NSG 1600- EAQs- Exam 4

At which interval are humidified oxygen systems replaced to prevent infection? A. 1 day B. 3 days C. 5 days D. 7 days

A

S&S: Acute Respiratory Distress

- Restlessness or behavioral changes - Tachycardia - Dilated pupils

A client is hospitalized with a diagnosis of emphysema. The nurse provides teaching and would begin with which aspect of care? A. The disease process and breathing exercises B. How to control or prevent respiratory infections C. Using aerosol therapy, especially nebulizers D. Priorities when performing everyday activities

A

When a client has a superficial tumor involving only 1 vocal cord, which surgery would the nurse anticipate? A. Cordectomy B. Tracheotomy C. Total laryngectomy D. Oropharyngeal resections

A

Which assessment finding of a client being treated in the emergency department after a motor vehicle collision indicates the need for immediate health care provider intervention? Select all that apply. A. Facial edema B. Septal deviation C. Clear nasal drainage D. Oxygen saturation 89% E. Bilateral periorbital bruising

A, B, C, D, E

Which risk factor for head and neck cancer would the nurse assess for in a client with a persistent, nagging cough? Select all that apply. A. Type of employment B. Presence of ear pain C. History of tobacco use D. Oral hygiene practices E. Amount of alcohol intake

A, B, C, D, E

Which trigger would the nurse instruct a client to avoid to decrease the incidence of asthma attacks? Select all that apply. A. Mold B. Cold air C. Pet dander D. Air pollution E. Cigarette smoke

A, B, C, D, E

Which procedure is shown in the picture? A. A thoracentesis B. A mediastinoscopy C. A transbronchial biopsy D. Computed tomography

A. a thoracentesis

A client is extubated in the postanesthesia care unit after surgery. For which common response would the nurse be alert when monitoring the client for acute respiratory distress? A. Bradycardia B. Restlessness C. Constricted pupils D. Clubbing of the fingers

B

How would the nurse position a client to practice supraglottic swallowing after tracheostomy? A. In bed B. Upright C. Lying down D. Position of comfort

B

Which parameter describes the maximum volume of air a client's lungs may contain? A. Vital capacity B. Total lung capacity C. Inspiratory capacity D. Functional residual capacity

B

Which rationale would the nurse use when explaining the purpose of pursed-lip breathing to a client with emphysema? A. Prevents bronchial spasm B. Decreases air trapping in lung D. Improves alveolar surface area E. Strengthens diaphragmatic contraction

B

Which actions would the nurse take to obtain subjective data about a client's respiratory status? Select all that apply. A. Palpate the chest and back for masses. B. Question the client about shortness of breath. C. Check the hematocrit and hemoglobin values. D. Inspect the skin and nails for integrity and color. E. Ask the client about color and quantity of sputum.

B, E

A client arrives in the emergency department with multiple crushing wounds of the chest, abdomen, and legs. What are the priority nursing assessments? A. Level of consciousness and pupil size B. Characteristics of pain and blood pressure C. Quality of respirations and presence of pulses D. Observation of abdominal contusions and other wounds

C

A client presents with hemoptysis. The nurse recalls that the clinical manifestation is associated with which disease? A. Anemia B. Pneumonia C. Tuberculosis D. Leukocytosis

C

A client with a coronary occlusion is experiencing chest pain and distress. Which is the primary reason that the nurse administers oxygen? A. To prevent dyspnea B. To prevent cyanosis C. To increase oxygen concentration to heart cells D. To increase oxygen tension in the circulating blood

C

A client with chronic obstructive pulmonary disease (COPD) has a blood pH of 7.25 and Pco2 of 60 mm Hg. These blood gas results require nursing attention because they indicate which condition? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

C

A client reports left-sided chest pain after playing racquetball. The client is hospitalized and diagnosed with left pneumothorax. When assessing the client's left chest area, the nurse expects to identify which finding? A. Dull sound on percussion B. Vocal fremitus on palpation C. Rales with rhonchi on auscultation D. Absence of breath sounds on auscultation

D

After percussing a client's posterior chest and hearing low-pitched hollow sounds over the whole chest, how will the nurse document the finding? A. Dull B. Flat C. Tympanic D. Resonance

D

The nurse provides education to a group of student nurses about pursed-lip breathing. The nurse would include which primary purpose of the respiratory exercise? A. Decreases chest pain B. Conserves energy C. Increases oxygen saturation D. Promotes elimination of CO2

D

When a client with a health care-acquired respiratory tract infection asks the nurse what this means, which response will the nurse give? A. "You developed an infection that requires antibiotics." B. "This is a highly contagious infection requiring isolation." C. "An infection you had before beginning treatment has flared up." D. "Your infection occurred because of exposure to a health care facility. "

D

After reviewing information about oxygenation for 4 clients with chronic obstruction pulmonary disease, which client will the nurse plan to teach about use of home long-term continuous oxygen therapy? A. Partial pressure of oxygen (PaO2) of 72; peripheral capillary oxygen saturation (SpO2) of 96 B. PaO2 of 60; SpO2 of 90 C. PaO2 of 55; SpO2 of 88 D. PaO2 of 70; SpO2 of 92

C

How would the nurse position a client with epistaxis? A. Supine B. Side-lying C. Upright leaning forward D. Sitting with the head tipped backward

C

Soft swishing sounds of breathing are heard when the nurse auscultates a client's chest. Which term would be used when documenting this assessment finding? A. Fine crackles B. Adventitious sounds C. Vesicular breath sounds D. Diminished breath sounds

C

The nurse described a client's abnormal breath sounds and included crackles, rhonchi, wheezes, and pleural friction rubs. Which breath sounds did the nurse hear? A. Vesicular B. Bronchial C. Adventitious D. Bronchovesicular

C

Which intervention would the nurse offer the client to help relieve the symptoms of sinusitis? A. Repositioning B. Humidified air C. Saline irrigation D. Frequent suctioning

C

Which parameter describes the maximum volume of air that can be inhaled after maximum expiration. A. Vital capacity B. Total lung capacity C. Inspiratory capacity D. Functional residual capacity

C

A client who is receiving peritoneal dialysis reports severe respiratory difficulty. Which immediate action would the nurse implement? A. Auscultate the lungs. B. Obtain arterial blood gases. C. Notify the health care provider. D. Apply pressure to the abdomen

A

Which instructions would the nurse share with the client being discharged after rhinoplasty? A. Avoid items that may trigger sneezing. B. Consume fluids at a tepid temperature. C. Brush the teeth thoroughly after each food intake. D. Sleep on the back using one pillow under the head.

A

Which parameter describes the maximum volume of air that can be exhaled after maximum inspiration? A. Vital capacity B. Total lung capacity C. Inspiratory capacity D. Functional residual capacity

A

Which statement describes a client's tidal volume? A. Tidal volume is the volume of air inhaled and exhaled with each breath. B. Tidal volume is the amount of air remaining in the lungs after forced expiration. C. Tidal volume is the additional air forcefully inhaled after normal inhalation. D. Tidal volume is the additional air forcefully exhaled after normal exhalation.

A

Which amount is the normal value of a client's inspiratory reserve volume? A. 0.5 L B. 1.0 L C. 1.5 L D. 3.0 L

D

Which parameter describes the volume of air remaining in the lungs at the end of normal exhalation. A. Vital capacity B. Total lung capacity C. Inspiratory capacity D. Functional residual capacity

D

Which part of the upper respiratory system is involved in equalizing the pressure within the middle ear while swallowing? A. Glottis B. Paranasal sinus C. Palatine tonsils D. Eustachian tubes

D

Which substance will the home care nurse instruct a client to use after laryngectomy to cleanse the stoma site? A. Sterile saline B. Steroid cream C. Oil-based lubricant D. Mild soap and water

D

Which action would the nurse take to prevent complications when caring for a client with a chest tube to water seal drainage system for a pneumothorax? Select all that apply. A. Emptying the drainage system when full B. Keeping the drainage system at heart level C. Notifying the health care provider of drainage greater than 50 mL/h D. Marking the time on the drainage unit every shift E. Laying the drainage system on its side during transport

D