Pulmonary/Respiratory Exam Med-Surg
You are performing tuberculosis (TB) screening in a clinic that has many patients who have immigrated to the United States. Before doing a TB skin test on a patient, which question is most important for you to ask? a. "Is there any family history of TB?" b. "Have you received the bacille Calmette-Guérin (BCG) vaccine for TB?" c. "How long have you lived in the United States?" d. "Do you take any over-the-counter (OTC) medications?"
"Have you received the bacille Calmette-Guérin (BCG) vaccine for TB?"
After discussing management of upper respiratory infections (URI) with a patient who has acute viral rhinitis, you determine that additional teaching is needed when the patient says: A. "I can take acetaminophen (Tylenol) to treat discomfort." B. "I will drink lots of juices and other fluids to stay hydrated." C. "I can use my nasal decongestant spray until the congestion is all gone." D. "I will watch for changes in nasal secretions or the sputum that I cough up."
"I can use my nasal decongestant spray until the congestion is all gone."
Which of the following indicates pleural effusion? a. "Lately I can only breathe well if I sit up." b. "During the night I sometimes get the chills." c. "I get a sharp, stabbing pain when I take a deep breath." d. "I'm coughing up larger amounts of thicker mucus for the last several days."
"I get a sharp, stabbing pain when I take a deep breath."
You reinforce instructions to a patient regarding nasal packing and splint inserted to manage her epistaxis. Which statement, if made by this patient, indicates a NEED FOR FURTHER instructions? A. "I should not bend my head below my heart level." B. "If I have to sneeze, I'll open my mouth and sneeze naturally." C. "I should continue using my Aspirin as usual." D. "If my nose starts to bleed, I will apply pressure to my nose by pinching my nostrils tightly closed for 10-15 minutes."
"I should continue using my Aspirin as usual."
You reinforce instructions to the patient with acute bacterial pharyngitis. Which statement, if made by this patient, indicates a NEED FOR FURTHER teaching? A. "I can gargle saltwater to help reduce swelling and irritation in my throat." B. "I should not drink more than 1 liter a day." C. "I should come back to ED if I develop high fever." D. "I should not share food or drinks with my family members."
"I should not drink more than 1 liter a day."
The nurse is discharging a patient newly diagnosed with restrictive airway disease (asthma). Which statement indicates the patient UNDERSTANDS the discharge instructions? A. "I will call 911 if my medications don't control an attack." B. "I should wash my bedding in warm water." C. "I can still eat at the Chinese restaurant when I want." D. "If I get a headache, I should take a non-steroidal anti-inflammatory drug (NSAID)."
"I will call 911 if my medications don't control an attack."
Which information will you include in the patient teaching plan for a patient who is receiving rifampin (Rifadin) for treatment of tuberculosis? a. "Your urine, sweat, and tears will be orange colored." b. "Read a newspaper daily to check for changes in vision." c. "Take vitamin B6 daily to prevent peripheral nerve damage." d. "Call the health care provider if you notice any hearing loss."
"Your urine, sweat, and tears will be orange colored."
A patient with TB has been admitted to the hospital and is placed in an airborne infection isolation room. Which of the following should the patient be taught (select all that apply)? a. Expect routine TST to evaluate infection. b. Visitors will not be allowed while in airborne isolation. c. Take all medications for full length of time to prevent multidrug-resistant TB. d. Wear a standard isolation mask if leaving the airborne infection isolation room. e. Maintain precautions in airborne infection isolation room by coughing into a paper tissue.
-Expect routine TST to evaluate infection. -Take all medications for full length of time to prevent multi drug-resistant TB. -Wear a standard isolation mask if leaving the airborne infection isolation room. -Maintain precautions in airborne infection isolation room by coughing into a paper tissue.
Zosyn (Piperacellin) 3.375 g IVPB Q 6 hours is prescribed for a patient with bacterial pneumonia. The medication is mixed with a total of 50 mL of NS 0.9% and to be delivered over 30 minutes. At what mL/hr rate will you run the IV pump? a. 25 mL/hr. b. 50 mL/hr. c. 75 mL/hr. d. 100 mL/hr.
100 mL/hr.
The following 4 patients are diagnosed with pneumonia. Which one should you see the first? a. 30 years old; febrile; RR 18; SpO2 94%; hacking cough b. 45 years old; febrile; RR 23; SpO2 88%; think productive cough c. 64 years old; afebrile; RR 20; SpO2 96%; no cough d. 72 years old; febrile; RR 19; SpO2 94%; no cough
45 years old; febrile; RR 23; SpO2 88%; think productive cough
You are caring for a variety of clients. For which client is it most essential for you to implement measures to prevent pulmonary embolism? a. 59-year-old who had a knee replacement b. 60-year-old who has bacterial pneumonia c. 68-year-old who had emergency dental surgery d. 76-year-old who has a history of thrombocytopenia
59-year-old who had a knee replacement
You are reviewing the charts for four patients who are scheduled for their yearly physical examinations in October. Which of the following patients will require the inactivated influenza vaccination? A. A 56-year-old patient who is allergic to eggs B. A 24-year-old patient who has allergies to penicillin and the cephalosporins C. A 30-year-old patient who takes corticosteroids for rheumatoid arthritis D. A 18-year-old patient who is going to college in the fall
A 30-year-old patient who takes corticosteroids for rheumatoid arthritis
After you have received change-of-shift report about the following four patients, which patient should you assess first? A. A 77-year-old patient with tuberculosis (TB) who has four antitubercular medications due in 15 minutes B. A 23-year-old patient with cystic fibrosis who has pulmonary function testing scheduled C. A 46-year-old patient who has a deep vein thrombosis and is complaining of sudden onset shortness of breath D. A 35-year-old patient who was admitted the previous day with pneumonia and has a temperature of 100.2° F (37.8° C)
A 46-year-old patient who has a deep vein thrombosis and is complaining of sudden onset shortness of breath
The most reliable and sensitive test of gas exchange is: A. Pulse Oximetry B. ABG C. Chest X- ray D. Respiration rate
ABG
Which of the following diagnostic tests provides the best information about acid-base balance, and oxygenation/ventilation status? A. Oximetry B. Hematocrit C. ABG D. CT Scan of the chest
ABG
Which of the following are risk factors of OSA? Select all that apply A. Obesity B. Large Uvula C. Short neck D. Smoking E. Enlarged tonsils/adenoids = ALL THE ABOVE
ALL THE ABOVE Obesity, Large Uvula, Short neck, Smoking, Enlarged tonsils/adenoids
The functional unit of the respiratory system is:
ALVEOLI
You palpate the posterior chest while the patient says "99" and note that no vibration is felt. How should this be charted? A. Diminished expansion B. Dullness to percussion C. Absent tactile fremitus D. Decreased breath sounds
Absent tactile fremitus
Which of the following is part of the respiratory tract? Choose all that apply. A. Bronchi B. Pharynx C. Larynx D. Sinuses
All the above: Bronchi, Pharynx, Larynx, Sinuses
After 2 months of tuberculosis (TB) treatment with a standard four-drug regimen, a patient continues to have positive sputum smears for acid-fast bacilli (AFB). Which action should you take next? a. Ask the patient whether medications have been taken as directed. b. Discuss the need to use some different medications to treat the TB. c. Schedule the patient for directly observed therapy three times weekly. d. Educate about using a 2-drug regimen for the last 4 months of treatment.
Ask the patient whether medications have been taken as directed.
The client diagnosed with an exacerbation of COPD is in respiratory distress. Which intervention should the nurse implement FIRST? A. Assist the client into a sitting position at 90 degrees. B. Administer oxygen at four (4) LPM via nasal cannula. C. Monitor vital signs. D. Notify the healthcare provider about the client's status.
Assist the client into a sitting position at 90 degrees.
A client who has been taking the four first-line drugs for tuberculosis treatment for a month reports all of the following changes. Which changes would cause the nurse to collaborate quickly with the health care provider? Select all that apply. A. Blurry vision B. Constipation C. Difficulty sleeping D. Nausea when drinking beer E. Red-tinged urine F. Sunburn with minimal sun exposure G. Yellowing of the sclera
Blurry vision Yellowing of the sclera
Before developing a care plan for a TB patient, you review the laboratory tests, and the chest X-ray results. Select the findings that you would be anticipating. Select all that apply. A. Chest x-ray: Flattened diaphragm B. CBC: Platelets 200,000/μL C. CBC: Platelets 200,000/μL D. Hemoglobin 20 g/dL
Chest x-ray: Flattened diaphragm Hemoglobin 20 g/dL
Which information is most relevant for the nurse to teach a client about CPAP therapy for OSA? Select all that apply. A. Avoid alcoholic beverages or drugs that make you sleepy within 3 hours of bed time. B. Clean the mask device daily. C. Ensure your mask device fits tightly enough to prevent airleaks. D. Keep open flames such as candles out of the room when CPAP is in use. E. Seal the mask edges to your face with petroleum jelly. F. Use only sterile water in the humidifier tank. G. Use the CPAP during all sleep periods, especially in bed. H. Do not share your mask or tubing system with others.
Clean the mask device daily. Ensure your mask device fits tightly enough to prevent airleaks Use the CPAP during all sleep periods, especially in bed Do not share your mask or tubing system with others.
When performing a medication reconciliation for a newly admitted client before planned abdominal surgery, the nurse notes that the client is prescribed salmeterol and fluticasone daily for asthma control. What is the priority action for the nurse to take regarding this information to prevent harm? A. Record and display the information in a prominent place within the client's medical record. B. Ask the client how long the drugs have been prescribed and how well the asthma is controlled. C. Collaborate with the surgeon to arrange for continuation of this therapy in the perioperative period. D. Ensure that parenteral forms of these drugs are prescribed for use while the client remains NPO after surgery.
Collaborate with the surgeon to arrange for continuation of this therapy in the perioperative period.
You are planning to conduct a health education seminar among populations vulnerable to tuberculosis (TB) infection. You should INCLUDE which ONE of the following in your teaching? A. Common symptoms of TB include fatigue, coughing blood, and night sweats. B. TB medications are only indicated for active TB infection. C. BCG vaccine is given for patients with latent (inactive) TB to prevent its activation. D. TB medications need to be taken 5-10 days to be effective.
Common symptoms of TB include fatigue, coughing blood, and night sweats.
When assessing the respiratory system of a 78-year-old patient, which finding indicates that you should take immediate action? A. The chest appears barrel shaped. B. The patient has a weak cough effort. C. Crackles are heard from the lung bases to the midline. D. Hyperresonance is present across both sides of the chest.
Crackles are heard from the lung bases to the midline.
Which of the following respiratory physiological changes occur as a result of aging? A. Increased elastic recoil B. Decreased functioning alveoli C. Increased cough force D. Increased response to high CO2 level
Decreased functioning alveoli
You obtain the following assessment data in a 76-year-old patient who has influenza. Which information will be most important to communicate to the health care provider? A. Fever of 100.4° F (38° C) B. Diffuse crackles in the lungs C. Sore throat and frequent cough D. Myalgia and persistent headache
Diffuse crackles in the lungs
Which symptom or change in assessment of a client with four broken ribs on the right side indicates to the nurse the possibility of a tension pneumothorax? A. Distended neck veins B. Mediastinal shift toward the left side C. Right-sided pain on deep inhalation D. Right side of the chest more prominent than the left
Distended neck veins
Which of the following are acute pulmonary complications developed from flu? A. Pulmonary Embolism B. Dyspnea and Crackles C. Bleeding in the nasopharyngeal area D. Migraine headaches
Dyspnea and Crackles
A 65-year-old client with exacerbation of chronic obstructive pulmonary disease (COPD) informs you that he received his pneumonia vaccine 6 years ago. Which of the following is essential to include in the plan of care during the client's hospital admission? a. No further nursing action is needed. b. Document the previous immunization on the client record. c. Explain to the client that he can only be revaccinated during the fall months.
Explain to the client that he can only be revaccinated during the fall months.
Review the following Culture and Sensitivity report of a sputum culture. What antibiotic do you expect the physician to prescribe for this patient? Ampicillin - I Cephalothin - R Erythromycin - R Gentamicin - S Oxacillin - R a. Amoxicillin b. Cephacetrile c. Cefuroxime d. Gentamicin
Gentamicin
A client is admitted to the hospital with a diagnosis of an exacerbation of asthma. What should you plan to do to best help this client? a. Determine the client's emotional state. b. Give prescribed drugs to promote bronchiolar dilation. c. Provide education about the impact of a family history. d. Encourage the client to use an incentive spirometer routinely.
Give prescribed drugs to promote bronchiolar dilation.
The diet that you will order for a TB patient to best meet his nutritional needs is a A. High-calorie, high-protein diet. B. Low-fat diet with six small feedings a day. C. High-calorie, high carbohydrate, bland diet. D. Regular diet with extra fluids to be taken with meals.
High-calorie, high-protein diet.
Which of the following is not a typical clinical manifestation of pneumonia? a. Dyspnea b. Productive cough c. Hoarseness d. Pleuritic pain
Hoarseness
You're reviewing sputum culture procedure with a student nurse. Which of the following statements if the student says requires correction? a. I should obtain the specimen first thing in the morning. b. I should collect sputum not saliva. c. I should start the antibiotic administration as soon as I collect the specimen. d. I should follow up with the lab regarding the results by the end of the shift
I should follow up with the lab regarding the results by the end of the shift
When teaching the patient with allergic rhinitis about management of the condition, you should explain that: A. Over the counter (OTC) antihistamines cause sedation, so prescription antihistamines are usually ordered. B. Corticosteroid nasal sprays will reduce inflammation, but systemic effects limit their use. C. Identification and avoidance of environmental triggers are the best way to avoid symptoms. D. Use of oral antihistamines for a few weeks before the allergy season may prevent reactions.
Identification and avoidance of environmental triggers are the best way to avoid symptoms.
Vancomycin is prescribed for a client with bacterial pneumonia. The prescriber orders a trough level of Vancomycin. You should have the laboratory obtain a blood sample from the client: a. Halfway between two IVPB administrations b. Immediately before administering the IVPB c. Anytime it is convenient for the client and laboratory
Immediately before administering the IVPB
Which of the following should be a priority nursing diagnosis for a patient who acquired bacterial pneumonia? a. Impaired gas exchange b. Fatigue c. Fluid volume excess d. Anxiety
Impaired gas exchange
A nurse assessing an older adult client with pneumonia notes the client is now confused and the oxygen saturation has dropped since the last assessment 1 hour ago from 90% to 84%. The nurse also notes the respiratory rate has increased from 26 to 32. What is the nurse's best first action? A. Encourage the client to use the incentive spirometer hourly. B. Increase her O2 flow rate by 2 L and reassess in 5 minutes. C. Increase the flow rate of the IV antibiotic. D. Document the changes as the only action.
Increase her O2 flow rate by 2 L and reassess in 5 minutes.
After a patient has undergone a septoplasty, which nursing intervention will be included in the plan of care? A. Educate the patient about how to safely remove and reapply nasal splint. B. Reassure the patient that the nose will look normal when the swelling subsides. C. Instruct the patient to keep the head elevated for 48 hours to minimize swelling and pain. D. Teach the patient to use nonsteroidal anti-inflammatory drugs (NSAIDs) for pain control.
Instruct the patient to keep the head elevated for 48 hours to minimize swelling and pain.
What is the priority nursing action taken by the nurse before preparing the patient for bronchoscopy? A. Teach the patient about the oral contrast solution used for the procedure. B. Keep the patient NPO. C. Encourage fluids before the procedure to loosen up the mucus plugs. D. Explain the risks involved in the bronchoscopy and convince the patient and obtain the consent from the patient before the procedure.
Keep the patient NPO.
Which of the following confirms the diagnosis of bacterial pneumonia? a. Dyspnea b. Hacking cough c. Leukocytosis d. Wheezes
Leukocytosis
The health care provider writes an order for bacteriologic testing for a patient who has a positive tuberculosis skin test. Which action will you take? a. Repeat the tuberculin skin testing. b. Teach about the reason for the blood tests. c. Obtain consecutive sputum specimens from the patient for 3 days. d. Instruct the patient to expectorate three specimens as soon as possible.
Obtain consecutive sputum specimens from the patient for 3 days.
The client diagnosed with community-acquired pneumonia is admitted to the medical unit. Which healthcare provider order should the nurse implement FIRST? A. Start IV with 1,000 mL 0.9% normal saline B. Ceftriaxone (Rocephin) 1 gm IVPB every 12 hours C. Obtain sputum and blood cultures, CBC and basic metabolic panel D. Monitor I & O
Obtain sputum and blood cultures, CBC and basic metabolic panel
The teaching plan for a patient with acute sinusitis will need to include of the following interventions EXCEPT A. Taking a hot shower will increase sinus drainage and decrease pain. B. Over the counter (OTC) antihistamines can be used to relieve congestion and inflammation. C. Saline nasal spray can be made at home and used to wash out secretions. D. Blowing the nose forcefully should be avoided to decrease nosebleed risk.
Over the counter (OTC) antihistamines can be used to relieve congestion and inflammation.
Which of the following is used for highly unstable patients with respiratory distress - Select all that apply A. Oxygen via a nasal cannula B. Oxygen via a non-rebreather mask C. Oxygen via a venturi mask D. Oxygen via a simple face mask
Oxygen via a non-rebreather mask Oxygen via a venturi mask
Which of the following is expected to find in ABG of a patient with bilateral pneumonia? a. PaO2 60 mmHg b. PaO2 80 mmHg c. PaO2 90 mmHg d. PaO2 100 mmHg
PaO2 60 mmHg
Who of the following is at highest risk to acquire pneumonia? a. Patient who has been using corticosteroid for 3 days. b. Patient who is 45 year and has COPD. c. Patient who has been a smoker for 5 years. d. Patient whose WBC counts is 2,000/mm3 post chemotherapy.
Patient whose WBC counts is 2,000/mm3 post chemotherapy.
You are caring for a patient who has just had a rhinoplasty for a broken nose and deviated septum. Which of the following post-op assessment findings must you report FIRST: A. Patient's pain level is 5/10. B. Patient's SpO2 (oxygen saturation) is 88%. C. Patient is upset with how his face looks. D. There is some blood on the patient's pledget (nasal tampon).
Patient's SpO2 (oxygen saturation) is 88%.
Pneumocystis pneumonia is a pulmonary fungal infection commonly seen is: a. Patients with lung cancer b. Patients with AIDS c. Patients with cystic fibrosis d. Patients with CODP
Patients with AIDS
A patient with acute shortness of breath is admitted to the hospital. Which action should the nurse take during the initial assessment of the patient? A. Complete a full physical examination to determine the systemic effect of the respiratory distress. B. Obtain a comprehensive health history to determine the extent of any prior respiratory problems. C. Delay the physical assessment and ask family members about any history of respiratory problems. D. Perform a respiratory system assessment and ask specific questions about this episode of respiratory distress.
Perform a respiratory system assessment and ask specific questions about this episode of respiratory distress.
Which action should you take first when a patient develops a nosebleed? A. Pack both nares tightly with 1/2-inch ribbon gauze. B. Pinch the lower portion of the nose for 10 minutes. C. Prepare supplies that will be needed for cauterization. D. Apply ice compresses over the patient's nose and cheeks.
Pinch the lower portion of the nose for 10 minutes.
The client is suspected of having a pulmonary embolus. Which diagnostic test suggests the presence of a pulmonary embolus and requires further investigation? A. Chest x-ray (CXR) B. Arterial blood gas C. Plasma D-dimer test D. Magnetic resonance imaging (MRI)
Plasma D-dimer test
A patient with complicated deviate septum is hospitalized to have septoplasty. Which of the following findings must you report to the surgeon before the surgery? A. Serum sodium is 134 mEq/L. B. PT is 12 seconds. C. Serum potassium is 4.8 mEq/L. D. Platelet count is 120,000/ L.
Platelet count is 120,000/ L.
The spouse of a 78-year-old client who was discharged to home 1 day ago after hospitalization for seasonal influenza calls to report the fever has returned and is now 103.4°F (39.7°C). What is the nurse's primary concern for this client? A. The client may not be taking the prescribed antiviral drug correctly B. A second strain of influenza is likely C. Pneumonia may be present D. The client may be dehydrated
Pneumonia may be present
When assessing a client with pleural effusion, you expect to identify: a. Moist crackles at the posterior of the lungs b. Deviation of the trachea toward the involved side c. Reduced or absent breath sounds at the base of the lung d. Increased resonance with percussion of the involved area
Reduced or absent breath sounds at the base of the lung
The nurse is caring for a patient with pneumonia. Which of the following nursing observations would indicate a therapeutic response to the treatment for the infection? A. Oral temperature 101* F, non-productive cough, SpO2 92% B. Respirations 20, moderate amount of white sputum, no dyspnea C. WBC of 13, 000 mm, urine output 40 ml/hr, no chest pain while coughing D. Coughing up thick green sputum, SpO2 91%, Oral temp 100.5* F
Respirations 20, moderate amount of white sputum, no dyspnea
The nurse should monitor for which expected finding if the patient develops Corpulmonale as a complication of TB? Select all that apply. A. Shortness of breath B. Peripheral edema C. Elevated temperature D. Hepatomegaly
Shortness of breath Peripheral edema Hepatomegaly
A client is admitted to the hospital with a diagnosis of atrial fibrillation, and the practitioner suspects mitral valve stenosis. When obtaining a health history, the nurse determines that it is most significant if the client presents a history of: A. Cystitis at age 28 B. Pleurisy at age 20 C. Strep throat at age 12 D. German measles at age 6
Strep throat at age 12
Which nursing actions can the RN working in a long-term care facility delegate to an experienced LPN/LVN caring for a patient with a permanent tracheostomy? A. Assessing the patient's risk for aspiration B. Suctioning the tracheostomy when needed C. Educating the patient about self-care of the tracheostomy D. Determining the need for replacement of the tracheostomy tube
Suctioning the tracheostomy when needed
Which nursing assessment data SUPPORT that the client has experienced a pulmonary embolism? A. Calf pain with dorsiflexion of the foot B. Left-sided chest pain and diaphoresis C. Sudden onset of chest pain and dyspnea D. Bilateral crackles and low-grade fever
Sudden onset of chest pain and dyspnea
Which outcome is appropriate for the client problem "ineffective gas exchange" for the client recently diagnosed with COPD? A. The client lists three (3) signs/symptoms to report to the healthcare provider. B. The client demonstrates the correct way to do pursed-lip breathing. C. The client will drink at least 2,500 mL of water daily. D. The client will be able to ambulate 100 feet with dyspnea.
The client demonstrates the correct way to do pursed-lip breathing.
You are caring for a hospitalized 82-year-old patient who has nasal packing in place to treat a nosebleed. Which of the following assessment findings will require the most immediate action? A. The patient complains of level 7 (0 to 10 scale) pain. B. The patient's temperature is 100.1° F (37.8° C). C. The nose appears red and swollen. D. The oxygen saturation is 89%.
The oxygen saturation is 89%.
You have completed patient teaching about the administration of salmeterol (Serevent) using a metered-dose inhaler (MDI). Which action by the patient indicates an understanding of the teaching? A. The patient activates the inhaler at the onset of expiration. B. The patient attaches a spacer before using the MDI. C. The patient floats the MDI in water to see if it is empty. D. The patient coughs vigorously after using the inhaler.
The patient attaches a spacer before using the MDI.
Which information about a patient who has a recent history of tuberculosis (TB) indicates that you can discontinue airborne isolation precautions? a. Chest x-ray shows no upper lobe infiltrates. b. TB medications have been taken for 6 months. c. Mantoux testing shows an induration of 10 mm. d. Three sputum smears for acid-fast bacilli are negative.
Three sputum smears for acid-fast bacilli are negative.
Which of the following would cause the medulla oblongata to increase the respiratory rate? A. Too much oxygen in the bloodstream B. Too much carbon dioxide in the bloodstream C. Decrease in metabolic needs
Too much carbon dioxide in the bloodstream
Which information will the nurse include when teaching the patient with asthma about the prescribed medications? A. Utilize the inhaled corticosteroid when shortness of breath occurs. B. Inhale slowly and deeply when using the dry-powder inhaler (DPI). C. Hold your breath for 5 seconds after using the bronchodilator inhaler. D. Tremors are an expected side effect of rapidly acting bronchodilators.
Tremors are an expected side effect of rapidly acting bronchodilators.
Auscultating bronchial breath sounds over the lung fields is considered abnormal. True or False?
True
Because the pressure of CO2 is higher in the blood vessels than the pressure of CO2 in the lungs, the CO2 moves from the blood to the lungs. True or False?
True
While receiving an adrenergic beta2 agonist drug for asthma, the client complains of palpitations, chest pain, and a throbbing headache. What is the most appropriate nursing action? a. Withhold the drug until additional orders are obtained. b. Tell the client not to worry; these are expected side effects from the medicine. c. Ask the client to relax; then give instructions to breathe slowly and deeply for several minutes. d. Explain that the effects are temporary and will subside as the body becomes accustomed to the drug.
Withhold the drug until additional orders are obtained.
When auscultating a patient's chest while the patient takes a deep breath, you hear loud, high-pitched, "blowing" sounds at both lung bases. You will document these as A. normal sounds. B. vesicular sounds. C. abnormal sounds D. adventitious sounds
adventitious sounds
You recognize that the goals of teaching regarding the transmission of pulmonary tuberculosis (TB) have been met when the patient with TB a. demonstrates correct use of a nebulizer. b. washes dishes and personal items after use. c. covers the mouth and nose when coughing. d. reports daily to the public health department.
covers the mouth and nose when coughing.
A patient with a possible pulmonary embolism complains of chest pain and difficulty breathing. You find a heart rate of 142, BP reading of 100/60, and respirations of 42. Your first action should be to A. elevate the head of the bed to 45 to 60 degrees. B. administer the ordered pain medication. C. notify the patient's health care provider. D. offer emotional support and reassurance.
elevate the head of the bed to 45 to 60 degrees.
On auscultation of a patient's lungs, you hear short, high-pitched sounds during exhalation in the lower 1/3 of both lungs. You should record this finding as A. expiratory crackles at the bases. B. expiratory wheezes in both lungs. C. abnormal lung sounds in the bases of both lungs. D. pleural friction rub in the right and left lower lobes.
expiratory wheezes in both lungs.
A patient with a pleural effusion is scheduled for a thoracentesis. Before the procedure, you will plan to a. start a peripheral intravenous line to administer the necessary sedative drugs. b. position the patient sitting upright on the edge of the bed and leaning forward. c. remove the water pitcher and remind the patient not to eat or drink anything for 6 hours. d. instruct the patient about the importance of incentive spirometer use after the procedure.
position the patient sitting upright on the edge of the bed and leaning forward.
When caring for a patient who is hospitalized with active tuberculosis (TB), you observe a family member who is visiting the patient. You will need to intervene if the family member a. washes the hands before entering the patient's room. b. hands the patient a tissue from the box at the bedside. c. puts on a surgical face mask before visiting the patient. d. brings food from a "fast-food" restaurant to the patient.
puts on a surgical face mask before visiting the patient.
A staff nurse has a tuberculosis (TB) skin test of 16-mm induration. A chest radiograph is negative, and the nurse has no symptoms of TB. The occupational health nurse will plan on teaching the staff nurse about the a. use and side effects of isoniazid (INH). b. standard four-drug therapy for TB. c. need for annual repeat TB skin testing. d. bacille Calmette-Guérin (BCG) vaccine.
use and side effects of isoniazid (INH).
When teaching the patient who is receiving standard multidrug therapy for tuberculosis (TB) about possible toxic effects of the antitubercular medications, you will give instructions to notify the health care provider if the patient develops a. yellow-tinged skin. b. changes in hearing. c. orange-colored sputum. d. thickening of the fingernails.
yellow-tinged skin.
