Respiratory

The nurse completed teaching on care at home to the mother of a child post-tonsil and adenoidectomy (T&A) surgery. The nurse determines the the mother understands the instructions when the mother makes which statement? " I should give ice pops or cold drinks but avoid giving anything red-colored." "Hemorrhage can occur up to a month after discharge due to sloughing from healing." "My child should gargle and use a hard-bristled toothbrush to clean the mouth of debris." "My child should cough and deep breath to keep the lungs clear and prevent pneumonia."

" I should give ice pops or cold drinks but avoid giving anything red-colored." Cold liquids will soothe the throat and decrease inflammation; red-colored food and beverages should be avoided because these can mask signs of bleeding.

The child with asthma is prescribed a albuterol MDI. Which statement should the nurse include when teaching the child how to administer this medication? "When administering medication via an MDI, avoid shaking the canister before discharging the medication." "When giving two 'puffs', press on the canister twice in succession to discharge the medication." "There should be a tight seal around the mouth piece of the inhaler before the medication is discharged." "Breath out as much air as possible, put the mouthpiece in the mouth, press the canister, and slowly inhale."

"Breath out as much air as possible, put the mouthpiece in the mouth, press the canister, and slowly inhale."

The nurse is caring for a child with bronchial asthma. Which statement is most important for the nurse to make when teaching the parents? "Bronchial Asthma is also called hyperactive airway disease." "Cold air and irritating odors can cause severe bronchoconstriction." "Frequent occurrences of bronchiolitis before age 5 could indicate asthma." "Severe respiratory alkalosis can result from respiratory failure in asthma.

"Cold air and irritating odors can cause severe bronchoconstriction." 2- It is important for the nurse to teach the parents about asthma triggers such as exposure to cold air, and irritating odors, which can cause severe bronchoconstriction, so that episodes can be avoided. Other triggers include inhalant antigens such as pollens, molds, house dust, food, and irritating odors, such as turpentine, smog, or cigarette smoke.

The mother of a 2-year-old telephones the clinic nurse to ask advice. The child has a temperature of 104 degrees (F) and a sore throat and has been drooling for a few days. The child is now sleepy. Which is the best advice by the nurse? "Take your child to an emergency department immediately." "Bring your child into the clinic to be seen as soon as possible." "Administer acetaminophen for the temperature and allow your child to sleep." "Use a spoon to look inside your child's mouth and throat and tell me what you see."

"Take your child to an emergency department immediately." An elevated temperature, sore throat, and drooling are symptoms of epiglottitis. The sleepiness could be from the effects of the elevated temperature or from respiratory depression. The child should be seen in an ED immediately because the child could develop respiratory failure.

The child is diagnosed with TB after returning to the U.S. from a trip to Africa. During the assessment, the nurse observes that the parents do not talk about the child's diagnosis as TB or use the word "TB" but rather use only the word "it". Which statement made by the nurse is best? "Tell me how you feel about your child's diagnosis and illness?" "If your child takes the prescribed medications, 'it' can be cured." "Why do you say 'it' rather than referring to the diagnosis of tuberculosis?" "How long has your child been having night sweats and a productive cough?"

"Tell me how you feel about your child's diagnosis and illness?" 1-An open-ended statement allows the parents time to express feelings and concerns, and the parents may provide the reason for referring to the TB as 'it'. Some cultures avoid calling the disease by name for fear that it may cause further harm.

A school-age child has been diagnosed with strep throat. The parent asks the nurse when the child can return to school. Which is the nurse's best response? "Forty-eight hours after the first documented normal temperature." "Twenty-four hours after the first dose of antibiotics." "Forty-eight hours after the first dose of antibiotics." "Twenty-four hours after the first documented normal temperature."

"Twenty-four hours after the first dose of antibiotics." Children with strept-throat are no longer contagious 24 hours after initiation of antibiotic therapy.

The nurse educates parents about the nutritional needs of their child with CF. Which response by a parent indicates an understanding of the child's nutritional needs? We will need to limit the amount of meat, carbohydrates, and fats in the diet plan." "We will need to prepare a low-carbohydrate, high-fat, diet plan with very little meat." "We will need to prepare a lot of meat and carbohydrates and some fats in the diet plan." "We will need to prepare moderate amounts of meats and low carbohydrate in the diet plan.

"We will need to prepare a lot of meat and carbohydrates and some fats in the diet plan." 3- A calorie-dense meal that includes high protein, high calories, and moderate fats will provide optimal nutrition and energy for a child with CF.

Which child is in the greatest need of emergency medical treatment? A 3-year-old who has a barky cough, is afebrile, and has mild intercostal retractions. A 6-year-old who has high fever, no spontaneous cough, and frog-like croaking. A 7-year-old who has abrupt onset on moderate respiratory distress, a mild fever, and a barky cough. A 13-year-old who has a high fever, stridor, and purulent secretions.

A 6-year-old who has high fever, no spontaneous cough, and frog-like croaking. 2- This child has signs and symptoms of epiglottitis and should recieve immediate emergency medical treatment. The child has not spontaneous cough and has a frog-like croaking because of a significant airway obstruction. 1- child has s/s of acute laryngitis and is not in significant amount of distress 3-child has s/s of LTB and is not in significant respiratory distress 4-child has s/s of bacterial tracheitis and symptoms should be treated with antibiotics but is not the child in the most significant amount of distress

The ED nurse is assessing a client complaining of dyspnea. The nurse auscultates the client's chest and hears wheezing throughout the lung fields. What might this indicate about the client? A narrowed airway Pneumonia The need for physiotherapy Hemothorax

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

A client presents to the ED after being in a boating accident about 3 hours ago. Now the client reports headache, fatigue, and the feeling that he just can't breathe enough. The nurse notes that the client is restless and tachycardic with an elevated blood pressure. This client may be in the early stages of what respiratory problem? Pneumoconiosis Pleural effusion Acute respiratory failure Pneumonia

Acute respiratory failure Early signs of acute respiratory failure are those associated with impaired oxygenation and may include restlessness, fatigue, headache, dyspnea, air hunger, tachycardia, and increased blood pressure. As the hypoxemia progresses, more obvious signs may be present, including confusion, lethargy, tachycardia, tachypnea, central cyanosis, diaphoresis, and, finally, respiratory arrest. Pneumonia is infectious and would not result from trauma. Pneumoconiosis results from exposure to occupational toxins. A pleural effusion does not cause this constellation of symptoms.

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

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 group of nursing students are reviewing the medications used to treat asthma. The students demonstrate understanding of the information when they identify which agent as appropriate for an acute episode of bronchospasm? Salmeterol Albuterol Ipratropium Cromolyn

Albuterol Albuterol is a short-acting b2-adrenergic agonist that is used for treatment of acute bronchospasm. Salmeterol is a long-acting b2-adrenergic agonist used for long-term control or exercise-induced asthma. Ipratropium is an anticholinergic agent used as an adjunct to b2-adrenergic agonists for treatment of bronchospasm. Cromolyn is a mast cell stabilizer used prophylactically but not to relieve bronchospasm during an acute wheezing episode.

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

An arterial blood gas (ABG) study The arterial oxygen tension (partial pressure or PaO2) indicates the degree of oxygenation of the blood, and the arterial carbon dioxide tension (partial pressure or PaCO2) indicates 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 planning care for the child diagnosed with RSV. Which interventions should the nurse plan to implement? Select all that apply. Promote rest by grouping care activities Encourage parents with young children to visit. Give ceftriaxone 500mg IV as prescribed once daily. Assess skin turgor and mucus membranes q4h and prn. Give oxygen to maintain oxygen saturation level >95%.

Assess skin turgor and mucus membranes q4h and prn Give oxygen to maintain oxygen saturation level >95%. Promote rest by grouping care activities

The nurse is caring for the hospitalized adolescent who is being monitored by pulse oximetry. When the nurse enters the room, the pulse oximeter monitor is showing an oxygen saturation of 84% and alarming. What should the nurse do next? Replace the pulse oximetry machine and probe Administer oxygen through a nasal cannula or by mask. Assess the client's level of consciousness and skin color Call the HCP for an order for arterial blood gases (ABG's

Assess the client's level of consciousness and skin color The nurse should immediately assess the client's mental status and skin color to quickly determine whether the signal tracing constitutes an emergency or whether it is an artifact. An artifact in the pulse oximeter monitoring system can be caused by altered skin temperature, movement of the client's finger, probe disconnection, or equipment malfunction.

A client's plan of care specifies postural drainage. What action should the nurse perform when providing this noninvasive therapy? Administer the treatment with the client in a high Fowler's or semi-Fowler's position. Perform the procedure immediately following the client's meals. Apply percussion firmly to bare skin to facilitate drainage. Assist the client into a position that will allow gravity to move secretions.

Assist the client into a position that will allow gravity to move secretions. Postural drainage is usually performed two to four times per day. The client uses gravity to facilitate postural draining. The skin should be covered with a cloth or a towel during percussion to protect the skin. Postural drainage is not given in an upright position or directly following a meal.

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? Pneumonia Asthma Pleurisy Emphysema

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

The nurse is preparing to perform chest physiotherapy on the child with CF. When should the nurse plan to perform the treatment? At least 1 hour after meals Before performing postural drainage Before a nebulized aerosol treatment After suctioning the upper respiratory tract

At least 1 hour after meals 1- The nurse should perform chest physiotherapy between meals to prevent esophageal reflux and aspiration.

A perioperative nurse is caring for a postoperative client. The client has a shallow respiratory pattern and is reluctant to cough or to begin mobilizing. The nurse should address the client's increased risk for what complication? Acute respiratory distress syndrome (ARDS) Atelectasis Aspiration Pulmonary embolism

Atelectasis

A nurse is working with a client who is undergoing a diagnostic workup for suspected asthma. What are the signs and symptoms that are consistent with a diagnosis of asthma? Select all that apply. Chest tightness Crackles Bradypnea Wheezing Coug

Chest tightness Wheezing Cough Chest tightness Asthma is a chronic inflammatory disease of the airways that causes airway hyperresponsiveness, mucosal edema, and mucus production. This inflammation ultimately leads to recurrent episodes of asthma symptoms: cough, chest tightness, wheezing, and dyspnea. Crackles and bradypnea are not typical symptoms of asthma.

The NA obtains the vitals illustrated for a 15-year-old who just underwent a bronchoscopy. What should the nurse do next? Correct Complete a thorough respiratory assessment. Answers: Correct Complete a thorough respiratory assessment. Ask the NA to recheck the vital signs in 15 minutes. Continue to monitor the adolescent's sedation status. Determine if the adolescent had anything hot to drink.

Complete a thorough respiratory assessment.

The nurse is reviewing the laboratory results for the child hospitalized with hemoptysis. Based on the results, the nurse should plan to implement measures to treat the child for which condition? Renal Failure Cystic Fibrosis (CF) Cardiac dysrhymias Type 1 diabetes mellitus

Cystic Fibrosis (CF) In CF, sodium and chloride are lost in the sweat, lowering the serum levels. Chloride levels of more than 60 mEq/L in sweat are diagnostic for CF. Dehydration from loss of NaCl increases the BUN level. The Hbg is a little low due to the hemoptysis, and the WBC's are elevated due to inflammation or infection.

A nurse is preparing to care for a client with bronchiectasis. The nurse should recognize that this client is likely to experience respiratory difficulties related to what pathophysiologic process? Intermittent episodes of acute bronchospasm Alveolar distention and impaired diffusion Excessive gas exchange in the bronchioles Dilation of bronchi and bronchioles

Dilation of bronchi and bronchioles

The nurse is caring for a client who is scheduled for a lobectomy for lung cancer. While assisting with a subclavian vein central line insertion, the nurse notes the client's oxygen saturation rapidly dropping. The client reports shortness of breath and becomes tachypneic. The nurse suspects a pneumothorax has developed. What further assessment findings support the presence of a pneumothorax? Diminished or absent breath sounds on the affected side Paradoxical chest wall movement with respirations Sudden loss of consciousness Muffled heart sounds

Diminished or absent breath sounds on the affected side In the case of a simple pneumothorax, auscultating the breath sounds will reveal absent or diminished breath sounds on the affected side. Paradoxical chest wall movements occur in flail chest conditions. Sudden loss of consciousness does not typically occur. Muffled or distant heart sounds occur in pericardial tamponade.

The nurse is to care for the 6-month-old diagnosed with Laryngotracheobronchitis [LTB] (croup). Which findings should the nurse expect when completing an initial assessment?Select all that apply. Dyspnea Dysphagia Hoarseness Barking cough Inspiratory stridor

Dyspnea Barking cough Inspiratory stridor

An admitting nurse is assessing a client with COPD. The nurse auscultates diminished breath sounds. These findings indicate to the nurse to monitor the client for what? Kyphosis and clubbing of the fingers Dyspnea and hypoxemia Sepsis and pneumothorax Bradypnea and pursed-lip breathing

Dyspnea and hypoxemia These changes in the airway require that the nurse monitor the client for dyspnea and hypoxemia. Kyphosis is a musculoskeletal problem. Sepsis and pneumothorax are atypical complications. Tachypnea is much more likely than bradypnea. Pursed-lip breathing can relieve dyspnea.

The child with a sore throat is hospitalized with a tentative diagnosis of epiglottitis. Which diagnostic test should the nurse plan to review to confirm the diagnosis? Bradycardia and frontal headache Dyspnea and substernal pain Peripheral cyanosis and restlessness Hypotension and tachycardia

Dyspnea and substernal pain Oxygen toxicity can occur when clients receive too high a concentration of oxygen for an extended period. Symptoms of oxygen toxicity include dyspnea, substernal pain, restlessness, fatigue, and progressive respiratory difficulty. Bradycardia, frontal headache, cyanosis, hypotension, and tachycardia are not symptoms of oxygen toxicity.

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? Emphysema Pulmonary fibrosis Pleural effusion Acute respiratory distress syndrome (ARDS)

Emphysema

The infant is hospitalized after having a respiratory infection and severe diarrhea for 5 days. The child has poor skin turgor, respirations 30 per minute, Temp- 101.3 (F), and watery green stools. The health HCP prescribes an antipyretic and IV fluids of D5NS with potassium additive. What nursing action is most important? Administer the prescribed antipyretic medication. Change the infant's diaper that has watery green stool. Apply oxygen because the child is experiencing rapid respirations. Ensure that the infant has had urine output before starting IV fluids.

Ensure that the infant has had urine output before starting IV fluids.

The nurse is caring for a client whose recent unexplained weight loss and history of smoking have prompted diagnostic testing for cancer. What symptom is most closely associated with the early stages of laryngeal cancer? Hoarseness Dyspnea Dysphagia Frequent nosebleeds

Hoarseness Hoarseness is an early symptom of laryngeal cancer. Dyspnea, dysphagia, and lumps are later signs of laryngeal cancer.

The nurse is providing care for a client who has recently been diagnosed with COPD. When educating the client about exacerbations, the nurse should prioritize what topic? Prompt administration of corticosteroids during exacerbations Identifying specific causes of exacerbations The importance of prone positioning during exacerbations The relationship between activity level and exacerbations

Identifying specific causes of exacerbations Prevention is key in the management of exacerbations, and it is important for the client to identify which factors cause exacerbations. Corticosteroids are not normally used as a rescue medication and prone positioning does not enhance oxygenation. Activity may or may not cause a client to have exacerbations; inactivity is not a risk factor.

The nurse is caring for a client at risk for atelectasis. The nurse implements a first-line measure to prevent atelectasis development in the client. What is an example of a first-line measure to minimize atelectasis? Incentive Spirometry Intermittent positive-pressure breathing (IPPB) Positive end-expiratory pressure (PEEP) Bronchoscopy

Incentive Spirometry Strategies to prevent atelectasis, which include frequent turning, early ambulation, lung-volume expansion maneuvers (deep-breathing exercises, incentive spirometry), and coughing, serve as the first-line measures to minimize or treat atelectasis by improving ventilation. In clients who do not respond to first-line measures or who cannot perform deep breathing exercises, other treatments such as positive end-expiratory pressure (PEEP), continuous or intermittent positive-pressure breathing (IPPB), or bronchoscopy may be used.

A client visiting the clinic is diagnosed with acute sinusitis. To promote sinus drainage, the nurse should instruct the client to perform what action? Apply a cold pack to the affected area. Apply heat to the forehead Perform postural drainage Increase fluid intake

Increase fluid intake For a client diagnosed with acute sinusitis, the nurse should instruct the client that hot packs, increasing fluid intake, and elevating the head of the bed can promote drainage. Applying heat will not promote sinus drainage. Postural drainage is used to remove bronchial secretions.

A nurse is caring for a client with COPD. The client's medication regimen has been recently changed and the nurse is assessing for therapeutic effect of a new bronchodilator. Therapeutic effects of this medication would include which of the following? Select all that apply. Negative sputum culture Increased viscosity of lung secretions Increased respiratory rate Increased expiratory flow rate Relief of dyspnea

Increased expiratory flow rate Relief of dyspnea The relief of bronchospasm is confirmed by measuring improvement in expiratory flow rates and volumes (the force of expiration, how long it takes to exhale, and the amount of air exhaled) as well as by assessing the dyspnea and making sure that it has lessened. Increased respiratory rate and viscosity of secretions would suggest a worsening of the client's respiratory status. Bronchodilators would not have a direct result on the client's infectious process.

A medical nurse has admitted a client to the unit with a diagnosis of failure to thrive. The client 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 client's physician because these symptoms are suggestive of what? Pneumothorax Lung Tumors Infection Pulmonary Edema

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 mucoid 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.

A client is brought to the ED by ambulance after a motor vehicle accident in which the client received blunt trauma to the chest. The client is in acute respiratory failure, is intubated, and is transferred to the ICU. What assessment parameters should the nurse monitor most closely? Select all that apply. Coping Level of consciousness Oral intake Arterial blood gases Vital signs

Level of consciousness Arterial blood gases Vital signs Clients are usually treated in the ICU. The nurse assesses the client's respiratory status by monitoring the level of responsiveness, ABGs, pulse oximetry, and vital signs. Oral intake and coping are not immediate priorities during the acute stage of treatment, but would become more important later during recovery.

A nurse has performed tracheal suctioning on a client who experienced increasing dyspnea prior to a procedure. When applying the nursing process, how can the nurse best evaluate the outcomes of this intervention? Determine whether the client can now perform forced expiratory technique (FET). Percuss the client's lungs and thorax. Measure the client's oxygen saturation. Have the client perform incentive spirometry.

Measure the client's oxygen saturation.

Which information will be most helpful in teaching parents about the primary prevention of foreign body aspiration? Signs and symptoms of foreign body aspiration. Therapeutic management of foreign body aspiration. Most common objects that toddlers aspirate. Risks associated with foreign body aspiration.

Most common objects that toddlers aspirate. Teaching parents the most common objects aspirated by toddlers will help them the most. Parents can avoid having those items in the household or in locations where toddlers may have access.

The nurse is caring for a client with bronchiectasis. Chest auscultation reveals the presence of copious secretions. What intervention should the nurse prioritize in this client's care? Oral administration of diuretics Intravenous fluids to reduce the viscosity of secretions Correct Postural chest drainage Pulmonary function testing

Postural chest drainage Postural drainage is part of all treatment plans for bronchiectasis, because draining of the bronchiectatic areas by gravity reduces the amount of secretions and the degree of infection. Diuretics and IV fluids will not aid in the mobilization of secretions. Lung function testing may be indicated, but this assessment will not relieve the client's symptoms.

The child is diagnosed with Cystic Fibrosis (CF). Which fact about CF should the nurse consider when developing the plan of care for the child? Pulmonary secretions are abnormally thick. Chronic constipation usually occurs with CF. CF is an autosomal dominant hereditary disorder. A child with CF will also have diabetes insipidus

Pulmonary secretions are abnormally thick. 1-Pulmonary secretions are abnormally thick, and lungs are filled with mucus that the cilia cannot clear.

The nurse has noted the emergence of a significant amount of fresh blood at the drain site of a client who is postoperative day 1 following total laryngectomy. What is the nurse's best action? Remove the client's drain and apply pressure with a sterile gauze. Assess the client, reposition the client supine, and apply wall suction to the drain. Rapidly assess the client and notify the surgeon about the client's bleeding. Administer a STAT dose of vitamin K to aid coagulation.

Rapidly assess the client and notify the surgeon about the client's bleeding. The nurse promptly notifies the surgeon of any active bleeding, which can occur at a variety of sites, including the surgical site, drains, and trachea. The drain should not be removed or connected to suction. Supine positioning would exacerbate the bleeding. Vitamin K would not be given without an order.

The child who had a tonsillectomy and adenoidectomy (T&A) is brought to the postoperative recovery room. In what position should the nurse place the child? Supine Side-lying Semi-fowler's with the head turned to the side High fowler's, head slightly forward and to the side

Side-lying 2- The nurse should place the child following a T&A in a side-lying position to facilitate drainage from the oropharynx. Semi fowlers and high fowlers would hinder drainage and increase risk for aspiration supine would allow secretions to pool at the back of the throat or buccal cavity

The triage nurse in the ED determines that the child is experiencing severe respiratory distress. Which assessment findings support the nurse's conclusion? Agitation, vomiting, diarrhea, and tachycardia Diaphoresis, restlessness, tachypnea, and anorexia Pallor, coughing, expiratory wheezes, and confusion Sternal retractions, grunting, cyanosis, and bradycar

Sternal retractions, grunting, cyanosis, and bradycardia Signs of severe respiratory distress include chest retractions, grunting, cyanosis, and bradycardia. Sternal retractions appear from the use of accessory muscles to breathe. Grunting is an involunary response to end-stage respiratory effort. Cyanosis indicates that a state of hypoxia exists due to lack of circulating oxygen, and progression to bradycardia is an ominous sign that the body is so overtaxed that it is wearing out. Pallor , coughing, expiratory wheeze, and confusion may indicate moderate respiratory distress.

A nursing student is discussing a client with viral pharyngitis with the preceptor at the walk-in clinic. What should the preceptor tell the student about nursing care for clients with viral pharyngitis? Teaching focuses on safe and effective use of antibiotics. The client should be preliminarily screened for surgery. Symptom management is the main focus of medical and nursing care. The focus of care is resting the voice to prevent chronic hoarseness.

Symptom management is the main focus of medical and nursing care. Nursing care for clients with viral pharyngitis focuses on symptomatic management. Antibiotics are not prescribed for viral etiologies. Surgery is not indicated in the treatment of viral pharyngitis. Chronic hoarseness is not a common sequela of viral pharyngitis, so teaching ways to prevent it would be of no use in this instance.

A nurse is admitting a new client who has been admitted with a diagnosis of COPD exacerbation. How can the nurse best help the client achieve the goal of maintaining effective oxygenation? Teach the client to perform airway suctioning. Assist the client in developing an appropriate exercise program. Teach the client strategies for promoting diaphragmatic breathing. Administer supplementary oxygen by simple face mask.

Teach the client strategies for promoting diaphragmatic breathing. The breathing pattern of most people with COPD is shallow, rapid, and inefficient; the more severe the disease, the more inefficient the breathing pattern. With practice, this type of upper chest breathing can be changed to diaphragmatic breathing, which reduces the respiratory rate, increases alveolar ventilation, and sometimes helps expel as much air as possible during expiration. Suctioning is not normally necessary in clients with COPD. Supplementary oxygen is not normally delivered by simple face mask and exercise may or may not be appropriate.

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

The client's pain intensifies when he coughs or takes a deep breath. The key characteristic of pleuritic pain is its relationship to respiratory movement. Taking a deep breath, coughing, or sneezing worsens the pain. The client's ABGs would most likely be abnormal and shortness of breath would be expected.

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

The importance of adhering closely to the prescribed medication regimen Successful treatment of TB is highly dependent on careful adherence to the medication regimen. The disease is not self-limiting; occupational and physical therapy is not necessarily indicated. TB is curable.

A nurse is teaching a client with asthma about the proper use of the prescribed inhaled corticosteroid. Which adverse effects should the nurse be sure to address in client teaching? Thrush Decreased level of consciousness Nausea and vomiting Temporarily increased respiratory secretions

Thrush Patients should rinse their mouth after administration to prevent thrush, a common complication associated with use of inhaled corticosteroids. The other listed adverse effects are not associated with inhaled corticosteroids.

A nurse's assessment reveals that a client with COPD may be experiencing bronchospasm. What assessment finding would suggest that the client is experiencing bronchospasm? Fine or coarse crackles on auscultation Wheezes or diminished breath sounds on auscultation Reduced respiratory rate or lethargy Slow, deliberate respirations and diaphoresis

Wheezes or diminished breath sounds on auscultation Wheezing and diminished breath sounds are consistent with bronchospasm. Crackles are usually attributable to other respiratory or cardiac pathologies. Bronchospasm usually results in rapid, inefficient breathing and agitation.

The nurse is caring for a client who has been scheduled for a bronchoscopy. How should the nurse prepare the client for this procedure? Administer a bolus of IV fluids. Arrange for the insertion of a peripherally inserted central catheter. Withhold food and fluids for several hours before the test. Administer nebulized bronchodilators every 2 hours until the test.

Withhold food and fluids for several hours before the test. Food and fluids are withheld for 4 to 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.