Nurs 108 exam 1

It is cold season and the school nurse been asked to provide an educational event for the parent teacher organization of the local elementary school. What should the nurse include in teaching about the treatment of pharyngitis? A) Pharyngitis is more common in children whose immunizations are not up to date. B) There are no effective, evidence-based treatments for pharyngitis. C) Use of warm saline gargles or throat irrigations can relieve symptoms. D) Heat may increase the spasms in pharyngeal muscles.

use of warm saline gargles or throat irrigations can relieve symtoms

The clinic nurse is caring for a patient who has been diagnosed with emphysema and who has just had a pulmonary function test (PFT) ordered. The patient asks, "What exactly is this test for?" What would be the nurse's best response? A) A PFT measures how much air moves in and out of your lungs when you breathe. B) A PFT measures how much energy you get from the oxygen you breathe? C) A PFT measures how elastic your lungs are. D) A PFT measures whether oxygen and carbon dioxide move between your lungs and your blood

A) A PFT measures how much air moves in and out of your lungs when you breathe. PFTs are routinely used in patients with chronic respiratory disorders. They are performed to assess respiratory function and to determine the extent of dysfunction. Such tests include measurements of lung volumes, ventilatory function, and the mechanics of breathing, diffusion, and gas exchange. Lung elasticity and diffusion can often be implied from PFTs, but they are not directly assessed. Energy obtained from respiration is not measured directly.

The medical nurse who works on a pulmonology unit is aware that several respiratory conditions can affect lung tissue compliance. The presence of what condition would lead to an increase in lung compliance? A) Emphysema B) Pulmonary fibrosis C) Pleural effusion D) Acute respiratory distress syndrome (ARDS)

A) Emphysema High or increased compliance occurs if the lungs have lost their elasticity and the thorax is overdistended, in conditions such as emphysema. Conditions associated with decreased compliance include pneumothorax, hemothorax, pleural effusion, pulmonary edema, atelectasis, pulmonary fibrosis, and ARDS.

The home care nurse is assessing the home environment of a patient who will be discharged from the hospital shortly after his laryngectomy. The nurse should inform the patient that he may need to arrange for the installation of which system in his home? A) a humidification system B) an air conditioning system C) a water purification system D) a radiant heating system

A) a humidification system

The nurse at a long-term care facility is assessing each of the residents. Which resident most likely faces the greatest risk for aspiration? A) a resident who suffered a severe stroke several weeks ago B) a resident with mid-stage Alzheimer's disease C) a 92-year-old resident who needs extensive help with ADLs D) a resident severe and deforming rheumatoid arthritis

A) a resident who suffered a severe stroke several weeks ago

The public health nurse is administering Mantoux tests to children who are being registered for kindergarten in the community. How should the nurse administer this test? A) administer intradermal injections into the children's inner forearms B) administer intramuscular injections into each child's vastus lateralis C) administer subcutaneous injections into each child's umbilical region D) administer a subcutaneous injection at a 45-degree angle into each child's deltoid

A) administer intradermal injections into the children's inner forearms

The nurse has assessed a patient's family history for three generations. The presence of which respiratory disease would justify this type of assessment? A) asthma B) obstructive sleep apnea C) community-acquired pneumonia D) pulmonary edema

A) asthma Asthma is a respiratory illness that has genetic factors. Sleep apnea, pneumonia, and pulmonary edema lack genetic risk factors

While planning a patient's care, the nurse identifies nursing actions to minimize the patient's pleuritic pain. What intervention should the nurse include in the plan of care? A) avoid actions that will cause the patient to breathe deeply B) ambulate the patient at least three times daily C) arrange for a soft-textured diet and increased fluid intake D) encourage the patient to speak as little as possible

A) avoid actions that will cause the patient to breathe deeply

The nurse is caring for a patient who is scheduled for a lobectomy for a diagnosis of lung cancer. While assisting with a subclavian vein central line insertion, the nurse notes the client's oxygen saturation rapidly dropping. The patient complains of shortness of breath and becomes tachypneic. The nurse suspects a pneumothorax has developed. Further assessment findings supporting the presence of a pneumothorax include what? A) diminished or absent breath sounds on the affected side B) paradoxical chest wall movement with respirations C) sudden loss of consciousness D) muffled heart sounds

A) diminished or absent breath sounds on the affected side

The perioperative nurse is writing a care plan for a patient who has returned from surgery 2 hours prior. Which measure should the nurse implement to most decrease the patient's risk of developing pulmonary emboli (PE)? A) early ambulation B) increased dietary intake of protein C) maintaining the patient in a supine position D) administering aspirin with warfarin

A) early ambulation

The ED nurse is assessing a young gymnast who fell from a balance beam. The gymnast presents with a clear fluid leaking from her nose. What should the ED nurse suspect? A) fracture of the cribriform plate B) rupture of an ethmoid sinus C) abrasion of the soft tissue D) fracture of the nasal septum

A) fracture of the cribriform plate

The nurse is caring for a patient whose recent unexplained weight loss and history of smoking have prompted diagnostic testing for cancer. What symptom is most clearly associated with the early stages of laryngeal cancer? A) hoarseness B) dyspnea C) dysphagia D) frequent nosebleeds

A) hoarseness

The nurse is caring for a patient with a lower respiratory tract infection. When planning a focused respiratory assessment, the nurse should know that this type of infection most often causes what? A) impaired gas exchange B) collapsed bronchial structures C) necrosis of the alveoli D) closed bronchial tree

A) impaired gas exchange the lower respiratory tract consists of the lungs, which contain the bronchial and alveolar structures needed for gas exchange. A lower respiratory tract infection does not collapse bronchial structures or close the bronchial tree. An infection does not cause necrosis of lung tissue.

The nurse is caring for a patient at risk for atelectasis. The nurse implements a first-line measure to prevent atelectasis development in the patient. What is an example of a first-line measure to minimize atelectasis? A) incentive spirometry B) intermittent positive-pressure breathing (IPPB) C) positive end-expiratory pressure (PEEP) D) bronchoscopy

A) incentive spirometry

A critical care nurse is caring for a patient diagnosed with pneumonia as a surgical complication. The nurse's assessment reveals that the patient has an increased work of breathing due to copious tracheobronchial secretions. What should the nurse encourage the patient to do? A) increase oral fluids unless contraindicated B) call the nurse for oral suctioning, as needed C) lie in a low Fowler's or supine position D) increase activity

A) increase oral fluids, unless contraindicated

The nurse is caring for a patient who needs education on his medication therapy for allergic rhinitis. The patient is to take cromolyn (Nasalcrom) daily. In providing education for this patient, how should the nurse describe the action of the medication? A) it inhibits the release of histamine and other chemicals B) it inhibits the action of proton pumps C) it inhibits the action of the sodium-potassium pump in the nasal epithelium D) it causes bronchodilation and relaxes smooth muscle in the bronchi

A) it inhibits the release of histamine and other chemicals

The nurse is assessing a patient who has a 35 pack-year history of cigarette smoking. In light of this known risk factor for lung cancer, what statement should prompt the nurse to refer the patient for further assessment? A) lately, I have this cough that just never seems to go away B) I find that I don't have nearly the stamina that I used to C) I seem to get nearly every cold and flu that goes around my workplace D) I never used to have allergies, but now I think I'm developing allergies to dust and pet hair

A) lately, I have this cough that just never seems to go away

A patient on the medical unit has told the nurse that he is experiencing significant dyspnea, despite that he has not recently performed any physical activity. What assessment question should the nurse ask the patient while preparing to perform a physical assessment? A) On a scale from 1 to 10, how bad would rate your shortness of breath? B) When was the last time you ate or drank anything? C) Are you feeling any nausea along with your shortness of breath? D) Do you think that some medication might help you catch your breath?

A) on a scale from 1 to 10, how bad would you rate your shortness of breath? Gauging the severity of the patient's dyspnea is an important part of the nursing process. Oral intake and nausea are much less important considerations. The nurse must perform assessment prior to interventions such as providing medication.

A nurse practitioner has provided care for three different patients with chronic pharyngitis over the past several months. Which patients are at greatest risk for developing chronic pharyngitis? A) patients who are habitual users of alcohol and tobacco B) patients who are habitual users of caffeine and other stimulants C) patients who eat a diet high in spicy foods D) patients who have gastrointestinal reflux disease (GERD)

A) patients who are habitual users of alcohol and tobacco

The nurse is providing patient teaching to a patient diagnosed with acute rhinosinusitis. For what possible complication should the nurse teach the patient to seek immediate follow-up? A) periorbital edema B) headache unrelieved by OTC medications C) clear drainage from the nose D) blood-tinged mucus when blowing the nose

A) periorbital edema

The nurse is assessing an adult patient following a motor vehicle accident. The nurse observes that the patient has an increased use of accessory muscles and is complaining of chest pain and shortness of breath. The nurse should recognize the possibility of what condition? A) pneumothorax B) anxiety C) acute bronchitis D) aspiration

A) pneumothorax

A patient has been brought to the ED by the paramedics. The patient is suspected of having ARDS. What intervention should the nurse first anticipate? A) preparing to assist with intubating the patient B) setting up oxygen at 5L/minute by nasal cannula C) performing deep suctioning D) setting up a nebulizer to administer corticosteroids

A) preparing to assist with intubating the patient

The nurse is caring for a patient who has returned to the unit following a bronchoscopy. The patient is asking for something to drink. Which criterion will determine when the nurse should allow the patient to drink fluid? A) Presence of a cough and gag reflex B) Absence of nausea C) Ability to demonstrate deep inspiration D) Oxygen saturation of 92%

A) presence of a cough and gag reflex After the procedure, it is important that the patient takes nothing by mouth until the cough reflex returns because the preoperative sedation and local anesthesia impair the protective layer and swallowing for several hours. Deep inspiration, adequate oxygen saturation levels, and absence of nausea do not indicate that oral intake is safe from the risk of aspiration.

A patient has had a nasogastric tube in place for 6 days due to the development of paralytic ileus after surgery. In light of the prolonged presence of the nasogastric tube, the nurse should prioritize assessments related to what complication? A) sinus infection B) esophageal strictures C) pharyngitis D) laryngitis

A) sinus infection

An x-ray of a trauma patient reveals rib fractures and the patient is diagnosed with a small flail chest injury. Which intervention should the nurse include in the patient's plan of care? A) Suction the patient's airway secretions. B) Immobilize the ribs with an abdominal binder. C) Prepare the patient for surgery. D) Immediately sedate and intubate the patient.

A) suction the patient's airway secretions

An adult patient has tested positive for tuberculosis (TB). While providing patient teaching, what information should the nurse prioritize? A) the importance of adhering closely to the prescribed medication regimen B) the fact that the disease is a lifelong, chronic condition that will affect ADLs C) the fact that TB is self-limiting, but can take up to 2 years to resolve D) the need to work closely with the occupational and physical therapists

A) the importance of adhering closely to the prescribed medication regimen

The ED nurse is assessing a patient complaining of dyspnea. The nurse auscultates the patient's chest and hears wheezing throughout the lung field. What might this indicate? A) The patient has a narrowed airway. B) The patient has pneumonia. C) The patient needs physiotherapy D) The patient has a hemothorax

A) the patient has a narrowed airway Wheezing is a high-pitched, musical sound that is often the major finding in a patient with bronchoconstriction or airway narrowing. Wheezing is not normally indicative of pneumonia or hemothorax. Wheezing does not indicate the need for physiotherapy.

A nurse educator is reviewing the implications of the oxyhemoglobin dissociation curve with regard to the case of a current patient. The patient currently has normal hemoglobin levels, but significantly decreased SaO2 and PaO2 levels. What is an implication of this physiological state? A) the patient's tissue demands may be met, but she will be unable to respond to physiological stressors B) The patient's short-term oxygen needs will be met, but she will be unable to expel sufficient CO2 C) the patient will experience tissue hypoxia with no sensation of shortness of breath or labored breathing D) the patient will experience respiratory alkalosis with no ability to compensate

A) the patient's tissue demands will be met, but she will be unable to respond to physiological stressors. With a normal hemoglobin level of 15 mg/dL and a PaO2 level of 40 mm Hg (SaO2 75%), there is adequate oxygen available for the tissues, but no reserve for the physiological stresses that increase tissue oxygen demand. If a serious incident occurs (e.g., bronchospasm, aspiration, hypotension, or cardiac dysrhythmias) that reduces the intake of oxygen from the lungs, tissue hypoxia results.

The school nurse is presenting a class on smoking cessation at the local high school. A participant in the class asks the nurse about the risk of lung cancer in those who smoke. What response related to risk for lung cancer in smokers is most accurate? A) the younger you are when you start smoking, the higher your risk of lung cancer B) the risk for lung cancer never decreases once you have smoked, which is why smokers need annual chest x-rays C) the risk for lung cancer is determined mostly by what type of cigarettes you smoke D) the risk for lung cancer depends primarily on the other risk factors for cancer that you have

A) the younger you are when you start smoking, the higher your risk of lung cancer

The nurse is performing a respiratory assessment of an adult patient and is attempting to distinguish between vesicular, bronchovesicular, and bronchial (tubular) breath sounds. The nurse should distinguish between these normal breath sounds on what basis? A) Their location over a specific area of the lung B) The volume of the sounds C) Whether they are heard on inspiration or expiration D) whether or not they are continuous breath sounds

A) their location over a specific area of the lung Normal breath sounds are distinguished by their location over a specific area of the lung; they are identified as vesicular, bronchovesicular, and bronchial (tubular) breath sounds. Normal breath sounds are heard on inspiration and expiration, and are continuous. They are not distinguished solely on the basis of volume.

A mother calls the clinic asking for a prescription for Amoxicillin for her 2-year-old son who had what the nurse suspects to be viral rhinitis. What should the nurse explain to this mother? A) I will relay your request promptly to the doctor, but I suspect that she won't get back to you if its a cold B) I'll certainly inform the doctor, but if it is a cold, antibiotics won't be used because they do not affect the virus C) I'll phone in the prescription for you since it can be prescribed by a pharmacist D) amoxicillin is not likely the best antibiotic, but I'll call in the right prescription for you

B) I'll inform the doctor, but if it is a cold, antibiotics won't be used because they do not affect the virus

The nurse is assessing a patient who frequently coughs after eating or drinking. How should the nurse best follow up this assessment? A) Obtain a sputum sample B) Perform a swallowing assessment C) Inspect the patient's tongue and mouth D) Assess the patient's nutritional status

B) Perform a swallowing assessment Coughing after food intake may indicate aspiration of material into the tracheobronchial tree; a swallowing assessment is thus indicated. Obtaining a sputum sample is relevant in cases of suspected infection. The status of the patient's tongue, mouth, and nutrition is not directly relevant to the problem of aspiration.

A patient is having her tonsils removed. The patient asks the nurse what function the tonsils normally serve. Which of the following would be the most accurate response? A) The tonsils separate your windpipe from your throat when you swallow. B) The tonsils help to guard the body from invasion of organisms. C) The tonsils make enzymes that you swallow and which aid with digestion. D) the tonsils help with regulating the airflow down into your lungs.

B) The tonsils help to guard the body from invasion of organisms. The tonsils, the adenoids, and other lymphoid tissue encircle the throat. These structures are important links in the chain of lymph nodes guarding the body from invasion of organisms entering the nose and throat. The tonsils do not aid digestion, separate the trachea from the esophagus, or regulate airflow to the bronchi.

A patient with a decreased level of consciousness is in a recumbent position. How should the nurse best assess the lung fields for a patient in this position? A) Inform the physician that the patient is in a recumbent position and anticipate an order for a portable x-ray. B) Turn the patient to enable assessment of all the patient's lung fields. C) Avoid turning the patient and assess the accessible breath sounds from the anterior chest wall D) Obtain a pulse oximetry reading, and if the reading is low, reposition the patient and auscultate breath sounds.

B) Turn the patient to enable assessment of all the patient's lung fields Assessment of the anterior and posterior lung fields is part of the nurse's routine evaluation. If the patient is recumbent, is it essential to turn the patient to assess all lung fields so that dependent areas can be assessed for breath sounds, including the presence of normal breath sounds and adventitious sounds. Failure to examine the dependent areas of the lungs can result in missing significant findings. This makes the other given options unacceptable.

The nurse is performing a respiratory assessment of a patient who has been experiencing episodes of hypoxia. The nurse is aware that this is ultimately attributable to impaired gas exchange. On what factor does adequate gas exchange primarily depend? A) appropriate perfusion/diffusion ration B) an adequate ventilation/perfusion ration C) adequate diffusion of gas in shunted blood D) appropriate blood nitrogen concentration

B) adequate ventilation/perfusion ratio Adequate gas exchange depends on an adequate ventilation/perfusion ratio. There is no perfusion/diffusion ratio. Adequate gas exchange does not depends on the diffusion of gas in shunted blood or a particular concentration of nitrogen.

A perioperative nurse is caring for a postoperative patient. The patient has a shallow respiratory pattern and is reluctant to cough or to begin mobilizing. The nurse should address the patient's increased risk for what complication? A) acute respiratory distress syndrome (ARDS) B) atelectasis C) aspiration D) pulmonary embolism

B) atelectasis

The nurse is performing the health interview of a patient with chronic rhinosinusitis who experiences frequent nose bleeds. The nurse asks the patient about her current medication regimen. Which medication would put the patient at a higher risk for recurrent epistaxis? A) afrin B) beconase C) sinstop pro D) singulair

B) beconase

The nurse is caring for a patient suspected of having ARDS. What is the most likely diagnostic test ordered in the early stages of this disease to differentiate the patient's symptoms from those of a cardiac etiology? A) carboxyhemoglobin level B) brain natriuretic peptide (BPN) level C) c-reactive protein(CRP) level D) complete blood count

B) brain natriuretic peptide (BNP) level

A gerontologic nurse is analyzing the data from a patient's focused respiratory assessment. The nurse is aware that the amount of respiratory dead space increases with age. What is the effect of this physiological change? A) increased diffusion of gases B) decreased diffusion capacity for oxygen C) decreased shunting of blood D) increased ventilation

B) decreased diffusion capacity for blood The amount of respiratory dead space increases with age. Combined with other changes, this results in a decreased diffusion capacity for oxygen with increasing age, producing lower oxygen levels in the arterial circulation. Decreased shunting and increased ventilation do not occur with age.

The nurse is conducting a presurgical interview for a patient with laryngeal cancer. The patient states that he drinks approximately 6-8 shots of vodka per day. It is imperative that the nurse inform the surgical team so the patient can be assessed for what? A) increased risk for infection B) delirium tremens C) depression D) nonadherence to postoperative care

B) delirium tremens

The nurse is doing rounds at the beginning of a shift and notices a sputum specimen in a container sitting on the bedside table in a patient's room. The nurse asks the patient when he produced the sputum specimen and he states that the specimen is about 4 hours old. What action should the nurse take? A) Immediately take the sputum specimen to the laboratory. B) Discard the specimen and assist the patient in obtaining another specimen C) Refrigerate the sputum specimen and submit it once it's chilled D) Add a small amount of normal saline to moisten the specimen

B) discard the specimen and assist the patient in obtaining another specimen Sputum samples should be submitted to the laboratory as soon as possible. Allowing the specimen to stand for several hours in a warm room results in the overgrowth of contaminated organisms and may make it difficult to identify the pathogenic organisms. Refrigeration of the sputum specimen and the addition of normal saline are not appropriate actions.

While assessing a patient who has pneumonia, the nurse has the patient repeat the letter E while the nurse auscultates. The nurse notes that the patient's voice sounds are distorted and that the letter A is audible instead of the letter E. How should this finding be documented? A) bronchophony B) egophony C) whispered pectoriloquy D) sonorous wheezes

B) egophony This finding would be documented as egophony, which can best be assessed by instructing the patient to repeat the letter E. The distortion produced by consolidation transforms the sounds into a clearly heard A rather than E. Bronchophony describes vocal resonance that is more intense and clearer than normal. Whispered pectoriloquy is a very subtle finding that is heard only in the presence of a rather dense consolidation in the lungs. Sound is so enhanced by the consolidation tissue that even whispered words are heard. Sonorous wheezes are not defined as a voice sound, but rather a breath sound.

A sputum study has been ordered for a patient who has developed coarse chest crackles and a fever. At what time should the nurse best collect the sample? A) Immediately after a meal B) First thing in the morning C) At bedtime D) After a period of exercise

B) first thing in the morning Sputum samples ideally are obtained early in the morning before the patient has had anything to eat or drink.

The nurse is assessing a newly admitted medical patient and notes there is a depression in the lower portion of the patient's sternum. This patient's health record should note the presence of what chest deformity? A) barrel chest B) funnel chest C) pigeon chest D) kyphoscoliosis

B) funnel chest A funnel chest occurs when there is a depression in the lower portion of the sternum, and this may lead to compression of the heart and great vessels, resulting in murmurs. A barrel chest is characterized by an increase in the anteroposterior diameter of the thorax and is a result of overinflation of the lungs. A pigeon chest occurs as a result of displacement of the sternum and includes an increase in the anteroposterior diameter. Kyphoscoliosis, which is characterized by elevation of the scapula and a corresponding S-shaped spine, limits lung expansion within the thorax

The perioperative nurse has admitted a patient who has just underwent a tonsillectomy. The nurse's postoperative assessment should prioritize which of the following potential complications of this surgery? A) difficulty ambulating B) hemorrhage C) infrequent swallowing D) bradycardia

B) hemorrhage

The nurse is doing discharge teaching in the ED with a patient who had a nosebleed. What should the nurse include in the discharge teaching of this patient? A) avoid blowing the nose for the next 45 minutes B) in case of recurrence, apply direct pressure for 15 minutes C) do not take aspirin for the next 2 weeks D) seek immediate medical attention if the nosebleed recurs

B) in case of recurrence, apply direct pressure for 15 minutes

The nurse recognizes that aspiration is a potential complication of a laryngectomy. How should the nurse best manage this risk? A) facilitate total parenteral nutrition (TPN) B) keep a complete suction setup at the bedside C) feed the patient several small meals daily D) refer the patient for occupational therapy

B) keep a complete suction setup at the bedside

The nurse is caring for a patient with lung metastases who just underwent a mediastinotomy. What should be the focus of the nurse's postprocedure care? A) assisting with pulmonary function test (PFT) B) maintaining the patient's chest tube C) administering oral suction as needed D) performing chest physiotherapy

B) maintaining the patient's chest tube Chest tube drainage is required after mediastinotomy. PFT, chest physiotherapy, and oral suctioning would all be contraindicated because of the patient's unstable health status

A patient has been diagnosed with pulmonary hypertension, in which the capillaries in the alveoli are squeezed excessively. The nurse should recognize a disturbance in what aspect of normal respiratory function? A) acid-base balance B) perfusion C) diffusion D) ventilation

B) perfusion Perfusion is influenced by alveolar pressure. The pulmonary capillaries are sandwiched between adjacent alveoli and , if the alveolar pressure is sufficiently high, the capillaries are squeezed. This does not constitute a disturbance in ventilation (air movement), diffusion (gas exchange), or acid-base balance.

The nurse is performing an assessment on a patient who has been diagnosed with cancer of the larynx. Part of the nurse's assessment addresses the patient's general state of nutrition. Which laboratory values would be assessed when determining the nutritional status of the patient? Select all that apply A) white blood cell count B) protein level C) albumin level D) platelet count E) glucose level

B) protein level C) albumin level E) glucose level

The nurse is caring for a patient who has a pleural effusion and who underwent a thoracoscopic procedure earlier in the morning. The nurse should prioritize assessment for which of the following? A) sputum production B) shortness of breath C) throat discomfort D) epistaxis

B) shortness of breath Follow-up care in the health care facility and at home involves monitoring the patient for shortness of breath (which might indicate a pneumothorax). All of the listed options are relevant assessment findings, but shortness of breath is the most serious complication

The nurse is caring for a patient who has just been diagnosed with chronic rhinosinusitis. While being admitted to the clinic, the patient asks, "Will this chronic infection hurt my new kidney?" What should the nurse know about chronic rhinosinusitis in patients who have had a transplant? A) the patient will have exaggerated symptoms of rhinosinusitis due to immunosuppression B) taking immunosuppressive drugs can contribute to chronic rhinosinusitis C) chronic rhinosinusitis can damage the transplanted organ D) immunosuppressive drugs can cause organ rejection

B) taking immunosuppressive drugs can contribute to chronic rhinosinusitis

The nurse is providing care for a patient who has just been admitted to the postsurgical unit following a laryngectomy. What assessment should the nurse prioritize? A) The patient's swallowing ability B) the patient's airway patency C) the patient's carotid pulses D) signs and symptoms of infection

B) the patient's airway patency

A patient states that her family has had several colds during this winter and spring despite their commitment to handwashing. The high communicability of the common cold is attributable to what factor? A) cold viruses are increasingly resistant to common antibiotics B) the virus is shed for 2 days prior to the emergence of symptoms C) a genetic predisposition to viral rhinitis has recently been identified D) overuse of OTC cold remedies creates a rebound susceptibility to future colds

B) the virus is shed for 2 days prior to the emergence of symptoms

A patient has just been diagnosed with squamous cell carcinoma of the neck. While the nurse is doing health education, the patient asks, "Does this kind of cancer tend to spread to others part of the body?" What is the nurse's best response? A) In many cases, this type of cancer spreads to other parts of the body B) this cancer usually does not spread to distant sites in the body C) you will have to speak to your oncologist about that D) squamous cell carcinoma is nothing to be concerned about, so try to focus on your health

B) this cancer usually does not spread to distant sites in the body

The nurse is caring for a patient with a severe nosebleed. The physician inserts a nasal sponge and tells the patient it may have to remain in place up to 6 days before it is removed. The nurse should identify that this patient is at increased risk for what? A) viral sinusitis B) toxic shock syndrome C) pharyngitis D) adenoiditis

B) toxic shock syndrome

A medical patient rings her call bell and expresses alarm to the nurse, stating, "I've just coughed up this blood. This can't be good, can it?" How can the nurse best determine whether the source of the blood was from the patient's lungs? A) obtain a sample and test the pH of the blood if possible B) try to see if the blood is frothy or mixed with mucus C) perform oral suctioning to see if blood is obtained D) swab the back of the patient's throat to see if blood is present

B) try to see if the blood is frothy or mixed with mucus Though not definitive, blood from the lung is usually bright red, frothy, and mixed with sputum. Testing the pH of nonarterial blood samples is not common practice and would not provide important data. Similarly, oral suctioning and swabbing the patient's mouth would not reveal the source.

A new employee asks the occupational health nurse about measures to prevent inhalation exposure of the substances. Which statement by the nurse will decrease the patient's exposure risk to toxic substances? A) Position a fan blowing on the toxic substances to prevent the substance from becoming stagnant in the air. B) Wear protective attire and devices when working with a toxic substance. C) Make sure that you keep your immunizations up to date to prevent respiratory diseases resulting from toxins. D) Always wear a disposable paper face mask when you are working with inhalable toxins.

B) wear protective attire and devices when working with a toxic substance

While assessing an acutely ill patient's respiratory rate, the nurse assesses four normal breath sounds followed by an episode of apnea lasting 20 seconds. How should the nurse document this finding? A) Eupnea B) Apnea C) Biots respiration D) Cheyne- Stokes

C) Biots respiration The nurse will document that the patient is demonstrating a Biots respiration pattern. Biots respiration is characterized by periods of normal breathing (three or four breaths) followed by varying periods of apnea (usually 10 seconds to 1 minute). Cheyne-Stokes is a similar respiratory pattern but involves a regular cycle where the rate and depth of breathing increase and then decrease until apnea occurs. Biots respiration is not characterized by the increase and decrease in the rate and depth, as characterized by Cheyne-Stokes. Eupnea is a normal breathing pattern of 12 to 18 breaths per minute. Bradypnea is a slower-than-normal rate (<10 breaths per minute), with normal depth and regular rhythm, and no apnea.

The nurse is completing a patient's health history with regard to potential risk factors for lung disease. What interview question addresses the most significant risk factor for respiratory diseases? A) have you ever been employed in a factory, smelter, or mill? B) Does anyone in your family have any form of lung disease? C) Do you currently smoke, or have you ever smoked? D) Have you ever lived in an area that has high levels of air pollution?

C) Do you currently smoke, or have you ever smoked? Smoking is the single most important contributor to lung disease, exceeds the significance of environmental, occupational, and genetic factors

A patient is undergoing testing to see if he has a pleural effusion. Which of the nurse's respiratory assessment findings would be most consistent with this diagnosis? A) Increased tactile fremitus, egophony, and a dull sound upon percussion of the chest wall B) Decreased tactile fremitus, wheezing, and a hyperresonant sound upon percussion of the chest wall. C) Lung fields dull to percussion, absent breath sounds, and a pleural friction rub D) Normal tactile fremitus, decreased breath sounds, and a resonant sound upon percussion of the chest wall.

C) Lung fields dull to percussion, absent breath sounds, and a pleural friction rub Assessment findings consistent with a pleural effusion include affected lung fields being dull to percussion and absence of breath sounds. A pleural friction rub may also be present. The other listed signs are not typically associated with a pleural effusion

A patient with chronic lung disease is undergoing lung function testing. What test result denotes the volume of air inspired and expired with a normal breath? A) Total lung capacity B) Forced vital capacity C) Tidal volume D) Residual volume

C) Tidal volume Tidal volume refers to the volume of air inspired and expired with a normal breath. Total lung capacity is the maximal amount of air the lungs and respiratory passages can hold after a forced inspiration. Forced vital capacity is vital capacity performed with a maximally forced expiration. Residual volume is the maximal amount of air left in the lung after a maximal expiration

A patient is being treated for bacterial pharyngitis. Which of the following should the nurse recommend when promoting the patient's nutrition during treatment? A) a 1.5L/ day fluid restriction B) a high-potassium, low-sodium diet C) a liquid or soft diet D) a high-protein diet

C) a liquid or soft diet

The nurse is caring for a patient admitted with an acute exacerbation of chronic obstructive pulmonary disease. During assessment, the nurse finds that the patient is experiencing increased dyspnea. What is the most accurate measurement of the concentration of oxygen in the patient's blood? A) A capillary blood sample B) Pulse oximetry C) An arterial blood gas (ABG) sample D) A complete blood count (CBC)

C) an arterial blood gas (ABG) sample The arterial tension (partial pressure of PaO2) indicates the degree of oxygenation of the blood, and the arterial carbon dioxide tension (partial pressure or PaCO2) indicated the adequacy of alveolar ventilation. ABG studies aid in assessing the ability of the lungs to provide adequate oxygen and remove carbon dioxide and the ability of the kidneys to reabsorb or excrete bicarbonate ions to maintain normal body pH. Capillary blood samples are venous blood, not arterial blood, so they are not as accurate as an ABG. Pulse oximetry is a useful clinical tool but does not replace ABG measurement, because it is not as accurate. A CBC does not indicate the concentration of oxygen.

The nurse is providing discharge teaching for a patient who developed a pulmonary embolism after total knee surgery. The patient has been converted from heparin to sodium warfarin (Coumadin) anticoagulant therapy. What should the nurse teach the patient? A) coumadin will continue to break up the clot over a period of weeks B) coumadin must be taken concurrent with ASA to achieve anticoagulation C) anticoagulant therapy usually lasts between 3 and 6 months D) he should take a vitamin supplement containing vitamin K

C) anticoagulant therapy usually lasts between 3 and 6 months

The nurse is caring for a patient who is receiving oxygen therapy for pneumonia. How should the nurse best assess whether the patient is hypoxemic? A) assess the patient level of consciousness (LOC) B) assess the patient's extremities for signs of cyanosis C) assess the patient's oxygen saturation D) review the patient's hemoglobin, hematocrit, and red blood cell levels

C) assess the patient's oxygen saturation

The ED nurse is assessing the respiratory function of a teenage girl who presented with acute shortness of breath. Auscultation reveals continuous wheezes during inspiration and expiration. This finding is most suggestive of what? A) pleurisy B) emphysema C) asthma D) pneumonia

C) asthma Sibilant wheezes are commonly associated with asthma. They do not normally accompany pleurisy, emphysema, or pneumonia.

A 45-year-old obese man arrives in a clinic with complaints of daytime sleepiness, difficulty going to sleep at night, and snoring. The nurse should recognize the manifestations of what health problem? A) adenoiditis B) chronic tonsilitis C) obstructive sleep apnea D) laryngeal cancer

C) chronic sleep apnea

The nurse is caring for an elderly patient in the PACU. The patient has had a bronchoscopy, and the nurse is monitoring for complications related to the administration of lidocaine. For what complication related to the administration of large doses of lidocaine in the elderly should the nurse assess? A) decreased urine output and hypertension B) headache and vision changes C) confusion and lethargy D) jaundice and elevated liver enzymes

C) confusion and lethargy Lidocaine may be sprayed on the pharynx or dropped on the epiglottis and vocal cords and into the trachea to suppress the cough reflex and minimize discomfort during a bronchoscopy. After the procedure, the nurse will assess for confusion and lethargy in the elderly, which may be due to the large doses of lidocaine administered during the procedure. The other listed signs and symptoms are not specific to this problem.

The nurse is creating a plan of care for a patient diagnosed with acute laryngitis. What intervention should be included in the patient's plan of care? A) place warm cloths on the patient's throat, as needed B) have the patient inhale warm steam three times daily C) encourage the patient to limit speech whenever possible D) limit the patient's fluid intake to 1.5 L/day

C) encourage the patient to limit speech whenever possible

The nurse is assessing the respiratory status of a patient who is experiencing an exacerbation of her emphysema symptoms. When preparing to auscultate, what breath sounds should the nurse anticipate? A) absence of breath sounds B) wheezing with discontinuous breath sounds C) faint breath sounds with prolonged expiration D) faint breath sounds with fine crackles

C) faint breath sounds with prolonged expiration The breath sounds of a patient with emphysema are faint or often completely inaudible. When they are heard, the expiratory phase is prolonged.

The nurse is caring for a patient in the ED for epistaxis. What information should the nurse include in patient discharge teaching as a way to prevent epistaxis? A) keep nasal passages clear B) use decongestants regularly C) humidify indoor environments D) use a tissue when blowing the nose

C) humidify indoor environments

The nurse is planning the care of a patient who is scheduled for a laryngectomy. The nurse should assign the highest priority to with postoperative nursing diagnosis? A) anxiety related to diagnosis of cancer B) altered nutrition related to swallowing difficulties C) ineffective airway clearance related to airway alterations D) impaired verbal communication related to removal of the larynx

C) ineffective airway clearance related to airway alterations

A medical nurse has admitted a patient to the unit with a diagnosis of failure to thrive. The patient has developed a fever and cough, so a sputum specimen has been obtained. The nurse notes that the sputum is greenish and that there is a large quantity of it. The nurse notifies the patients physician because these symptoms are suggestive of what? A) Pneumothorax B) Lung tumors C) Infection D) Pulmonary edema

C) infection The nature of the sputum is often indicative of its cause. A profuse amount of purulent sputum (thick and yellow, green, or rust-colored) or a change in color of the sputum is a common sign of a bacterial infection. Pink-tinged sputum suggests a lung tumor. Profuse, frothy, pink material, often welling up into the throat, may indicate pulmonary edema. A pneumothorax does not result in copious, green sputum.

The occupational health nurse is obtaining a patient history during a pre-employment physical. During the history, the patient states that he has hereditary angioedema. The nurse should identify what implication of this health condition? A) It will result in increased loss of work days B) it may cause episodes of weakness due to reduced cardiac output C) it can cause life-threatening airway obstruction D) it is unlikely to interfere with the individual's health

C) it can cause life-threatening airway obstruction

A patient asks the nurse why an infection in his upper respiratory system is affecting the clarity of his speech. Which structure serves as the patient's resonating chamber in speech? A) Trachea B) Pharynx C) Paranasal sinuses D) Larynx

C) paranasal sinuses A prominent function of the sinuses is to serve as a resonating chamber in speech. The trachea, also known as the windpipe, serves as the passage between the larynx and the bronchi. The pharynx is a tubelike structure that connects the nasal and oral cavities to the larynx. The pharynx also functions as a passage for the respiratory and digestive tracts. The major function of the larynx is vocalization through the function of the vocal cords. The vocal cords are ligaments controlled by muscular movements that produce sound.

The nurse is performing preoperative teaching with a patient who has cancer of the larynx. After completing patient teaching, what would be most important for the nurse to do? A) give the patient his or her cell phone number B) refer the patient to a social worker or psychologist C) provide the patient with audiovisual materials about the surgery D) reassure the patient and family that everything will be alright

C) provide the patient with audiovisual materials about the surgery

The nurse has noted the emergence of a significant amount of fresh blood at the drain site of a patient who is postoperative 1 day following a total laryngectomy. How should the nurse respond to this development? A) remove the patient's drain and apply pressure with a sterile gauze B) assess the patient, reposition the patient supine, and apply wall suction to the drain C) rapidly assess the patient and notify the surgeon about the patient's bleeding D) administer a STAT dose of vitamin K t aid coagulation

C) rapidly assess the patient and notify the surgeon about the patient's bleeding

The nurse is teaching a patient with allergic rhinitis about the safe and effective use of his medications. What would be the most essential information to give this patient about preventing possible drug interactions? A) prescription medications can be safely supplemented with OTC medications B) Use only one pharmacy so the pharmacist can check drug interactions C) read drug labels carefully before taking OTC medications D) consult the internet before selecting an OTC medication

C) read drug labels carefully before taking OTC medications

A nursing student is discussing a patient with viral pharyngitis with the preceptor at the walk-in clinic. What should the preceptor tell the student about nursing care for patients with viral pharyngitis? A) teaching focuses on safe and effective use of antibiotics B) the patient should be preliminarily screened for surgery C) symptom management is the main focus of medical and nursing care D) the focus of care is resting the voice to prevent chronic hoarseness

C) symptom management is the main focus of medical and nursing care

The nurse is creating a care plan for a patient who is status post-total laryngectomy. Much of the plan consists of long-term postoperative communication plan for alaryngeal communication. What form of alaryngeal communication will likely be chosen? A) esophageal speech B) electric larynx C) tracheoesophageal puncture D) American sign language (ASL)

C) tracheoesophageal puncture

In addition to heart rate, blood pressure, respiratory rate, and temperature, the nurse needs to assess a patients arterial oxygen saturation (SaO2). What procedure will best accomplish this? A) Incentive spirometry B) Arterial blood gas (ABG) measurement C) Peak flow measurement D) Pulse oximetry

D) Pulse oximetry Pulse oximetry is a noninvasive procedure in which a small sensor is positioned over a pulsating vascular bed. It can be used during transport and causes the patient no discomfort. An incentive spirometer is used to assist the patient with deep breathing after surgery. ABG measurement can measure SaO2, but this is an invasive procedure that can be painful. Some patients with asthma use peak flow meters to measure levels of expired air.

The nurse is caring for a patient who has just returned to the unit after a colon resection. The patient is showing signs of hypoxia. The nurse knows that this is probably caused by what? A) Nitrogen narcosis B) Infection C) Impaired diffusion D) Shunting

D) Shunting Shunting appears to be the main cause of hypoxia after thoracic or abdominal surgery and most types of respiratory failure. Impairment of normal diffusion is a less common cause. Infection would not likely be present at this early stage of recovery and nitrogen narcosis only occurs from breathing compressed air.

A patient is being treated for a pulmonary embolism and the medical nurse is aware that the patient suffered an acute disturbance in pulmonary perfusion. This involved an alteration in what aspect of normal physiology? A) maintenance of constant osmotic pressure in the alveoli B) maintenance of muscle tone in the diaphragm C) pH balance in the pulmonary veins and arteries D) adequate flow of blood through the pulmonary circulation

D) adequate flow of blood through the pulmonary circulation Pulmonary perfusion is the actual blood flow through the pulmonary circulation. Perfusion is not defined in terms of pH balance, muscle tone, or osmotic pressure.

A 42-year-old patient is admitted to the ED after an assault. The patient received blunt trauma to the face and has a suspected nasal fracture. Which of the following interventions should the nurse perform? A) administer nasal spray and apply an occlusive dressing to the patient's face B) position the patient's head in a dependent position C) irrigate the patient's nose with warm tap water D) apply ice and keep the patient's head elevated

D) apply ice and keep the patient's head elevated

The nurse is caring for a patient who is postoperative day 2 following a total laryngectomy for supraglottic cancer. The nurse should prioritize what assessment? A) assessment of body image B) assessment of jugular venous pressure C) assessment of carotid pulse D) assessment of swallowing ability

D) assessment of swallowing ability

The patient has just had an MRI ordered because a routine chest x-ray showed suspicious areas in the right lung. The physician suspects bronchogenic carcinoma. An MRI would most likely be ordered to assess for what in this patient? A) alveolar dysfunction B) forced vital capacity C) tidal volume D) chest wall invasion

D) chest wall invasion MRI is used to characterize pulmonary nodules; to help stage bronchogenic carcinoma (assessment of chest wall invasion); and to evaluate inflammatory activity in interstitial lung disease, acute pulmonary embolism, and chronic thrombolytic pulmonary hypertension. Imaging would not focus on the alveoli since the problem is in the bronchi. A static image such as an MRI cannot inform PFT.

A patient has been diagnosed with heart failure that has not yet responded to treatment. What breath sound should the nurse expect to assess on auscultation? A) expiratory wheezes B) inspiratory wheezes C) rhonchi D) crackles

D) crackles Crackles reflect underlying inflammation or congestion and are often present in such conditions as pneumonia, bronchitis, and congestive heart failure. Rhonchi and wheezes are associated with airway obstruction, which is not part of the pathophysiology of heart failure.

As a clinic nurse, you are caring for a patient who has been prescribed an antibiotic for tonsillitis and has been instructed to take the antibiotic for 10 days. When you do a follow-up call with this patient, you are informed that the patient is feeling better and is stopping the medication after taking it for 4 days. What information should you provide to this patient? A) Keep the remaining tablets for an infection at a later time. B) Discontinue the medications if the fever is gone. C) Dispose of the remaining medication in a biohazard receptacle. D) Finish all the antibiotics to eliminate the organism completely.

D) finish all the antibiotics to eliminate the organism completely

A patient's total laryngectomy has created a need for alaryngeal speech which will be achieved through the use of transesophageal puncture. What action should the nurse describe to the patient when teaching him about this process? A) training on how to perform controlled belching B) use of an electronically enhanced artificial pharynx C) insertion of a specialized nasogastric tube D) fitting for a voice prosthesis

D) fitting for a voice prosthesis

A patient visiting the clinic is diagnosed with acute sinusitis. To promote sinus drainage, the nurse should instruct the patient to perform which of the following? A) Apply a cold pack to the affected area. B) Apply a mustard poultice to the forehead. C) Perform postural drainage. D) Increase fluid intake.

D) increase fluid intake

The campus nurse at a university is assessing a 21-year-old student who presents with a severe nosebleed. The site of bleeding appears to be the anterior portion of the nasal septum. The nurse instructs the student to tilt her head forward and the nurse applies pressure to the nose, but the student's nose continues to bleed. Which intervention should the nurse next implement? A) Apply ice to the bridge of her nose B) Lay the patient down on a cot C) Arrange for transfer to the local ED D) Insert a tampon in the affected nare

D) insert a tampon into the affected nare

A patient is scheduled to have excess pleural fluid aspirated with a needle in order to relieve her dyspnea. The patient inquires about the normal function of pleural fluid. What should the nurse describe? A) it allows for full expansion of the lungs within the thoracic cavity B) it prevents the lungs from collapsing within the thoracic cavity C) it limits lung expansion within the thoracic cavity D) it lubricates the movement of the thorax and lungs

D) it lubricates the movement of the thorax and lungs The visceral pleura cover the lungs; the parietal pleura line the thorax. The visceral and parietal pleura and the small amount of pleural fluid between these membranes serve to lubricate the thorax and lungs and permit smooth motion of the lungs within the thoracic cavity with each breath. The pleura do not allow full expansion of the lungs, prevent the lungs from collapsing, or limit lung expansion within the thoracic cavity.

The nurse is explaining the safe and effective administration of nasal spray to a patient with seasonal allergies. What information is most important to include in this teaching? A) finish the bottle of nasal spray to clear the infection effectively B) nasal spray can only be shared between immediate family members C) nasal spray should be administered in a prone position D) overuse of nasal spray may cause rebound congestion

D) overuse of nasal spray may cause rebound congestion

A patient comes to the ED and is admitted with epistaxis. Pressure has been applied to the patient's midline septum for 10 minutes, but the bleeding continues. The nurse should anticipate what treatment to control the bleeding? A) irrigation with a hypertonic solution B) nasopharyngeal suction C) normal saline application D) silver nitrate application

D) silver nitrate application

The nurse is caring for a patient recently diagnosed with lung disease encourages the patient not to smoke. What is the primary rationale behind this nursing action? A) smoking decreases the amount of mucus production B) smoke particles compete for binding sites on hemoglobin C) smoking causes atrophy of the alveoli D) smoking damages the ciliary cleansing mechanism

D) smoking damages the ciliary cleansing mechanism

A patient has a diagnosis of multiple sclerosis. The nurse is aware that neuromuscular disorders such as multiple sclerosis may lead to a decreased vital capacity. What does vital capacity measure? A) the volume of air inhaled and exhaled with each breath. B) the volume of air in the lungs after a maximal inspiration. C) the maximal volume of air inhaled after normal expiration. D) the maximal volume of air exhaled from the point of maximal inspiration

D) the maximal volume of air exhaled from the point of maximal inspiration Vital capacity is measured by having the patient take in a maximal breath and exhale fully through a spirometer. Vital lung capacity is the maximal volume of air exhaled from the point of maximal inspiration, and neuromuscular disorders such as multiple sclerosis may lead to decreased vital capacity. Tidal volume is defined as the volume of air inhaled and exhaled with each breath. The volume of air in the lungs after a maximal inspiration is the total lung capacity. Inspiratory capacity is the maximal volume of air inhaled after normal expiration.

The nurse is caring for a patient who has been in a motor vehicle accident and the care team suspects that the patient has developed pleurisy. Which of the nurse's assessment findings would best corroborate this diagnosis? A) The patient is experiencing painless hemoptysis B) the patient's ABGs are normal, but he demonstrates increased work of breathing C) the patient's oxygen saturation level is below 88% but he denies shortness of breath D) the patient's pain intensifies when he coughs or takes a deep breath.

D) the patient's pain intensifies when he coughs or takes a deep breath

The nurse is providing patient teaching to a young mother who has brought her 3-month-old infant to the clinic for a well-baby checkup. What action should the nurse recommend to the woman to prevent the transmission of organisms to her infant during the cold season? A) Take preventative antibiotics, as ordered B) Gargle with warm salt water regularly C) Dress herself and her infant warmly D) Wash her hands frequently

D) wash her hands frequently

A nurse is caring for a patient who has been scheduled for a bronchoscopy. How should the nurse prepare the patient for this procedure? A) administer a bolus of IV fluids B) arrange for the insertion of a peripherally inserted central catheter C) administer nebulized bronchodilators every 2 hours until the test D) Withhold food and fluids for several hours before the test

D) withhold food and fluids for several hours before the test Food and fluids are withheld for 4-8 hours before the test to reduce the risk of aspiration when the cough reflex is blocked by anesthesia. IV fluids, bronchodilators, and a central line are unnecessary.