Respiratory Questions MS Exam 3 prep

Emergency treatment of a client in status asthmaticus includes which of the following medications? A Inhaled beta-adrenergic agents B Inhaled corticosteroids C I.V. beta-adrenergic agents D Oral corticosteroids

A Inhaled beta-adrenergic agents Inhaled beta-adrenergic agents help promote bronchodilation, which improves oxygenation. I.V. beta-adrenergic agents can be used but have to be monitored because of their greater systemic effects. They're typically used when the inhaled beta-adrenergic agents don't work. Corticosteroids are slow-acting, so their use won't reduce hypoxia in the acute phase.

Which of the following patients are MOST at risk for developing pneumonia? **Select-all-that-apply: A. A 53 year old female recovering from abdominal surgery. B. A 69 year old patient who recently received the pneumococcal conjugate vaccine. C. A 42 year old male with COPD and is on continuous oxygen via nasal cannula. D. A 8 month old with RSV (respiratory syncytial virus) infection.

A. A 53 year old female recovering from abdominal surgery. C. A 42 year old male with COPD and is on continuous oxygen via nasal cannula. D. A 8 month old with RSV (respiratory syncytial virus) infection.

An elderly client with pneumonia may appear with which of the following symptoms first? A Altered mental status and dehydration B Fever and chills C Hemoptysis and dyspnea D Pleuritic chest pain and cough

A Altered mental status and dehydration Fever, chills, hemoptysis, dyspnea, cough, and pleuritic chest pain are common symptoms of pneumonia, but elderly clients may first appear with only an altered mental status and dehydration due to a blunted immune response.

A male client admitted to an acute care facility with pneumonia is receiving supplemental oxygen, 2 L/minute via nasal cannula. The client's history includes chronic obstructive pulmonary disease (COPD) and coronary artery disease. Because of these history findings, the nurse closely monitors the oxygen flow and the client's respiratory status. Which complication may arise if the client receives a high oxygen concentration? A Apnea B Anginal pain C Respiratory alkalosis D Metabolic acidosis

A Apnea Hypoxia is the main breathing stimulus for a client with COPD. Excessive oxygen administration may lead to apnea by removing that stimulus. Anginal pain results from a reduced myocardial oxygen supply. A client with COPD may have anginal pain from generalized vasoconstriction secondary to hypoxia; however, administering oxygen at any concentration dilates blood vessels, easing anginal pain. Respiratory alkalosis results from alveolar hyperventilation, not excessive oxygen administration. In a client with COPD, high oxygen concentrations decrease the ventilatory drive, leading to respiratory acidosis, not alkalosis. High oxygen concentrations don't cause metabolic acidosis.

Which of the following ABG abnormalities should the nurse anticipate in a client with advanced COPD? A Increased PaCO2 B Increased PaO2 C Increased pH D Increased oxygen saturation

A Increased PaCO2 As COPD progresses, the client typically develops increased PaCO2 levels and decreased PaO2 levels. This results in decreased pH and decreased oxygen saturation. These changes are the result of air trapping and hypoventilation.

The nurse is caring for a client diagnosed with right middle lobe pneumonia. The nurse should perform which intervention to mobilize secretions? a. Administer antibiotics as ordered. b. Limit fluid to intravenous fluids only. c. Place the client in a prone position to increase alveolar expansion. d. Assist client to use incentive spirometer hourly.

d. Assist client to use incentive spirometer hourly.

Which of the following respiratory disorders is most common in the first 24 to 48 hours after surgery? A Atelectasis B Bronchitis C Pneumonia D Pneumothorax

A Atelectasis Atelectasis develops when there's interference with the normal negative pressure that promotes lung expansion. Clients in the postoperative phase often splint their breathing because of pain and positioning, which causes hypoxia. It's uncommon for any of the other respiratory disorders to develop.

Which of the following physical assessment findings would the nurse expect to find in a client with advanced COPD? A Increased anteroposterior chest diameter B Underdeveloped neck muscles C Collapsed neck veins D Increased chest excursions with respiration

A Increased anteroposterior chest diameter Increased anteroposterior chest diameter is characteristic of advanced COPD. Air is trapped in the overextended alveoli, and the ribs are fixed in an inspiratory position. The result is the typical barrel-chested appearance. Overly developed, not underdeveloped, neck muscles are associated with COPD because of their increased use in the work of breathing. Distended, not collapsed, neck veins are associated with COPD as a symptom of the heart failure that the client may experience secondary to the increased workload on the heart to pump into pulmonary vasculature. Diminished, not increased, chest excursion is associated with COPD.

A male client with pneumococcal pneumonia is admitted to an acute care facility. The client in the next room is being treated for mycoplasmal pneumonia. Despite the different causes of the various types of pneumonia, all of them share which feature? A Inflamed lung tissue B Sudden onset C Responsiveness to penicillin D Elevated white blood cell (WBC) count

A Inflamed lung tissue The common feature of all types of pneumonia is an inflammatory pulmonary response to the offending organism or agent. Although most types of pneumonia have a sudden onset, a few (such as anaerobic bacterial pneumonia and mycoplasmal pneumonia) have an insidious onset. Antibiotic therapy is the primary treatment for most types of pneumonia; however, the antibiotic must be specific for the causative agent, which may not be responsive to penicillin. A few types of pneumonia, such as viral pneumonia, aren't treated with antibiotics. Although pneumonia usually causes an elevated WBC count, some types, such as mycoplasmal pneumonia, don't.

An elderly client has been ill with the flu, experiencing headache, fever, and chills. After 3 days, she develops a cough productive of yellow sputum. The nurse auscultates her lungs and hears diffuse crackles. How would the nurse best interpret these assessment findings? A It is likely that the client is developing a secondary bacterial pneumonia. B The assessment findings are consistent with influenza and are to be expected. C The client is getting dehydrated and needs to increase her fluid intake to decrease secretions. D The client has not been taking her decongestants and bronchodilators as prescribed.

A It is likely that the client is developing a secondary bacterial pneumonia. Pneumonia is the most common complication of influenza, especially in the elderly. The development of a purulent cough and crackles may be indicative of a bacterial infection are not consistent with a diagnosis of influenza. These findings are not indicative of dehydration. Decongestants and bronchodilators are not typically prescribed for the flu.

Auscultation of a client's lungs reveals crackles in the left posterior base. The nursing intervention is to: A Repeat auscultation after asking the client to deep breathe and cough. B Instruct the client to limit fluid intake to less than 2000 ml/day. C Inspect the client's ankles and sacrum for the presence of edema D Place the client on bedrest in a semi-Fowlers position.

A Repeat auscultation after asking the client to deep breathe and cough. Although crackles often indicate fluid in the alveoli, they may also be related to hypoventilation and will clear after a deep breath or a cough. It is, therefore, premature to impose fluid (2) or activity (4) restrictions (which Margaret would totally do if Dani weren't there to smack her). Inspection for edema (3) would be appropriate after re-auscultation.

A slightly obese female client with a history of allergy-induced asthma, hypertension, and mitral valve prolapse is admitted to an acute care facility for elective surgery. The nurse obtains a complete history and performs a thorough physical examination, paying special attention to the cardiovascular and respiratory systems. When percussing the client's chest wall, the nurse expects to elicit: A Resonant sounds B Hyperresonant sounds C Dull sounds D Flat sounds

A Resonant sounds When percussing the chest wall, the nurse expects to elicit resonant sounds — low-pitched, hollow sounds heard over normal lung tissue. Hyperresonant sounds indicate increased air in the lungs or pleural space; they're louder and lower pitched than resonant sounds. Although hyperresonant sounds occur in such disorders as emphysema and pneumothorax, they may be normal in children and very thin adults. Dull sounds, normally heard only over the liver and heart, may occur over dense lung tissue, such as from consolidation or a tumor. Dull sounds are thudlike and of medium pitch. Flat sounds, soft and high-pitched, are heard over airless tissue and can be replicated by percussing the thigh or a bony structure.

The nurse in charge formulates a nursing diagnosis of Activity intolerance related to inadequate oxygenation and dyspnea for a client with chronic bronchitis. To minimize this problem, the nurse instructs the client to avoid conditions that increase oxygen demands. Such conditions include: A Drinking more than 1,500 ml of fluid daily B Being overweight C Eating a high-protein snack at bedtime D Eating more than three large meals a day

B Being overweight Conditions that increase oxygen demands include obesity, smoking, exposure to temperature extremes, and stress. A client with chronic bronchitis should drink at least 2,000 ml of fluid daily to thin mucus secretions; restricting fluid intake may be harmful. The nurse should encourage the client to eat a high-protein snack at bedtime because protein digestion produces an amino acid with sedating effects that may ease the insomnia associated with chronic bronchitis. Eating more than three large meals a day may cause fullness, making breathing uncomfortable and difficult; however, it doesn't increase oxygen demands. To help maintain adequate nutritional intake, the client with chronic bronchitis should eat small, frequent meals (up to six a day).

A client with acute asthma showing inspiratory and expiratory wheezes and a decreased expiratory volume should be treated with which of the following classes of medication right away? A Beta-adrenergic blockers B Bronchodilators C Inhaled steroids D Oral steroids

B Bronchodilators Bronchodilators are the first line of treatment for asthma because bronchoconstriction is the cause of reduced airflow. Beta-adrenergic blockers aren't used to treat asthma and can cause bronchoconstriction. Inhaled or oral steroids may be given to reduce the inflammation but aren't used for emergency relief.

Assessing a client who has developed atelectasis postoperatively, the nurse will most likely find: A A flushed face B Dyspnea and pain C Decreased temperature D Severe cough and no pain

B Dyspnea and pain Atelectasis is a collapse of the alveoli due to obstruction or hypoventilation. Clients become short of breath, have a high temperature, and usually experience severe pain but do not have a severe cough (4). The shortness of breath is a result of decreased oxygen-carbon dioxide exchange at the alveolar level.

A client has just returned to a nursing unit following bronchoscopy. A nurse would implement which of the following nursing interventions for this client? A Encouraging additional fluids for the next 24 hours B Ensuring the return of the gag reflex before offering foods or fluids C Administering atropine intravenously D Administering small doses of midazolam (Versed)

B Ensuring the return of the gag reflex before offering foods or fluids After bronchoscopy, the nurse keeps the client on NPO status until the gag reflex returns because the preoperative sedation and the local anesthesia impair swallowing and the protective laryngeal reflexes for a number of hours. Additional fluids is unnecessary because no contrast dye is used that would need to be flushed from the system. Atropine and Versed would be administered before the procedure, not after.

The nurse would anticipate which of the following ABG results in a client experiencing a prolonged, severe asthma attack? A Decreased PaCO2, increased PaO2, and decreased pH. B Increased PaCO2, decreased PaO2, and decreased pH. C Increased PaCO2, increased PaO2, and increased pH. D Decreased PaCO2, decreased PaO2, and increased pH.

B Increased PaCO2, decreased PaO2, and decreased pH. As the severe asthma attack worsens, the client becomes fatigued and alveolar hypotension develops. This leads to carbon dioxide retention and hypoxemia. The client develops respiratory acidosis. Therefore, the PaCO2 level increase, the PaO2 level decreases, and the pH decreases, indicating acidosis.

Dr. Jones prescribes albuterol sulfate (Proventil) for a patient with newly diagnosed asthma. When teaching the patient about this drug, the nurse should explain that it may cause: A Nasal congestion B Nervousness C Lethargy D Hyperkalemia

B Nervousness Albuterol may cause nervousness. The inhaled form of the drug may cause dryness and irritation of the nose and throat, not nasal congestion; insomnia, not lethargy; and hypokalemia (with high doses), not hyperkalemia. Other adverse effects of albuterol include tremor, dizziness, headache, tachycardia, palpitations, hypertension, heartburn, nausea, vomiting and muscle cramps.

The nurse assesses a male client's respiratory status. Which observation indicates that the client is experiencing difficulty breathing? A Diaphragmatic breathing B Use of accessory muscles C Pursed-lip breathing D Controlled breathing

B Use of accessory muscles The use of accessory muscles for respiration indicates the client is having difficulty breathing. Diaphragmatic and pursed-lip breathing are two controlled breathing techniques that help the client conserve energy.

Which of the following are typical signs and symptoms of pneumonia? **Select-all-that-apply: A. Stridor B. Coarse crackles C. Oxygen saturation less than 90% D. Non-productive, nagging cough E. Elevated white blood cells F. Low PCO2 of less than 35 G. Tachypnea

B. Coarse crackles C. Oxygen saturation less than 90% E. Elevated white blood cells G. Tachypnea

A 72 year-old male patient who is diagnosed with bilateral lower lobe pneumonia is admitted to your unit. The patient has a history of systolic heart failure and arthritis. On assessment, you note the patient has a respiratory rate of 21, oxygen saturation 93% on 2L nasal cannula, is alert & oriented, and has a productive cough with green/yellowish sputum. Which of the following nursing interventions will you provide to this patient based on your assessment findings and the patient's diagnosis? **Select-all-that-apply: A. Keep head-of-the-bed less than 30 degrees at all times. B. Collect sputum cultures. C. Encourage 3L of fluids a day to keep secretions thin. D. Encourage incentive spirometer usage E. Provide education about receiving the Pneumovax vaccine every 5 years.

B. Collect sputum cultures. D. Encourage incentive spirometer usage E. Provide education about receiving the Pneumovax vaccine every 5 years.

A client has been taking flunisolide (Aerobid), two inhalations a day, for treatment of asthma. He tells the nurse that he has painful, white patches in his mouth. Which response by the nurse would be the most appropriate? A "This is an anticipated side-effect of your medication. It should go away in a couple of weeks." B "You are using your inhaler too much and it has irritated your mouth." C "You have developed a fungal infection from your medication. It will need to be treated with an antibiotic." D "Be sure to brush your teeth and floss daily. Good oral hygiene will treat this problem."

C "You have developed a fungal infection from your medication. It will need to be treated with an antibiotic." Use of oral inhalant corticosteroids, such as flunisolide, can lead to the development of oral thrush, a fungal infection. Once developed, thrush must be treated by antibiotic therapy; it will not resolve on its own. Fungal infections can develop even without overuse of the Corticosteroid inhaler. Although good oral hygiene can help prevent the development of a fungal infection, it cannot be used alone to treat the problem.

A male client with chronic obstructive pulmonary disease (COPD) is recovering from a myocardial infarction. Because the client is extremely weak and can't produce an effective cough, the nurse should monitor closely for: A Pleural effusion B Pulmonary edema C Atelectasis D Oxygen toxicity

C Atelectasis In a client with COPD, an ineffective cough impedes secretion removal. This, in turn, causes mucus plugging, which leads to localized airway obstruction — a known cause of atelectasis. An ineffective cough doesn't cause pleural effusion (fluid accumulation in the pleural space). Pulmonary edema usually results from left-sided heart failure, not an ineffective cough. Although many noncardiac conditions may cause pulmonary edema, an ineffective cough isn't one of them. Oxygen toxicity results from prolonged administration of high oxygen concentrations, not an ineffective cough.

Nurse Joy is caring for a client after a bronchoscopy and biopsy. Which of the following signs, if noticed in the client, should be reported immediately to the physician? A Dry cough B Hermaturia C Bronchospasm D Blood-streaked sputum

C Bronchospasm If a biopsy was performed during a bronchoscopy, blood-streaked sputum is expected for several hours. Frank blood indicates hemorrhage. A dry cough may be expected. The client should be assessed for signs of complications, which would include cyanosis, dyspnea, stridor, bronchospasm, hemoptysis, hypotension, tachycardia, and dysrhythmias. Hematuria is unrelated to this procedure.

Immediately following a thoracentesis, which clinical manifestations indicate that a complication has occurred and the physician should be notified? A Serosanguineous drainage from the puncture site B Increased temperature and blood pressure C Increased pulse and pallor D Hypotension and hypothermia

C Increased pulse and pallor Increased pulse and pallor are symptoms associated with shock. A compromised venous return may occur if there is a mediastinal shift as a result of excessive fluid removal. Usually, no more than 1 L of fluid is removed at one time to prevent this from occurring.

Which of the following assessment findings would help confirm a diagnosis of asthma in a client suspected of having the disorder? A Circumoral cyanosis B Increased forced expiratory volume C Inspiratory and expiratory wheezing D Normal breath sounds

C Inspiratory and expiratory wheezing Inspiratory and expiratory wheezes are typical findings in asthma. Circumoral cyanosis may be present in extreme cases of respiratory distress. The nurse would expect the client to have a decreased forced expiratory volume because asthma is an obstructive pulmonary disease. Breath sounds will be "tight" sounding or markedly decreased; they won't be normal.

A client with pneumonia develops dyspnea with a respiratory rate of 32 breaths/minute and difficulty expelling his secretions. The nurse auscultates his lung fields and hears bronchial sounds in the left lower lobe. The nurse determines that the client requires which of the following treatments first? A Antibiotics B Bed rest C Oxygen D Nutritional intake

C Oxygen The client is having difficulty breathing and is probably becoming hypoxic. As an emergency measure, the nurse can provide oxygen without waiting for a physicians order. Antibiotics may be warranted, but this isn't a nursing decision. The client should be maintained on bedrest if he is dyspneic to minimize his oxygen demands, but providing additional will deal more immediately with his problem. The client will need nutritional support, but while dyspneic, he may be unable to spare the energy needed to eat and at the same time maintain adequate oxygenation.

Aminophylline (theophylline) is prescribed for a client with acute bronchitis. A nurse administers the medication, knowing that the primary action of this medication is to: A Promote expectoration B Suppress the cough C Relax smooth muscles of the bronchial airway D Prevent infection

C Relax smooth muscles of the bronchial airway

Which of the following organisms most commonly causes community-acquired pneumonia in adults? A Haemiphilus influenzae B Klebsiella pneumoniae C Streptococcus pneumoniae D Staphylococcus aureus

C Streptococcus pneumoniae Pneumococcal or streptococcal pneumonia, caused by streptococcus pneumoniae, is the most common cause of community-acquired pneumonia. H. influenzae is the most common cause of infection in children. Klebsiella species is the most common gram-negative organism found in the hospital setting. Staphylococcus aureus is the most common cause of hospital-acquired pneumonia.

A client with emphysema should receive only 1 to 3 L/minute of oxygen, if needed, or he may lose his hypoxic drive. Which of the following statements is correct about hypoxic drive? A The client doesn't notice he needs to breathe B The client breathes only when his oxygen levels climb above a certain point C The client breathes only when his oxygen levels dip below a certain point D The client breathes only when his carbon dioxide level dips below a certain point

C The client breathes only when his oxygen levels dip below a certain point Clients with emphysema breathe when their oxygen levels drop to a certain level; this is known as the hypoxic drive. They don't take a breath when their levels of carbon dioxide are higher than normal, as do those with healthy respiratory physiology. If too much oxygen is given, the client has little stimulus to take another breath. In the meantime, his carbon dioxide levels continue to climb, and the client will pass out, leading to a respiratory arrest.

Which phrase is used to describe 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 the vital capacity performed with a maximally forced expiration. Residual volume is the maximal amount of air left in the lung after a maximal expiration.

At 11 p.m., a male client is admitted to the emergency department. He has a respiratory rate of 44 breaths/minute. He's anxious, and wheezes are audible. The client is immediately given oxygen by face mask and methylprednisolone (Depo-medrol) I.V. At 11:30 p.m., the client's arterial blood oxygen saturation is 86% and he's still wheezing. The nurse should plan to administer: A Alprazolam (Xanax) B Propranolol (Inderal) C Morphine D Albuterol (Proventil)

D Albuterol (Proventil) The client is hypoxemic because of bronchoconstriction as evidenced by wheezes and a subnormal arterial oxygen saturation level. The client's greatest need is bronchodilation, which can be accomplished by administering bronchodilators. Albuterol is a beta2 adrenergic agonist, which causes dilation of the bronchioles. It's given by nebulization or metered-dose inhalation and may be given as often as every 30 to 60 minutes until relief is accomplished. Alprazolam is an anxiolytic and central nervous system depressant, which could suppress the client's breathing. Propranolol is contraindicated in a client who's wheezing because it's a beta2 adrenergic antagonist. Morphine is a respiratory center depressant and is contraindicated in this situation.

The nurse assesses the respiratory status of a client who is experiencing an exacerbation of COPD secondary to an upper respiratory tract infection. Which of the following findings would be expected? A Normal breath sounds B Prolonged inspiration C Normal chest movement D Coarse crackles and rhonchi

D Coarse crackles and rhonchi Exacerbations of COPD are frequently caused by respiratory infections. Coarse crackles and rhonchi would be auscultated as air moves through airways obstructed with secretions. In COPD, breath sounds are diminished because of an enlarged anteroposterior diameter of the chest. Expiration, not inspiration, becomes prolonged. Chest movement is decreased as lungs become overdistended.

A client has been taking benzonatate (Tessalon Perles) as prescribed. A nurse concludes that the medication is having the intended effect if the client experiences: A Decreased anxiety level B Increased comfort level C Reduction of N/V D Decreased frequency and intensity of cough

D Decreased frequency and intensity of cough Benzonatate is a locally acting antitussive the effectiveness of which is measured by the degree to which it decreases the intensity and frequency of cough without eliminating the cough reflex.

A 66-year-old client has marked dyspnea at rest, is thin, and uses accessory muscles to breathe. He's tachypneic, with a prolonged expiratory phase. He has no cough. He leans forward with his arms braced on his knees to support his chest and shoulders for breathing. This client has symptoms of which of the following respiratory disorders? A ARDS B Asthma C Chronic obstructive bronchitis D Emphysema

D Emphysema These are classic signs and symptoms of a client with emphysema. Clients with ARDS are acutely short of breath and require emergency care; those with asthma are also acutely short of breath during an attack and appear very frightened. Clients with chronic obstructive bronchitis are bloated and cyanotic in appearance.

Which of the following diets would be most appropriate for a client with COPD? A Low fat, low cholesterol B Bland, soft diet C Low-Sodium diet D High-calorie, high-protein diet

D High-calorie, high-protein diet The client should eat high-calorie, high-protein meals to maintain nutritional status and prevent weight loss that results from the increased work of breathing. The client should be encouraged to eat small, frequent meals. A low-fat, low-cholesterol diet is indicated for clients with coronary artery disease. The client with COPD does not necessarily need to follow a sodium-restricted diet, unless otherwise medically indicated.

A nurse instructs a female client to use the pursed-lip method of breathing and the client asks the nurse about the purpose of this type of breathing. The nurse responds, knowing that the primary purpose of pursed-lip breathing is to: A Promote oxygen intake B Strengthen the diaphragm C Strengthen the intercostal muscles D Promote carbon dioxide elimination

D Promote carbon dioxide elimination Pursed-lip breathing facilitates maximal expiration for clients with obstructive lung disease. This type of breathing allows better expiration by increasing airway pressure that keeps air passages open during exhalation. Options A, B, and C are not the purposes of this type of breathing.

Pseudoephedrine (Sudafed) has been ordered as a nasal decongestant. Which of the following is a possible side effect of this drug? A Constipation B Bradycardia C Diplopia D Restlessness

D Restlessness Side effects of pseudoephedrine are experienced primarily in the cardiovascular system and through sympathetic effects on the CNS. The most common CNS effects include restlessness, dizziness, tension, anxiety, insomnia, and weakness. Common cardiovascular side effects include tachycardia, hypertension, palpitations, and arrhythmias. Constipation and diplopia are not side effects of pseudoephedrine. Tachycardia, not bradycardia, is a side effect of pseudoephedrine.

Which of the following measures can reduce or prevent the incidence of atelectasis in a post-operative client? A Chest physiotherapy B Mechanical ventilation C Reducing oxygen requirements D Use of an incentive spirometer

D Use of an incentive spirometer Using an incentive spirometer requires the client to take deep breaths and promotes lung expansion. Chest physiotherapy helps mobilize secretions but won't prevent atelectasis. Reducing oxygen requirements or placing someone on mechanical ventilation doesn't affect the development of atelectasis.

A client has been treated with antibiotic therapy for right lower-lobe pneumonia for 10 days and will be discharged today. Which of the following physical findings would lead the nurse to believe it is appropriate to discharge this client? A Continued dyspnea B Fever of 102*F C Respiratory rate of 32 breaths/minute D Vesicular breath sounds in right base

D Vesicular breath sounds in right base If the client still has pneumonia, the breath sounds in the right base will be bronchial, not the normal vesicular breath sounds. If the client still has dyspnea, fever, and increased respiratory rate, he should be examined by the physician before discharge because he may have another source of infection or still have pneumonia.

The nurse is teaching a client with newly diagnosed emphysema how to manage the disease. The client asks how pursed lip breathing helps the emphysema. What would be the best response by the nurse? a. It prevents air sacs in the lungs from trapping air. b. It decreases the pressure in the airways. c. The resistance on exhalation increases muscle strength in the diaphragm. d. It helps slow the respiratory rate.

a. It prevents air sacs in the lungs from trapping air.

A postoperative client with emphysema is receiving oxygen at 2L/min via nasal cannula when the client reports shortness of breath. The spouse asks the nurse to increase the oxygen to help the client breathe easier. Which response by the nurse is appropriate? a. I have a better technique. I will switch him to 100% non-rebreather mask. b. Higher concentration of oxygen may decrease breathing and cause more difficulty. c. I think you should leave for an hour: it's just anxiety, and rest will improve the breathing. d. This is an indication that he is in pain. I will treat that.

b. Higher concentration of oxygen may decrease breathing and cause more difficulty.

The nurse considers that which concept should have priority for discussion during discharge teaching for a client who has chronic bronchitis? **Select all that apply a. Fluid restriction b. Smoking cessation c. Avoidance of crowds d. Side effects of drug therapy.

b. Smoking cessation c. Avoidance of crowds

When teaching a client scheduled for a bedside thoracentesis. What would the nurse explain is the primary purpose for this procedure? a. It is used to obtain pleural tissue for evaluation. b. It is used to determine the stage of lung tumor. c. It is used to withdraw fluid from the pleural space. d. It is used to directly examine the pleural space.

c. It is used to withdraw fluid from the pleural space.

The home health nurse is assessing an adolescent who has frequent school absences because of acute asthma attacks. Assessment reveals mild inspiratory wheezes and current oxygen saturation (SaO2) of 98%. The client can answer questions in full sentences and accurately demonstrates the use of inhalers. After documenting this data. What would be the next best action by the nurse? a. Report to home health agency that client has adequate knowledge of how to manage disease. b. Question family members to determine if they know CPR in event of respiratory emergency. c. Perform an environmental assessment to identify asthma triggers. d. Report the situation to the Department of Youth Services for truancy and possible neglect.

c. Perform an environmental assessment to identify asthma triggers.