Lesson 1 Gas Exchange Adaptive Quizzing

A chest tube with an attached closed-drainage system is inserted in the client who was stabbed in the chest. Which is an important nursing intervention when caring for this client? A. Observe for fluid fluctuations in the water-seal chamber B. Obtain a prescription for morphine to minimize agitation C. Apply a thoracic binder to prevent excessive tension on the tube D. Clamp the tubing securely to prevent a rapid decline in pressure

A. Observe for fluid fluctuations in the water-seal chamber

An older client with shortness of breath is admitted to the hospital. The medical history reveals a diagnosis of pneumonia 3 days ago. Which vital sign assessment would be seen as a sign that the client needs immediate medical attention? A. SpO2: 89% B. Temperature: 101F C. Blood pressure: 130/80 mmHg D. Respiratory rate: 26

A. SpO2: 89%

Which action would the nurse take to decrease the risk of ventilator-associated pneumonia for a client receiving mechanical ventilation? A. Suction the client on a regular schedule B. Elevate the head of the bed to at least 30 degrees C. Schedule daily changes of the ventilator tubing D. Maintain continuous sedation during ventilator use

B. Elevate the head of the bed to at least 30 degrees

Which finding would the nurse expect when assessing a client with acute respiratory distress syndrome(ARDS)? A. Hypertension B. Tenacious sputum C. Altered mental status D. Slowed rate of breathing

C. Altered mental status

Which nursing action would the nurse classify as the highest priority when a client's chest tube has accidentally dislodged? A. Place the client in a left side-lying position B. Apply oxygen via nonrebreather C. Apply a petroleum gauze dressing over the site D. Prepare to insert a new chest tube

C. Apply a petroleum gauze dressing over the site

A nurse is caring for a client 36 hours after chest tube insertion. The tube is attached to a three-chamber, closed chest drainage system. The nurse identifies that the water in the underwater seal tube is not fluctuating. Which action should the nurse take? A. Take the clients vital signs B. Inform the health care provider C. Turn the client to the unaffected side D. Check the tube to ensure that it is not kinked

D. Check the tube to ensure that it is not kinked

Which action will the nurse include in the plan for care for a client after a bronchoscopy examination? A. Check for gag reflex B. Send the client for a chest x-ray C. Assess breathing every 30 minutes D. Have the client avoid the Valsalva maneuver

A. Check for gag reflex

Which manifestation would the nurse expect when assessing a client with atelectasis? A. Crackles at the base B. Rhonchi and wheezes C. Hyperresonance to percussion D. Sudden onset of shortness of breath

A. Crackles at the base

The nurse teaches a client with COPD and cor pulmonale about nutrition. Which instruction would the nurse include? A. Eat small meals 6 times a day to limit oxygen needs B. Drink large amounts of fluid to help liquefy secretions C. Lie down after eating to conserve energy needed for digestion D. Increase the intake of protein to decrease intravascular hydrostatic pressure

A. Eat small meals 6 times a day to limit oxygen needs

Which early sign of respiratory acidosis would the nurse expect the client with a restrictive airway disease to exhibit? Select all that apply. A. Headache B. Irritability C. Restlessness D. Hypertension E. Lightheadedness

A. Headache B. Irritability C. Restlessness

Which lab result would the nurse expect when reviewing the results for a client hospitalized with COPD exacerbation? A. Hematocrit 51% B. PaCO2 28 mmHg C. Blood glucose 200 mg/dL D. Serum potassium 3.4 mEq/L

A. Hematocrit 51%

Which intervention would the nurse provide a 3 month old infant hospitalized with RSV? A. Administering an antiviral agent B. Clustering care to conserve energy C. Administering a bronchodilator every 4 hours D. Providing an antitussive agent whenever necessary

B. Clustering care to conserve energy

When a client with COPD reports a 5 pound weight gain in 1 week, the nurse will assess for other signs and symptoms of which complication? A. Polycythemia B. Cor Pulmonale C. Compensated acidosis D. Left ventricular failure

B. Cor Pulmonale

A client has chest tubes attached to a chest tube drainage system. Which intervention would the nurse perform when caring for this client? A. Clamp the chest tubes when suctioning B. Palpate the surrounding area for crepitus C. Change the dressing daily using aseptic technique D. Empty the drainage chamber at the end of the shift

B. Palpate the surrounding area for crepitus

After a subtotal gastrectomy, a client is returned to the surgical unit. Which is an appropriate nursing action to prevent pulmonary complications? A. Ambulating the client to increase respiratory exchange B. Promoting frequent turning and deep breathing to mobilize secretions C. Maintaining a consistent oxygen flow rate to increase oxygen saturation D. Keeping a nonrebreather mask in place to ensure adequate oxygenation

B. Promoting frequent turning and deep breathing to mobilize secretions

The nurse is providing post op care to a client who is being weaned from mechanical ventilation. Which is a priority intervention? A. Assessing lung sounds every 15 minutes B. Remaining with the client to evaluate for respiratory distress C. Monitoring the oxygen saturation levels from the monitor at the desk D. Teaching the family members about ways to keep the client calm

B. Remaining with the client to evaluate for respiratory distress

When a client with COPD has a new prescription for daily low dose prednisone, which information will the nurse include when teaching the client? A. Take the medication an hour before eating B. Report any dark stools to the healthcare provider C. Weight loss is a common side effect of the medication D. Take the medication as soon as you experience any dyspnea

B. Report any dark stools to the healthcare provider

For a client with a history of 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? A. Lessen the client's chest discomfort B. Restores negative pressure in the pleural space C. Drains accumulated fluid from the pleural cavity D. Prevents subcutaneous emphysema in the chest wall

B. Restores negative pressure in the pleural space

When providing care for a client with a pneumothorax and chest tube, which assessment finding indicates the chest tube has been effective? A. Productive cough B. Return of breath sounds C. Increase pleural drainage in the chamber D. Constant bubbling in the water-seal chamber

B. Return of breath sounds

Which finding would the nurse expect when assessing a client with compensated metabolic acidosis? A. Muscle twitching B. Mental instability C. Deep and rapid respirations D. Tachycardia and cardiac dysrhythmias

C. Deep and rapid respirations

Which action would the nurse anticipate implementing when providing care for a client with acute respiratory distress syndrome(ARDS) who is intubated and on mechanical ventilation? A. Deflate the endotracheal tube cuff hourly B. Schedule a change in ventilator tubing every 24 hours C. Determine need for suctioning based on client assessments D. Leave fraction of inspired oxygen (FiO2) at the highest setting as the client oxygenation improves

C. Determine need for suctioning based on client assessments

A client with emphysema reports increased shortness of breath and becoming increasingly anxious. The health care provider prescribes oxygen at 1 L/min via nasal cannula. The nurse recognizes that this prescription is appropriate for which reason? A. The client doesn't need any more than 1L/min B. High concentrations of oxygen cause alveoli to rupture C. High concentrations of oxygen eliminate the respiratory drive in some patients D. The oxygen at 1L/min should be enough to diminish the anxiety

C. High concentrations of oxygen eliminate the respiratory drive in some patients

The ABGs of a client with COPD deteriorate, and respiratory failure is impending. Which clinical indicator would the recognize as a consistent with the client's condition? A. Cyanosis B. Bradycardia C. Mental confusion D. Distended neck veins

C. Mental confusion

After being notified that a client with a sucking chest wound is being transported to the ER, the nurse will anticipate which INITIAL collaborative intervention? A. Obtain a chest x-ray B. Notify the on-call surgeon C. Prepare for chest tube insertion D. Draw blood for laboratory studies

C. Prepare for chest tube insertion

The nurse administers albuterol to a child with asthma. Which common side effect would the nurse monitor for in the child? A. Flushing B. Dyspnea C. Tachycardia D. Hypotension

C. Tachycardia

When caring for a sedated client who is being mechanically ventilated, which action will the nurse first take when the low flow alarm is persistently sounding? A. Adjust the alarm settings B. Notify the respiratory therapist C. Ventilate manually and call for help D. Check all connections and ventilator tubing

C. Ventilate manually and call for help

Which assessment findings would indicate a possible asthma exacerbation? Select all that apply. A. Fever B. Stridor C. Wheezing D. Tachycardia E. Hypotension

C. Wheezing D. Tachycardia

A client has COPD. To decrease the risk of CO2 intoxication(CO2 narcosis), which would the nurse do? A. Initiate pulmonology hygiene to clear air passages of trapped mucus B. Instruct to deep-breathe slowly with inhalation longer than exhalation C. Encourage continuous rapid panting to promote respiratory exchange D. Administer oxygen at a low concentration to maintain respiratory drive

D. Administer oxygen at a low concentration to maintain respiratory drive

Which client is at in increased risk for hospital acquired pneumonia? A. Client who was admitted yesterday with hypoxia and fever B. Client who has been on mechanical ventilation for 5 days C. Client who reports being on an airplane with other sick individuals D. Client who was admitted to the hospital 5 days ago for abdominal pain

D. Client who was admitted to the hospital 5 days ago for abdominal pain

A child admitted to the hospital with a diagnosis of status asthmaticus appears to be improving. Which technique is the most objective way for the nurse to evaluate the child's response to therapy? A. Auscultating breath sounds B. Monitoring the respiratory pattern C. Assessing the lips for decreased cyanosis D. Evaluating the child's peak expiratory flow rate

D. Evaluating the child's peak expiratory flow rate

A client with a spontaneous pneumothorax asks, "Why did they put this tube into my chest?" Which information would the nurse provide about the purpose of the chest tube? A. It checks for bleeding in the lung B. It monitors the function of the lung C. It drains fluid from the pleural space D. It removes air from the pleural space

D. It removes air from the pleural space

Which finding would the nurse expect when assessing a client with cor pulmonale? A. Weight loss B. Slow heart rate C. Urinary frequency D. Lower extremity edema

D. Lower extremity edema

The nurse instructs a client to breath deeply to open collapsed alveoli. Which explanation could the nurse offer to explain the relationship between alveoli and improved oxygenation? A. The alveoli need oxygen to live B. The alveoli have no direct effect on oxygenation C. Collapsed alveoli increase oxygen demand D. Oxygen is exchanged for carbon dioxide in the alveolar membrane

D. Oxygen is exchanged for carbon dioxide in the alveolar membrane

Which medical intervention would the nurse anticipate will be included in the management of a client with acute respiratory distress syndrome (ARDS)? A. Chest tube insertion B. Aggressive diuretic therapy C. Administration of beta blockers D. Positive end-expiratory pressure (PEEP)

D. Positive end-expiratory pressure (PEEP)