NCLEX RN- Respiratory

The nurse provides instructions to a client after a total laryngectomy. Which statement by the client indicates a need for further instruction? 1."I need to protect the stoma from water." 2."Soaps should be avoided near the stoma." 3."I should use diluted alcohol on the stoma to clean it." 4."I should apply a non-oil-based ointment to the skin surrounding the stoma."

3. "I should use diluted alcohol on the stoma to clean it."

A client with a chest injury has suffered flail chest. The nurse assesses the client for which most distinctive sign of flail chest? 1. cyanosis 2. hypotension 3. paradoxical chest movement 4. dyspnea, especially on exhalation

3. Paradoxical chest movement

The client is admitted to the hospital with a diagnosis of Legionnaires' disease. The nurse is providing information on the disease and treatment expectations. Which statement by the client indicates an understanding of the disease and treatments? 1."I should avoid all contact with my family." 2."I should avoid large crowds for at least 3 weeks." 3."I cannot give Legionnaires' disease to other people." 4."I will have to take antibiotics until my symptoms disappear."

3."I cannot give Legionnaires' disease to other people."

A client is diagnosed with a rib fracture and asks the nurse why strapping of the ribs is not being done. Which response by the nurse is most appropriate? 1."Strapping is useful only if the ribs are fractured in several places at once." 2."That's a good idea. I'll ask the primary health care provider for a prescription for the needed supplies." 3."That isn't done because people often would develop pneumonia from the constricting effect on the lungs." 4."That might help you to breathe better, but this facility does not carry the necessary supplies in the stockroom. When you get home, you can purchase them at the medical supply store."

3."That isn't done because people often would develop pneumonia from the constricting effect on the lungs."

The nurse is caring for a group of clients on the clinical nursing unit. The nurse interprets that which of these clients is at most risk for the development of pulmonary embolism? 1.A 25-year-old woman with diabetic ketoacidosis 2.A 65-year-old man out of bed 1 day after prostate resection 3.A 73-year-old woman who has just had pinning of a hip fracture 4.A 38-year-old man with pulmonary contusion sustained in an automobile crash

3.A 73-year-old woman who has just had pinning of a hip fracture

The nurse working on a medical respiratory nursing unit is caring for several clients with respiratory disorders. The nurse should determine that which client on the nursing unit is at the lowest risk for infection with tuberculosis? 1.An uninsured man who is homeless 2.A newly immigrated woman from Korea 3.A man who is an inspector for the U.S. Postal Service 4.An older woman admitted from a long-term care facility

3.A man who is an inspector for the U.S. Postal Service

The nurse is caring for a dyspneic client with decreased breath sounds. The nurse should carry out which intervention to decrease the client's work of breathing? 1.Instruct the client to limit fluid intake. 2.Place the client in low-Fowler's position. 3.Administer the prescribed bronchodilator. 4.Place a continuous pulse oximeter on the client.

3.Administer the prescribed bronchodilator.

A client is suspected of having a pulmonary embolus. The nurse assesses the client, knowing that which is a common clinical manifestation of pulmonary embolism? 1.Dyspnea 2.Bradypnea 3.Bradycardia 4.Decreased respirations

1. Dyspnea

The nurse and an assistive personnel (AP) are assisting the respiratory therapist to position a client for postural drainage. The AP asks the nurse how the respiratory therapist selects the position to be used for the procedure. The nurse responds that a position is chosen that will use gravity to help drain secretions from which primary areas? 1.Lobes 2.Alveoli 3.Trachea 4.Main bronchi

1. Lobes

The nurse is taking the history of a client with occupational lung disease (silicosis). The nurse should assess whether the client wears which item during periods of exposure to silica particles? 1. Mask 2. Gown 3. Gloves 4. Eye protection

1. Mask

A client who is human immunodeficiency virus (HIV)-positive has had a tuberculin skin test (TST). The nurse notes a 7-mm area of induration at the site of the skin test and interprets the result as which finding? 1.Positive 2.Negative 3.Inconclusive 4.Need for repeat testing

1. Positive

The nurse has provided a client with tuberculosis (TB) instructions on proper handling and disposal of respiratory secretions. The nurse determines that the client demonstrates understanding of the instructions when the client makes which statement? 1."I will discard used tissues in a plastic bag." 2."I need to wash my hands at least 4 times a day." 3."I will brush my teeth and rinse my mouth once a day." 4."I will turn my head to the side if I need to cough or sneeze."

1."I will discard used tissues in a plastic bag."

The nurse is providing immediate postprocedure care to a client who had a thoracentesis to relieve a tension pneumothorax that resulted from rib fractures. The goal is that the client will exhibit normal respiratory functioning, and the nurse provides instructions to assist the client with this goal. Which client statement indicates that further instruction is needed? 1."I will lie on the affected side for an hour." 2."I can expect a chest x-ray exam to be done shortly." 3."I will let you know at once if I have trouble breathing." 4."I will notify you if I feel a crackling sensation in my chest."

1."I will lie on the affected side for an hour."

A client with a history of recent upper respiratory infection comes to the urgent care center complaining of chest pain. The nurse determines that the pain is most likely of a respiratory origin if the client makes which statement about the pain? 1."It hurts more when I breathe in." 2."I have never had this pain before." 3."It hurts on the left side of my chest." 4."The pain is about a 6 on a scale of 1 to 10."

1."It hurts more when I breathe in."

The nurse is teaching a client about changes in body image related to chronic obstructive pulmonary disease (COPD). Which statement by the client would indicate that teaching was successful? 1."My nails may become clubbed." 2."My nails may have multiple small pits." 3."I may develop flattening of the nail plate." 4."I may develop horizontal depressions on my nails."

1."My nails may become clubbed."

The nurse reads in the progress notes for a client with pneumonia that areas of the client's lungs are being perfused but are not being ventilated. How does the nurse correctly interpret this documentation? 1.A shunt unit exists. 2.Anatomical dead space is present. 3.Physiological dead space is present. 4.Ventilation-perfusion matching is occurring.

1.A shunt unit exists.

A client has been treated for pleural effusion with a thoracentesis. The nurse determines that this procedure has been effective if the nurse notes which assessment finding? 1.Absence of dyspnea 2.Increased severity of cough 3.Dull percussion notes over lung tissue 4.Decreased tactile fremitus over lung tissue

1.Absence of dyspnea

The nurse is preparing a list of home care instructions for a client who has been hospitalized and treated for tuberculosis. Which instructions should the nurse include on the list? Select all that apply. 1.Activities should be resumed gradually. 2.Avoid contact with other individuals, except family members, for at least 6 months. 3.A sputum culture is needed every 2 to 4 weeks once medication therapy is initiated. 4.Respiratory isolation is not necessary because family members already have been exposed. 5.Cover the mouth and nose when coughing or sneezing and put used tissues in plastic bags. 6.When 1 sputum culture is negative, the client is no longer considered infectious and usually can return to former employment.

1.Activities should be resumed gradually 3.A sputum culture is needed every 2 to 4 weeks once medication therapy is initiated. 4.Respiratory isolation is not necessary because family members already have been exposed. 5.Cover the mouth and nose when coughing or sneezing and put used tissues in plastic bags.

A client with a fat embolus is experiencing respiratory distress. The nurse plans to assist with which therapies? 1.Administration of plasma expanders, low-flow oxygen, and suctioning 2.Administration of bronchodilators, intubation, and mechanical ventilation 3.Administration of oxygen, intubation, and mechanical ventilation with positive end-expiratory pressure 4.Administration of antihypertensives, high-flow oxygen, and continuous positive airway pressure mask

3.Administration of oxygen, intubation, and mechanical ventilation with positive end-expiratory pressure

The nurse is preparing a list of home care instructions for a client who has been hospitalized and treated for tuberculosis. Which instructions should the nurse include on the list? Select all that apply. 1.Activities should be resumed gradually. 2.Avoid contact with other individuals, except family members, for at least 6 months. 3.A sputum culture is needed every 2 to 4 weeks once medication therapy is initiated. 4.Respiratory isolation is not necessary, because family members already have been exposed. 5.Cover the mouth and nose when coughing or sneezing and put used tissues in plastic bags. 6.When 1 sputum culture is negative, the client is no longer considered infectious and usually can return to former employment.

1.Activities should be resumed gradually. 3.A sputum culture is needed every 2 to 4 weeks once medication therapy is initiated. 4.Respiratory isolation is not necessary, because family members already have been exposed. 5.Cover the mouth and nose when coughing or sneezing and put used tissues in plastic bags.

An ambulatory care nurse is assessing a client with chronic sinusitis. The nurse would expect to note which assessment findings in this client? Select all that apply. 1.Anosmia 2.Chronic cough 3.Purulent nasal discharge 4.Intolerance to hot weather 5.Intolerance to strong aromas

1.Anosmia 2.Chronic cough 3.Purulent nasal discharge

A client is returning from surgery after a pulmonary lobectomy. Which pieces of equipment should the nurse have at the bedside? Select all that apply. 1.Clamp 2.Code cart 3.Central line kit 4.Vaseline gauze 5.Tracheotomy set 6.Suction equipment

1.Clamp 4.Vaseline gauze 6.Suction equipment

The nurse is caring for a client diagnosed with tuberculosis (TB). Which assessments, if made by the nurse, are consistent with the usual clinical presentation of TB? Select all that apply. 1.Cough 2.Dyspnea 3.Weight gain 4.High-grade fever 5.Chills and night sweats

1.Cough 2.Dyspnea 5.Chills and night sweats

The nurse is providing education to a group of adolescents diagnosed with asthma. The nurse informs the group that which can be triggers for an asthma attack? Select all that apply. 1.Dry air 2.Clean air 3.Exercise 4.Rest and sleep 5.An upper respiratory infection (URI) 6.Nonsteroidal anti-inflammatory drugs (NSAIDs)

1.Dry air 3.Exercise 5.An upper respiratory infection (URI) 6.Nonsteroidal anti-inflammatory drugs (NSAIDs)

A client with acquired immunodeficiency syndrome (AIDS) has histoplasmosis. The nurse should assess the client for which expected finding? 1.Dyspnea 2.Headache 3.Weight gain 4.Hypothermia

1.Dyspnea

A client with acquired immunodeficiency syndrome (AIDS) has histoplasmosis. The nurse should assess the client for which expected finding? 1.Dyspnea 2.Headache 3.Weight gain 4.Hypothermia

1.Dyspnea

The community health nurse is conducting an educational session with community members regarding the signs and symptoms associated with tuberculosis. The nurse informs the participants that tuberculosis is considered as a diagnosis if which signs and symptoms are present? Select all that apply. 1.Dyspnea 2.Headache 3.Night sweats 4.A bloody, productive cough 5.A cough with the expectoration of mucoid sputum

1.Dyspnea 3.Night sweats 4.A bloody, productive cough 5.A cough with the expectoration of mucoid sputum

The community health nurse is conducting an educational session with community members regarding the signs and symptoms associated with tuberculosis. The nurse informs the participants that tuberculosis is considered as a diagnosis if which signs and symptoms are present? Select all that apply. 1.Dyspnea 2.Headache 3.Night sweats 4.A bloody, productive cough 5.A cough with the expectoration of mucoid sputum

1.Dyspnea 3.Night sweats 4.A bloody, productive cough 5.A cough with the expectoration of mucoid sputum

A client arrives in the hospital emergency department with a bloody nose. What is the initial nursing action? 1.Place the client in supine position. 2.Apply an ice collar around the client's neck. 3.Assist the client to a sitting position with the head tilted forward. 4.Instruct the client to swallow the blood until the bleeding can be controlled.

3.Assist the client to a sitting position with the head tilted forward

A client with chronic obstructive pulmonary disease (COPD) is being evaluated for lung transplantation. The nurse performs the initial physical assessment. Which findings should the nurse anticipate in this client? Select all that apply. 1.Dyspnea at rest 2.Clubbed fingers 3.Muscle retractions 4.Decreased respiratory rate 5.Increased body temperature 6.Prolonged expiratory breathing phase

1.Dyspnea at rest 2.Clubbed fingers 3.Muscle retractions 6.Prolonged expiratory breathing phase

The nurse is doing volunteer work in a homeless shelter. The nurse should monitor the individuals for which initial signs and symptoms of tuberculosis? Select all that apply. 1.Fatigue 2.Lethargy 3.Chest pain 4.Morning cough 5.Low-grade fever 6.Labored breathing

1.Fatigue 2.Lethargy 4.Morning cough 5.Low-grade fever

A client with silicosis is being monitored yearly at the health care clinic. On assessment, the nurse should ask the client about which manifestations of the disorder? Select all that apply. 1.Fatigue 2.Malaise 3.Anorexia 4.Weight gain 5.Dyspnea at rest

1.Fatigue 2.Malaise 3.Anorexia

A clinic nurse notes that large numbers of clients present with flu-like symptoms. Which recommendations should the nurse include in the plan of care for these clients? Select all that apply. 1.Get plenty of rest. 2.Increase intake of liquids. 3.Take antipyretics for fever. 4.Get a flu shot immediately. 5.Eat fruits and vegetables high in vitamin C.

1.Get plenty of rest. 2.Increase intake of liquids. 3.Take antipyretics for fever. 5.Eat fruits and vegetables high in vitamin C.

A chest x-ray report for a client indicates the presence of a left apical pneumothorax. The nurse would assess the status of breath sounds in that area by placing the stethoscope in which location? 1.Just under the left clavicle 2.Midsternum, 1 inch to the left 3.Over the fifth intercostal space 4.Midsternum, 1 inch to the right

1.Just under the left clavicle

A client did not seek medical treatment for a previous respiratory infection, and subsequently an empyema developed in the left lung. The nurse should assess the client for which signs and symptoms associated with this problem? 1.Pleural pain and fever 2.Decreased respiratory rate 3.Diaphoresis during the day 4.Hyperresonant breath sounds over the left thorax

1.Pleural pain and fever

The nurse is performing a respiratory assessment on a client with a left lower lobe lung mass. Chest auscultation over the posterior left lower lobe reveals these breath sounds. The nurse would interpret this as which sound? 1.Pleural friction rub 2.Vesicular breath sounds 3.Bronchial breath sounds 4.Bronchovesicular breath sounds

3.Bronchial breath sounds

The nurse is providing preoperative teaching to the client about the use of an incentive spirometer in the postoperative period. Which instructions should the nurse include? Select all that apply. 1.Sit upright in the bed or in a chair. 2.Inhale as deeply and quickly as possible. 3.Hold the device in a downward position. 4.Place the mouthpiece in your mouth and seal your lips tightly around it. 5.After maximum inspiration, hold the breath for 2 to 3 seconds and exhale.

1.Sit upright in the bed or in a chair. 4.Place the mouthpiece in your mouth and seal your lips tightly around it. 5.After maximum inspiration, hold the breath for 2 to 3 seconds and exhale.

The nurse is caring for a client after a bronchoscopy and biopsy. Which finding, if noted in the client, should be reported immediately to the primary health care provider? 1.Dry cough 2.Hematuria 3.Bronchospasm 4.Blood-streaked sputum

3.Bronchospasm

The nurse is teaching a client with emphysema about positions that help breathing during dyspneic episodes. The nurse instructs the client that which positions alleviate dyspnea? Select all that apply. 1.Sitting up and leaning on a table 2.Standing and leaning against a wall 3.Lying supine with the feet elevated 4.Sitting up with the elbows resting on knees 5.Lying on the back in a low-Fowler's position

1.Sitting up and leaning on a table 2.Standing and leaning against a wall 4.Sitting up with the elbows resting on knees

The nurse is teaching a client with emphysema about positions that help breathing during dyspneic episodes. The nurse instructs the client that which positions alleviate dyspnea? Select all that apply. 1.Sitting up and leaning on a table 2.Standing and leaning against a wall 3.Lying supine with the feet elevated 4.Sitting up with the elbows resting on knees 5.Lying on the back in a low-Fowler's position

1.Sitting up and leaning on a table 2.Standing and leaning against a wall 4.Sitting up with the elbows resting on knees

A client is experiencing severe dyspnea, and the nurse listens to the client's breath sounds and hears this sound. The nurse should document this finding as which sound? 1.Stridor 2.Crackles 3.Rhonchi 4.High-pitched wheezes

1.Stridor

A client who has undergone radical neck dissection for a tumor has a potential problem of obstruction related to postoperative edema, drainage, and secretions. To promote adequate respiratory function in this client, the nurse should implement which activities? Select all that apply. 1.Suctioning the client as needed 2.Encouraging coughing every 2 hours 3.Placing the bed in low-Fowler's position 4.Supporting the neck incision when the client coughs 5.Monitoring the respiratory status frequently as prescribed

1.Suctioning the client as needed 2.Encouraging coughing every 2 hours 4.Supporting the neck incision when the client coughs 5.Monitoring the respiratory status frequently as prescribed

A client tells the nurse that the primary health care provider (PHCP) has stated a diagnosis of silicosis. The nurse determines that which finding is consistent with this respiratory disorder? 1.The client has reduced lung volume and fibrosis on chest x-ray. 2.There is evidence of silica in the bloodstream but no clinical symptoms. 3.The client has normal pulmonary function studies but has shortness of breath. 4.Massive pulmonary fibrosis is visible on chest x-ray, and extrapulmonary symptoms are apparent

1.The client has reduced lung volume and fibrosis on chest x-ray

A client is returned to the nursing unit after thoracic surgery with chest tubes in place. During the first few hours postoperatively, what type of drainage should the nurse expect? 1.Serous 2.Bloody 3.Serosanguineous 4.Bloody, with frequent small clots

2. Bloody

The nurse is teaching a client with pulmonary disease about fundamental concepts of gas exchange. When asked for further details by the client, the nurse explains that gas exchange occurs through which process? 1.Osmosis 2.Diffusion 3.Ionization 4.Active transport

2. Diffusion

A client with a history of silicosis is admitted to the hospital with respiratory distress and impending respiratory failure. Which item(s) should the nurse place at the client's bedside? 1. Code cart 2. Intubation tray 3. Thoracentesis tray 4. Chest tube and drainage system

2. Intubation tray

The nurse caring for a client with chronic obstructive pulmonary disease (COPD) anticipates which arterial blood gas (ABG) findings? 1.pH, 7.40; PaO2, 90 mm Hg; CO2, 39 mEq/L; HCO3, 23 mEq/L 2.pH, 7.32; PaO2, 85 mm Hg; CO2, 57 mEq/L; HCO3, 26 mEq/L 3.pH, 7.47; PaO2, 82 mm Hg; CO2, 30 mEq/L; HCO3, 31 mEq/L 4.pH, 7.31; PaO2, 95 mm Hg; CO2, 22 mEq/L; HCO3, 19 mEq/L

2. pH, 7.32; PaO2, 85 mm Hg; CO2, 57 mEq/L; HCO3, 26 mEq/L

A client who experiences frequent upper respiratory infections (URIs) asks the nurse why food does not seem to have any taste during illness. Which response by the nurse is most appropriate? 1."You lack the energy to cook wholesome meals." 2."Blocked nasal passages impair the sense of smell." 3."Loss of appetite is triggered by the infectious organism." 4."Infection blocks sensation in the taste buds of the tongue."

2."Blocked nasal passages impair the sense of smell."

The nurse has provided discharge instructions to the client who has had a pneumonectomy. Which statement, if made by the client, indicates an understanding of appropriate home care measures? 1."I should restrict my fluid intake for 2 weeks." 2."I should perform arm exercises 2 or 3 times a day." 3."If I experience any soreness in my chest or shoulder, I should notify the primary health care provider." 4."If I experience any numbness or altered sensation around the incision, I should contact the primary health care provider."

2."I should perform arm exercises 2 or 3 times a day."

The nurse providing instructions to a client using an incentive spirometer tells the client to sustain the inhaled breath for 3 seconds. What statement by the client indicates successful teaching? 1."It will open up the major airways." 2."It will keep the small airways open." 3."It will increase lubrication for the lungs." 4."The lungs can better rid themselves of secretions."

2."It will keep the small airways open."

The nurse is caring for a client hospitalized with acute exacerbation of chronic obstructive pulmonary disease. Which findings would the nurse expect to note on assessment of this client? Select all that apply. 1. Low arterial PCo2 level 2. a hyper-inflated chest noted on the chest x-ray 3. decreased oxygen saturation with mild exercise 4. A widened diaphragm noted on the chest x-ray 5. pulmonary function tests that demonstrate increased vital capacity

2.A hyperinflated chest noted on the chest x-ray 3.Decreased oxygen saturation with mild exercise

The nurse is caring for a client hospitalized with acute exacerbation of chronic obstructive pulmonary disease. Which findings would the nurse expect to note on assessment of this client? Select all that apply. 1.A low arterial PCO2 level 2.A hyperinflated chest noted on the chest x-ray 3.Decreased oxygen saturation with mild exercise 4.A widened diaphragm noted on the chest x-ray 5.Pulmonary function tests that demonstrate increased vital capacity

2.A hyperinflated chest noted on the chest x-ray 3.Decreased oxygen saturation with mild exercise

Which are risk factors for chronic obstructive pulmonary disease (COPD)? Select all that apply. 1.Purified air 2.Cigarette smoking 3.Genetic risk factor 4.Environmental factors 5.Eating plenty of fruits and vegetables 6.Alpha-1 antitrypsin (AAT) deficiency

2.Cigarette smoking 3.Genetic risk factor 4.Environmental factors 6.Alpha-1 antitrypsin (AAT) deficiency

The nurse is developing a plan of care for a client at risk for acute respiratory distress syndrome (ARDS). As part of the plan, the nurse will assess for which sign or symptom for early detection of this disorder? 1.Edema 2.Dyspnea 3.Frothy sputum 4.Diminished breath sounds

2.Dyspnea

The nurse is caring for a client who suffered an inhalation injury from a wood stove. The carbon monoxide blood report reveals a level of 12%. Based on this level, the nurse would anticipate noting which sign in the client? 1.Coma 2.Flushing 3.Dizziness 4.Tachycardia

2.Flushing

The nurse is auscultating breath sounds in a hospitalized client with emphysema and hears these sounds. The nurse should document this finding as which sound? 1.Crackles 2.High-pitched wheezes 3.Bronchial breath sounds 4.Bronchovesicular breath sounds

2.High-pitched wheezes

Which are possible causes of upper airway obstruction? Select all that apply. 1.Thin secretions 2.Laryngeal edema 3.Head and neck cancer 4.Foreign body aspiration 5.Lymph node enlargement

2.Laryngeal edema 3.Head and neck cancer 4.Foreign body aspiration 5.Lymph node enlargement

The nurse is caring for a client with acute respiratory distress syndrome (ARDS). What should the nurse expect to note in the client? 1.Pallor 2.Low arterial PaO2 3.Elevated arterial PaO2 4.Decreased respiratory rate

2.Low arterial PaO2

The nurse is reading a tuberculin skin test for a client with no documented health problems. The site has no induration and a 1-mm area of ecchymosis. How should the nurse interpret the result? 1.Positive 2.Negative 3.Uncertain 4.Borderline

2.Negative

An emergency department nurse is performing a respiratory assessment on a client who is complaining of painful breathing. On palpation the nurse notes a coarse grating sensation during inspiration, and on auscultation the nurse hears this breath sound. The nurse interprets these findings as characteristic of which condition? 1.Asthma 2.Pleurisy 3.Emphysema 4.Pulmonary edema

2.Pleurisy

Which nursing interventions are appropriate in caring for a client with emphysema? Select all that apply. 1.Reduce fluid intake to less than 1500 mL/day. 2.Teach diaphragmatic and pursed-lip breathing. 3.Encourage alternating activity with rest periods. 4.Teach the client techniques of chest physiotherapy. 5.Keep the client in a supine position as much as possible

2.Teach diaphragmatic and pursed-lip breathing. 3.Encourage alternating activity with rest periods. 4.Teach the client techniques of chest physiotherapy.

The nurse instructs a client on pursed-lip breathing and asks the client to demonstrate the breathing technique. Which observation by the nurse would indicate that the client is performing the technique correctly? 1.The client breathes in through the mouth. 2.The client breathes out slowly through the mouth. 3.The client avoids using the abdominal muscles to breathe out. 4.The client puffs out the cheeks when breathing out through the mouth.

2.The client breathes out slowly through the mouth.

A client who is experiencing respiratory difficulty asks the nurse, "Why is it so much easier to breathe out than in?" In providing a response, the nurse explains that breathing is easier on exhalation because of which respiratory responses? 1.Air flows by gravity. 2.The respiratory muscles relax. 3.The respiratory muscles contract. 4.Air is flowing against a pressure gradient.

2.The respiratory muscles relax.

A client diagnosed with tuberculosis (TB) is distressed over fatigue and the loss of physical stamina. What should the nurse tell the client? 1.This is expected and will last for at least 1 year. 2.This is expected, and the client should gradually increase activity as tolerated. 3.This is an unexpected finding with TB, but it should resolve within 1 month or so. 4.This is a short-lived problem that should be gone within 1 week after beginning medication therapy.

2.This is expected, and the client should gradually increase activity as tolerated.

Which position would best help the breathing of a client with chronic obstructive pulmonary disease (COPD)? 1.Sitting position 2.Tripod position 3.Supine position 4.High-Fowler's position

2.Tripod position

A client has experienced pulmonary embolism. The nurse should assess for which symptom, which is most commonly reported? 1.Hot, flushed feeling 2.Sudden chills and fever 3.Chest pain that occurs suddenly 4.Dyspnea when deep breaths are taken

3.Chest pain that occurs suddenly

The nurse participating in a client care conference with other health team members is discussing the condition of a client with adult respiratory distress syndrome (ARDS). The primary health care provider states that because of fluid in the alveoli, surfactant production is falling. The nurse anticipates that insufficient surfactant will cause which effect? 1.Atelectasis and viral infection 2.Bronchoconstriction and stridor 3.Collapse of alveoli and decreased compliance 4.Decreased ciliary action and retained secretions

3.Collapse of alveoli and decreased compliance

The nurse who is participating in a client care conference with other members of the health care team is discussing the condition of a client with acute respiratory distress syndrome (ARDS). The primary health care provider (PHCP) states that as a result of fluid in the alveoli, surfactant production is falling. What does the nurse anticipate as a physiological consequence? 1.Atelectasis and viral infection 2.Bronchoconstriction and stridor 3.Collapse of alveoli and decreased compliance 4.Decreased ciliary action and retained secretions

3.Collapse of alveoli and decreased compliance

The nurse is caring for a client who had tuberculin skin testing 48 hours ago on admission to the nursing unit. The nurse reads the test result as positive. Which action by the nurse has the highest priority? 1.Document the finding in the client's record. 2.Call the employee health service department. 3.Contact the primary health care provider (PHCP). 4.Call the radiology department for a chest radiographic study to be done.

3.Contact the primary health care provider (PHCP).

The nurse is assessing the functioning of a chest tube drainage system in a client who has just returned from the recovery room following a thoracotomy with wedge resection to remove a cancerous tumor. Which are the expected assessment findings? Select all that apply. 1.Excessive bubbling in the water seal chamber 2.Vigorous bubbling in the suction control chamber 3.Drainage system maintained below the client's chest 4.50 mL of drainage in the drainage collection chamber 5.Occlusive dressing in place over the chest tube insertion site 6.Fluctuation of water in the tube in the water seal chamber during inhalation and exhalation

3.Drainage system maintained below the client's chest 4.50 mL of drainage in the drainage collection chamber 5.Occlusive dressing in place over the chest tube insertion site 6.Fluctuation of water in the tube in the water seal chamber during inhalation and exhalation

The nurse is caring for a client who is on strict bed rest and creates a plan of care with goals related to the prevention of deep vein thrombosis and pulmonary emboli. Which nursing action is most helpful in preventing these disorders from developing? 1.Restricting fluids 2.Placing a pillow under the knees 3.Encouraging active range-of-motion exercises 4.Applying a heating pad to the lower extremities

3.Encouraging active range-of-motion exercises

The nurse reads that a client's tuberculin skin test is positive and notes that previous tests were negative. The client becomes upset and asks the nurse what this means. The nurse should base the response on which interpretation? 1.Systemic tuberculosis 2.Pulmonary tuberculosis 3.Exposure to tuberculosis 4.No evidence of tuberculosis

3.Exposure to tuberculosis

The nurse is caring for a client with a respiratory disorder who is attempting to stop smoking. The primary health care provider has recommended nicotine gum. When reviewing this treatment with the client, the nurse should provide which instruction? 1.Drink water while chewing the gum. 2.Only chew the gum for a maximum of 10 minutes. 3.Hold the gum between the cheek and teeth periodically. 4.Eat a light snack immediately before chewing the gum.

3.Hold the gum between the cheek and teeth periodically.

A client with chronic obstructive pulmonary disease (COPD) is experiencing exacerbation of the disease. The nurse should determine that which finding documented in the client's record is an expected finding with this client? 1.Increased oxygen saturation with ambulation 2.A widened diaphragm documented by chest x-ray 3.Hyperinflation of lungs documented by chest x-ray 4.A shortened expiratory phase of the respiratory cycle

3.Hyperinflation of lungs documented by chest x-ray

The nurse is providing an educational session to community members regarding histoplasmosis. The nurse should provide which information about this disease? 1.It is caused by a tick bite. 2.It is caused by contamination from cat feces. 3.It can be caused by the inhalation of spores from bird droppings. 4.It can be contagious by respiratory contact with an infected person

3.It can be caused by the inhalation of spores from bird droppings

The nurse is caring for a postoperative pneumonectomy client. Which finding on assessment of the client is an adverse sign or symptom indicating pulmonary edema? 1.Pain with deep breathing 2.Increased chest tube drainage 3.Lung crackles in the remaining lung 4.Respiratory rate of 20 breaths/minute

3.Lung crackles in the remaining lung

The nurse is teaching a client with emphysema about positions that help breathing during dyspneic episodes. The nurse instructs the client to avoid which position, which would aggravate breathing? 1.Sitting up and leaning on a table 2.Standing and leaning against a wall 3.Lying on the back in a low-Fowler's position 4.Sitting up with the elbows resting on the knees

3.Lying on the back in a low-Fowler's position

The nurse is providing instructions to a client about diaphragmatic breathing. The nurse tells the client that this technique is helpful because in normal respiration, as the diaphragm contracts, it takes which action? 1.Aids in exhalation 2.Moves up and inward 3.Moves downward and out 4.Makes the thoracic cage smaller

3.Moves downward and out

The nurse is instructing a client in diaphragmatic breathing. To reinforce the need for this technique, the nurse teaches the client that in normal respiration, which is an action of the diaphragm? 1.Aids in exhalation as it contracts 2.Moves up and inward as it contracts 3.Moves downward and out as it contracts 4.Makes the thoracic cage smaller as it contracts

3.Moves downward and out as it contracts

A client with a chest injury has suffered flail chest. The nurse assesses the client for which most distinctive sign of flail chest? 1.Cyanosis 2.Hypotension 3.Paradoxical chest movement 4.Dyspnea, especially on exhalation

3.Paradoxical chest movement

The nurse is assisting a radiologist to facilitate a thoracentesis. The nurse assists the client to a position that widens the spaces between the ribs to help drain which area? 1.Alveoli 2.Trachea 3.Pleural space 4.Main bronchi

3.Pleural space

The nurse is planning care for an 81-year-old unresponsive client admitted to the hospital with a medical diagnosis of pneumonia. The nurse has identified the problem of inability to clear the airway related to retained secretions. Which intervention is most appropriate? 1.Initiate and maintain supplemental oxygen as prescribed. 2.Plan activities with rest periods to conserve oxygen needs. 3.Provide nasotracheal suctioning as needed to remove secretions. 4.Monitor oxygenation (the oxygen saturation [SaO2]) during activity.

3.Provide nasotracheal suctioning as needed to remove secretions.

The nurse monitors the respiratory status of the client being treated for acute exacerbation of chronic obstructive pulmonary disease (COPD). Which assessment finding would indicate deterioration in ventilation? 1.Cyanosis 2.Hyperinflated chest 3.Rapid, shallow respirations 4.Coarse crackles auscultated bilaterally

3.Rapid, shallow respirations

The nurse performs an admission assessment on a client with a diagnosis of tuberculosis. The nurse should check the results of which diagnostic test that will confirm this diagnosis? 1.Chest x-ray 2.Bronchoscopy 3.Sputum culture 4.Tuberculin skin test

3.Sputum culture

The nurse has conducted discharge teaching with a client diagnosed with tuberculosis who has been receiving medication for 2 weeks. The nurse determines that the client has understood the information if the client makes which statement? 1."I need to continue medication therapy for 1 month." 2."I can't shop at the mall for the next 6 months." 3."I can return to work if a sputum culture comes back negative." 4."I should not be contagious after 2 to 3 weeks of medication therapy."

4. "I should not be contagious after 2 to 3 weeks of medication therapy."

The nurse is assessing a client with multiple trauma who is at risk for developing acute respiratory distress syndrome. The nurse should assess for which earliest sign of acute respiratory distress syndrome? 1. Bilateral wheezing 2. inspiratory crackles 3. intercostal retractions 4. increased respiratory rate

4. increased respiratory rate

The nurse is assessing the respiratory status of a client who has suffered a fractured rib. The nurse should expect to note which finding? 1. slow, deep respirations 2. rapid, deep respirations 3. paradoxical respirations 4. pain, especially with inspiration

4. pain, especially with inspiration

The nurse is discharging a client with chronic obstructive pulmonary disease (COPD) and reviewing specific instructional points about COPD. What comment by the client indicates that further teaching is needed? 1."I need to avoid alcohol and sedative medications." 2."I have to cut down on the percentage of carbohydrates in my diet." 3."Besides smoking, I can't be around second- or thirdhand smoke." 4."I have to keep my nasal cannula oxygen levels between 4 and 6 L/min."

4."I have to keep my nasal cannula oxygen levels between 4 and 6 L/min."

The clinic nurse administers a tuberculin skin test to a client. The nurse tells the client to return to the clinic for the results in how long? 1.6 to 12 hours 2.12 to 24 hours 3.24 to 28 hours 4.48 to 72 hours

4.48 to 72 hours

The nurse is providing care for a client recently admitted with new onset pleurisy. Upon auscultation of the client's lungs, the nurse notes the absence of the pleural friction rub, which was documented on previous assessments. What is the most likely indication for this change in the client's lung sounds? 1.Effectiveness of medication therapy 2.The deep breaths that the client is taking 3.Decreased inflammatory reaction at the site 4.Accumulation of pleural fluid in the inflamed area

4.Accumulation of pleural fluid in the inflamed area

The nurse is performing an admission assessment on a client with tuberculosis (TB) and is collecting subjective and objective data. Which finding would the nurse expect to note? 1.High fever 2.Flushed skin 3.Complaints of weight gain 4.Complaints of night sweats

4.Complaints of night sweats

The clinic nurse is providing instructions to a client with a diagnosis of pharyngitis. The nurse provides which instruction to the client? 1.Drink hot tea throughout the day. 2.Drink hot cocoa instead of coffee. 3.Restrict fluid intake to 1000 mL daily. 4.Eat foods that are highly seasoned in moderation.

4.Eat foods that are highly seasoned in moderation.

A client with chronic obstructive pulmonary disease (COPD) has a respiratory rate of 24 breaths per minute, bilateral crackles, and cyanosis and is coughing but unable to expectorate sputum. Which problem is the priority? 1.Low cardiac output secondary to cor pulmonale 2.Gas exchange alteration related to ventilation-perfusion mismatch 3.Altered breathing pattern secondary to increased work of breathing 4.Inability to clear the airway related to inability to expectorate sputum

4.Inability to clear the airway related to inability to expectorate sputum

The nurse is assessing a client with multiple trauma who is at risk for developing acute respiratory distress syndrome. The nurse should assess for which earliest sign of acute respiratory distress syndrome? 1.Bilateral wheezing 2.Inspiratory crackles 3.Intercostal retractions 4.Increased respiratory rate

4.Increased respiratory rate

The nurse is teaching a client with chronic airflow limitation (CAL) about positions that help breathing during dyspneic episodes. Which position, assumed by the client, would indicate that the client needs additional teaching on positioning? 1.Sitting up and leaning on a table 2.Standing and leaning against a wall 3.Sitting up with elbows resting on knees 4.Lying on the back in a low-Fowler's position

4.Lying on the back in a low-Fowler's position

The nurse is caring for a client who is anxious and is experiencing dyspnea and restlessness from hypoxemia associated with pulmonary edema. Auscultation of the lungs reveals these breath sounds. The nurse determines that these breath sounds are usually caused by which condition? 1.Obstruction of the bronchus 2.Inflammation of the pleural surfaces 3.Passage of air through a narrowed airway 4.Opening of small airways that contain fluid

4.Opening of small airways that contain fluid

The nurse is assessing the respiratory status of a client who has suffered a fractured rib. The nurse should expect to note which finding? 1.Slow, deep respirations 2.Rapid, deep respirations 3.Paradoxical respirations 4.Pain, especially with inspiration

4.Pain, especially with inspiration

The nurse instructs a client with chronic obstructive pulmonary disease (COPD) to use the pursed-lip method of breathing and evaluates the teaching by asking the client about the purpose of this type of breathing. The nurse determines that the client understands if the client states that the primary purpose of pursed-lip breathing is to promote which outcome? 1.Promote oxygen intake. 2.Strengthen the diaphragm. 3.Strengthen the intercostal muscles. 4.Promote carbon dioxide elimination.

4.Promote carbon dioxide elimination.

The nurse is caring for a client with tuberculosis (TB) who is fearful of the disease and anxious about the prognosis. In planning nursing care, the nurse should incorporate which intervention as the best strategy to assist the client in coping with the illness? 1.Allow the client to deal with the disease in an individual fashion. 2.Ask family members whether they wish a psychiatric consultation. 3.Encourage the client to visit with the pastoral care department's chaplain. 4.Provide reassurance that continued compliance with medication therapy is the most proactive way to cope with the disease.

4.Provide reassurance that continued compliance with medication therapy is the most proactive way to cope with the disease.

A client being mechanically ventilated after experiencing a fat embolism is visibly anxious. What is the best nursing action? 1.Ask a family member to stay with the client at all times. 2.Encourage the client to sleep until arterial blood gas results improve. 3.Ask the primary health care provider for a prescription for succinylcholine. 4.Provide reassurance to the client and give small doses of morphine sulfate intravenously as prescribed.

4.Provide reassurance to the client and give small doses of morphine sulfate intravenously as prescribed.

A client with long-standing empyema undergoes decortication of the affected lung area. Postoperatively the nurse should place the client in which position? 1.Modified left lateral recumbent 2.Supine 3.Side-lying 4.Semi-Fowler's

4.Semi-Fowler's

The nurse is assessing a client with the typical clinical manifestations of tuberculosis (TB). During history-taking the nurse anticipates that the client will report presence of cough and fatigue for what period of time? 1.1 or 2 days 2.1 to 2 weeks 3.Almost 1 week 4.Several weeks to months

4.Several weeks to months

The nurse is giving discharge instructions to a client with pulmonary sarcoidosis. The nurse concludes that the client understands the information if the client indicates to report which early sign of exacerbation? 1.Fever 2.Fatigue 3.Weight loss 4.Shortness of breath

4.Shortness of breath

The nurse provides discharge instructions to a client with pulmonary sarcoidosis. The nurse concludes that the client understands the information if the client indicates to report which early sign of exacerbation? 1.Fever 2.Fatigue 3.Weight loss 4.Shortness of breath

4.Shortness of breath

The nurse is instructing a hospitalized client with a diagnosis of emphysema about measures that will enhance the effectiveness of breathing during dyspneic periods. Which position should the nurse instruct the client to assume? 1.Sitting up in bed 2.Side-lying in bed 3.Sitting in a recliner chair 4.Sitting up and leaning on an overbed table

4.Sitting up and leaning on an overbed table

The nurse in an ambulatory clinic is preparing to administer a tuberculin skin test to a client who may have been exposed to a person with tuberculosis (TB). The client reports having received the bacillus Calmette-Guérin (BCG) vaccine before moving to the United States from a foreign country. Which interpretation should the nurse make? 1.The client has no risk of acquiring TB and needs no further workup. 2.The client is at increased risk for acquiring TB and needs immediate medication therapy. 3.The client's test result will be negative, and a sputum culture will be required for diagnosis. 4.The client's test result will be positive, and a chest x-ray study will be required for evaluation.

4.The client's test result will be positive, and a chest x-ray study will be required for evaluation.

A client who has been diagnosed with pleurisy tells the nurse that it is painful to inhale. The nurse responds that this is an expected finding because of which physical response to this disorder? 1.The stretch receptors in the lungs are irritated. 2.The diaphragm is weak and is difficult to move. 3.This condition causes nerve endings to be especially sensitive. 4.The inflamed pleurae cannot glide against each other as they normally do.

4.The inflamed pleurae cannot glide against each other as they normally do.

The nurse caring for a client who has a pneumothorax notes continuous bubbling in the water seal chamber of the client's closed chest drainage system. How should the nurse interpret this finding? 1.The drainage chamber is full. 2.The pneumothorax is resolving. 3.The suction chamber system is shut off. 4.There is an air leak somewhere in the system.

4.There is an air leak somewhere in the system.

The emergency department nurse is assessing a client who has sustained a blunt injury to the chest wall. Which finding indicates the presence of a pneumothorax in this client? 1.A low respiratory rate 2.Diminished breath sounds 3.The presence of a barrel chest 4.A sucking sound at the site of injury

Diminished breath sounds