Prep U questions Chapter 39: Oxygenation and Perfusion

A woman comes to the emergency room with her 2-year-old son. She states he woke up and had a loud barking cough. The child is suffering from: A. Pulmonary fibrosis B. Croup C. Asthma D. atelectasis

B. Croup

A client with a diagnosis of advanced Alzheimer disease is unable to follow directions required to use an inhaled bronchodilator. Which medication delivery system is most appropriate for this client? A. Metered-dose inhaler with spacer B. Nebulizer C. Metered-dose inhaler without spacer D. Dry powder inhaler

B. Nebulizer

Which teaching about the oxygen analyzer is important for the nurse to provide to a client using oxygen? A. It regulates the amount of oxygen received. B. It decreases dry mucous membranes via delivering small water droplets. C. It determines whether the client is getting enough oxygen. D. It prescribes oxygen concentration.

C. It determines whether the client is getting enough oxygen.

Which diagnostic procedure measures lung size and airway patency, producing graphic representations of lung volumes and flows? A. Bronchoscopy B. Skin tests C. Chest x-ray D. Pulmonary function tests

D. Pulmonary function tests

The nurse is caring for a client who has excess levels of carbon dioxide in the blood, and chronic hypoxemia. Which intervention will the nurse recommend? A. Diaphragmatic breathing B. Incentive spirometry C. Deep breathing D. Pursed-lip breathing

D. Pursed-lip breathing

A nurse assessing a client's respiratory status gets a weak signal from the pulse oximeter. The client's other vital signs are within reference ranges. What is the nurse's best action? A. Place the probe on the client's earlobe. B. Shine available light on the equipment to facilitate accurate reading. C. Use a blood pressure cuff to increase circulation to the site. D. Warm the client's hands and try again.

D. Warm the client's hands and try again.

A nurse is volunteering at a day camp. A child is stung by a bee and develops wheezing in the upper airways. The child is experiencing: A. bronchiectasis. B. bronchiolitis. C. bronchitis. D. a bronchospasm.

D. a bronchospasm.

A client has been put on oxygen therapy because of low oxygen saturation levels in the blood. What should the nurse use to regulate the amount of oxygen delivered to the client? A. nasal cannula B. nasal strip C. oxygen analyzer D. flow meter

D. flow meter

While examining a client, the nurse palpates the client's chest and back. What would the nurse expect to identify with this technique? A. presence of pleural rub B. fluid-filled portions of the lung C. consolidated portions of the lung D. pattern of thoracic expansion

D. pattern of thoracic expansion

A nurse is assigned to care for a client admitted to the health care facility with the diagnosis of atelectasis. When interviewing the client, the nurse would anticipate a history of: A. asthma. B. croup. C. alcohol use. D. pneumonia

D. pneumonia

The air quality index has rated it a red air quality day in the city. Which information will the nurse share with the client about promoting effective respiratory self-care? A. Stay indoors as much as possible B. Practice good hand hygiene C. Avoid exposure to large crowds D. Cut down on smoking

A. Stay indoors as much as possible

The nurse is caring for a client who has a percutaneous tracheostomy (PCT) following a skydiving accident. Which oxygen delivery device will the nurse select? A. Tracheostomy collar B. Nasal cannula C. Simple mask D. Face tent

A. Tracheostomy collar

A client is learning how to do diaphragmatic breathing. For which length of time will the nurse advise the client to rest between repetitions of the exercise? A. 1 minute B. 4 minutes C. 2 minutes D. 30 seconds

C. 2 minutes

The nurse is implementing an order for oxygen for a client with facial burns. Which delivery device will the nurse gather? A. tracheostomy collar B. nasal cannula C. face tent D. simple mask

C. face tent

A nurse is delivering 3 L/min oxygen to a client via nasal cannula. What percentage of delivered oxygen is the client receiving? A. 47% B. 28% C. 23% D. 32%

D. 32%

When reviewing data collection on a client with a cardiac output of 2.5 liter/minute, the nurse inspects the client for which symptom? A. weight loss B. strong, rapid pulse C. increased urine output D. rapid respirations

D. rapid respirations

A nurse is assessing the breath sounds of a newborn. Which sound is an expected finding for this developmental level? A. Crackles B. Wheezes C. Bruits D. Clear sounds

A. Crackles

The nurse is caring for a client who has been prescribed humidified oxygen at 6 L/minute. Which type of liquid will the nurse gather to set up the humidifier? A. Distilled water B. Mineral oil C. Tap water D. Normal Saline

A. Distilled water

A client's primary care provider has informed the nurse that the client will require thoracentesis. The nurse should suspect that the client has developed which disorder of lung function? A. Pleural effusion B. Tachypnea C. Pneumonia D. Wheezes

A. Pleural effusion

The client demonstrates soft, high-pitched, discontinuous sounds in the left lower lobe of the lung. How will the nurse accurately document this finding? A. Wheezes B. Crackles C. Bronchial D. Vesicular

B. Crackles

A client who uses portable home oxygen states, "I still like to smoke cigarettes every now and then." What is the appropriate nursing response? A. "I understand; I used to be a smoker also." B. "An occasional cigarette will not hurt you." C. "You should never smoke when oxygen is in use." D. "Oxygen is a flammable gas."

C. "You should never smoke when oxygen is in use."

A nurse is preparing to use a wall unit to suction the endotracheal tube of a 9-year-old child. At what pressure should the suction be set? A. 100 to 150 mm Hg B. 60 to 80 mm Hg C. 80 to 125 mm Hg D. 100 to 130 mm Hg

C. 80 to 125 mm Hg

The client is reporting to the nurse that the continuous positive airway pressure (CPAP) mask is torture. What is the best response from the nurse? A. Perhaps we need to change you to a different type of mask. B. Would you like to talk to your health care provider concerning this? C. Tell me more about why it bothers you. D. Can you explain to me what settings you are using?

C. Tell me more about why it bothers you.

The nurse is caring for a client who has had a percutaneous tracheostomy (PCT) following a motor vehicle accident and has been prescribed oxygen. What delivery device will the nurse select that is most appropriate for this client? A. Nasal cannula B. Simple mask C. Tracheostomy collar D. Face tent

C. Tracheostomy collar

The nurse auscultates a client with soft, high-pitched popping breath sounds on inspiration. The nurse documents the breath sounds heard as: A. vesicular. B. bronchovesicular. C. crackles. D. wheezes.

C. crackles.

A nurse assessing a client's respiratory effort notes that the client's breaths are shallow and 8 per minute. Shortly after, the client's respirations cease. Which form of oxygen delivery should the nurse use for this client? A. Nasal cannula B. Oxygen tent C. Oxygen mask D. Ambu bag

D. Ambu bag

A client is admitted to the hospital with shortness of breath, cyanosis and an oxygen saturation of 82% (0.82) on room air. Which action should the nurse implement first? A. Raise the head of the bed B. Educate client on incentive spirometry C. Assist with intubation D. Apply oxygen as prescribed

D. Apply oxygen as prescribed

The nurse is caring for a client with a chest tube. Which assessment finding indicates that the tube is functioning correctly? A. drainage system is positioned slightly above chest level B. small amount of subcutaneous air is detected at the site of tube insertion C. dressing is moist and intact D. respirations are at 20 breaths per minute

D. respirations are at 20 breaths per minute

The nurse is caring for an older adult client on home oxygen who has dentures but has quit wearing them stating that the dentures irritate the gums. What nursing action is appropriate? A. Increase the flow of oxygen. B. Check the fit of the oxygen mask. C. Contact the oxygen supplier to request an oxygen tent. D. Discontinue oxygen therapy until the client is reassessed by the healthcare provider.

B. Check the fit of the oxygen mask.

The nurse schedules a pulmonary function test to measure the amount of air left in a client's lungs at maximal expiration. What test does the nurse order? A. Forced Expiratory Volume (FEV) B. Residual Volume (RV) C. Tidal volume (TV) D. Total lung capacity (TLC

B. Residual Volume (RV)

Oxygen and carbon dioxide move between the alveoli and the blood by: A. Negative pressure B. Osmosis C. Hyperosmolar pressure D. Diffusion

D. Diffusion

The nurse is caring for a postoperative client who has a prescription for meperidine 75 mg intramuscularly (IM) every 4 hours as needed for pain. Before and after administering meperidine, the nurse would assess which most important sign? A. Respiratory rate and depth B. Apical pulse C. Orthostatic blood pressure D. Urinary intake and output

A. Respiratory rate and depth

A client has edema of the feet and ankles, along with crackles in the lower lobes and a frothy, productive cough. The client is suffering from: A. congestive heart failure. B. lung cancer. C. myocardial infarction. D. pulmonary embolism.

A. congestive heart failure.

The nurse is caring for a client who has a compromised cardiopulmonary system and needs to assess the client's tissue oxygenation. The nurse would use which appropriate method to assess this client's oxygenation? A. Pulmonary function B. Arterial blood gas C. Hemoglobin levels D. Hematocrit values

B. Arterial blood gas

A client 57 years of age is recovering in a hospital following a bilateral mastectomy and breast reconstruction 2 days earlier. Since her surgery, the client has been unwilling to mobilize despite the nurse's education on the benefits of early mobilization following surgery. The nurse would recognize that the client's prolonged immobility creates a risk for: A. Pneumothorax B. Atelectasis C. Tachypnea D. Hemothorax

B. Atelectasis

What assessments would a nurse make when auscultating the lungs? A. presence of edema B. air flow through the respiratory passages C. Abnormals chest structures D. volume of air exhales or inhaled

B. air flow through the respiratory passages

A client who was prescribed CPAP reports nonadherence to treatment. What is the priority nursing intervention? A. Explain the use of a BiPAP mask instead of a CPAP mask B. Document outcomes of modifications in care. C. Ask the client what factors contribute to nonadherence. D. Contact the health care provider to report the client's current status.

C. Ask the client what factors contribute to nonadherence.

The nurse is caring for a client receiving oxygen therapy via nasal cannula. The client suddenly becomes cyanotic with a pulse oximetry reading of 91%. What is the next most appropriate action the nurse should take? A. Elevate head of the bed B. Reposition client C. Assess oxygen tubing connection D. Assess lung sounds

C. Assess oxygen tubing connection

The home care nurse visits a client with compromised lung function. The client has greenish-yellow sputum with a musty odor. Which assessment is the priority for the client? A. Draw arterial blood gases. B. Obtain sputum culture for tuberculosis. C. Auscultate bilateral breath sounds. D. Request pulmonary function studies.

C. Auscultate bilateral breath sounds.

A client is reporting slight shortness of breath and lung auscultation reveals the presence of bilateral coarse crackles. The client's SaO2 is 90% on pulse oximetry. The nurse has applied supplementary oxygen by nasal cannula, recognizing that the flow rate by this method should not exceed: A. 6 L/minute. B. 1 L/minute. C. 10 L/minute. D. 4 L/minute.

A. 6 L/minute.

Which dietary guideline would be appropriate for the older adult homebound client with advanced respiratory disease who informs the nurse that she has no energy to eat? A. Eat smaller meals that are high in protein. B. Eat one large meal at noon. C. Snack on high-carbohydrate foods frequently. D. Contact the physician for nutrition shake.

A. Eat smaller meals that are high in protein.

A nurse using a pulse oximeter to measure a client's SpO2 obtains a reading of 95%. What is the nurse's most appropriate action? A. Review the medications that the client has taken in the past 90 minutes. B. Raise the head of the client's bed slightly, if tolerated. C. Document this expected assessment finding. D. Encourage the client to do deep-breathing exercises.

C. Document this expected assessment finding.

The nurse is caring for a client admitted for a mild exacerbation of asthma who has been prescribed portable oxygen at 2 L/min. What delivery device will the nurse select to apply oxygen to the client? A. Simple Mask B. Face tent C. Nasal cannula D. Tracheostomy collar

C. Nasal cannula

The nurse is suctioning a client's tracheostomy when the tracheostomy becomes dislodged and the nurse is unable to replace it easily. What is the nurse's most appropriate response? A. Page the respiratory therapist STAT. B. Assess the client's respiratory status and check vital signs every 1 minute for the next hour. C. Cover the tracheostomy stoma and apply oxygen by nasal cannula D. Maintain the client's oxygenation and alert the health care provider immediately.

D. Maintain the client's oxygenation and alert the health care provider immediately.

After insertion of a chest tube, fluctuations in the water-seal chamber that correspond with inspiration and expiration are an expected and normal finding. True or False

True

A nurse is performing CPR on a client who collapsed. Which guidelines should be used for this procedure? Select all that apply. A. Use the head tilt-chin lift maneuver to open the airway. B. If possible, place the client on a soft mattress to minimize injury. C. If trauma to the head or neck is present or suspected, do not attempt to open the airway. D. Look, listen, and feel for air exchange for at least 10 seconds and no more than 20 seconds. E. Rest elbows on the flat surface under the client, grasp the angle of the client's lower jaw, and lift with both hands. F. Position the client supine on his or her back.

A. Use the head tilt-chin lift maneuver to open the airway. E. Rest elbows on the flat surface under the client, grasp the angle of the client's lower jaw, and lift with both hands. F. Position the client supine on his or her back.

While auscultating a client's chest, the nurse auscultates crackles in the lower lung bases. What condition does the nurse identify the client is experiencing? A. presence of sputum in the trachea B. presence of fluid in the lungs C. air passing through narrowed airways D. inflammation of pleural surfaces

B. presence of fluid in the lungs

The nurse is teaching the client with a pulmonary disorder about deep breathing. The client asks, "Why is it important to start by breathing through my nose, then exhaling through my mouth?" Which appropriate response would the nurse give this client? A. "Breathing through your nose first will warm, filter, and humidify the air you are breathing." B. "If you breathe through the mouth first, you will swallow germs into your stomach." C. "Breathing through your nose first encourages you to sit up straighter to increase expansion of the lungs during inhalation." D. "We are concerned about you developing a snoring habit, so we encourage nasal breathing first."

A. "Breathing through your nose first will warm, filter, and humidify the air you are breathing."

Which guideline is recommended for determining suction catheter depth when suctioning an endotracheal tube? A. Using a suction catheter with centimeter increments on it, insert the suction catheter into the endotracheal tube until the centimeter markings on both the endotracheal tube and catheter align, and insert the suction catheter no further than an additional 1 cm. B. Using a spare endotracheal tube of the same size as being used for the client, insert the suction catheter halfway to the end of the tube and note the length of catheter used to reach this point. C. Combine the length of the endotracheal tube and any adapter being used, and add an additional 2 cm. D. For a closed system, combine the length of the endotracheal or tracheostomy tube and any adapter being used, and add an additional 3 cm.

A. Using a suction catheter with centimeter increments on it, insert the suction catheter into the endotracheal tube until the centimeter markings on both the endotracheal tube and catheter align, and insert the suction catheter no further than an additional 1 cm.

Which guideline describes the proper method for measuring the appropriate length to use when inserting a nasopharyngeal airway? A. When holding the airway on the side of the client's face, it should reach from the tragus of the ear to the tip of the nostril B. The airways come in standard sizes determined by the height and weight of the client C. When holding the airway on the side of the client's face, it should reach from the tip of their ear to the nostril times two D. When holding the airway on the side of the client's face, it should reach from the opening of the mouth to the back angle of the jaw

A. When holding the airway on the side of the client's face, it should reach from the tragus of the ear to the tip of the nostril

The nurse is caring for a client with a 35% Venturi mask. Which administration considerations should the nurse use? Select all that apply. A. Inflate the reservoir bag with oxygen before placing mask. B. Ensure that air intake valves are not blocked. C. Assess the mask is tight against the face so oxygen does not leak. D. Examine the needed flow rate on the mask matches the rate on the oxygen flow meter. E. Use gauze pads under elastic strap to relieve irritation to scalp or ears.

B. Ensure that air intake valves are not blocked. D. Examine the needed flow rate on the mask matches the rate on the oxygen flow meter. E. Use gauze pads under elastic strap to relieve irritation to scalp or ears.

A nurse must take a client's pulse oximetry reading. The nurse is explaining the technique to the client. Which statements about pulse oximetry are true? Select all that apply. A. A range of 88% to 95% is considered normal oxygen saturation for infants. B. Sensors are available for use on the finger, toe, foot, earlobe, forehead, and bridge of the nose. C. Pulse oximetry measurement requires insertion of an arterial line. D. The pulse oximetry sensor can produce accurate results even if circulation to the sensor site is impaired. E. Once the oximetry probe is correctly placed, a beam of red and infrared light travels through the tissue and blood vessels. F. Pulse oximeters display oxygen saturation and respiratory rate.

B. Sensors are available for use on the finger, toe, foot, earlobe, forehead, and bridge of the nose. E. Once the oximetry probe is correctly placed, a beam of red and infrared light travels through the tissue and blood vessels.

A health care provider orders the collection of a sputum specimen from a client with a suspected bacterial infection. Which action best ensures a usable specimen? A. Discard the first sputum produced by the client. B. Place the client in the dorsal recumbent position to collect the specimen. C. Instruct the client to inhale deeply and then cough. D. Have the client clear the nose and throat and gargle with salt water before beginning the procedure.

C. Instruct the client to inhale deeply and then cough.

The nurse is administering oxygen to an older adult client who has been assessed to have increased work of breathing. If the intervention has been effective, what finding(s) will the nurse expect on the evaluation of the client? Select all that apply. A. Respiratory rate is 33 breaths/min at rest. B. Oxygen saturation reads 88% on 5L of oxygen. C. Mucous membranes are pink and moist. D. Heart rate is 64 beats/min. E. The client is able to state the date, time, and location.

C. Mucous membranes are pink and moist. D. Heart rate is 64 beats/min. E. The client is able to state the date, time, and location.

When a nurse observes that an older client's skin is dry and shiny and his nails are thickened, the nurse determines that the client is most likely experiencing A. Malnutrition B. Anemia C. Poor tissue perfusion D. Congestive heart failure

C. Poor tissue perfusion