse is caring for a client with a history of chronic obstructive pulmonary disease (COPD). What complications are associated most commonly with COPD? 1 Cardiac problems 2 Joint inflammation 3 Kidney dysfunction 4 Peripheral neuropathy

Cardiac problems

The nurse assesses a client with emphysema. The nurse expects to find which sign of chronic obstructive pulmonary disease (COPD)? 1 Increased breath sounds 2 Atrophic accessory muscles 3 Shortened expiratory phase of the respiratory cycle 4 Chest with an increased anteroposterior (AP) diameter

Chest with an increased anteroposterior (AP) diameter

A client with emphysema is admitted to the hospital with pneumonia. On the third hospital day, the client complains of a sharp pain on the right side of the chest. The nurse suspects a pneumothorax. What breath sound is most likely to be present when the nurse assesses the client's right side? Crackling Wheezing Decreased sounds Adventitious sounds

Decreased sounds -affected lung will not expand, incomplete aeration

A circulating nurse in the operating room learns of being HIV positive. What should this nurse do regarding participation in exposure-prone procedures? 1 Adhere to standard precautions at all times 2 Avoid handling equipment used in direct client care 3 Disinfect all equipment used for non-invasive procedures 4 Discuss procedures that can be performed with a review panel

Discuss procedures that can be performed with a review panel

A 5-year-old child who is HIV positive is taken to the health department for immunizations before the start of school. The CD4 count shows severe immunosuppression. What immunizations can the child be given safely at this time? Select all that apply. 1 Varicella 2 Hepatitis A 3 Polio vaccine (IPV) 4 Measles, mumps, rubella (MMR) 5 Diphtheria, tetanus, pertussis (DTaP)

Hepatitis A Polio vaccine (IPV) Diphtheria, tetanus, pertussis (DTaP)

A client comes to the clinic for a physical and asks to be tested for acquired immune deficiency syndrome (AIDS). Which test should the nurse explain will be used for the initial screening for human immunodeficiency virus (HIV)? 1 CD4 T cell count 2 Western blot test 3 Polymerase chain reaction test 4 Enzyme-linked immunosorbent assay (ELISA)

Enzyme-linked immunosorbent assay (ELISA) -The ELISA is the first screening test done to detect serum antibodies that bind to HIV antigens on test plates. The CD4 T cell count is not a screening test; it is done to monitor the progression of HIV infection and response to treatment. The Western blot test is not done first; the Western blot is done to validate repeatedly reactive ELISA results. The polymerase chain reaction test is not an initial screening test; it is done when there are consistently inconclusive test results with previous screening tests

A client is admitted with a tentative diagnosis of pneumonia. On admission the client is not in respiratory distress, but later develops chest pain and a fever of 103° F (39.4° C). A productive cough produces rust-colored sputum. How should the nurse interpret these findings? 1 Onset of pulmonary edema 2 Expected course of pneumonia 3 Presence of a pulmonary embolus 4 Insidious onset of tuberculosis (TB)

Expected course of pneumonia

Which organism would the nurse explain is consistent with a protozoal infection in clients with acquired immunodeficiency syndrome (AIDS)? 1 Candidiasis 2 Tuberculosis 3 Cryptococcosis 4 Toxoplasmosis

Toxoplasmosis -Toxoplasmosis is a protozoal infection in the AIDS client and an AIDS-defining condition in adults. Candidiasis is an indication of fungal infection. Tuberculosis is a bacterial infection. Cryptococcosis is a fungal infection

A client with human immunodeficiency virus (HIV) infection is diagnosed with tuberculosis. Before starting antitubercular pharmacotherapy, what essential test results should the nurse review? 1 Liver function studies 2 Pulmonary function studies 3 Electrocardiogram and echocardiogram Incorrect4 White blood cell counts and sedimentation rate

Liver function studies

What is the underlying rationale for why a nurse assesses a client with emphysema for clinical indicators of hypoxia? 1 Pleural effusion 2 Infectious obstructions 3 Loss of aerating surface 4 Respiratory muscle paralysis

Loss of aerating surface

The nurse is advising a client with acquired immunodeficiency syndrome (AIDS) to avoid the consumption of undercooked meat. Which infection can be prevented in the client by following this measure? 1 Tuberculosis 2 Cryptococcosis 3 Cryptosporidiosis 4 Toxoplasmosis encephalitis

Toxoplasmosis encephalitis -Toxoplasmosis encephalitis is caused by Toxoplasma gondii, which may occur due to the ingestion of infected undercooked meat or by contact with contaminated cat feces.

The nurse is teaching the client with chronic obstructive pulmonary disease (COPD) to use pursed-lip breathing (PLB). What is the rationale for the nurse's teaching? 1 Prolonged exhalation to decrease air trapping 2 Shortened inhalation to reduce bronchial swelling 3 Increased respiratory rate to improve arterial oxygenation 4 Decreased use of diaphragm to increase amount of inspired air

Prolonged exhalation to decrease air trapping

A nurse is providing morning hygiene to a bedridden client who was admitted for exacerbation of chronic obstructive pulmonary disease (COPD). What is the priority nursing intervention when the client becomes short of breath during the care? 1 Obtain a pulse oximeter to determine the client's oxygen saturation level. 2 Put the client in a high Fowler position. 3 Darken the lights and provide a rest period of at least 15 minutes. 4 Continue the hygiene activities while reassuring the client.

Put the client in a high Fowler position.

The nurse observes a client with chronic obstructive pulmonary disease (COPD) breathing rapidly and using accessory muscles of respiration. The nurse auscultates the lungs and hears crackles and wheezes. What action should the nurse take? 1 Encourage the client to take slow, deep breaths and administer 5 L/min oxygen per nasal cannula. 2 Place the client in a side-lying position and perform chest physiotherapy using clapping and vibration. 3 Raise the head of the bed to a high-Fowler position and administer 2 L/min oxygen per nasal cannula. 4 Assist the client in assuming a position of comfort and perform postural drainage

Raise the head of the bed to a high-Fowler position and administer 2 L/min oxygen per nasal cannula.

A nurse is caring for a 26-year-old client recently diagnosed with human immunodeficiency virus (HIV) and has a CD4 count of 150. The client needs an update on immunizations and asks which ones are needed. Which vaccines are required to comply with the recommended immunization schedule for a client with HIV? 1 Influenza; measles, mumps, rubella (MMR); varicella; and hepatitis A vaccines 2 Pneumococcal, MMR, influenza, and varicella vaccines 3 Diphtheria, tetanus, hepatitis A, and hepatitis C vaccines 4 Tetanus, hepatitis B, influenza, and pneumococcal vaccines

Tetanus, hepatitis B, influenza, and pneumococcal vaccines -According to recent recommendations, adults with HIV should receive tetanus, influenza, hepatitis B, and pneumococcal vaccines. Live pathogen vaccines (MMR, varicella) are contraindicated for individuals who are immunosuppressed. Currently there is no immunization for hepatitis C, and the diphtheria vaccine is not recommended.

A nurse is caring for a client with the diagnosis of emphysema, a chronic obstructive pulmonary disease (COPD). The client is hypoxemic and also has chronic hypercarbia. Which statement reflects the oxygen needs of this client? 1 The client may need up to 60% oxygen flow via Venturi mask. 2 The client requires lower levels of oxygen delivery, usually 1 to 3 L/min via nasal cannula. 3 The client should receive humidified oxygen delivered by a face mask. 4 The client's respiratory treatment plan should have oxygen eliminated from it.

The client requires lower levels of oxygen delivery, usually 1 to 3 L/min via nasal cannula.

A male newborn has been exposed to human immunodeficiency virus (HIV) in utero. Which assessment supports the diagnosis of HIV infection in the newborn? 1 Delay in temperature regulation 2 Continued bleeding after circumcision 3 Hypoglycemia within the first day of birth 4 Thrush that does not respond readily to treatment

Thrush that does not respond readily to treatment

A client with chronic obstructive pulmonary disease (COPD) reports chest congestion, especially upon awakening in the morning. What should the nurse suggest to the client? t1 Use a humidifier in the bedroom. 2 Sleep with two or more pillows. 3 Cough regularly even if the cough does not produce sputum. 4 Cough and deep breathe each night before going to sleep

Use a humidifier in the bedroom.

A client with acquired immunodeficiency syndrome (AIDS) and Cryptococcus pneumonia frequently is incontinent of feces and urine and produces copious sputum. When providing care for this client, which is the nurse's priority? 1 Wear goggles when suctioning the client's airway 2 Use gown, mask, and gloves when bathing the client 3 Use gloves to administer oral medications to the client 4 Wear a gown when assisting the client with the bedpan

Use gown, mask, and gloves when bathing the client

Which intervention would reduce the risk of perinatal transmission via vaginal birth in an adolescent who is diagnosed with HIV infection? 1 Using forceps during delivery 2 Using a fetal scalp electrode during delivery 3 Using antiretroviral during the intrapartum period 4 Administering zidovudine an hour before labor

Using antiretroviral during the intrapartum period

The nurse provides teaching about self-care management to a client who recently was diagnosed with emphysema. The nurse concludes that further teaching is needed when the client makes which statement? 1 "I will try to avoid smoking." 2 "I will maintain complete bed rest." 3 "I'll control the temperature in my home." 4 "I'll need to clean my mouth several times a day.

"I will maintain complete bed rest."

The nurse is counseling an HIV positive woman on precautions to be followed. Which statement by the client indicates the need for further counseling? 1 "I will avoid smoking and have nutritious food." 2 "I will go for pelvic examination every 12 months." 3 "I will undergo regular screening for syphilis, gonorrhea, and other vaginal infections." 4 "I will use female condoms if my partner refuses to use condoms."

"I will undergo regular screening for syphilis, gonorrhea, and other vaginal infections."

Which is the first medication approved to reduce the risk of human immunodeficiency virus (HIV) infection in unaffected individuals? 1 Truvada 2 Abacavir 3 Cromolyn 4 Methdilazine

Truvada