NU 122 Respiratory Test

A nurse is administering a purified protein (PPD) test to a client. Which statement concerning PPD testing is true? A. A positive reaction indicates that the client has been exposed to the disease B. A negative reaction always excludes the diagnosis of TB C. The PPD can be read within 18 hrs after injection D. A positive reaction indicates that the client has active TB

A. A positive reaction indicates that the client has been exposed to the disease

A client is receiving IV Heparin at a rate of 14 units/kg/min. The client weighs 75 kg. The nurse starts the infusion at 1315. At 1745 the client pulls the IV catheter out. How many units of Heparin did the client receive? A. 289,170 units B. 283,500 units C. 636,552 units D. 1,071 units

A. 289,170 units

A patient with bacterial pneumonia has coarse crackles and thick sputum. Which action should the nurse plan to promote airway clearance? A. Help the patient to splint the chest when coughing B. Encourage pursed-lip breathing technique C. Restrict fluids during the day D. Encourage the patient to wear the nasal oxygen cannula

A. Help the patient to splint the chest when coughing

A patient with pneumonia has a fever of 101.4 F, a productive cough and oxygen saturation of 88%. The patient is weak and needs assistance to get out of bed. Which patient problem should the nurse assign as the priority? A. Impaired gas exchange B. Fatigue C. Impaired mobility D. Hyperthermia

A. Impaired gas exchange

When assessing a client with advanced COPD which are expected findings? A. Increased anteroposterior chest diameter (barrel chest) B. Increased chest excursions with respirations C. Collapsed neck veins D. Underdeveloped neck muscles

A. Increased anteroposterior chest diameter (barrel chest)

A nurse is providing education to a group of nursing students on the primary symptoms of emphysema. Which symptoms would not be included in the list of clinical manifestations? A. Dyspnea B. Cyanosis C. Pursed lip-breathing D. Ineffective, chronic cough

B. Cyanosis

A client is 1 day postoperative a total laryngectomy and radical neck dissection for cancer. What would be the priority goal by the nurse? A. Improve body image and self-esteem of the client B. Maintain a patent airway C. Prevent aspiration by offering intermittent suctioning to the client D. Assist a client to communicate through use of esophageal speech by 12 hrs postoperative

B. Maintain a patent airway

A patient is hospitalized with active TB. Which assessment finding indicates to the nurse that prescribed airborne precautions are likely to be discontinued? A. Chest X-ray shows no upper lobe infiltrates B. Sputum smears for acid fast bacilli are negative C. TB medications have been taken for 6 months D. Mantoux testing shows an induration of 10mm

B. Sputum smears for acid fast bacilli are negative

A patient with right lower-lobe pneumonia has been treated with IV antibiotics for 3 days. Which assessment date obtained by the nurse indicates that the treatment was effective? A. Bronchial breath sounds are heard at the right base B. The patients WBC has decreased to 6,000/uL C. Increased tactile fremits is palpable over the right chest D. The patient coughs up small amount of green mucus

B. The patients WBC has decreased to 6,000/uL

A healthcare provider has entered orders for a client with COPD. Which of the following orders should the nurse question? A. Oxygen via nasal cannula 2L/min B. Titrate Oxygen to maintain oxygen saturation of 98-100% C. Keep head of bed elevated 30-40 degrees D. Albuterol nebulizer treatments Q4H PRN

B. Titrate Oxygen to maintain oxygen saturation of 98-100%

A client is scheduled for a radical neck surgery and a total laryngectomy. During the preoperative teaching, the nurse should prepare the client for having: A. A gastrostomy tube B. An endotracheal tube C. A laryngectomy tube D. A chest tube

C. A laryngectomy tube

The nurse supervises a student nurse who is assigned to take care of a patient with active TB. Which action, if performed by the student nurse, would require an intervention by the nurse? A. Hand washing is performed before entering the room B. A snack is brought to the patient from the unit refrigerator C. A surgical face mask is applied before visiting the patient D. The patient is offered a tissue from the box at the bedside

C. A surgical face mask is applied before visiting the patient

A client has been instructed on how to provide a sputum sample for C&S. The nurse finds the sample on the patients over the bed table at the start of her shift. The nurse asks the client when he produced the sample. The clients states "sometime early this morning", but he cannot give a specific time. What should the nurse do with the sample? A. Document the color and amount of the sample, label the specimen cup and send it to lab B. Label the specimen and send to lab STAT C. Discard it and ask client for another sample D. Label and place the sample in the fridge for lab collection later

C. Discard it and ask client for another sample

A nurse consulting with a nutrition specialist knows it's important to consider a special diet for a client with chronic obstructive pulmonary disease (COPD). Which diet is appropriate for this client? A. 1800 calorie ADA B. Full liquid C. High protein D. Low fat

C. High protein

The nurse notes that a patient has incisional pain, poor cough effort and scattered coarse crackles after a thoracotomy. Which action should the nurse take first? A. Assist the patient to sit upright in a chair B. Observe the patient use the incentive spirometer C. Medicate the patient with prescribed morphine D. Splint the patients chest during cough

C. Medicate the patient with prescribed morphine

The nurse administers the prescribed therapies for a patient with cor pulmonale and right-sided heart failure. Which assessment could be used to evaluate the effectiveness of the therapies? A. Monitor for elevated WBC B. Auscultate for crackles in the lungs C. Observe for distended neck veins D. Palpate for heaves of thrills over the heart

C. Observe for distended neck veins

The nurse is teaching a client with COPD to assess for signs and symptoms of right-sided heart failure. Which sign or symptom should be included in the teaching plan? A. Clubbing of the nail beds B. Hypertension C. Peripheral Edema D. Increased appetite

C. Peripheral Edema

A nurse administers cefazolin instead of ceftriaxone to an 8 yr old with pneumonia. The client has suffered no adverse effects. The nurse tells the charge nurse of the incident but fears disciplinary action from reporting the error. What should the charge nurse tell the nurse? A. If you do not report the error I will have to B. There is no need to report it as the medications are the same C. Reporting the error helps to identify system problems to improve client safety D. Notify the clients healthcare provider to see if she wants this reported

C. Reporting the error helps to identify system problems to improve client safety

A nurse is completing an assessment of a client and finds the following assessment: Temp of 100.8 F; RR of 18 with a oxygen saturation of 97% on room air; apical pulse of 86 bpm. The client states he has lost 20lbs over the past few months and has been fatigued. He also complains of chest pain that increases when coughing. He states that his cough is dry and nonproductive. What diagnosis would the nurse suspect? A. Pneumonia B. Aspiration pneumonia C. TB D. Lung abscess

C. TB

After change-of-shift report, which patient should the nurse see first? A. A 72 yr old with pulmonole who has 4+ bilateral edema in his legs and feet B. A 28 yr old with a history of lung transplant 1 month ago and a fever of 101 degrees F C. A 40 yr old with pleural effusion who reports severe stabbing chest pain D. A 64 yr old with lung cancer and tracheal deviation after subclavian catheter insertion

D. A 64 yr old with lung cancer and tracheal deviation after subclavian catheter insertion

A patient with a possible pulmonary embolism reports chest pain and difficulty breathing. The nurse finds the HR of 142 bpm, BP 100/60 and RR of 42. Which action should the nurse take first? A. Notify the physician B. Administer anticoagulant drug therapy C. Prepare patient for a CT D. Elevate the head of the bed to semi-fowlers position

D. Elevate the head of the bed to semi-fowlers position

A nurse is providing education to a client with atelectasis. What interventions should the nurse include in her teaching plan? A. Bedrest B. Short shallow breathing C. Frequent turning and positioning D. High flow oxygen use

D. High flow oxygen use

The nurse has just auscultated coarse crackles bilateral on a patient with a tracheostomy tube in place. If the patient is unsuccessful in coughing up secretions, what action should the nurse take?

Put on sterile gloves and use a sterile catheter to suction

The nurse is providing education to a student nurse on the proper use of chest tubes and chest fluid management. What statement from the nursing student would require additional teaching? A. I should mark the level of drainage on the collection column chamber since I cannot empty the drainage from the chamber B. The suction setting should be increased until the nurse can see increased drainage C. I should not milk the tube id the drainage is to thick D. The most important factor that effects fluid drainage from the chest is gravity

The most important factor that effects fluid drainage from the chest is gravity

An occupational health nurse works at a manufacturing plant where there is potential exposure to inhaled dust. Which action, if recommended by the nurse, will be most helpful in reducing the incidence of lung disease? a. Treat workers with pulmonary fibrosis. b. Teach about symptoms of lung disease. c. Require the use of protective equipment. d. Monitor workers for coughing and wheezing.

c. Require the use of protective equipment.