Med Surg Ch 30-32
An 18 month old child is brought to the ED by their parents who explain that their child swallowed a watch battery. Radiologic studies show that the battery is in the lungs. Which area of the lung is the battery most likely to be in? a. right upper lung. b. left upper lung. c. right lower lung. d. left lower lung.
a
Clients who have had a laryngectomy are devastated by their loss of the ability to speak normally. WHy should a nurse provide extra time and support with these clients? a. These clients need support and help in understanding and choosing an alternative method of speech. b. these clients may be alert or confused after the procedure c. these clients avoid an electric larynx or electric larynx or tracheoesophageal puncture. d. These clients need to learn to use the continuous positive airway pressure.
a
Malignancy of the larynx can be a devastating diagnosis. What does a client with a diagnosis of laryngeal cancer require? a. emotional support b. referral for counseling c. family counseling d. referral for vocational training.
a
The instructor of the pre nursing physiology class is explaining respiration to the class. What does the instructor explain is the main function of respiration? a. to exchange oxygen and CO2 between the atmospheric air and the blood and between the blood and the cells. b. to move CO2 out of the atmospheric air and into the expired air. c. to move o2 out of the atmospheric air and into the retained air. d. to exchange atmospheric air between the blood cells.
a
What determines the amount of CO2 in the blood for the lungs to excrete? a. the amount of hydrogen ions in the blood b. the amount of bicarbonate in the blood c. the amount of carbolic acid in the blood d. the amount of plasma in the blood.
a
You are caring for a client who is in respiratory distress. The physician orders arterial blood gases (ABGs) to determine various factors related to blood oxygenation. What site can ABGs be obtained from? a. a puncture at the radial artery b. the trachea and bronchi c. the pleural surfaces d. a catheter in the arm vein
a
You are caring for a client who is status post nasal polypectomy. What would you instruct this client to report? a. excessive swallowing b. nasal stuffiness c. diarrhea d. coughing
a
You are studying for a physiology test over the respiratory system. What should you know about central in the medulla? a. the respond to changes in CO2 levels and hydrogen ion concentrations (pH) in the cerebrospinal fluid. b they respond to changes in the o2 levels in the brain c. they respond to changes is CO2 levels in the brain d. they respond to changes in 02 levels and bicarbonate levels in the cerebrospinal fluid.
a
Your client has just been diagnosed with laryngeal cancer. The client ask you what causes laryngeal cancer. What would be your best response? a. research has shown that heredity contributes to having laryngeal cancer b. research has shown that habitual resting of the voice contributes to laryngeal cancer. c. a carcinogen associated with laryngeal cancer is carbon monoxide d. a carcinogen associated with laryngeal cancer is allergies.
a
Your client is scheduled for a bronchoscopy to visualize the larynx, trachea, and bronchi. What precautions would you recommend to the client before the procedure? a. abstain from food for at least 6 hours before the procedure b. avoid sedatives or narcotics as they depress the vagus nerve. c. avoid atropine's as they dry the secretions. d. practice holding the breath for short periods.
a
Your client is status post total laryngectomy and cannot talk. What intervention should you make to help this client of communicate? a. provide alternative methods of communication b. teach the client esophageal speech c. teach the client about artificial larynx. d. provide a lip reader as a translator.
a
ou are a nurse caring for a client who has just had a tracheostomy. What should you monitor frequently? a. airway patency b. level of consciousness c. psychologic status d. pain level
a
what is the reason for chest tubes after thoracic surgery? a. draining secretions, air, and blood from the thoracic cavity is necessary. b. chest tubes allow air into the pleural space. c. chest tubes indicate when the lungs have re-expanded by ceasing to bubble d. draining secretions and blood while allowing air to remain in the thoracic cavity is necessary.
a
you are an occupational health nurse in a large ceramic manufacturing company. how would you intervene to prevent occupational lung disease in the employees of the company? a. fit all employees with protective masks. b. insist on adequate breaks c. give workshops on disease prevention d. provide employees with smoking cessation materials
a
you are caring for a client who has just been diagnosed with lung cancer. what is a cardinal sign of lung cancer? a. mucopurulent sputum b. pain on inspiration c. obvious trauma d. shortness of breath
a
you are caring for a client with chronic respiratory failure. what are the signs and symptoms of chronic respiratory failure? a. progressive loss of lung function associated with chronic disease b. sudden loss of lung function associated with chronic disease c. progressive loss of lung function with history of normal lung function d. sudden loss of lung function with history of normal lung function
a
your an ICU nurse caring for a client who was admitted with a diagnosis of smoke inhalation. you know that this client is at increased risk for which of the following: a. acute respiratory distress syndrome b. lung cancer c. bronchitis d. tracheobronchitis
a
A client come into the clinic complaining of hoarseness that has lasted for about a month. What would you suspect? a. laryngeal cancer b. laryngeal polyps c. chronic paryngitis d. chronic tonsilittis
b
Perfusion refers to blood supply to the lungs, through which the lungs receive nutrients and oxygen. What are the two methods of perfusion? a. ventilation is the process of gas exchange. b. ventilation is the movement of air in and out of the respiratory tract. c. ventilation is the process of getting oxygen to the cells. d. ventilation is the exchange of gases in the lung.
b
The nurse is caring for a client diagnosed with asthma. While performing the shift assessment, the nurse auscultates breath sounds including sibilant wheezes, which are continuous musical sounds. What characteristics describe sibilant wheezes? a. they result from air passing through widened air passages. b. they can be heard during inspiration and expiration c. they are heard in clients with decreased secretions. d. they occur when the pleural surfaces are inflamed.
b
The nurse is caring for a client in sickle cell crisis. The plan of care for this client includes giving oxygen by nasal cannula. What is the rational behind this nursing action? a. someone in sickle cell crisis is in so much pain it is hard for them to breathe. b. the sickled red blood cells have damaged oxyhemoglobin so adequate oxygen does not reach the cells. c. When the read blood cells sickle, they lose their oxygen carrying ability so adequate oxygen does not reach the cells. d. the body uses more oxygen when it is in pain, so it is hard for the person to breathe.
b
The nursing instructor is talking with senior nursing students about diagnostic procedures used in respiratory diseases. The instructor discusses thoracentesis, defining it as a procedure performed for diagnostic purposes or to aspirate accumulated excess fluid or air from the pleural space. What would the instructor tell students purulent fluid indicates? a. cancer b. infection c. inflammation d. heart failure.
b
What happens to the diaphragm during inspiration? a. it relaxes and raises b. it contracts and flattens c. it relaxes and flattens d. it contracts and raises.
b
You are a nurse in the radiology unit of your hospital. You are caring for a client who is scheduled for a lung scan. You know that lung scans need the use of radioisotopes and scanning machine. Before the perfusion scan, what must the client be assessed for? a. bleeding b. iodine allergy c. dysrhythmias d. inflammation
b
You are an ED nurse caring for a client who experienced a trauma to the upper airway. What intervention should you perform to manage the risk of anxiety. a. provide detailed explanations b. assist in positive visualization c. caution against frequent coughing. d. encourage deep breathing every 2 hours.
b
You are caring for a client who is post sinus surgery. When you assess this client you ask them how many fingers you are holding up. Why do you assess postoperative visual acuity? a. to assess possible hemorrhage b. to assess damage to the optic nerve. c. to assess postoperative infection. d. to asses impaired drainage.
b
the new client on the unit was admitted with acute respiratory failure. what are the signs and symptoms of acute respiratory failure? a. insidious onset in client who had normal lung function b. sudden onset in client who had normal lung function c. insidious onset in client who had compromised lung function d. sudden onset in client who had compromised lung function
b
the nurse is caring for a client with TB. why should the nurse always encourage a client with TB to perform active ROM exercises three times a day? a. for medication absorption b. for maintaining muscle strength c. for use as a baseline for evaluation d. for effective pain control
b
you are caring for a client with obstructive pulmonary disease. your nursing care includes diagnoses, outcomes, and interventions for what? a) pain b)atelectasis c)activity intolerance d) side effects of medication therapy
b
you are caring for a client with secondary pulmonary hypertension. what assessment finding would you expect? a. schock b. orthopnea c.lung tissue infarction d.restlessness
b
A client comes into the ED with epistaxis. What intervention should you perform when caring for a client with epistaxis? a. apply a moustache dressing. b. provide a nasal splint. c. apply direct continuous pressure. d. place the client in a semi fowlers position.
c
Perfusion refers to blood suply to the lungs, through which the lungs receive nutrients and oxygen. What are the two methods or perfusion? a. the two methods of perfusion are the bronchial and alveolar circulation. b. the two methods of perfusion are the bronchial and capillary circulation. c. The two methods of perfusion are the bronchial and pulmonary circulation. d. the two methods of perfusion are the alveolar and pulmonary circulation.
c
The Family Nurse Practitioner is performing a physical examination of a client. The NP examines the clients anterior posterior and lateral chest walls. what is the NP assessing? a. deviation from the midline b. difficulty in swallowing c. evidence of muscle weakness d. suppressed gag reflex.
c
The nurse is caring for a client who was admitted after a fall from their motorcycle. The client has a diagnosis of fractured ribs. what nursing interventions should the nurse implement for a client with fractured ribs? a. encourage the client to cough every 2 hrs b. recommend that the client expectorate c. instruct the client on elastic bandage d. avoid immobilizing the client
c
The nurse is preparing a client for a diagnostic procedure. What should the nurse remember when providing information and appropriate explanations about diagnostic procedures to clients? a. explanations should be as detailed as possible b. explanations should never be repeated. c. energy levels of clients may be decreased d. activity should be emphasized before and after procedures.
c
The nurse working in the radiology clinic is assisting with a pulmonary angiography. The nurse knows that when monitoring clients after a pulmonary angiography, what should the physician be notified about? a. raised temperature in the affected limb b. excessive capillary refill c. absent distal pulses d. flushed feeling in the client.
c
You are a clinic nurse caring for a client who is 2 months post laryngectomy. What is a nursing diagnosis pertaining to this client? a. pain related to laryngeal surgery b. infection related to laryngeal surgery c. social isolation related to change in body image, tracheal stoma, and change or loss of speech. d. imbalanced Nutrition less than body requirements related to laryngeal pain.
c
You are admitting a client from the PACU who has just had a tracheostomy. What intervention is necessary for this client before they come to your unit? a. wire cutters are taped to the head of the bed. b. a tacheal dilator is placed at the bedside. c. a tracheostomy tray is placed at the bedside. d. a mouth block is taped to the wall at the head of the bed.
c
You are assessing the respiratory system of a client just admitted to your unit. What do you know to assess beside the physical and functional issues related to breathing? a. How these issues affect the clients quality of life b. how these issues affect the relationships in the clients life c. how these issues affect the clients effort to breathe. d. how these issues affect the clients ability to function.
c
You are caring for a client who has just been told they have advanced laryngeal cancer and will have to have a total laryngectomy. You are doing preoperative teaching with this client. What do you know is a subject you should cover? a. visiting hours b. pain before surgery c. alternative methods of communication d. post operative nutrition
c
You are caring for a client who is 42 years old and status post adenoidectomy. You find the client in respiratory distress when you enter their room. You ask another nurse to call the physian and bring an endotracheal tube into the room. What do you suspect? a. infection b. post operative bleeding c. edema of the upper airway d. plugged tracheostomy tube.
c
You are performing a preoperative assessment on a client who is scheduled for a tonsillectomy. Why would you ask the client about the use of herbal supplements? a. they produce anorexia b. they impair the immune system c. they prolong bleeding d. they lower high density lipoprotein levels.
c
You are presenting about upper respiratory infections at an education event for a local community group. What should you be sure to include regarding cold tablets containing antihistamines? a. These clients need support and help in understanding and choosing an alternative method of speech. b. they lead to frequent sinus drainage c. they decrease discomfort temporarily. d. they prolong bleeding.
c
You are speaking at a local PTO meeting about upper respiratory infections. Which preventative factor for rhinitis should you teach the attendees? a. avoid clearing the throat. b. use a straw to drink fluids c. get adequate rest and sleep d. avoid carbonated fluids.
c
You are the hospice nurse caring for a client with pulmonary fibrosis who wants to die at home. The client is having difficulty breathing. The family asks why it is so hard for the client to breathe. What would be the nurses best response. a. they are dying and no longer have the energy to breathe. b. this is normal when a person is near the end of their life. c. the fibrosis of the lungs makes the lungs stiff which makes it harder to breathe. d. the disease is making your loved one retain carbon dioxide so there is not enough room in the blood for adequate oxygen.
c
Your client has a history of hoarseness lasting longer than 2 weeks. The client is now complaining of feeling a lump in their throat. What would you suspect this client has? a. cancer of the pharynx b. laryngeal cancer c. laryngeal polyps d. cancer of the tonsils.
c
Your client has just had an invasive procedure to assess the respiratory system. What do you know should be assessed on this client? a. watery sputum b. loss of consciousness c. respiratory distress d. masses in pleural space.
c
the clinic nurse is caring for a client who has just been diagnosed with COPD. the client asks the nurse what COPD means. what would be the best response? a. it is an umbrella term for diseases like acute bronchitis b. it means that the lungs have been damaged in such a was that there is limited airflow in and out of the lungs c. it means your lungs cant expand and contract like the are supposed to which makes it hard for you to breathe. d. it is a term that covers so many lung diseases i cant list them all.
c
the local public health department is holding a flu vaccine clinic. the health department recommends flu vaccinations for healthcare workers and people at high risk for complications, or for those exposed daily to many different people. when using FluMist (live, attenuated influenza vaccine) what group is not approved? a. children between 6 & 12 years b. people with hypersensitivity to milk products c. adolescents who regularly take aspirin d. adults above 70 years
c
the nursing instructor is talking with the junior class of nursing students about lung cancer. what would be the best rationale the instructor could give for the difficulty of early diagnosis of lung cancer? a. symptoms are often minimized by clients b. there are no early symptoms of lung cancer c. symptoms often mimic other infectious diseases d. symptoms often do not appear until the disease is well established
c
you are a clinical nurse caring for a client with acute bronchitis. The client asks what may have caused the infection. what may induce bronchitis? A) aspirin b)drug ingestion C) chemical irritation d) direct lung damage
c
you are preparing a client for emergency thoracic surgery. what would you document in your assessment? a. emergency contacts b. IV fluids ordered c. general statement of the clients condition d. detailed physical assessment
c
A student nurse is caring for a client who is severely anemic. The instructor asks the student how anemia affects the transport of oxygen to the cells. What would be the students best answer? a. the cells get oxygen from the plasma b. the cells are denied adequate oxygen because most of the oxygen in the body is transported by the white blood cells. c. the cells have to work harder with the decreased oxygen levels. d. the cells are denied adequate oxygen because most of the oxygen in the body is transported by the hemoglobin in red blood cells.
d
The client you are caring for has just been told they have advanced laryngeal cancer. What is the treatment of choice? a. partial laryngectomy b. laser surgery c. radiation therapy. d. total laryngectomy
d
The instructor in the anatomy and physiology class is talking about alveolar respiration? a. determines the amount of oxygen in the body b. determines amount of bicarbonate in the body c. determines amount of PaCo2 in the body d. determines amount of CO2 in the body.
d
The nursing instructor is teaching a pre-nursing pathophysiology class. The class is covering the respiratory system. The instructor explains that the respiratory system is comprised of both the upper and lower respiratory system. The nose is part of the upper respiratory system. The instructor continues to explain that the nasal cavities have a vascular and ciliated mucous lining. What is the purpose of the vascular and ciliated mucous lining of the nasal cavities? a. cool and dry expired air. b. move mucous to the back of the throat. c. moisten and filter expired air. d. warm and humidify inspired air.
d
The student nurse is caring for a client who has serial sputum tests ordered. The student asks their instructor why the sputum tests have to be repeated on the successive days. What would be the instructors best response? a. some clients cannot produced enough sputum to be tested, so successive samples may be needed. b. the sputum produced today may be from the left lung and tomorrow it may be from the right lung. c. sometimes two tests are needed to verify a positive finding. d. a negative sputum test does not always mean that there is no disease present, so more than one test may be needed.
d
What client would be most in need of an endotracheal tube? a. a client status post tonsillectomy b. ambulatory clients c. older adult clients d. comatose clients.
d
You are caring for a client admitted with chronic bronchitis. The client is having difficulty breathing, and the family asks you what causes this difficulty. What would be your best response? a. anytime there is a chronic disease process it is hard for the person to breathe. b. having a chronic respiratory disease scars the lung and affects the effort it takes to breathe. c. in this particular case your family member is just overly tired and having problems breathing. d. conditions such as chronic bronchitis cause thickening of the bronchial mucosa so it makes it harder to breathe.
d
You are caring for a client diagnosed with enlarged adenoids. What condition is produced by enlarged adenoids? a. encrusted mucous membranes b. hardened secretions c. erosion of the trachea d. noisy breathing
d
You are doing preoperative teaching with a client scheduled for laryngeal surgery. What should you teach this client to help prevent atelectasis? a. monitor for signs of dysphagia b. provide meticulous mouth care every 4 hours. c. caution against frequent coughing. d. encourage deep breathing every 2 hours.
d
You are performing pulmonary function studies on clients in the clinic. What position do you know a client should be in to have maximum lung capacities and volumes? a. lying on the unaffected side b. resting the head on a pillow c. lying flat on the back d. in the standing position.
d
Your client has had laryngeal surgery. What is as expected outcome in client? a. the clients suture line remains intact. b. the client maintains an adequate caloric intake. c. The client can swallow without difficulty d. the clients breathing patterns improve.
d
the ICU nurse caring for a 2-year old near drowning victim monitors for what possible complication? a. atelectasis b. adult respiratory distress syndrome c. metabolic alkalosis d. respiratory acidosis
d
the nursing instructor is discussing pulmonary arterial hypertension with the nursing students. what would the instructor describe as the pathophysiology of secondary pulmonary arterial hypertension? a. bronchial thickening increased resistance and pressure in the pulmonary vascular bed. b. chronic lung disease causes scaring in the bronchioles raising pressure in the pulmonary vascular bed. c left-sided heart failure causes increased resistance and pressure in the pulmonary vascular bed. d. alveolar destruction causes increased resistance and pressure in the pulmonary vascular bed
d
the orthopedic nurse caring for a client in traction for a femur fracture knows to monitor the client for which of the following? a. pneumonia b. bed sore c. fat embolus d. DVT
d
you are assessing a clients potential for pulmonary emboli. what finding indicates possible deep vein thrombosis? a. pain in the feet b. inability to dorsiflex c. negative Homan's sign d. pain in the calf
d
you are caring for a client status post lung resection. when assessing your client you find that the bubbling in the water-seal chamber for the chest tubes is more than you expected. what should you check when bubbling in the water-seal chamber is excessive? a. see if the chest tube is clogged b. see if the wall suction unit has malfunctioned c. see if a kink has developed in the tubing d. see if there are leaks in the system
d
your client has just returned from the PACU after a rt lobe resection. The client has two chest tubes in place. you know that the anterior chest tube usually is placed to remove which of the following: a. blood b. pleural fluid c. mediasteinal fluid d. air
d
