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Respiratory, quiz 2

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The nurse is completing the admission of an older adult patient with a history of COPD whose diagnosis is pneumonia. Which assessments would be most important to include in obtaining the history? (Select all that apply.) a. Smoking history and exposure to secondhand smoke b. Current medications c. Chief complaint and onset of symptoms d. Support system e. Home oxygen use f. Liver function

A, B, C, D, E

During assessment, a patient states, "It's hard for me to breathe, and I feel short-winded all the time." Which terminology is most appropriate for the nurse to use to document this assessment? Apnea Dyspnea Tachypnea Respiratory fatigue

Dyspnea Rationale Dyspnea is a subjective description refective of the patient's statement indicating difficulty in breathing. Apnea refers to the absence of breathing. Tachypnea refers to an increased rate of breathing, usually greater than 20 breaths/min. Respiratory fatigue is a subjective description. It usually refers to the patient exhibiting signs and symptoms associated with a comprehensive respiratory assessment. The respiratory assessment includes laborious breathing, use of accessory muscles, and slowing of respirations.

An 83-year-old patient is admitted with a temperature of 102 F (38.8 C), chest pain, and fatigue. What is the infected fluid that the physician removes called? a. Emboli b. Emphysema c. Sputum d. Empyema

d. Empyema

A clinic nurse is reinforcing instructions to a client with a diagnosis of pharyngitis. Which intervention should the client be encouraged to perform? Avoid foods that are highly seasoned. Restrict fluid intake to 1000 mL daily. Drink warm herbal tea throughout the day. Substitute hot chocolate in place of coffee.

The nurse is listening to the client's breath sounds and hears musical whistling noises on inspiration and expiration scattered throughout the right lung fields. How should the nurse interpret these noises? Crackles Wheezes Rhonchi Pleural friction rub

The nurse is collecting data from a client who is experiencing the typical signs/symptoms of tuberculosis (TB). Which are signs and symptoms of tuberculosis? Select all that apply. Weight gain Night sweats Sporadic coughing Mucopurulent sputum Afternoon low grade fever

2,4,5

A nurse is assigned an adult client who needs oropharyngeal suctioning. Which of the following actions should the nurse take? Apply suction only after the catheter is being withdrawn from the oropharyngeal site Insert catheter in line with the center of the tongue Perform continuous suction for 25 to 35 seconds Set wall suction between 120 to 150 mmHg

Apply suction only after the catheter is being withdrawn from the oropharyngeal site

How should a patient be positioned after a thoracentesis is completed and the dressing applied? Prone Semi-Fowler High Fowler Side lying on unaffected side

Side lying on unaffected side

A patient comes to the clinic complaining of severe headache with facial tenderness. Transillumination shows darkened sinuses. The nurse anticipates which diagnosis? Sinusitis Influenza A Common cold Allergic rhinitis

Sinusitis Rationale Diseased sinuses are dark under transillumination. Transilumination is not used to diagnose infuenza A, the common cold, or allergic rhinitis.

A nurse is caring for a client who witness a bombing incident is nervous and hyperventilating. The nurse would monitor the client for signs of which of the following acid-base imbalances? Metabolic alkalosis Respiratory alkalosis Metabolic acidosis Respiratory acidosis

Respiratory alkalosis Rationale: A client who hyperventilates blows off excessive carbon dioxide. This would have the effect of inducing alkalosis. Because a respiratory problem is triggering the alteration, it is called a respiratory alkalosis.

The nurse is collecting respiratory data from an adult client and is auscultating for normal breath sounds. The nurse should expect to hear bronchial breath sounds in which anatomical area? Refer to figure. A B C D

A patient visits the clinic with new-onset sinus pain and headache. Which instruction would the nurse provide first? "Inhale steam often." "Use oral corticosteroids." "Take inhaled corticosteroids." "Complete antibiotic therapy in its entirety."

"Inhale steam often." Rationale The first instruction should be to inhale steam often, which promotes drainage of the sinuses. Oral corticosteroids have systemic effects that prevent them from being the preferred therapy. Inhaled corticosteroids may help reduce inflammation. Antibiotic therapy is used only in cases proven to be bacterial in origin.

A female client is scheduled to have a chest x-ray. Which question is most important to ask the client during data collection? "Can you hold your breath easily?" "Are you able to hold your arms above your head?" "Is there any possibility that you could be pregnant?" "Are you wearing any metal chains or jewelry?"

"Is there any possibility that you could be pregnant?"

The nurse is talking with a client who is going to have a radical neck dissection and total laryngectomy. Which client statement indicates a need for further teaching concerning postoperative management? "I will gradually eat oral fluids and food." "I will require a lot of pain med after surgery." "I will need to support my head when I sit up." "I will determine options to restore some form of speech."

The nurse is admitting a client with a possible diagnosis of chronic bronchitis. The nurse collects data from the client and notes that which signs/symptoms support this diagnosis? Select all that apply. Scant mucus Early-onset cough Marked weight loss Purulent mucous production Mild episodes of dyspnea

2,4,5

The nurse is assigned to assist the primary health care provider (PHCP) with the removal of a chest tube. Which interventions should the nurse anticipate performing during this process? Select all that apply. Reinforce instructions to breathe deeply while the tube is removed. Cover the site with an occlusive dressing after the tube is removed. Clamp the chest tube near the insertion site just before the removal. Raise the drainage system to the level of the chest tube insertion site. Have the client perform the Valsalva maneuver as the chest tube is pulled out.

2,5

The nurse is assessing a client who has frequent episodes of asthma. Which assessment finding is most closely associated with asthma? Fine rhonchi Pink, frothy sputum Bilateral wheezing Rhonchi that clear with a cough

The nurse is gathering data on a client with a diagnosis of tuberculosis. The nurse should review the results of which diagnostic test to confirm this diagnosis? Chest x-ray Bronchoscopy Sputum culture Tuberculin skin test

The nurse is assessing a client diagnosed with sinusitis. Which are signs and symptoms of sinusitis? Select all that apply. A high fever Nuchal rigidity Headache, especially in the morning Elevated white blood cell (WBC) count Feeling of heaviness over affected areas

3,4,5

A client attached to mechanical ventilation suddenly becomes restless and pulls out the tracheostomy tube. Which is the nurse's priority intervention? Prepare for reintubation. Call the rapid response team. Call the registered nurse. Check the client for spontaneous breathing.

A client has a chest tube that is attached to a chest drainage system. The chest tube becomes disconnected. What should the nurse do immediately? Assess lung sounds. Clamp tube above open end. Put gloved thumb over open end. Put open end under sterile water.

A client is admitted to the hospital with a diagnosis of carbon dioxide narcosis. In addition to respiratory failure, the nurse plans to monitor the client for which complication of this disorder? Paralytic ileus Hypernatremia Hyperglycemia Increased intracranial pressure

A client is admitted to the hospital with acute exacerbation of chronic obstructive pulmonary disease (COPD). Which arterial blood gas supports this diagnosis? Po2 of 68 mm Hg and Pco2 of 40 mm Hg Po2 of 55 mm Hg and Pco2 of 40 mm Hg Po2 of 70 mm Hg and Pco2 of 50 mm Hg Po2 of 60 mm Hg and Pco2 of 50 mm Hg

A client with pneumonia is experiencing problems with ventilation as a result of accumulated respiratory secretions. The nurse determines that which data accurately indicate effectiveness of the treatments prescribed for this problem? Venous oxygen saturation is 95%. Respiratory rate is 20 breaths per minute. Client demonstrated effective coughing techniques. Arterial blood gases indicate a pH of 7.4, Po2 of 80 mm Hg, and Pco2 of 40 mm Hg.

A primary health care provider is about to remove a chest tube from a client. Once the dressing is removed and the sutures have been cut, the nurse assisting the primary health care provider asks the client to do which action? Exhale immediately. Breathe in and out rapidly. Breathe deeply and rapidly. Perform the Valsalva maneuver.

The nurse checks the water seal chamber of a closed chest drainage system and notes fluctuations in the chamber. Based on this finding, the nurse makes which determination? An air leak is present. The tubing is kinked. The lung has re-expanded. The system is functioning as expected.

The nurse is assigned to care for a client who has a chest tube. The nurse is told to monitor the client for crepitus (subcutaneous emphysema). Which method should be used to monitor the client for crepitus? Auscultating the posterior breath sounds Asking the client about pain upon inspiration Placing the hands over the rib area and observing the expansion Palpating the skin around the chest and neck for a crackling sensation

The nurse is caring for a client with tuberculosis (TB) who is fearful of the disease and anxious about the prognosis. In planning nursing care, the nurse should incorporate which action as the best strategy to assist the client in coping with the disease? Ask family members if they wish a psychiatric consult. Allow the client to deal with the disease in an individual fashion. Encourage the client to visit with the pastoral care department chaplain. Provide reassurance that continued compliance with medication therapy is the most proactive way to cope with the disease.

The nurse is caring for the client who is at risk for lung cancer because of an extremely long history of heavy cigarette smoking. The nurse tells the client to report which frequent early symptom of lung cancer? Hoarseness Pleuritic pain Hemoptysis Nonproductive hacking cough

The nurse is checking the chest tube drainage system of a postoperative client who had a right upper lobectomy. The closed drainage system has 300 mL of bloody drainage, and the nurse notes intermittent bubbling in the water-seal chamber. One hour following the initial data collection, the nurse notes that the bubbling in the water-seal chamber is now constant, and the client appears dyspneic. Based on these findings, which action should the nurse do first? Check the client's vital signs. Note the amount of drainage. Check the client's lung sounds. Inspect chest tube connections.

The nurse is reinforcing discharge teaching to a client diagnosed with tuberculosis who has been taking medication for 1½ weeks. The nurse knows that the client has understood the information if which statement is made? "I can't shop at the mall for the next 6 months." "I need to continue medication therapy for 2 months." "I can return to work if a sputum culture comes back negative." "I should not be contagious after 2 to 3 weeks of medication therapy."

What happens when there is a decrease in the oxygen level in the blood? The alveoli diffuse more oxygen into the blood Chemoreceptors in the carotid body and aortic body stimulate the respiratory centers to modify respiratory rates The pituitary stimulates the respiratory system to increase respiratory rate The parietal pleura increases the negative pressure

Chemoreceptors in the carotid body and aortic body stimulate the respiratory centers to modify respiratory rates The chemoreceptors in the carotid bodies and the aortic bodies send a message to the respiratory centers to modify respirations.

The nurse is caring for a patient with epistaxis and finds that the patient has risk for aspiration. Which immediate intervention should the nurse provide? Provide ventilator support by placing the patient in the supine position. Place a mild hot pack on the nostrils of the patient to prevent aspiration. Close the patient's nostrils, and breathe through the mouth. Instruct the patient to continuously swallow expectorated blood to clear the airways.

Close the patient's nostrils, and breathe through the mouth.

Which instruction by the nurse is inappropriate for teaching the proper technique for the collection of a sputum specimen? Bring the sputum up from the lungs. Notify the staff as soon as the specimen is collected so it can be sent to the laboratory without delay. Maintain adequate fluid intake. Collect specimens after meals.

Collecting specimens before meals will avoid possible emesis from coughing after eating.

The nurse would determine that tracheal suctioning is needed if which of the following is noted? Arterial oxygen level of 90 mm Hg Respiratory rate of 18 breaths/min, up from 16 breaths/min Two hours elapsed since the last suctioning Congested breath sounds and audible crackles on the lung fields and coughing

Congested breath sounds and audible crackles on the lung fields and coughing Rationale: Suctioning is indicated only when the client has adventitious breath sounds or has accumulation of secretions. It is not performed routinely according to time elapsed since the last suctioning ("two hours elapsed since the last suctioning"). Arterial blood gas results and respiratory rate ("arterial oxygen level of 90 mm Hg" and "respiratory rate of 18 breaths/min, up from 16 breaths/min") are not good indicators of the need for suctioning because they may be influenced by a number of other factors in addition to the need for suctioning.

A nurse is performing the morning assessment of a patient with heart failure.On auscultation the nurse notes sounds similar to hair being rolled between fingers near the ear. How would the nurse document this finding? Crackles Sibilant wheezes Sonorous wheezes Pleural friction rubs

Crackles Rationale The nurse is hearing crackles caused by pulmonary edema Sibilant wheezes are high-pitched musical noises. Sonorous wheezes are low-pitched sounds. Pleural friction rubs are grating noises.

Which test is a quick and reliable aid to diagnosis latent TB? TB tine test QFT-G Sputum smears PPD skin test

QFT-G Sputum smears, cultures and PPD skin test are still done. However, QFT-G offers a quick and reliable diagnosis for the patient and health care provider. The results of QFT-G are greater specificity and results are available 24 hours after the blood is collected.

A patient reports taking pseudoephedrine for allergies in the spring. The nurse cautions the patient to limit the use to less than 5 consecutive days to prevent which complication? Epistaxis Anaphylaxis Rebound congestion Desiccation of mucous membranes

Rebound congestion Rationale Rebound congestion can occur after abruptly stopping medicines such as pseudoephedrine after 3 to 5 days of consecutive use. The patientis not at risk for epistaxis, anaphylaxis, or desiccation of mucous membranes.

When teaching the client about topical nasal decongestant sprays with steroid, the nurse should warn that overuse of such medication is likely to result in what adverse effect? Ulceration of the nasal mucous membrane Decreased ability to fight microorganisms Rebound congestion with nasal stuffiness Nasal irritation with rhinorrhea

Rebound congestion with nasal stuffiness

Which position is the most beneficial for a patient after surgery for creation of a tracheostomy? Lithotomy Trendelenburg Semi-fowler's Dorsal recumbent

Semi-fowler's

Which are the medications considered first line anti-infectives against pulmonary tuberculosis? (Select all that apply) Streptomycin Ethambutol INH Pyrazinamide Rifampin

Streptomycin Ethambutol INH Pyrazinamide Rifampin

The nurse explains that the opening between the vocal cords is the __________.

glottis

A patient has a metabolic acidosis. The nurse anticipates the patient will demonstrate which symptom? Tachycardia Bradycardia Increased respiratory rate Decreased respiratory rate

Increased respiratory rate Rationale Metabolic acidosis causes the lungs to increase respirations to blow off extra carbon dioxide and increase blood pH. Increased heart rate and decreased respiratory rate occurs in metabolic alkalosis, in which the body must conserve carbon dioxide to decrease blood pH.

A patient has metabolic acidosis. The nurse anticipates the patient will demonstrate which symptom? Tachycardia Bradycardia Increased respiratory rate Decreased respiratory rate

A nurse is assisting in the care of a client who had an ileostomy created a few days ago. Owing to the normally high output of drainage from this type of ostomy, the nurse monitors the client for signs of what acid-base imbalance? Metabolic alkalosis Metabolic acidosis Respiratory acidosis Respiratory alkalosis

Metabolic acidosis Rationale: Intestinal secretions are high in bicarbonate because of the effects of pancreatic secretions. These fluids may be lost from the body before they can be reabsorbed in conditions such as diarrhea or creation of ileostomy. The decreased bicarbonate level creates the actual base deficit of metabolic acidosis.

An arterial blood gas sample has been drawn. Which intervention by the nurse is the most important for preserving the integrity of the specimen? Place the specimen on ice. Place the specimen in a location from where it can be picked up within 4 hours. Place the specimen in room-temperature water. Have the patient initial and sign the specimen.

Place the specimen on ice. Rationale The arterial blood gas sample must be placed on ice and taken to the laboratory immediately to preserve the integrity of the specimen. The nurse should not place the specimen in room temperature water. Although the nurse should hold pressure at the site and chart the date and time of the procedure with the patient's response, these interventions do not apply to the preservation of the specimen.

A patient reports of frequent bleeding from a nostril. Which advice would the nurse provide to the patient to prevent recurrent hemorrhage? "Use a vaporizer frequently." "Sneeze with the mouth closed." "Avoid blowing the nose vigorously." "Expectorate any blood rather than swallowing it."

"Avoid blowing the nose vigorously." Rationale Epistaxis is a condition of frequent bleeding from one or both nostrils. The patient should be instructed to avoid blowing the nose vigorously to prevent recurrent hemorrhage. Using a vaporizer or nasal lubricant helps keep the nasal membranes moist. Patients with epistaxis should be taught to sneeze with the mouth open to prevent the risk of aspiration. Blood and blood clots should be expectorated out rather than swallowed. However, that does not prevent recurrent hemorrhage in the patient.

The nurse is taking the nursing history of a client with silicosis. The nurse checks whether the client wears which item during periods of exposure to silica particles? Mask Gown Gloves Eye protection

The nurse is providing education to a patient with tuberculosis who requires drug therapy. Which patient statement demonstrates an understanding of the principles of therapy? "Only one medication is necessary for a cure." "I should take all four medications until l feel better." "Regardless of medical treatment, tuberculosis cannot be cured." "I must take all four drugs for 6 to 9 months for prevention of resistant organisms."

"I must take all four drugs for 6 to 9 months for prevention of resistant organisms." Rationale Treating tuberculosis requires the administration of four different medications for 6 to 9 months to prevent resistant organisms and to cure the disease. A single medication regimen is not sufficient to manage the disease. Medications must be taken for the prescribed amount of time to achieve a cure, even if the patient "feels better" before completion. With appropriate treatment, tuberculosis can be eradicated.

A client schedules an appointment for managing his laryngitis. Until the client can be examined later that morning, what nursing advice would be most helpful? "Sucking ice chips should help" "Rest your voice" "Drink plenty of hot liquids" "Rub mentholatum on your throat"

"Rest your voice"

A client with chronic obstructive pulmonary disease (COPD) on bed rest is weaned from the ventilator before transferring to a medical unit. To adequately restore client strength before getting the client out of bed, which is the priority client activity for the nurse to incorporate in the plan of care? Instruct the client to reposition himself. Elevate the head of the bed to 15 degrees. Transfer the client to the chair three times daily. Perform passive flexion and extension of the ankles.

The nurse is assigned to assist with caring for a client who has a chest tube. The nurse notes fluctuations of the fluid level in the water-seal chamber. Based on this observation, which action would be appropriate? Continue to monitor. Empty the drainage. Encourage the client to deep breathe. Encourage the client to hold his or her breath periodically.

The nurse is assigned to care for a client after a left pneumonectomy. Which position is contraindicated for this client? Lateral position Low-Fowler's position Semi-Fowler's position Head of the bed elevation at 40 degrees

The nurse is assisting in caring for a client with a tracheal tube attached to a ventilator when an alarm sounds. Which action should the nurse do first? Check the client. Check the ventilator. Manually ventilate the client with a resuscitation bag. Call the respiratory therapist or rapid response team.

The nurse is assisting in caring for a postoperative client who had a pneumonectomy. The nurse monitors the client for which adverse sign/symptom indicating acute pulmonary edema? Frothy sputum Pain with deep breathing Increased chest tube drainage Respiratory rate of 20 breaths per minute

The nurse is assisting in caring for the client immediately after removal of the endotracheal tube following radical neck dissection. The nurse interprets that which sign experienced by the client should be reported immediately to the registered nurse (RN)? Stridor Lung congestion Occasional pink-tinged sputum Respiratory rate of 26 breaths per minute

The nurse is caring for a client following segmental resection of the upper lobe of the left lung. The nurse notes 700 mL of grossly bloody drainage in the chest tube drainage system during the first hour following surgery. Which statement represents the nurse's accurate interpretation of this finding? This finding requires further data collection. This finding indicates the need for autotransfusion. This finding is expected following this type of surgery. This finding indicates a malfunction of the chest tube drainage system.

The nurse is caring for a client who is suspected of having lung cancer. The nurse monitors the client for which most frequent early sign of lung cancer? Cough Wheezing Pleuritic pain Blood-streaked sputum

A client is admitted to the emergency department with carbon monoxide poisoning. Which signs and symptoms indicate carbon monoxide poisoning? Select all that apply. Mental changes Cardiac irregularities Cherry-red skin color Abnormal arterial blood gas results Negative carboxyhemoglobin levels

1,2,3

A clinic nurse is assisting in caring for a client whose chief complaint is the presence of flulike symptoms. Which recommendations by the nurse are therapeutic? Select all that apply. Get plenty of rest. Take antipyretics for fever. Increase intake of liquids. Get a flu vaccine immediately. Eat carbohydrates only for energy.

1,2,3

The nurse is collecting data on a client with chronic sinusitis. Which are signs and symptoms of chronic sinusitis? Select all that apply. Loss of smell Chronic cough Nasal stuffiness Clear nasal discharge Severe evening headache

1,2,3

A client is being prepared for a thoracentesis. The nurse reinforces instructions with the client given by the registered nurse. Which points should be included in the instructions? Select all that apply. The client leans over a bedside table. The client should sit on the edge of the bed. The procedure involves obtaining a biopsy. A time-out is performed before the procedure. The procedure is performed during a bronchoscopy. A local anesthetic is administered before the procedure.

1,2,4,6

The client is diagnosed with pleurisy. The nurse should expect to see which signs and symptoms? Select all that apply. Pleural friction rub Sharp, knife-like pain Cyanosis of lips and nailbeds Pain that occurs on both sides of the chest Pain that occurs most often during inspiration

1,2,5

A nurse is suctioning a client through a tracheostomy tube. The nurse plans to apply suction during the withdrawal of the catheter for a period of time no greater than: 25 seconds 30 seconds 10 seconds 35 seconds

10 seconds

A cardiac monitor alarm sounds, and the nurse notes a straight line on the monitor screen. What is the nurse's immediate nursing action? Call a code. Check the client. Confirm the rhythm. Check the cardiac leads and wires.

A client diagnosed with tuberculosis (TB) is distressed over the loss of physical stamina and fatigue. The nurse should provide which explanation for these symptoms? Expected and will last for at least a year Expected and the client should very gradually increase activity as tolerated An unexpected finding with TB, but it should resolve within about 1 month A short-lived problem that should be gone within 1 week of medication therapy

A client with a tracheostomy gets easily frustrated when trying to communicate personal needs to the nurse. The nurse determines that which method for communication may be the easiest for the client? Use a pad and paper. Use a picture or word board. Have the family interpret needs. Devise a system of hand signals.

A client with chronic obstructive pulmonary disease (COPD) who is beginning oxygen therapy asks the nurse why the flow rate cannot be increased. The nurse explains that this can be harmful because it could cause which difficulty? It could be drying to nasal passages. It could decrease the client's oxygen-based respiratory drive. It could increase the risk of pneumonia from drier air passages. It could decrease the client's carbon dioxide-based respiratory drive.

The chest x-ray report for a client states that the client has a left apical pneumothorax. The nurse should monitor the status of breath sounds in that area by placing the stethoscope in which location? Near the lateral twelfth rib Just under the left clavicle In the fifth intercostal space Posteriorly under the left scapula

The emergency department nurse is caring for a client who sustained a blunt injury to the chest wall. Which sign noted in the client indicates the presence of a pneumothorax? Bradypnea Shortness of breath A low respiratory rate The presence of a barrel chest

The low-exhaled volume (low-pressure) alarm sounds on a ventilator. The nurse rushes to the client's room and checks the client to determine the cause of the alarm but is unable to do so. Which would be the next immediate nursing action? Call the rapid response team overhead. Ventilate the client with a resuscitation bag. Call the respiratory therapist to the bedside. Call the client's primary health care provider to the bedside.

A client with a diagnosis of lung cancer returns to the nursing unit after a left pneumonectomy. Which nursing actions should be done? Select all that apply. Turn completely on the side. Administer humidified oxygen. Instruct on the use of the incentive spirometer. Monitor vital signs and pulse oximetry frequently. Place in respiratory isolation to prevent infection.

2,3,4

A client has just returned from intrathoracic surgery where a chest tube was placed. The nurse notes a small amount of serosanguineous drainage on the chest tube's dressing. Which action should the nurse take? Notify the surgeon. Change the dressing. Reinforce the dressing. Document the findings.

The nurse is preparing to administer two inhalations of ipratropium bromide (Atrovent). When providing this medication, the nurse will instruct the patient to: (Select all that apply.) a. hold the canister horizontally. b. keep the eyes closed. c. exhale through the mouthpiece. d. wait 15 seconds before the second inhalation. e. shake the canister thoroughly prior to use.

B, D, E

A patient returns from nasoseptoplasty for correction of a deviated septum. For which early sign of a life-threatening condition must the nurse be vigilant? Pallor Oliguria Hypotension Frequent swallowing

Frequent swallowing Rationale Frequent swallowing is the earliest sign ofhemorrhage. Pallor oliguria, and hypotension rel late signs of hypotension.

Which of the following can cause a low pulse oximetry reading? (Select all that apply) Inadequate peripheral extremity circulation Hyperthermia Nail polish Edema Increased hemoglobin level

Inadequate peripheral extremity circulation Nail polish Edema

A patient in the hospital has a positive purifed protein derivative (PPD) skin test result but a negative chest x-ray examination and no symptoms of tuberculosis The nurse understands the patient falls into which category? Active tuberculosis Remission Infected with tuberculosis Cured of tuberculosis

Infected with tuberculosis Rationale The patient has a tuberculosis infection but is not infectious and does not have active tuberculosis disease. The patient is not in remission or cured of tuberculosis.

A nurse in the clinic is administering an allergy skin test to a patient who becomes diaphoretic and anxious The nurse notes the patient's lips and tongue are swelling and circumoral cyanosis occurs. Which action should the nurse perform first? Call for an ambulance. Administer oxygen via a face mask. Administer Benadry orally. Inject epinephrine into the patient's outer thigh.

Inject epinephrine into the patient's outer thigh. Rationale The patient is experiencing an anaphylactic reaction that has compromised the airway. The nurse should administer an epinephrine injection into the patient's outer thigh as soon as possible. Then, the nurse should all fran ambulance, administer oxygen via a face mask, and administer oral Benadryl if the patient is awake and can swallow.

Which drug is a potent vasodilator that is used in the treatment of pulmonary edema? Zileuton (Zyfo) Nitroprusside (Nipride) Pancuronium (Pavulon) Erythromycin (Erythrocin)

Nitroprusside (Nipride) Rationale Nitroprusside (Nipride)is a potent vasodilator that is used in the treatment of pulmonary edema and is administered intravenously. Zileuton (Zyfo)is a leukotriene synthesis inhibitor used for treating asthma. Pancuronium (Pavulon) is a neurologic blocking agent used in the treatment of acute respiratory distress syndrome (ARDS) Erythromycin (Erythrocin) is an antibiotic commonly used in chronic bronchitis.

A nurse is observing a nursing student listening to the breath sounds of a client. The nurse intervenes if the student performs which incorrect procedure? Uses the diaphragm of the stethoscope Asks the client to normally breathe Asks the client to sit upright The student auscultates and places the stethoscope on the client's gown

The student auscultates and places the stethoscope on the client's gown

Why would the nurse encourage a patient who has emphysema to frequently do pursed-lip breathing? To moisten secretions To reduce the oxygen demand To facilitate lung expansion To prevent airway collapse during expiration

To prevent airway collapse during expiration Rationale Patients with emphysema have ineffective breathing patterns. Pursed-lip breathing is encouraged in these patients because it provides internal stability to the airways and, thus, prevents airway collapse. Adequate fluid intake helps moisten secretions, aiding in their clearance. Reduced exposure to the infection will reduce the oxygen demand. Deep breathing and coughing exercises are useful in facilitating lung expansion.

The young man who had a bronchoscopy 1 hour ago asks when he can eat. Which response would be most helpful? If there is no blood in his sputum In 8 hours after a period of nothing by mouth When the gag reflex returns In 24 hours, but must take cold liquids for the rest of the day

When the gag reflex returns

What is the purpose of the cilia? a. Warm and moisturize inhaled air. b. Sweep debris toward nasal cavity. c. Stimulate cough reflex. d. Produce mucus.

b. Sweep debris toward nasal cavity.

The nurse is caring for a client with a tracheostomy tube who is receiving mechanical ventilation. The nurse is monitoring for complications related to the tracheostomy and suspects tracheoesophageal fistula when which occurs? Suctioning is required frequently. Aspiration of gastric contents occurs when suctioning. The client's skin and mucous membranes are light pink. Excessive secretions are suctioned from a tracheostomy.

The nurse is caring for a client with emphysema receiving oxygen. The nurse should consult with the registered nurse if the oxygen flow rate exceeded how many L/min of oxygen? 1 L/min 2 L/min 6 L/min 10 L/min

A child has been diagnosed with asthma and the nurse is providing education to the family. Which statement by the mother indicates a need for further teaching? a. "I will place the stuffed animals in the freezer overnight." b. "We will confine our dog to the kitchen area." c. "I should wash bedding in hot water." d. "A damp cloth should be used when I dust."

b. "We will confine our dog to the kitchen area."

The nurse is preparing to perform chest physiotherapy (CPT) on a client. In performing postural drainage, which statement is incorrect? Breathe in a fast-paced pattern. Perform postural drainage before meals. Perform good mouth care after the procedure. Instruct client not to sit up between position changes.

The nurse is preparing to perform nasotracheal suctioning on a client. The nurse places the client's bed in which position to effectively perform this procedure? Refer to figure. Semi fowlers Trendburgelrs Reverse trendenburglers Supin

Which instruction will the nurse include when teaching a patient with seasonal rhinitis and blocked nasal passages about intranasal corticosteroid therapy? a. "Clear your nasal passage after administration." b. "Anticipate a therapeutic benefit within 24 hours." c. "Use a decongestant prior to administration." d. "Report nasal burning to your healthcare provider."

c. "Use a decongestant prior to administration."

The nurse is obtaining a history of respiratory symptoms on a patient with the diagnosis o COPD. The patient reports smoking one pack of cigarettes per day for the past 20 years. The nurse calculates the pack-years as: a. 5. b. 10. c. 20. d. 40.

c. 20.

A patient at sports camp is complaining of itchy and watery eyes, coughing, and sneezing when outdoors. The patient's chart states that he has an allergy to grasses. Which medication will the nurse administer? a. Antitussive b. Expectorant c. Antihistamine d. Decongestant

c. Antihistamine

The nurse is teaching a patient with a history of COPD to self-administer tiotropium (Spiriva) by dry powder inhalation. Which information provided by the nurse is accurate? a. The medication capsules can be used multiple times. b. Press on the canister while inhaling. c. Avoid breathing into the mouthpiece. d. Wash the device with cold water.

c. Avoid breathing into the mouthpiece.

What happens when there is a decrease in the oxygen level in the blood? a. Pituitary stimulates the respiratory system to increase respiratory rate. b. The alveoli diffuse more oxygen into the blood. c. Chemoreceptors in the carotid body and aortic body stimulate the respiratory centers to modify respiratory rates. d. The parietal pleura increases the negative pressure

c. Chemoreceptors in the carotid body and aortic body stimulate the respiratory

What structures in the respiratory tract assist in removing foreign bodies such as smoke and bacteria? a. Villi b. Golgi bodies c. Ciliary hairs d. Erector pili

c. Ciliary hairs

Which medication may be given to patients with allergic seasonal rhinitis who do not respond to antihistamines and sympathomimetics? a. Leukotrienes b. Mineralocorticoids c. Corticosteroids d. Cortisol

c. Corticosteroids

Which is a common expectorant in over-the-counter medications? a. Dextromethorphan b. Diphenhydramine c. Guaifenesin d. Codeine

c. Guaifenesin(Mucinex)

How does pursed lip breathing assist patients with asthma during an attack? a. It distracts the patient with a breathing techniques to reduce anxiety. b. It gets rid of CO2 faster. c. It opens bronchioles by backflow air pressure. d. It increases PACO2.

c. It opens bronchioles by backflow air pressure.

A client with acquired immunodeficiency syndrome (AIDS) has become infected with histoplasmosis. The nurse monitors the client for which manifestation of histoplasmosis? Dyspnea Headache Weight gain Hypothermia

The nurse is caring for a client with fractured ribs. Which statement indicates a need for further teaching? "My ribs will be healed in a month." "I should only need pain med for a week." "I should stay calm and rest after taking pain meds." "I need to support my ribs when I deep breathe and cough."

A client is at risk of developing a pulmonary embolism. The nurse monitors for which initial sign/symptom? Hot, flushed feeling Sudden chills and fever Chest pain that occurs suddenly Dyspnea noted when deep breaths are taken

A client with a suspected throat infection with Streptococcus needs to have a throat culture obtained. The nurse should take which action after obtaining the culture if the specimen cannot be delivered to the laboratory for at least an hour? Refrigerate the specimen. Obtain a second specimen immediately. Discard the specimen and make the client wait an hour to get a new one. Keep the client nothing-by-mouth (NPO) for 30 minutes and obtain a second specimen.

A client is seen in the health care clinic and a diagnosis of acute sinusitis is made. The nurse reinforces home care instructions to the client regarding measures that will promote sinus drainage and comfort. Which statement by the client indicates a need for further education? "I will need surgery to drain the sinuses." "I should try to sleep with the head of the bed elevated." "I should apply heat such as a wet pack over the sinuses." "I should drink large amounts of fluids."

"I will need surgery to drain the sinuses." Rationale: The nurse provides instructions to the client regarding measures to promote sinus drainage, comfort, and resolution of the infection. The nurse instructs the client to apply heat in the form of hot wet packs over the affected sinuses to promote comfort and help resolve the infection. Large amounts of fluids are important to help liquefy secretions. Sleeping with the head of the bed elevated to a 45-degree angle will assist in promoting drainage. Surgery may be performed to improve drainage in chronic conditions if other measures are not helpful.

A client who is postoperative with incisional pain complains to the nurse about completing respiratory exercises. The client is willing to do the deep breathing exercises but states that it hurts to cough. The nurse provides gentle encouragement and appropriate pain management to the client, knowing that coughing is needed for which reason? To expel mucus from the airways To dilate the terminal bronchioles To exercise the muscles of respiration To provide for increased oxygen tension in the alveoli

A client with acquired immunodeficiency syndrome (AIDS) has histoplasmosis. Which sign/symptom should the nurse expect the client to experience? Dyspnea Headache Weight gain Hypothermia

The nurse is caring for the client diagnosed with tuberculosis (TB). Which finding made by the nurse would be inconsistent with the usual clinical presentation of tuberculosis? High-grade fever Chills and night sweats Anorexia and weight loss Nonproductive or productive cough

The nurse is caring for a client with laryngitis. Which interventions should the nurse implement? Select all that apply. Discourage smoking. Use a room humidifier. Speak only in whispers. Use the intercom to contact the nurse. Use lozenges that contain a topical anesthetic agent.

1,2,5

A client at risk for pulmonary embolism (PE) suddenly develops respiratory distress, chest pain, and anxiety. The nurse should plan to take which actions? Select all that apply. Check vital signs. Administer warfarin. Notify the registered nurse. Begin low-flow oxygen therapy. Raise the bed to a low-Fowler's position.

1,3,4

The nurse reviews the D-dimer serum test results of a patient and suspects that the patient has a pulmonary embolism. Which D-dimer level may have caused the nurse to suspect this? 75 ng/L 300ng/L 450 ng/L 1598 ng/L

1598 ng/L Rationale D-dimer serum test results are useful in the diagnosis of pulmonary embolism, which leads to the obstruction of a pulmonary artery caused by a thrombus or an embolus. Plasma D-dimer serum levels greater than 1591 ng/L indicate the presence of a thrombus or an embolus. Therefore, the nurse suspects the patient has pulmonary embolism as the D-dimer level was 1598ng/L.D-dimer serum levels of75 ng/L,300 ng/Land 450 ng/Lare the values that are within the normal range (68-494ng/4).

The low-pressure alarm sounds on the ventilator. The nurse checks the client and then attempts to determine the cause of the alarm but is unsuccessful. Which initial action should the nurse take? Administer oxygen. Ventilate the client manually. Check the client's vital signs. Start cardiopulmonary resuscitation (CPR).

The nurse has finished suctioning a client. The nurse should use which parameters to best determine the effectiveness of suctioning? Client skin color (pink) Breath sounds are clear Client statement of comfort Sao2 is 98% by pulse oximetry

The nurse is caring for a client hospitalized with acute exacerbation of chronic obstructive pulmonary disease (COPD). Which should the nurse expect to note? Hypocapnia Hyperinflated lungs on chest x-ray Increased oxygen saturation with exercise A widened diaphragm noted on chest x-ray

The nurse is observing a client with chronic obstructive pulmonary disease (COPD) performing the pursed-lip breathing technique. Which observation by the nurse would indicate accurate performance of this breathing technique? The client's inhalation is twice as long as exhalation. The client's exhalation is twice as long as inhalation. The client loosens the abdominal muscles while breathing out. The client inhales with pursed lips and exhales with the mouth open wide.

The nurse is performing nasopharyngeal suctioning on a client and suddenly notes the presence of bloody secretions. Which action should the nurse implement? Continue suctioning to remove the blood. Check the amount of suction pressure being applied. Encourage the client to cough out the bloody secretions. Remove the suction catheter from the nose and begin vigorous suctioning through the mouth.

The nurse is planning care for a client whose oxygenation is being monitored by a pulse oximeter. Which intervention is important to ensure accurate monitoring of the client's oxygenation status? Tape the sensor to the client's finger. Instruct the client not to move the sensor. Place the sensor on a finger below the blood pressure cuff. Notify the primary health care provider immediately of an O2 saturation less than 90%.

The nurse reinforces instructing a client how to use an incentive spirometer. Which observation would indicate the ineffective use of this equipment by the client? The client inhales slowly. The client is breathing through the nose. The client removes the mouthpiece from the mouth to exhale. The client forms a tight seal around the mouthpiece with the lips.

A client with an oral endotracheal tube attached to a mechanical ventilator is about to begin the weaning process. The nurse asks the primary health care provider whether this process should be delayed temporarily based on administration of which medication to the client in the last hour? Digoxin Lorazepam Furosemide Metoclopramide

2 Rationale: Antianxiety medications (such as lorazepam) and opioid analgesics are used cautiously or withheld whenever possible in the client being weaned from a mechanical ventilator. These medications may interfere with the weaning process by suppressing the respiratory drive. The other medications do not interfere with the respiratory drive and will not affect the weaning process.

The nurse is caring for a client hospitalized with acute exacerbation of chronic obstructive pulmonary disease (COPD). Which should the nurse expect to note in this client? Select all that apply. Hypocapnia Dyspnea during exertion Presence of a productive cough Difficulty breathing while talking Increased oxygen saturation with exercise A shortened expiratory phase of respiration

2,3,4

The nurse is planning therapeutic interventions for a client who experienced a rib fracture 2 days earlier. The nurse understands that which intervention should be included? Select all that apply. Ice Rest Local heat Analgesics Oxygen by nasal cannula

2,3,4

Which nursing actions would contribute to monitoring and maintaining a patent airway for the postoperative client? Select all that apply. Repositioning client every 4 hours Position on the side until fully recovered Encouraging coughing and deep breathing Monitoring pulse oximetry readings frequently Encouraging the use of an incentive spirometer

2,3,4,5

The nurse is observing a nursing student listening to the breath sounds of a client. The nurse intervenes if the student performs which incorrect procedure? Asks the client to sit upright Uses the diaphragm of the stethoscope Places the stethoscope on the client's gown Asks the client to breathe slowly and deeply through the mouth

The nurse is performing nasotracheal suctioning of a client. The nurse determines that the client is adequately tolerating the procedure if which observation is made? Skin color becomes cyanotic. Secretions are becoming bloody. Coughing occurs with suctioning. Heart rate decreases from 78 to 54 beats per minute.

The nurse is providing morning care to a client who has a closed chest tube drainage system to treat a pneumothorax. When the nurse turns the client to the side, the chest tube is accidentally dislodged from the chest. After immediately applying sterile gauze over the chest tube insertion site which should the nurse do next? Replace the chest tube system. Obtain a pulse oximetry reading. Notify the registered nurse (RN). Place the client in Trendelenburg's position.

The nurse is suctioning an adult client through a tracheostomy tube. During the procedure, the nurse notes that the client's oxygen saturation by pulse oximetry is 89%. Which action should the nurse implement? Continue suctioning. Call respiratory therapy. Stop the suctioning procedure. Obtain a smaller suction catheter.

Which physical assessment(s) would be pertinent to the patient with asthma? (Select all that apply.) a. Lung sounds b. Patient color c. Respiratory rate and effort d. Peak expiratory flow e. Pulse oximetry reading f. Bowel sounds

A, B, C, D, E

While collecting data on a patient who underwent tonsillectomy and adenoidectomy(T&A), the nurse observes that the patient is swallowing continuousy. The nurse reports the observation to a health care provider. Which instruction does the nurse expect to get from the health care provider for effective care of the patient? Apply epinephrine on the surgical site. Administer erythromycin (lotycin) intravenously. I Promote nasal irrigation through normal saline. Administer lodoxamide (Alomide) four times a day.

Apply epinephrine on the surgical site. Rationale T&A is a surgical procedure in which the tonsils and the adenoids are excised. This procedure is performed in patients who have recurrent tonsillitis (infection to tonsils). Bleeding from the surgical site is a common complication observed postoperatively. Frequent swallowing by the patient is an indication of excessive bleeding from the surgical site. Epinephrine may be prescribed to prevent bleeding in such patients and is usually applied on the surgical site with the help of a sponge. Nasal irrigation is performed to prevent dryness in the nostrils, which is unrelated to the T&A procedure. Erythromycin is prescribed to treat bacterial infections, which manifest as fever rather than frequent swallowing. Lodoxamide (Alomide) is prescribed for allergic conjunctivitis, not to treat recurrent tonillitis.

The nurse should plan to fill which chamber of the chest drainage unit to prevent atmospheric air from reentering the pleural space? Refer to figure. A B C D

The nurse is caring for a patient at risk for hypoxia. Which precautions should the nurse take? Select all that apply. Be alert to signs of shortness of breath. Administer medications for restlessness. Ensure that the patient's airway is free. Keep an oxygen mask on the patient all the time. Use pulse oximetry to assess oxygen saturation levels.

Be alert to signs ofshortness of breath. Ensure that the patient's airway is free. Use pulse oximetry to asses oxygen saturation levels. Rationale Hypoxemia poses a dangerous threat to the patient. The most obvious symptom ofhypoxemia is shortness of breath. The nurse should be alert to this symptom and take rapid actions to clear the patient's airway.The nurse should ensure that the patient's airway is not obstructed with secretions or fuids. This reduces the risk for hypoxia. Pulse oximetry is used to test the patient's oxygen saturation levels and verif if the patient is at risk for oxygen depletion. Restlessness is a symptom of hypoia;ifthe patient is restless, the nurse takes immediate steps to supply oxygen to the patient. The health care provider prescribes the oxygen mask and specifes how long it is to beapplied It i not administered ll the time because overuse can cause physiologic changes in breathing.

A patient is admitted to the hospital with a history of night sweats, weight loss, hemoptysis, and fever and chill for the last 2 weeks. Which action should the nurse perform first? Obtain blood cultures from two sites. Initiate airborne precautions. Administer the ordered antibiotics. Initiate contact precautions.

Initiate airborne precautions. Rationale The nurse should frst initiate airborne precautions on suspicion ofactive tuberculosis disease. The nurse should obtain blood cultures from two sites (with a prescription) andadminister the ordered antibiotics. The patient does not require contact precautions.

A client who has had a radical neck dissection related to laryngeal cancer begins to bleed at the incision site. Which action by the nurse would be contraindicated? Positioning patient on Fowler's position Monitoring the client's airway Calling the physician immediately Lowering the head of the bed to a flat position

Lowering the head of the bed to a flat position

A patient with dyspnea undergoes a sinus radiographic study, which shows a shadowy sinus. The nurse knows this indicates which condition? Epistaxis Nasal polyps Deviated septum Stenosis of sinuses

Nasal polyps Rationale Nasal polyps appear as shadows in the sinus on sinus radiography. Epistaxis, deviated septum, and stenosis of sinuses do not appear shadowy on radiography.

The nurse recognizes that the _______ reading in an arterial gas report indicates the amount of oxygen dissolved in the plasma

PaO2

An adult patient is admitted for an asthma attack. Which assessment obtained by the nurse would support that albuterol (Proventil) was effective? a. Decrease in wheezing present on auscultation b. Less dyspnea while positioned in a high Fowler's position c. Sputum production is clear and watery d. Respiratory rate decreased to 38 breaths/min

a. Decrease in wheezing present on auscultation

Which patient assessment indicates the most severe respiratory distress? Substernal retraction, SaO2 84% Substernal retraction, SaO2 90% Symmetrical chest wall expansion, SaO2 88% Abdominal breathing, SaO2 97%

Substernal retraction, SaO2 84%

A 62-year-old patient is seen in the emergency department with epistaxis. When a patient has epistaxis, the correct nursing interventions would be place the patient in Fowler's position with the head leaning forward. compress the nostrils tightly below the bone and hold for 1 minute. place hot compresses over the nose. place the patient in low-Fowler's position with the head hyperextended.

place the patient in Fowler's position with the head leaning forward.

The appropriate nursing intervention for a patient, age 40, who is diagnosed with active tuberculosis would be to place the patient in any isolation precautions. place the patient in acid-fast bacillus (AFB) isolation or airborne precautions. place the patient in drainage and secretion precautions. maintain the patient in enteric isolation.

place the patient in acid-fast bacillus (AFB) isolation or airborne precautions.

While collecting data on a patient who underwent a nasoseptoplasty, the nurse observes ecchymosis on the patient's face postoperatively. Which activity does the nurse instruct the patient to avoid? Daytime sleeping Coughing vigorously Using ice pack compressions Using pillows while sleeping

Coughing vigorously Rationale Nasoseptoplasty is performed to reconstruct, align, and straighten the deviated nasal septum. Patients who undergo nasoseptoplasty may develop ecchymosis and edema postoperatively. The nurse should suggest that the patient try to avoid coughing because it may worsen the ecchymosis. The sleeping patterns of the patient are not related to ecchymosis caused by nasoseptoplasty. lce packs are applied postoperatively to prevent bleeding. Patients are sometimes asked to avoid using pillows to avoid problems related to the spine, but not to reduce ecchymosis.

A nurse is caring for a client who is at risk for lung cancer due to an extremely long history of heavy cigarette smoking. The nurse tells the client to report which most frequent early symptom of lung cancer? Pleuritic pain Hoarseness Nonproductive hacking cough Hemoptysis

Nonproductive hacking cough Rationale: Cough is the most frequent early symptom of lung cancer, which begins as nonproductive and hacking, and progresses to productive. In the smoker who already has a cough, a change in the character and frequency of the cough usually occurs. Hoarseness and blood-streaked sputum are later signs. Pain is a very late sign and is usually pleuritic in nature.

A nurse is assisting a health care provider with the placement of a central line in a patient. While the health care provider is inserting the line, the patient suddenly develops acute dyspnea and tachypnea. The health care provider quickly directs the nurse:"Get a chest tube tray, STAT!" Which condition does the nurse suspect in the patient? Lung cancer Atelectasis Pneumothorax Pulmonary embolus (PE)

Pneumothorax Rationale The patient has likely developed a pneumothorax. pneumothorax is a collection of air or gas in the pleural space, causing the lung to collapse. In this case, it would be secondary to central line placement(i.e. the lung tissue was punctured), which is one of the risks of the procedure. With a pneumothorax, the lung's negative pressure is disrupted, and the lung is unable to inflate fully. A chest tube is inserted to help reestablish negative pressure. It would be extremely unlikely that lung cancer would be discovered during the placement of a central line. Typially lung cancer will be detected on chest x-ray examination, with further investigation via magnetic resonance imaging (MRI) or computed tomography (CT),as well as tissue cytology or biopsy. Atelectasis refers to lung tissue collapse caused by occlusion of air to a portion of the lung. It does not have a dramatic presentation, as in this scenario although the patient may complain of dyspnea, air hunger, and other signs and symptoms of hypoxia. Development of a PE does often have a dramatic presentation; however, because the health care provider was performing central line placement, it is more likely to be a pneumothorax. A PE is caused by passage of a foreign substance (blood clot, air, fat, or amniotic fluid) into the pulmonary artery or its branches, with resulting obstruction of blood supply to the lung tissue and subsequent collapse. The patient experiencing a PE may have sudden, sharp, constant pleuritic chest pain that worsens with inspiration, as well as acute, unexplained dyspnea and tachypnea.

The nurse is caring for a patient with a diagnosis of pleural effusion. The physician is most likely to order a ______________ to remove fluid from around the lungs so that the patient may breathe more easily. Thoraxtenesis Amniocentesis Paracentesis Thoracentesis

Thoracentesis

Mr. AFB received a PPD skin test in the clinic on Tuesday. He should return to the clinic to have the results read on which of the following days? On weekends Thursday and Friday Wednesday and Thursday Friday and Saturday

Thursday and Friday

The nurse is assessing a patient with a respiratory problem. Which questions are likely to be included in the assessment? Select all that apply. "Does your cough produce sputum?" "What medications are you taking?" "Do you have any shortness of breath?" "Do you often work long hours?" "Do you have any neurologic conditions?"

"Does your cough produce sputum?" "What medications are you taking?" "Do you have any shortness of breath?" Rationale When the nurse is assessing a patient for respiratory problems, the nurse asks the patient about the cough and sputum to assess the nature of the cough. The nurse asks about drug history to understand what medications were prescribed earlier. The nurse also asks the patient if the patient feels shortness of breath to assess the risk for hypoxia. This also helps to understand what medical problems the patient has. Long working hours is a factor contributing to stress and is not a relevant issue in this case. Asking about neurologic conditions is not required to assess respiratory issues.

A nursing student prepares to instruct a client to expectorate a sample of sputum that will be sent to the laboratory for Gram stain, culture, and sensitivity and describes the procedure to the licensed practical nurse (LPN), who is the primary nurse. The LPN corrects the student if which incorrect description is provided? "I will ask the client to brush the teeth and rinse the mouth before expectorating." "I will use a sterile container from the supply area." "I will have the client take a breath and gather his saliva before shallow coughing." "I will send the specimen immediately to the laboratory."

"I will have the client take a breath and gather his saliva before shallow coughing." Rationale: Because of the nature of the test, the sputum must be collected in a sterile (not a clean) container. The client should brush the teeth and rinse the mouth to decrease the number of contaminating organisms. The client should take a few deep breaths, and then cough forcefully (not spit) into the container. The specimen should be sent directly to the laboratory. It should not be allowed to stand for long periods at room temperature to prevent overgrowth of contaminating organisms.

The nurse is caring for a patient who has prescribed oxymetazoline (Afrin) for nasal congestion. Which instruction would the nurse give to ensure patient safety? "Avoid exposure to sunlight." "Take the medication for l0 days." "Stop the medication after 4 days." "Take the medication with orange juice."

"Stop the medication after 4 days." Rationale Oxymetazoline (Afrin) is used to clear nasal congestion in patients with respirator tract infections. The nurse should ask the patient to stop the drug after4days. The drug may cause a rebound effect in the patient causing severe congestion if more than four doses are taken. Patients on diuretics are instructed to avoid sun exposure because they cause phototoxicity as a side effect. Oxymetazoline (Afrin) does not cause phototoity. If the medication is used for l0 days consecutively, it may cause rebound congestion in the patient. Some medications, such as potassium iodide, are mixed with fruit juice to mask their strong odor, but not oxymetazoline (Afrin).

A client begins to drain small amounts of red blood from a tracheostomy tube 36 hours after a supraglottic laryngectomy. The licensed practical nurse should perform which action? Notify the registered nurse. Increase the frequency of suctioning. Add moisture to the oxygen delivery system. Document the character and amount of drainage.

A client experiencing a pleural effusion had a thoracentesis. Analysis of the extracted fluid revealed a high red blood cell count. The nurse interprets that this result is consistent with which diagnosis? Trauma Infection Liver failure Heart failure (HF)

A client has undergone a right pneumonectomy. The nurse positioning this client following admission from the postanesthesia care unit avoids placing the client in which harmful position? Right lateral Low-Fowler's position Semi-Fowler's position High-Fowler's position

A client with active tuberculosis (TB) demonstrates less-than-expected interest in learning about the prescribed medication therapy. Which technique would the nurse ultimately need to employ in order to encourage participation? Directly observed therapy More medication instructions Involvement of the family in teaching Reinforcement by the primary health care provider

A client with arthritis of the hands and fingers is having difficulty using a metered-dose inhaler (MDI). The nurse suggests asking the primary health care provider for which prescription? Use of a spacer Use of a nebulizer Use of an oral (pill) form of the medication Use of an intravenous (IV) form of the medication

The nurse is caring for a client at home who has had a tracheostomy tube for several months. The nurse monitors the client for complications associated with the long-term tracheostomy and suspects tracheoesophageal fistula if which observation is noted for the client? Abdominal distention Purulent drainage around the tracheotomy site Excessive secretions from the tracheotomy site Inability to pass a suction catheter through the tracheotomy

The nurse is caring for a client with an endotracheal tube attached to a ventilator. The high-pressure alarm sounds on the ventilator. The nurse prepares to perform which priority nursing intervention? Suction the client. Check for a disconnection. Notify the respiratory therapist. Evaluate the tube cuff for a leak.

The nurse is collecting data on a client admitted to the hospital with suspected carbon monoxide poisoning and notes that the client behaves as if intoxicated. The nurse uses this data to make which interpretation? The behavior is likely the result of hypoxia. The client probably suffers from alcoholism. The client must also have a high blood alcohol level. The carbon monoxide has caused the blood glucose to fall.

The nurse is discussing signs of severe airway obstruction with a group of nursing students. Which sign should the nurse emphasize as one that indicates severe airway obstruction? Cyanosis A loud cough Pink color to the skin Respiratory rate of 12 to 16 breaths per minute

The nurse is performing tracheal suctioning on an assigned client. The nurse uses which parameter as the accurate indicator that suctioning has been effective? Breath sounds are now clear. Suctioning is required only once a shift. Oxygen saturation has increased two points. Respiratory rate has gone down by four breaths per minute.

The nurse is planning to suction a client through a tracheostomy tube. Which is the amount of time for application of suction during withdrawal of the catheter? 10 seconds 25 seconds 30 seconds 35 seconds

The nurse is preparing to obtain a sputum specimen from the client. Which nursing action is essential in obtaining a proper specimen? Have the client take three deep breaths. Limit fluids before obtaining the specimen. Ask the client to obtain the specimen after eating. Ask the client to spit into the collection container.

The nurse is working in a tuberculosis (TB) screening clinic. The nurse understands that which population is at highest risk for TB? Residents of a long-term care facility Persons admitted to the hospital for day surgery A family who has recently emigrated from Australia Children older than 6 years of age in a summer school program

The nurse notes that a hospitalized client has experienced a positive reaction to the tuberculin skin test. Which action by the nurse is a priority? Report the findings. Document the finding in the client's record. Call the employee health service department. Call the radiology department for a chest x-ray.

The nurse is assisting in planning care for a client scheduled for insertion of a tracheostomy. Which equipment should the nurse plan to have at the bedside when the client returns from surgery? Obturator Oral airway Epinephrine Tracheostomy tube with the next larger size

1 Rationale: A replacement tracheostomy tube of the same size and an obturator is kept at the bedside at all times in case the tracheostomy tube is dislodged. In addition, a curved hemostat that could be used to hold the trachea open, if dislodgment occurs, should also be kept at the bedside. An oral airway and epinephrine would not be needed.

The nurse is determining the need for suctioning in a client with an endotracheal tube (ETT) attached to a mechanical ventilator. Which observations are consistent with the need for suctioning? Select all that apply. Restlessness Gurgling sounds with respiration Presence of congestion in the lungs Increased pulse and respiratory rates Low peak inspiratory pressure on the ventilator

1,2,3,4

The nurse is preparing a plan of care for the client who will be returning from surgery following a right lung wedge resection. Included in the plan of care is that in the postoperative period, the nurse should avoid which positioning? In low-Fowler's In semi-Fowler's On the left side On the right side

The nurse is reinforcing instructions to a client following a total laryngectomy about caring for the stoma. Which instructions should the nurse provide to the client? Select all that apply. Protect the stoma from water. Soaps should be avoided near the stoma. Wash the stoma daily using a washcloth. Use diluted alcohol on the stoma to clean it. Apply a thin layer of petroleum jelly to the skin surrounding the stoma. Use soft tissues to clean any secretions that accumulate around the stoma.

1,2,3,5

The nurse is assisting in preparing a list of instructions for an adult client who is being discharged following a tonsillectomy. Which instructions should the nurse include in the list? Select all that apply. Avoid hot fluids. Avoid rough foods. Consume milk products. Rest for the next 24 hours. Consume carbonated beverages. Eat ice cream to soothe the throat.

1,2,4

The nurse is preparing to suction an adult client through the client's tracheostomy tube. Which interventions should the nurse perform for this procedure? Select all that apply. Apply suction for up to 10 seconds. Hyperoxygenate the client before suctioning. Set the wall suction unit pressure at 160 mm Hg. Apply suction while gently inserting the catheter. Apply intermittent suction while rotating and withdrawing the catheter. Advance the catheter until resistance is met and then pull the catheter back 1 cm.

1,2,5,6

The nurse is told that an assigned client will have a fenestrated tracheostomy tube inserted. The nurse plans care knowing that which facts are true with the use of a fenestrated tracheostomy tube? Select all that apply. Enables the client to speak Is necessary for mechanical ventilation Must have the cuff deflated when capped Eliminates the need for tracheostomy care Prevents air from being inhaled through the tracheostomy opening

1,3

The nurse is reinforcing discharge instructions to the client with pulmonary sarcoidosis. The nurse knows that the client understands the information if the client verbalizes which early sign of exacerbation? Fever Fatigue Weight loss Shortness of breath

Which diagnostic tests indicate active tuberculosis? Select all that apply. Chest x-ray Tuberculin skin test Gastric analysis washings Sputum smear and culture Interferon gamma release assays (IGRA)

1,3,4

The nurse is preparing a list of homecare instructions for the client who has been hospitalized and treated for tuberculosis. Which instructions should the nurse reinforce? Select all that apply. Activities should be resumed gradually. Avoid contact with other individuals except family members for at least 6 months. A sputum culture is needed every 2 to 4 weeks once medication therapy is initiated. Respiratory isolation is not necessary because family members have already been exposed. Cover the mouth and nose when coughing or sneezing and confine used tissues to plastic bags. When one sputum culture is negative, the client is no longer considered infectious and can usually return to his or her former employment.

1,3,4,5

The nurse is preparing to assist a primary health care provider with the insertion of a chest tube. The nurse anticipates that which supplies will be required for the chest tube insertion site? Select all that apply. Elastoplast tape Sterile Kerlix dressing Sterile 4 × 4 gauze pads Povidone-iodine solution Petrolatum (Vaseline) gauze

1,3,4,5

Which are the signs and symptoms characteristic of emphysema? Select all that apply. Cyanosis Wheezing Weight loss Barrel chest Shortness of breath Decreased lung sounds

1,3,4,5,6 Rationale: The client with emphysema has a barrel chest, weight loss, and decreased lung sounds. Late signs and symptoms include shortness of breath and cyanosis. Wheezing is absent but is noted in other conditions such as asthma.

The nurse is providing endotracheal suctioning to a client who is mechanically ventilated when the client becomes restless and tachycardic. Which actions should the nurse take? Select all that apply. Notify the RN. Notify the Rapid Response Team. Finish the suctioning as quickly as possible. Discontinue suctioning until the client is stabilized. Contact the respiratory department to suction the client.

1,4

The nurse assessing a client diagnosed with laryngeal cancer would note which signs and symptoms? Select all that apply. Hemoptysis Kussmaul respirations Enlarged thyroid gland A sensation of a "lump" in the throat Hoarseness lasting more than 3 weeks

1,4,5

A client is admitted to the nursing unit following a lobectomy. The nurse caring for the client notes that, in the first hour after admission, the chest tube drainage was 75 mL. During the second hour, the drainage dropped to 5 mL. Which finding does this indicate? This is normal. The tube may be occluded. The lung has fully reexpanded. The client needs to cough and deep breathe.

A client is returned to the nursing unit following thoracic surgery with chest tubes in place. During the first few hours postoperatively, the nurse assisting in caring for the client checks for drainage. Which type of drainage is expected? Serous Bloody Serosanguineous Bloody with several clots

A client enters the urgent care center with epistaxis but no obvious facial injury. The nurse should take which action? Prepare a nasal balloon for insertion. Have the client sit down, lean forward, and apply pressure to the nose. Place the client in the semi-Fowler's position, and apply ice packs to the nose. Position the client in a sitting position, and ask the client to bite on a tongue blade.

A client reports the chronic use of nasal sprays. The nurse reinforces instructions to this client about which piece of information related to chronic use of nasal sprays? Nosebleeds are common. The protective mechanism of the nose may be damaged. It is acceptable to double the dose if one dose is ineffective. Fungal infections of the nose may occur because of container contamination.

The nurse checks a closed chest tube drainage system on a client who had a lobectomy of the left lung 24 hours ago. The nurse notes that there has been no chest tube drainage for the past hour. Which should the nurse do first? Contact the registered nurse. Check for kinks in the chest drainage system. Check the client's blood pressure and heart rate. Connect a new drainage system to the client's chest tube.

The nurse determines that which client is at greatest risk for development of acute respiratory distress syndrome (ARDS)? A client with blunt chest trauma A client with pancreatitis and gram-negative sepsis A client who has received 1 unit of packed red blood cells A client with acute pulmonary edema after myocardial infarction

The nurse instructs a client on pursed-lip breathing and asks the client to demonstrate the breathing technique. Which observation by the nurse indicates that the client is performing the technique correctly? The client breathes in through the mouth. The client breathes out slowly through the mouth. The client avoids using the abdominal muscles to breathe out. The client puffs out the cheeks when breathing out through the mouth.

The nurse is assigned to assist in caring for a client diagnosed with a pneumothorax who has a chest tube connected to a closed-chest drainage system. The client asks the nurse why a chest tube was inserted. Which response by the nurse explains the purpose of a chest tube? "To help lessen any discomfort." "To allow for reexpansion of the lung." "It will help prevent any lung infections." "To prevent further damage to the lung."

The nurse is assisting a client who underwent radical neck surgery to get out of bed. How does the nurse provide support to this client who is afraid to move the head? The nurse applies a soft cervical collar. The nurse places a hand behind the client's head. The nurse raises the head of the bed 90 degrees. The nurse assists the client to roll to the side of the bed and sit up slowly.

The nurse is assisting a client with a closed chest tube drainage system to get out of bed to a chair. During the transfer, the chest tube gets caught in the leg of the chair and accidentally dislodges from the insertion site. Which action should the nurse implement? Change the dressing site on the chest. Cover the insertion site with sterile gauze. Reinsert the chest tube using sterile technique. Transfer the client back to bed and encourage the client to breathe deeply.

The nurse is assisting in caring for a client with a newly inserted tracheostomy. The nurse notes documentation of an airway problem because of thick respiratory secretions. The nurse should monitor for which item as the best indicator of an adequate respiratory status? Oxygen saturation of 89% Respiratory rate of 18 breaths per minute Moderate amounts of tracheobronchial secretions Small to moderate amounts of frank blood suctioned from the tube

The nurse is caring for a client after pulmonary angiography via catheter insertion into the left groin. The nurse monitors for an allergic reaction to the contrast medium by observing for the presence of which? Hypothermia Respiratory distress Hematoma in the left groin Discomfort in the left groin

The nurse is caring for a hospitalized client with a suspected diagnosis of tuberculosis (TB). Which finding does the nurse expect to note during data collection? High fever Chills and night sweats Complaints of diarrhea Petechiae on the upper extremities

The nurse is caring for a restless client who keeps biting down on an orotracheal tube. The nurse uses which intervention to prevent the client from obstructing the airway with the teeth? Bite stick Oral airway Nasal airway Padded tongue blade

The nurse is monitoring a client with a closed chest tube drainage system and notes fluctuation of the fluid level in the water-seal chamber during inspiration and expiration. On the basis of this finding, which conclusion should the nurse make? There is a leak in the system. The chest tube is functioning as expected. The amount of suction needs to be decreased. The occlusive dressing at the insertion site needs reinforcement.

The nurse is reviewing the health care record of a client with a new onset of pleurisy. The nurse notes documentation that the client does not have a pleural friction rub that was auscultated the previous day. How should this finding be interpreted? The medication therapy has been effective. Pleural fluid has accumulated in the inflamed area. The deep breaths that the client is taking are helping. There is a decreased inflammatory reaction at the site.

The nurse is suctioning a client through a tracheal tube. During the suctioning procedure, the nurse notes on the cardiac monitor that the heart rate has dropped 10 beats. Which should be the nurse's next action? Notify the registered nurse immediately. Stop the procedure and oxygenate the client. Continue to suction the client at a quicker pace. Ensure that the suction is limited to 15 seconds.

The nursing student and clinical instructor are performing tracheotomy suction at the bedside of an adult client with a tracheostomy. Which action by the nursing student is incorrect, causing the clinical instructor to intervene? The student uses wall suction unit pressure of 100 mm Hg. The student suctions the client's tracheotomy tube for 15 seconds. The student places the client in semi-Fowler's position before suctioning. The student inserts the catheter into the tracheostomy without applying suction.

Which statement by the client indicates a need for further teaching regarding the reinforced home care instructions for acute sinusitis? "I should drink large amounts of fluids." "I will need surgery to drain my sinuses." "I should apply a wet, warm heat pack over my sinuses." "I will need to sleep with the head of the bed elevated."

The nurse is reinforcing instructions to a hospitalized client with a diagnosis of emphysema about positions that will enhance the effectiveness of breathing during dyspneic episodes. Which position should the nurse instruct the client to assume? Side-lying in bed Sitting in a recliner chair Sitting up in bed at a 90 degree angle Sitting on the side of the bed leaning on an overbed table

The nurse is assigned to assist in caring for a client with a chest tube drainage system. Which interventions should the nurse implement? Select all that apply. Pin excess tubing to the bedclothes. Check for subcutaneous emphysema. Empty the chest tube drainage at the end of the shift. Check to see that the chest tube drainage is fluctuating. Maintain chest tube drainage container below the client's chest.

2,4,5

The nurse is reviewing the record of a client with acute respiratory distress syndrome (ARDS). The nurse determines that which finding documented in the client's record is consistent with the most expected characteristic of this disorder? Central cyanosis Arterial Pao2 of 48 Arterial Pao2 of 81 Respiratory rate of 10 breaths per minute

2 80-100 mmHg. If a PaO2 level is lower than 80 mmHg, it means that a person is not getting enough oxygen

A client who has been taking isoniazid for 1½ months complains to the nurse about numbness, paresthesia, and tingling in the extremities. The nurse interprets that the client is experiencing which adverse effect? Hypercalcemia Peripheral neuritis Small blood vessel spasm Impaired peripheral circulation

2 Rationale: An adverse effect of isoniazid is peripheral neuritis. This is manifested by numbness, tingling, and paresthesia in the extremities. This adverse effect can be minimized with pyridoxine (vitamin B6) intake.

A client with tuberculosis (TB) asks the nurse about precautions to take after discharge from the hospital to prevent transmitting infection to others. Which statements indicate prevention of transmission of tuberculosis? Select all that apply. "I will bleach my clothes and bedding after use." "My family and I will practice good hand hygiene." "I will discard disposable tissues into a plastic bag." "I will cover my mouth when I cough, sneeze, or laugh." "All the deep pile carpeting will be removed from my home."

2,3,4

The nurse is assisting in planning care for a client with a chest tube. The nurse should suggest to include which interventions in the plan? Select all that apply. Pin the tubing to the bed linens. Be sure all connections remain airtight. Be sure all connections are taped and secure. Monitor closely for tubing that is kinked or obstructed. Empty the drainage from the drainage collection chamber daily.

2,3,4

The nurse is caring for an older client who is on bed rest. The nurse plans which intervention to prevent respiratory complications? Decreasing the oral fluid intake Monitoring the vital signs every shift Changing the client's position every 2 hours Instructing the client to bear down every hour and to hold his or her breath

The nurse is caring for several clients with respiratory disorders. Which client is at least risk for developing a tuberculosis infection? An uninsured man who is homeless A woman newly immigrated from Korea A man who is an inspector for the U.S. Postal Service An older woman admitted from a long-term care facility

The nurse is monitoring a client following a motor vehicle crash. Which finding would indicate a need for chest tube placement? Chest pain and shortness of breath Peripheral cyanosis and hypotension Shortness of breath and tracheal deviation Decreasing oxygen saturation and bradypnea

A client arrives in the emergency department with a bloody nose. Which is the initial nursing action? Place the client in a supine position. Apply an ice collar around the client's neck. Assist the client to a sitting position with the head tilted slightly forward. Instruct the client to swallow the blood until the bleeding can be controlled.

A client arrives in the emergency department with an episode of status asthmaticus. What is the nurse's priority action? Obtain a set of vital signs. Administer oxygen at 21%. Place the client in high-Fowler's position. Obtain equipment for starting an intravenous line.

A client had thoracic surgery 2 days ago and has a chest tube in place connected to a closed chest tube system. The nurse notes continuous bubbling in the water seal chamber. The nurse determines which? This is normal on the second postoperative day. The client has a large amount of fluid that is being evacuated by the system. There is a leak in the system that requires immediate investigation and correction. This is due to the suction applied to the system, which is set at 20 cm of suction pressure.

A client has a prescription for continuous monitoring of oxygen saturation by pulse oximetry. The nurse performs which best action to ensure accurate readings on the oximeter? Apply the sensor to a finger that is cool to the touch. Apply the sensor to a finger with very dark nail polish. Ask the client to limit motion in the hand attached to the pulse oximeter. Place the sensor distal to an intravenous (IV) site with a continuous IV infusion.

A client has undergone fluoroscopy-assisted aspiration biopsy of a lung lesion. The nurse determines that the client is experiencing complications from the procedure if the nurse makes which observation? Skin pink, warm, and dry Oxygen saturation 97% by pulse oximetry Absence of breath sounds in the right upper lobe Pulse rate of 80 beats per minute, up from 74 beats per minute

A client who has had a radical neck dissection begins to hemorrhage at the incision site. Which action by the nurse would be contraindicated? Monitoring the client's airway Applying manual pressure over the site Lowering the head of the bed to a flat position Calling the primary health care provider immediately

A client who has just suffered a flail chest is experiencing severe pain and dyspnea. Which would be the appropriate nursing action? Reposition the client. Document the findings. Notify the registered nurse. Medicate the client for pain.

A client with no history of respiratory disease is admitted to the hospital with respiratory failure. Does the nurse review the arterial blood gas reports for which results are consistent with this disorder? Pao2 58 mm Hg, Paco2 32 mm Hg Pao2 60 mm Hg, Paco2 45 mm Hg Pao2 49 mm Hg, Paco2 52 mm Hg Pao2 73 mm Hg, Paco2 62 mm Hg

A client with pneumonia is admitted to the hospital, and the primary health care provider writes prescriptions for the client. Which prescription should the nurse complete first? Increase the intake of oral fluids. Administer a prescribed antibiotic. Obtain a culture and sensitivity of sputum. Encourage the use of an incentive spirometer.

A client with right pleural effusion by chest x-ray is being prepared for a thoracentesis. The client experiences dizziness when sitting upright. The nurse assists the client to which position for the procedure? Sims' position with the head of the bed flat Prone with the head turned to the side supported by a pillow Left side-lying with the head of the bed elevated at 45 degrees Right side-lying with the head of the bed elevated at 45 degrees

A hospitalized client is dyspneic and has been diagnosed with left pneumothorax by chest x-ray. Which sign or symptom observed by the nurse clearly indicates that the pneumothorax is rapidly worsening? Hypertension Pain with respiration Tracheal deviation to the right Respiratory rate of 18 breaths per minute

The nurse is caring for a client after a bronchoscopy and biopsy. Which finding should be reported immediately to the primary health care provider (PHCP)? Dry cough Hematuria Bronchospasm Blood-tinged sputum

The nurse is reviewing the arterial blood gas results of an assigned client. Which arterial blood gases indicate metabolic alkalosis? pH of 7.35, Pco2 of 50 mm Hg, HCO3- of 32 mEq/L pH of 7.45, Pco2 of 35 mm Hg, HCO3- of 22 mEq/L pH of 7.38, Pco2 of 45 mm Hg, HCO3- of 32 mEq/L pH of 7.48, Pco2 of 40 mm Hg, HCO3- of 36 mEq/L

The nurse is performing nasotracheal suctioning of a client. The nurse interprets that the client is adequately tolerating the procedure if which observation is made? Skin color becomes cyanotic. Secretions are becoming bloody. Coughing occurs with suctioning. Heart rate decreases from 78 beats/minute to 54 beats/minute.

3 Rationale: Coughing is a normal response to suctioning for the client with an intact cough reflex, and it is not an indication that the client is not tolerating the procedure. The client should be encouraged to cough to help with removal of secretions from the lungs. The nurse should monitor for the adverse effects of suctioning, which include cyanosis (pulse oximetry falls below 90% or 5% from baseline), excessively rapid or slow heart rate (a 20 beat/minute change), or the sudden development of bloody secretions. If they occur, the nurse stops suctioning, administers oxygen as appropriate, and reports these signs to the PHCP immediately.

What is true about arterial blood gases (ABGs)? (Select all that apply.) a. They are measured from an arterial sample. b. They measure partial pressures of carbon dioxide. c. They measure blood pH. d. They measure partial pressures of sodium. e. They measure partial pressures of oxygen.

A, B, C, E

The nurse is assisting with monitoring the functioning of a chest-tube drainage system in a client who just returned from the recovery room after a thoracotomy with wedge resection. Which findings should the nurse expect to note? Select all that apply. Excessive bubbling in the water-seal chamber Vigorous bubbling in the suction-control chamber 50 mL of drainage in the drainage-collection chamber The drainage system is maintained below the client's chest. An occlusive dressing is in place over the chest-tube insertion site. Fluctuation of water in the tube of the water-seal chamber during inhalation and exhalation

3,4,5,6

The nurse is monitoring the respiratory status of a client following insertion of a tracheostomy. The nurse understands that oxygen saturation measurements obtained by pulse oximetry may be inaccurate if the client has which coexisting problems? Select all that apply. Fever Epilepsy Hypotension Respiratory failure Use of peripheral vasoconstrictors

3,5

The nurse is providing endotracheal suctioning to a client who is mechanically ventilated when the client becomes restless and tachycardic. Which action should the nurse take? Call the primary health care provider. Contact the respiratory department to suction the client. Hyperoxygenate and hyperventilate the client with an Ambu bag and resuction. Monitor vital signs and discontinue attempts at suctioning until the client is stabilized.

The nurse is instructing a client about pursed-lip breathing, and the client asks the nurse about its purpose. The nurse should tell the client that the primary purpose of pursed-lip breathing is which? Promote oxygen intake Strengthen the diaphragm Strengthen the intercostal muscles Promote carbon dioxide elimination

The nurse is monitoring a client for Biot's respirations. Which condition causes Biot's respirations? Emphysema Renal failure Severe anxiety Neurological disorders

A client being discharged from the hospital to home with a diagnosis of tuberculosis is worried about the possibility of infecting family members and others. Which information should reassure the client that contaminating family members and others is not likely? The family does not need therapy, and the client will not be contagious after 1 month of medication therapy. The family does not need therapy, and the client will not be contagious after 6 consecutive weeks of medication therapy. The family will receive prophylactic therapy, and the client will not be contagious after 1 continuous week of medication therapy. The family will receive prophylactic therapy, and the client will not be contagious after 2 to 3 consecutive weeks of medication therapy.

A client who is experiencing severe respiratory acidosis has a potassium level of 6.2 mEq/L. The nurse determines this result is best characterized by which interpretation? Expected and indicates the result of massive hemolysis Unexpected and indicates a concurrent history of renal insufficiency Unexpected and indicates a deficit of hydrogen ions in the bloodstream Expected and indicates that acidosis has driven hydrogen ions into the cell, forcing potassium out

A client who underwent a bronchoscopy was returned to the nursing unit 1 hour ago. The nurse determines that the client is experiencing complications of the procedure if the nurse notes which sign/symptom? Oxygen saturation of 95% Weak gag and cough reflex Respiratory rate of 22 breaths per minute Breath sounds greater on the right than the left

A client with a nasal tumor is being admitted to the hospital. The nurse collects data about which primary symptom that the client is expected to exhibit? Epistaxis Headache Runny nose Nasal obstruction

A client with a respiratory disorder has anorexia secondary to fatigue and dyspnea while eating. The nurse determines that the client has followed the recommendations to improve intake if which action is taken? The client selects foods that are very dry. The client increases the use of milk products. The client increases the use of stimulants such as caffeine. The client plans to eat the largest meal of the day at a time when hungry.

A postoperative client is using an incentive spirometer. The nurse observes the client inhale slowly with the mouthpiece placed between the teeth with the lips closed. The client inhales to the preset inspiratory goal and holds the breath for about 3 seconds, then exhales slowly. The client takes one breath and returns the incentive spirometer to the bedside. Based on this observation, which interpretation should the nurse make? The client should be inhaling and exhaling quickly. The client is using the incentive spirometer correctly. The client should not be holding the breath following inhalation. The client should be repeating the sequence 10 to 20 times in each session.

The nurse is assessing a client with multiple traumas who is at risk for developing acute respiratory distress syndrome (ARDS). The nurse should assess for which earliest sign of acute respiratory distress syndrome? Diffuse crackles Bilateral wheezing Intercostal retractions Increased respiratory rate

The nurse is assisting a primary health care provider with the insertion of an endotracheal tube (ETT). The nurse should plan which as a final measure to determine correct tube placement? Hyperoxygenate the client. Tape the tube securely in place. Listen for bilateral breath sounds. Verify placement by a chest x-ray.

The nurse is assisting in admitting a client who is suspected of having tuberculosis (TB) to the nursing unit. The nurse plans to admit the client to which type of room? Venting through single filters and ultraviolet light Natural lighting with three air exchanges per hour One air exchange per hour and venting to the outside Venting to the outside, six air exchanges per hour, and ultraviolet light

The nurse is assisting in caring for a client with pneumonia who suddenly becomes restless. Arterial blood gases are drawn, and the results reveal a Pao2 of 60 mm Hg. The nurse reviews the plan of care for the client and determines that which priority problem potentially exists for this client? Fatigue Aspiration Airway obstruction Ineffective gas exchange

The nurse is assisting in collecting subjective and objective data from a client admitted to the hospital with tuberculosis (TB). The nurse should expect to note which finding? High fever Flushed skin Complaints of weight gain Complaints of night sweats

The nurse is caring for a client who is being treated for a pneumothorax with a closed chest tube drainage system. When repositioning the client, the chest tube disconnects. Which nursing action should be immediate? Clamp the chest tube. Instruct the client to inhale. Call the primary health care provider. Reattach the chest tube to the drainage system.

The nurse is suctioning a client through a tracheostomy tube. During the procedure, the client begins to cough, and the nurse notes the presence of an audible wheeze. The nurse attempts to remove the suction catheter from the client's trachea but is unable to do so. What is the nurse's priority response? Call a code. Administer a bronchodilator. Contact the registered nurse Disconnect the suction source from the catheter.

The nurse is teaching a client with chronic airflow limitation (CAL) about positions that help breathing during dyspneic episodes. The nurse instructs the client to avoid which position because it will aggravate breathing? Sitting up and leaning on a table Standing and leaning against a wall Sitting up with elbows resting on knees Lying on his or her back in low-Fowler's position

The nurse is told that an assigned client will have the chest tubes removed. The nurse plans to do which in preparation for the procedure? Clamp the chest tubes. Empty the drainage system. Disconnect the drainage system. Administer pain medication 15 to 30 minutes before the procedure.

The nurse provides instructions to a client about the use of an incentive spirometer. The nurse determines that the client needs further teaching about its use if the client makes which statement? "I need to sit upright when using the device." "I will inhale slowly, maintaining a constant flow." "I need to place my lips completely over the mouthpiece." "After maximal inspiration, I will hold my breath for 10 seconds and then exhale."

The primary health care provider has prescribed amantadine for a client admitted to the hospital for hip replacement surgery. The nurse recognizes that this medication was prescribed because the client's history showed recent exposure to which? Bronchitis Pneumonia Tuberculosis Type A influenza

While assessing a client who is admitted to the hospital with a diagnosis of pleurisy, the nurse would note which characteristic symptom of this disorder? Early morning fatigue Dyspnea that is relieved by lying flat Pain that worsens when the breath is held Knifelike pain that worsens on inspiration

Which statement(s) about acetylcysteine is/are true? (Select all that apply.) a. It reduces viscosity of secretions. b. It treats acetaminophen toxicity. c. It is stored at room temperature. d. It is given to improve airway flow. e. It is odorless. f. It is administered by inhalation.

A, B, D, F

A client is admitted to the hospital with acute exacerbation of chronic obstructive pulmonary disease (COPD) and has an arterial blood gas test done. Which results would the nurse expect to note? Po2 of 70 mm Hg and Pco2 of 45 mm Hg Po2 of 68 mm Hg and Pco2 of 40 mm Hg Po2 of 62 mm Hg and Pco2 of 40 mm Hg Po2 of 60 mm Hg and Pco2 of 50 mm Hg

4 80-100 mmHg. If a PaO2 level is lower than 80 mmHg, it means that a person is not getting enough oxygen

Which principle(s) would be when teaching a patient to use a steroid inhaler? (Select all that apply.) a. Frequent oral hygiene is necessary. b. The inhaler should be used on a PRN basis only. c. Rinse and spit after inhalation of the medication. d. When taking a steroid drug as well as a bronchodilator, the bronchodilator should be administered first. e. Hold the breath for 10 seconds during inhalation of the medication.

A, C, D, E

Which statement(s) about ipratropium bromide (Atrovent) is/are true? (Select all that apply.) a. It is administered by aerosol inhalation. b. It relieves nasal congestion. c. It decreases mucus secretion. d. It has minimal effect on ciliary activity. e. It is used for short-term treatment of bronchospasm. f. It may cause tachycardia or urinary retention.

A, D, F

Which infection is usually bacterial in origin? Laryngitis Pharyngitis Acute rhinitis Acute follicular tonsillitis

Acute follicular tonsillitis Rationale Acute follicular tonsillitis, or inflammation of the tonsils,is usually the result of an airborne or foodborne bacterial infection, often Streptococcus. It can be viral, but this occurs less often. lf caused by group A beta-hemolytic streptococci, such sequelae as rheumatic fever, carditis, and nephritis must be considered. Laryngitis often occurs secondary to other respiratory (viral or bacterial infections, although it may be related to voice abuse or inhalation of irritating fumes. When laryngitis occurs in children younger than age 5 years, it can easily lead to airway obstruction because of the small diameter of the larynx. Pharyngitis, which frequently accompanies the common cold, is usually viral in origin. Less frequently, it may be bacterial in origin, caused by hemolytic streptococci, staphylococci, or other bacteria. Acute rhinitis, or the common cold, is an inflammatory condition of the mucous membranes of the nose and accessory sinuses. It is usually caused by one or more viruses; however, it may become complicated by a bacterial infection.

A tuberculin test (Mantoux test) is administered to an individual infected with human immunodeficiency virus (HIV). Seventy-two hours later, the nurse evaluates the test site and documents the results as positive, indicating that the individual has been exposed to tuberculosis. Which of the following findings did the nurse note to make this interpretation? An area of induration at the test site measuring 7 mm Redness and swelling at the test site with an induration measuring 3 mm An area of induration at the test site measuring 2 mm Redness and swelling at the test site without induration

An area of induration at the test site measuring 7 mm Rationale: Normally, an area of induration greater than 15 mm is considered positive in low-risk individuals. However, an area of induration that measures 5 mm or greater in people with HIV infection is considered positive. Redness and swelling do not indicate a positive test result.

A nurse is called to the room of a patient on continuous pulse oximetry, which reads 68% oxygen saturation. Which action should the nurse perform first? Assess the probe and the patient. Call the health care provider. Administer 100%oxygen at 2 L/min. Begin bag-mask ventilation.

Assess the probe and the patient. Rationale The nurse should frst asss the patient and the probe to determine whether the probe is attached and working properly. lf the probe is working correctly and the patient demonstrates signs of hypoxia, the nurse should call the health care provider and administer 2 Lof oxygen if the patient is taking spontaneous, ffective breaths. I not, the nurse should consider bag-mask ventilation.

Which statement(s) is/are true regarding the nursing assessment of a patient with a respiratory disorder? (Select all that apply.) a. Central cyanosis typically is observed on the fingers and earlobes. b. Clubbing of the fingernails is a sign of hypoxia. c. As oxygen levels diminish, mental alertness will progressively deteriorate. d. The normal respiratory rate in an adult is 10 breaths/min. e. Episodes of apnea are present in Cheyne-Stokes.

B, C, E

Anurse is caring fora patient l2 hours afteralung tissue biopsy. The nurse notes streaks of blood in the patient's sputum. Which action should the nurse perform at this time? Obtain vital signs. Document the findings. Call the health care provider. Prepare the patient for surgery.

Document the findings. Rationale Blood streaks in the sputum are normal for several days after a lung tissue biopsy. The nurse should document the findings and be alert forincreased bloodin the sputum. It is not necessary to obtain vital signs, all the health care provider, or prepare the patient for surgery.

A nurse is caring for a patient l2 hours after lung tissue biopsy. The nurse notes streaks of blood in the patient's sputum. Which action should the nurse perform at this time? Obtain vital signs. Document the findings. Call the health care provider. Prepare the patient for surgery.

Document the findings. Rationale Blood streaks in the sputum are normal for several days afteralung issue biops. The nurse should document the findings and be alert forincreased blood in the sputum. Itis not necessary to obtain vital signs, all the health care provider, or prepare the patient for surgery.

A patientis suffering from hypoxia.In which areas of the patient's body does the nurse expect bluish discoloration? Selec all that apply. Chest Sclera Earlobe Nail bed Conjunctiva

Earlobe Nail bed Conjunctiva Rationale Hypoxia is reduced oxygen in circulating red boo els It consists of two types, central and peripheral. Peripheral cyanosis is seen in the ear lobes and nail beds, and central cyanosis is seen in the conjunctiva. Cyanosis is not readily visible on the skin of the chest or on the sclera because of poor blood supply.

Which term describes the presence of infected fluid that accumulated in the pleural space? Pleurisy Empyema Atelectasis Pleural effusion

Empyema Rationale The presence of infected fluid that has accumulated in the pleural space is called empyema. Empyema can be acute or chronic. In acute empyema, there is inflammation of the affected area with a thin layer of fuid. In chronic empyema the fluid thickens, and the pleura becomes scarred and fibrosis, losing its elasticity. Pleurisy is an inflammation of the parietal and visceral pleura.It can be caused by either a bacterial or viral infection. The underlying pathophysiologic changes an inflammation of any part of the pleura.It may occur spontaneously but is more commonly associated with pneumonia, pulmonary infarction, pleural trauma, early stages of tuberculosis, or a lung tumor. Atelectasis is lung tissue collapse caused by the occlusion of air to a portion of the lung. Pleural effusion is the presence of fluid that has accumulated in the pleural space but is not infected. This rarely occurs by itself but is a result of another disease process.

The nurse is caring for a 70-year-old patient with pneumonia. Which nursing intervention would be the best to promote expectoration in the patient? Provide 700 calories intake per day. Encourage 3 L of fuid intake per day. Have the patient avoid vigorous coughing and breathing. Avoid upright positioning of the patient.

Encourage 3 L ofuid intake per day. Rationale As the elderly patient faces difficulty expectorating, the nurse should adequately hydrate the patient to promote expectoration. A minimum of3 Lfuidis administered orally or intravenously to a patient with pneumonia. An elderly patient is provided a minimum of 1500 calories per day to maintain strength in the body. Coughing and deep breathing are encouraged to promote expectoration in patients with pneumonia. Upright and side-lying positions are comfortable and promote the patient's breathing pattern in such conditions as pneumonia.

The nurse is collecting data on a patient who underwent a tracheostomy, and crackles are heard during auscultation of the lungs Which intervention may help this patient? Avoid providing pureed food to prevent choking. Assist the patient to sleep in the supine position. Close the nostrils and ask to breathe from the mouth. Encourage coughing and deep breathing in the patient.

Encourage coughing and deep breathing in the patient. Rationale Tracheostomy is performed on patients with laryngeal cancer. Crackles in breathing are heard when there is an obstruction in the airways because of excessive secretions. The nurse should ask the patient to take deep breaths and cough frequently to clear the obstructions Pureed food does not cause choking and is preferable for a patient who has undergone a tracheostomy. Patients with obstructed airways are placed in Fowler's position to clear the airway. The nurse would close the nose of the patient with epistaxis and ask the patient to breathe from the mouth. This intervention is not performed for patients with tracheostomy.

The nurse is collecting data on a patient who underwent a tracheostomy, and crackles are heard during auscultation of the lungs. Which intervention may help this patient? Avoid providing pureed food to prevent choking. Assist the patient to sleep in the supine position. Close the nostrils and ask to breathe from the mouth. Encourage coughing and deep breathing in the patient.

Encourage coughing and deep breathing in the patient. Rationale Tracheostomy is performed on patients with laryngeal cancer. Crackles in breathing are heard when there is an obstruction in the airways because of excessive secretions. The nurse should ask the patient to take deep breaths and cough frequently to clear the obstructions. Pureed food does not cause choking and is preferable for a patient who has undergone a tracheostomy. Patients with obstructed airways are placed in Fowler's position to clear the airway. The nurse would close the nose of the patient with epistaxis and ask the patient to breathe from the mouth. This intervention is not performed for patients with tracheostomy.

A client with a chronic airflow limitation is experiencing respiratory acidosis as a complication. The nurse who is trying to enhance the client's respiratory status would avoid doing which of the following? Keeping the head of the bed elevated Encouraging the client to breathe fast and shallowly Monitoring the flow rate of supplemental oxygen Assisting the client to turn, cough, and deep breathe

Encouraging the client to breathe fast and shallowly Rationale: The client with respiratory acidosis is experiencing elevated carbon dioxide levels due to insufficient ventilation. The nurse would encourage the client to breathe slowly and deeply (not shallowly) to expand alveoli and to promote better gas exchange. The actions listed in options 1, 2, and 3 are helpful actions on the part of the nurse.

The nurse would perform which nursing intervention for a patient with chronic obstructive pulmonary disease (COPD)?\ Encouraging a low-calorie, low-protein diet Administering high-flow oxygen, usually 40%or greater Performing physical therapy immediately before meals to stimulate appetite Encouraging the patient to get a fu vaccination each year and a pneumococcal revaccination every 5 years

Encouraging the patient to getafu vaccination each yearand a pneumococcal revaccination every 5 years Rationale Appropriate nursing interventions for a patient with COPD include encouraging the patient to get a flu vaccination each year and a pneumococcal revaccination every 5 years. These patients are chronically ill and at greater risk of developing complications either from the flu or from pneumonia. The patient with COPD should be encouraged to eat a high-calorie, high-protein diet to maintain nutritional status. This should be divided into six small meals per day, rather than three larger ones. Low-flow oxygen (l-2 L via nasal cannula) therapy is usually prescribed for the patient with COPD.A higher flow rate of oxygen can be dangerous for the patient with COPD because it diminishes the brain's respiratory center and can lead to respiratory failure. Physical therapy should not be performed immediately before meals for the patient with COPD; rather, the patient should be encouraged to rest for 30 minutes before a meal. This will conserve energy and decrease dyspnea.

The nurse is caring for a patient with breathing problems. Which information does the nurse include in the patient's plan of care? Select all that apply. Teach the patient aerobic exercises. Ensure that the patient's airway is open. Monitor the patient's oxygen saturation. Place the patient in high-Fowler's position. Evaluate the effectiveness of the patient's respiratory effort.

Ensure that the patient's airway is open. Monitor the patient's oxygen saturation. Place the patient in high-Fowler's position. Evaluate the effectiveness of the patient's respiratory effort. Rationale When a nurse provides respiratory care to a patient, the most important responsibility is to ensure that the patient's airway is open and there is adequate air exchange. This ensures patient safety and prevents respiratory failure. The nurse also monitors oxygen saturation levels in the patient to ensure that the patient is not at risk for hypoxemia. The patient with breathing problems is turned frequently so that secretions are not retained in the airway. Typically, any patient with respiratory problems is placed in high-Fowler's position as it assists with ventilation. Patients with respiratory problems are asked to perform minimal activity as activities exhaust them rather quickly. The nurse does not teach any aerobic exercises because the patient will not be able to perform them.

The nurse is caring fora patient with breathing problems. Which information does the nurse include in the patient's plan of care? Select all that apply. Teach the patient aerobic exercises. Ensure that the patient's airway is open. Monitor the patient's oxygen saturation. Place the patient in high-Fowler's position. Evaluate the effectiveness of the patient's respiratory effort.

A postoperative client with incisional pain complains to the nurse about completing respiratory exercises. The client is willing to do the deep breathing exercises but states that it hurts to cough. The nurse provides gentle encouragement and appropriate pain management to the client, knowing that coughing is needed to: Provide for decreased oxygen tension in the alveoli. Dilate the terminal bronchioles. Expel and clear mucus from the airways. Exercise the muscles of respiration.

Expel and clear mucus from the airways. Rationale: Coughing is one of the protective reflexes. Its purpose is to move mucus that is in the airways upward toward the mouth and nose. Coughing is needed in the postoperative client to mobilize secretions and expel them from the airways. The other options do not accurately address the purpose of coughing in the postoperative client.

A nurse reads a client's Mantoux skin test as positive. The nurse notes that previous tests were negative. The client becomes upset and asks the nurse what this means. The nurse's response is based on the understanding that the client has: Systemic tuberculosis Pulmonary tuberculosis No evidence of tuberculosis Exposure to tuberculosis

Exposure to tuberculosis Rationale: A client who tests positive on a Mantoux skin test has either been exposed to tuberculosis or has inactive (dormant) tuberculosis. The client must then be tested by chest x-ray and sputum culture to confirm the diagnosis.

tuberculosis (TB) is treated with multiple drugs to which organisms are susceptible. How many drugs are usually preferred to increase the therapeutic effectiveness? Four Three One Two

Four At least four drugs, in combination, are used to prevent the emergence of organisms resistant to the others, thus increasing the therapeutic effectiveness.

A patient has labored respirations, pink coloration ofskin, and frothy sputum. The chest radiographic examination of the patient showed alveolar edema and an enlarged heart. Which medication does the nurse expect to be prescribed for the patient? Zileuton (Zyfo) Furosemide (Lasix) Pancuronium (Pavulon) Erythromycin (Erythrocin)

Furosemide (Lasix) Rationale Labored respirations, pink coloration of the skin (cyanosis), and frothy sputum are the most obvious signs of pulmonary edema. It is diagnosed on the basis of alveolar edema and enlarged heart demonstrated by the chest radiographic examination. Therefore, diuretics, such as furosemide (Lasix), may be prescribed to reduce alveolar and systemic edema by increasing urinary output. Zileuton (Zyflo) is a leukotriene synthesis inhibitor used in the treatment of asthma. Pancuronium (Pavulon) is a neurologic blocking agent used in the treatment of acute respiratory distress syndrome (ARDS) Erythromycin (Erythrocin) is an antibiotic commonly used in chronic bronchitis.

Appropriate nursing care for a patient with pneumonia includes which interventions? Select all that apply. Help the patient conserve energy. Encourage the patient to limit fluids. Position the patient with the side of the "good" lung up. Place the patient in semi-Fowler's position to high-Fowler's position Educate the patient about the importance of hand washing.

Help the patient conserve energy. Place the patient in semi-Fowler's position to high-Fowler's position Educate the patient about the importance of hand washing. Rationale Appropriate nursing care for a patient with pneumonia includes helping the patient conserve energy, which will decrease oxygen demand. The nurse should allow rest periods and should facilitate optimal air exchange by placing the patient in high-Fowler's position, which allows maximum lung inflation to promote air exchange. ppropriate nursing care for a patient with pneumonia includes educating the patient about the importance of hand washing to prevent the spread of infection. Appropriate nursing care for a patient with pneumonia includes implementing interventions to foster the ability to move secretions This wll be tailored to the individual patient and may include coughing, positioning, suctioning, and liquefying secretions. Medications, such as bronchodilators, expectorants, and mucolytic agents, may be prescribed. Hydration to 3 L/day of fluid may be encouraged unless contraindicated. The patient with pneumonia should be positioned with the "good" lung down when lying in the supine position. The "good" or unaffected side benefits from improved perfusion in the dependent position, and the "bad" side or the side of the lung affected by pneumonia will benefit by being in the upright position, which allows for maximal inflation of the alveoli. This position should not be used exclusively and should be alternated with semi-Fowler's position.

Help the patient conserve energy. Place the patient in semi-Fowler's position to high-Fowler's position Educate the patient about the importance of hand washing. Rationale Appropriate nursing care for patients with pneumonia includes helping the patient conserve energy, which will decrease oxygen demands. The nurse should allow rest periods and should facilitate optimal air exchange by placing the patient in high-Fowler's position, which allows maximum lung inflation to promote air exchange. Appropriate nursing care for patients with pneumonia includes educating the patient about the importance of handwashing to prevent the spread of infection. Appropriate nursing care for a patient with pneumonia includes implementing interventions to foster the ability to move secretion. This will be tailored to the individual patient and may include coughing, positioning, suctioning, and liquefying secretions. Medications, such as bronchodilators, expectorants, and mucolytic agents, may be prescribed. Hydration to 3 L/day of fluid may be encouraged unless contraindicated. The patient with pneumonia should be positioned with the "good" lung down when lying in the supine position. The "good" or unaffected side benefits from improved perfusion in the dependent position, and the "bad" side or the side of the lung affected by pneumonia will benefit by being in the upright position, which allows for maximal inflation of the alveoli. This position should not be used exclusively and should be alternated with semi-Fowler's position.

A nurse is assisting with obtaining an arterial blood gas sample. After the procedure, which action should the nurse take next? Institute complete bed rest. Hold firm pressure at the site. Obtain postprocedure vital signs. Administer oxygen via face mask.

Hold firm pressure at the site. Rationale The nurse should hold firm pressure at the site for at least 2 minutes after the specimen has been obtained to prevent the formation of a hematoma. Bed rest, postprocedure vital signs, and oxygen are unnecessary if the patient tolerated the procedure well.

Hold firm pressure at the site. Rationale The nurse should hold firm pressure at the site forat least 2 minutes after the specimen has been obtained to prevent formation ofa hematoma. Bed rest, postprocedure vital signs, and oxygen are unnecessary if the patient tolerated the procedure well.

A nurse in the clinic is administering an allergy skin test to a patient who becomes diaphoretic and anxious. The nurse notes the patient's lips and tongue are swelling and circumoral cyanosis occurs. Which action should the nurse perform first? Call for an ambulance. Administer oxygen via a face mask. Administer Benadryl orally. Inject epinephrine into the patient's outer thigh.

Inject epinephrine into the patient's outer thigh. Rationale The patient is experiencing an anaphylactic reaction that has compromised the airway. The nurse should administer an epinephrine injection into the patient's outer thigh as soon as possible. Then, the nurse should all for an ambulance, administer oxygen via a face mask,and administer oral Benadryl if the patientis awake and can swallow.

A patient is one of many recently diagnosed with Legionnaires' disease at a conference. The nurse anticipates administering which medication? Acyclovir Griseofulvin Oral azithromycin Intravenous erythromycin

Intravenous erythromycin Rationale Legionnaires' disease is a bacterial infection that requires intravenous erythromyin initially, followed by oral erythromycin for an extended period. Acyclovir, griseofulvin, and azithromycin are inappropriate medications for this disease.

The nurse is collecting data on a patient who exhibits weakness, weight loss, and shortened breath. The nurse measures the patient's inflamed tissue as 8 mm after a Mantoux test. Which immediate treatment would the health care provider prescribe to ensure the patient's safety? Intranasal fluticasone (Flovent) Isoniazid (INH) and rifampin (Rifadin) 100 mg of zafrlukast (Accolate) intravenous Theophylline (Accurbron) and para-aminosalicylate sodium (PAS)

Isoniazid (INH) and rifampin (Rifadin) Rationale Weakness, weight loss, and shortened breath are the characteristic symptoms of tuberculosis (TB). The Mantoux test, or tuberculin skin test, is performed to identify the presence of Mycobacterium tuberculosis in blood. The tissue on the skin gets inflamed and hardened;if the inflamed area measures more than 5 mm, it confirms that the patient is infected with tuberculosis. The health care provider will immediately prescribe first-line antituberculosis drugs, such as isoniazid (INH) and rifampin (Rifadin) to the patient. Fluticasone (Flovent) is a corticosteroid used in treating various respiratory tract infections and also used in treating TB as a second-line agent. Zafrlukast (Accolate)is an anti-inflammatory agent used in the treatment of asthma. Theophyline (Accurbron) is a bronchodilator used to treat such conditions as asthma. Paraaminosalicylate sodium (PAS) is a second-line antituberculosis agent used if treatment with the first-line drugs is not effective.

The nurse is collecting data on a patient who exhibits weakness, weight loss and shortened breath. The nurse measures the patient's inflamed tissue as 8 mm after a Mantoux test. Which immediate treatment would the health care provider prescribe to ensure the patient's safety? Intranasal fluticasone (Flovent) Isoniazid (NH) and rifampin Rifadin) 100 mg of zafrlukast (Accolate) intravenous Theophylline (Accurbron) and para-aminosalicylate sodium (PAS)

Isoniazid (NH) and rifampin Rifadin) Rationale Weakness, weight loss, and shortened breath are the characteristic symptoms of tuberculosis (TB).The Mantoux test, or tuberculin skin test,is performed to identify the presence of Mycobacterium tuberculosis in blood. The tissue on the skin gets inflamed and hardened; if the inflamed area measures more than5mm, it confirms that the patient is infected with tuberculosis. The health care provide will immediately prescribe first-line antituberculosis drugs, such as isoniazid (INH and rifampin (Rifadin) to the patient. Fluticasone (Flovent) is a corticosteroid used in treating various respiratory tract infections and also used in treating TB as a second-line agent. Zafirlukast (Accolate)is an anti-inflammatory agent used in the treatment of asthma. Theophylline (Accurbron) is a bronchodilator used to treat such conditions as asthma. Paraaminosalicylate sodium (PAS) is a second-line antituberculosis agent used if treatment with the frst-line drugs is not effective.

The nurse is caring fora patient who has a chest tube to drain a pneumothorax.Which actions should the nurse perform? Select all that apply. Milk the chest tube to increase drainage. Keep the drainage below the patient's chest level. Clamp the chest tube when the patient is moving about. lf the tube becomes disconnected, ask the patient to cough and exhale as much as possible. Fill the water seal chamber up to the mark specified by the manufacturer, and observe it.

Keep the drainage below the patient's chest level. lf the tube becomes disconnected, ask the patient to cough and exhale as much as possible. Fill the water seal chamber up to the mark specified by the manufacturer, and observe it. Rationale The chest tube drainage set should be kept below the patient's chest level because it is facilitated by gravity. lf the tube becomes disconnected, ask the patient to exhale or cough because this gets rid of air from the pleural space. t is essetilto of the water seal chamber to the level specified by the manufacturer. Fluctuation or bubbling in the water seal chamber could indicate leakage in the drainage system. Milking the chest tube helps to remove blood clots in the tube; it is not required in pneumothorax. Do not keep the drainage set above the level of the patient's chest because it will be difficult to drain against gravity. The drainage tube should not be clamped because it can result in a pneumothorax.

A patient arrives at the clinic complaining of hoarseness for the past 3 weeks, difficulty swallowing, and pain radiating to the ear. The nurse palpates cervical lymph nodes and finds them to be enlarged, and a lump is felt inferior to the right mandible. The nurse is concerned about which life-threatening condition? Goiter Laryngeal cancer Esophageal varices Inflammation of the submandibular salivary gland

Laryngeal cancer Rationale Hoarseness lasting longer than 2 weeks, pain radiating to the ear and difficulty swallowing are symptoms of laryngeal cancer. These symptoms do not indicate goiter, esophageal varices, orinfammation of the submandibular salivary gland.

The nurse is preparing a patient with a respiratory infection for acute hemodialysis. The patient has also prescribed erythromycin (lotycin) Which condition of the patient is the nurse caring for? Acute pharyngitis Chronic bronchitis Legionnaires' disease Severe acute respiratory syndrome (SARS)

Legionnaires' disease Rationale Legionnaires' disease is caused by a microorganism named Legionllapneumophila Infected individuals may experience breathing difficulty, and their body temperature may increase. The patient is administered erythromycin (lotycin) to treat the infection. The disease also causes renal impairment in the patient, and acute hemodialysis may be helpful In such conditions as pharyngitis and laryngitis patients experience sore throat and mild elevations in the body temperature. Bronchodilators, not antibiotics, typically are used to treat chronic bronchitis SARS is an infection caused by a coronavirus. Infected individuals would have such symptoms as fever and difficulty breathing. However, the patient's renal function is not affected.

The nurse providing instructions to the client using an incentive spirometer tells the client to sustain the inhaled breath for 3 seconds. When the client asks the nurse about the rationale for this action, the nurse explains that the primary benefit is to: Dilate the major bronchi. Maintain and promotes inflation of the alveoli. Enhance ciliary action in the tracheobronchial tree. Increase surfactant production.

Maintain and promotes inflation of the alveoli. Rationale: Sustained inhalation helps maintain inflation of terminal bronchioles and alveoli, thereby promoting better gas exchange. Routine use of such devices such an incentive spirometer can help prevent atelectasis and pneumonia in clients at risk. "Dilate the major bronchi," "increase surfactant production," and "enhance ciliary action in the tracheobronchial tree" are not reasons for sustaining inflation.

A patient underwent diagnostic bronchoscopy,and a tissue biopsy was performed. Which interventions should the nurse follow for the patient after bronchoscopy? Select all that apply. Offer adequate liquids to the patient . Ask the patient to lie in the supine position . Monitor for signs of stridor and increased dyspnea Observe for the presence of blood -streakedsputum . Encourage the patient to change positions ,as prescribed .

Monitor for signs of stridor and increased dyspnea Observe for the presence of blood-streaked sputum . Encourage the patient to change positions as prescribed . Rationale Patients who undergo bronchoscopy should be monitored for the sign of stridor and increased dyspnea.Blood-streaked sputum is expected days after biopsy;therefore , the nurse has to monitor the patient's sputum for signs of hemorrhage .The patient is encouraged to change positions,according to the health care provider's instructions, to facilitate the removal of secretions .Nothing by mouth (NPO)status is maintain trained after bronchoscopy until the gag reflex returns. Therefore,the patient should not be offered any liquids for up to 2 hours after the procedure.The patient should be placed in semi -Fowler'sposition to facilitate the removal of secretions .

Which statement most accurately describes the disease tuberculosis (TB)? All strains of TB are resistant to antibiotic therapy. TB rates are the highest in the white population in the United States. TB is easily spread from person to person via respiratory secretions. Most people who become infected with the TB organism do not progress to the active disease stage.

Most people who become infected with the TB organism do not progress to the active disease stage. Rationale Most people who become infected with the TB organism do not progress to the active disease stage; they remain asymptomatic and noninfectious. These people will have a positive tuberculin skin test result, and chest radiography results will be negative. These people retain a lifelong risk of developing reactivation TB if the immune system becomes compromised. Not all strains of TB are resistant to antibiotic therapy.A growing percentage of new TB cases are resistant to the medications that are traditionally used to fight the disease.TB rates in the white population in the United States are about half those in the nonwhite population. More than two-thirds of reported cases occur in racial and ethnic minorities, particularly among Hispanic and African- American populations. a common misconception about TB is that it is easily spread-in fact, most people exposed to TB do not become infected. The body's first line of defense, the upper airway, prevents most inhaled TB organisms from ever reaching the lungs.

While assessing a respiratory patient, the nurse notices that the patient is having difficulty bringing up the mucous secretions trapped in the lung. Which intervention does the nurse perform? Oxygen therapy Nebulizer treatment Incentive spirometer Nasopharyngeal suctioning

Nebulizer treatment Rationale When mucous secretions are trapped in the lung, the nurse uses nebulizer treatment to thin the secretions, which can then be coughed up by the patient. The nurse provides oxygen therapy for patients with depleted oxygen. The nurse uses an incentive spirometer to encourage the patient to perform breathing exercises. Nasopharyngeal suctioning is performed when a patient is unable to adequately clear secretions from the pharynx.

The nurse is caring for a newly admitted client with pneumonia. The primary health care provider has prescribed a sputum specimen for culture and sensitivity. The nurse should perform the actions concerning the sputum collection in which priority order? Arrange the actions in the order that they should be performed. All options must be used. Obtain and label a sterile container. 1 Administer the prescribed antibiotics. 2 Send the specimen immediately to the laboratory. 3 Have the client brush teeth and rinse mouth with water. 4 Have the client take several deep breaths before coughing. 5 Have the client expectorate sputum (not saliva) into sterile container.

Obtain and label a sterile container. Have the client brush teeth and rinse mouth with water. Have the client take several deep breaths before coughing. Have the client expectorate sputum (not saliva) into sterile container. Send the specimen immediately to the laboratory. Administer the prescribed antibiotics.

A 55-year-old man comes to the health nurse at his place of work with epistaxis. He reports he has frequent nosebleeds that he can usually control himself. What would be the most helpful assessment after the nurse has stopped the bleeding? Record the approximate amount of blood lost Record the last episode of epistaxis Obtain or check the blood pressure Inquire about a diarrhea

Obtain or check the blood pressure Check the blood pressure for hypotension to assess for hypovolemic shock. Adults can lose as much as 1 L of blood in an hour with heavy epistaxis.

A nurse is assisting in planning care for a client scheduled for insertion of a tracheostomy. What equipment would the nurse plan to have at the bedside when the client returns from surgery? Epinephrine Tracheostomy with the next larger size Obturator Oral airway

Obturator Rationale: A replacement tracheostomy tube of the same size and an obturator is kept at the bedside at all times in case the tracheostomy tube is dislodged. Additionally, a curved hemostat that could be used to hold the trachea open if dislodgement occurs should also be kept at the bedside. An oral airway and epinephrine would not be needed.

A patient informs the nurse that the patient cannot breathe while lying fat and must sleep with two pillows. Which word would the nurse use to document this condition? Hypoxia Dyspnea Orthopnea Adventitious lung sounds

Orthopnea Rationale Orthopnea is a condition in which a patient must sit orstand to be able to breathe comfortably. The patient with orthopnea has difculty breathing while lying flat. Hypoxia is oxygen deficiency. Dyspnea is a subjective feeling of shortness of breath experienced by the patient. Adventitious lung sounds are abnormal breath sounds (superimposed on breath sounds) that are audible when auscultating with a stethoscope.

Which arterial blood gas value would indicate that a patient with bronchitis is experiencing hypercapnia? Potential hydrogen (pH) is7.40 Oxygen saturation (SaO2) is 96% The partial pressure of carbon dioxide (PaCO z) is 65 mm Hg The partial pressure of oxygen (PaO) is 50 mm Hg

Partial pressure of carbon dioxide (PaCO z) is 65 mm Hg Rationale Hypercapnia is a condition in which the partial pressure of carbon dioxide (PaCO z) in the blood is increased above the normal level of35 to 45 mmHg.APaCO zof65 mm Hgisindicative ofhypercapnia. The potential hydrogen (pH) of blood is slightly basic, ranging from 7.35 to7.45.A pH of7 40 falls within this normal range. An oxygen saturation (SaO z) above 95% is considered a healthy (safe) level. partial pressure of oxygen (PaO 2) of 50 mm Hg indicates hypoxemia (an abnormally low-level of oxygen in the blood), but not hypercapnia.

A client has been taking isoniazid (INH) for 1 ½ month. The client complains to the nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing: Peripheral neuritis Small blood vessel spasm Hypercalcemia Impaired peripheral circulation

Peripheral neuritis Rationale: A common side effect of isoniazid (INH) is peripheral neuritis. This is manifested by numbness, tingling, and paresthesias in the extremities. This side effect can be minimized with pyridoxine (vitamin B6) intake.

A nursing diagnosis for the patient with a new laryngectomy would be Social isolation related to impaired verbal communication related to the removal of the larynx. What is an appropriate nursing intervention? Provide a pad and pencil or magic slate to write on Refrain from conversations with the patient to reduce stress level Ignore and offer books or jigsaw puzzles for entertainment Complete care quickly

Provide a pad and pencil or magic slate to write on

A nurse is caring for a client with tuberculosis who is fearful of the disease and anxious about the prognosis. In planning nursing care, the nurse would incorporate which of the following as the best strategy to assist the client in coping with the disease? Encourage the client to visit with the pastoral care department chaplain. Ask family members if they wish a psychiatric consult. Provide reassurance that continued compliance with medication therapy is the most proactive way to cope with the disease. Allow the client to deal with the disease in an individual fashion.

Provide reassurance that continued compliance with medication therapy is the most proactive way to cope with the disease.

Which method of diagnosing a pulmonary embolism is the most definitive? Bronchoscopy Pulmonary angiography A ventilation-perfusion (V/Q) scan Helical or spiral computed tomography (CT)

Pulmonary angiography Rationale Pulmonary angiography is the most definitive method of diagnosing a pulmonary embolism. Radiographic contrast material is injected into the pulmonary arteries allowing visualization of the pulmonary vasculature. This test is considered to be the gold standard for diagnosing a pulmonary embolism because false-positive results may influence the results obtained from aV/Q scan. Bronchoscopy is not a diagnostic tool used to diagnose a pulmonary embolism. In bronchoscopy, a bronchoscope is inserted into the trachea and bronchi. This is performed to look for abnormalities, obtain tissue biopsy, and obtain secretions for cell or bacteriologic examination. V/Q scan is used to diagnose a pulmonary embolism, and although it is accurate most of the time, it is not the most definitive method. The V/Q scan has definite advantages over the pulmonary angiogram, however. t is less costly and less invasive. If the scan is normal, then a pulmonary embolism has been ruled out. lf the scan is equivocal, the diagnosis of pulmonary embolism is questionable because various lung pathologies also can cause abnormalities on the scan. Helical or spiral CTimages the abdomen and chest within 30 seconds and represents a significant improvement over traditional CT. Furthermore, when a contrast agent is used, the entire region being scanned can be imaged in just a few seconds after administration, further improving contrast imaging. This testis not used, however, to diagnose a pulmonary embolism.

Which method of diagnosing a pulmonary embolism is the most definitive? Bronchoscopy Pulmonary angiography A ventilation-perfusion(V/Q) scan Helical or spiral computed tomography(CT)

Pulmonary angiography Rationale Pulmonary angiography is the most definitive method of diagnosing a pulmonary embolism. Radiographic contrast material is injected into the pulmonary arteries allowing visualization of the pulmonary vasculature. This test is considered to be the gold standard for diagnosing a pulmonary embolism because false-positive results may influence the results obtained from aV/Q scan. Bronchoscopy is not a diagnostic tool used to diagnose a pulmonary embolism. In bronchoscopy, a bronchoscope is inserted into the trachea and bronchi. This is performed to look for abnormalities, obtain tissue biopsy, and obtain secretions for cell or bacteriologic examination. V/Q scan is used to diagnose a pulmonary embolism,and although it is accurate most of the time, it is not the most definitive method. The V/Q scan has definite advantages over the pulmonary angiogram, however. It is less costly and less invasive. If the scan is normal, then a pulmonary embolism has been ruled out. If the scan is equivocal, the diagnosis of pulmonary embolism is questionable because various lung pathologies also can cause abnormalities on the scan. Helical or spiral CTimages the abdomen and chest within 30 seconds and represents a significant improvement over traditional CT. Furthermore, when a contrast agent is used, the entire region being scanned can be imaged in just a few seconds after administration, further improving contrast imaging. This test is not used, however, to diagnose a pulmonary embolism.

Which parameters does the nurse monitor in a patient who has developed hypoxia as a result of severe anemia? Select all that apply. Pulse rate Blood urea Serum bilirubin Respiratory rate Skin color change

Pulse rate Respiratory rate Skin color change Rationale Hypoxia presents as an increase in pulse rate and a rise in respiratory rate and depth of respiration. In the late stages of hypoxia, the skin and mucus membrane may become bluish in color. Blood urea is a renal parameter, so it is less significant when monitoring a patient with hypoxia. Serum bilirubin indicates the liver function, so it is less significant when monitoring a patient with hypoxia.

Anurse is caring for patient with sinusitis refractory to therapy with medications. The nurse knows which procedure is the next step? Transillumination Sinus computed tomography (CT) Sinus radiography Radical antrum operation

Radical antrum operation Rationale The next step would be to create a hole in the sinus to promote drainage with the radical antrum operation. The patient has already been diagnosed with sinusitis, so transillumination, sinus CT, and sinus radiography are inappropriate.

A nurse observing patients in the dining room of a skilled nursing facility sees a patient beginning to choke on food. Which action should the nurse perform first? Perform a blind finger sweep of the patient's mouth to clear the obstruction. Ask the patient, "Are you choking?" Begin the Heimlich maneuver. Use a jaw-thrust technique to open the patient's airway.

Rationale The nurse should first determine whether the patient's airway is obstructed by asking the patient to speak. If the patient cannot speak, the nurse should look in the mouth to see if the obstruction can be visualized. If an obstruction is visualized, the patient can attempt to remove it. However, a blind finger sweep is never used because the obstruction can be pushed further down the airway. lf the attempt at removal unsuccessful, the nurse should perform the Heimlich maneuver. The jaw-thrust technique is not appropriate at this time.

The nurse is preparing to use pulse oximetry to monitor the oxygen saturation level in a patient. Which precautions should the nurse take before applying the fingertip sensors? Ensure that the patient is not short of breath. Remove the patient's nail polish before applying the sensors. Ensure that the patient's blood pressure and pulse are normal. Ensure that the patient has performed the appropriate breathing exercises.

Remove the patient's nail polish before applying the sensors. Rationale In pulse oximetry, clip-on probes are used on the earlobe, fingertip, or toe to measure oxygen saturation. When fingertip sensors are used,itis important to remove the nail polish before applying the sensors. This helps the pulse oximeter to function effectively. Shortness of breath in the patient indicates hypoxia and the need for additional oxygen. The patient's blood pressure and pulse reading are not required at this stage. The nurse teaches the patient breathing exercises to improve oxygenation and respiratory effort or to evaluate patency of the airway.

A patient's arterial blood gas results are pH =7.2l, partial pressure of carbon dioxide(PaCO 2)=60 mm Hg, partial pressure of oxygen (PaO2) =60, bicarbonate (HCO3)=30.The nurse knows this patient has which acid-base imbalance? Metabolic acidosis Respiratory acidosis Respiratory alkalosis No imbalance; these are normal blood gas results

Respiratory acidosis

The nurse performs auscultation of the lungs in a patient and observes unilateral, high- pitched, musical, and whistle-like sounds during inspiration. Which description does the nurse document about the adventitious breath sounds of the patient? Rhonchi Coarse crackles Sibilant wheezes Pleural friction rub

Sibilant wheezes Rationale Sibilant wheezes are abnormal sounds superimposed on breath sounds. These are unilatera or bilateral, high- pitched, musical, and whiste-like sounds during inspiration orexpiration. Rhonchi orsonorous wheezes are loud, low, coarse sounds, such as snoring, which are heard atany point of inspiration orexpiration. Coarse crackles are loud bubbly sounds heard in early inspiration Pleural friction rub refers to dry, creaking, grating and low-pitched sounds with a machine-like quality heard during both inspiration and expiration.

A nurse is gathering data on a client with a diagnosis of tuberculosis (TB). The nurse reviews the results of which diagnostic test that will confirm this diagnosis? Bronchoscopy Chest x-ray Sputum Culture PPD skin test

Sputum Culture

A nurse is suctioning a client through an endotracheal tube. During the suctioning procedure, the nurse notes on the cardiac monitor that the heart rate has dropped 10 beats. The nurse should: Notify the registered nurse immediately. Continue to suction the client at a quicker pace. Stop the procedure and oxygenate the client. Ensure that the suction is limited to 15 seconds.

Stop the procedure and oxygenate the client. Rationale: During suctioning the nurse should monitor the client closely for complications including hypoxemia, drop in heart rate due to vagal stimulation, mucosal trauma, hypotension, and paroxysmal coughing. If complications develop (especially cardiac irregularities), the nurse should stop the procedure and oxygenate the client.

Which independent nursing measures are effective in helping ease a patient to expectorate thick secretions? (Select all that apply) Suctioning Providing hydration Positioning in sitting position Assisting to deep breathe first before coughing Starting and pushing IV fluids

Suctioning Providing hydration Positioning in sitting position Assisting to deep breathe first before coughing Independent nursing intervention to help a patient to expectorate would include positioning, assisting to cough, suctioning, and providing hydration IV therapy; provision of a mucolytic agent requires a physician's order and is not an independent nursing action..

What is the purpose of the cilia? Stimulate cough reflex Warm and cools inhaled air Sweep debris toward nasal cavity Produce mucus

Sweep debris toward nasal cavity The cilia are fine hairlike processes on the outer surfaces of small cells that produce a motion that sweeps the debris toward the nasal cavity. Large particles that are swept away stimulate the cough reflex, but not the cilia themselves.

Prevention of acute respiratory complications in surgical patients is a nursing goal that involves which intervention? Keeping at-risk patients in an upright position during the postoperative course. Teaching all preoperative patients how to use incentive spirometer and how to cough and deep breathe effectively. Obtaining baseline arterial blood gases for all preoperative patients over the age of 65. Obtaining baseline pulmonary function tests for all preoperative patients.

Teaching all preoperative patients how to use incentive spirometer and how to cough and deep breathe effectively.

A client with a persistent upper respiratory infection develops acute bronchitis. Aside from the characteristics of the client's cough, what other pertinent assessment findings should the nurse document? Any self-treatment measures used by the client Family history of respiratory disease Current vital signs The appearance of respiratory secretions

The appearance of respiratory secretions

Which arterial blood gas value would indicate that a patient with bronchitis is experiencing hypercapnia? Potential hydrogen (pH) is 7.40 Oxygen saturation (SaO2) is 96% The partial pressure of carbon dioxide (PaCO 2) is 65 mmHg The partial pressure of oxygen (PaO z) is 50 mm Hg

The partial pressure of carbon dioxide (PaCO 2) is 65 mmHg Rationale Hypercapnia is a condition in which the partial pressure of carbon dioxide (PacO z) in the blood is increased above the normal level of35 to 45 mmHg.APaCO zof65mm Hg isindicative ofhypercapnia. The potential hydrogen (pH) of blood is slightly basic, ranging from 7.35 to7.45.A pH of7.4 falls within this normal range. n oxygen saturation (SaO z) above 95%is considered a healthy (safe) level. the partial pressure of oxygen (PaO 2) of 50 mm Hg indicates hypoxemia (an abnormally low level of oxygen in the blood), but not hypercapnia.

The nurse is collecting data on a patient with asthma being administered theophylline (Theo-Dur). The nurse reviews the laboratory reports of the patient and finds serum concentrations of theophylline (Theo-Dur) as 15mcg/mL. Which inference would the nurse make? The patient is at risk of drug toxicity. The drug dosage should be increased. The patient is at risk of Reye's syndrome. The patient has normal drug concentrations.

The patient has normal drug concentrations. Rationale The normal serum drug concentrations of theophylline range from l0 to 20 mcg/mL.A level of 15 mcg/mL indicates the optimal therapeutic concentration of the drug in the patient. If the drug concentration exceeds 20 mcg/mL, it indicates the risk of toxicity. The drug dosage should be increased when the serum concentration is below l0 mcg/mL. Reye's syndrome is caused by aspirin use in infants and children. Theophylline does not cause Reye's syndrome.

Anurse is providing education to a patient with severe obstructive sleep apnea (OSA) who has not been compliant with nasal continuous positive airway pressure (nCPAP) therapy. Which suggestion would be most helpful? Lose at least l5 pounds. Use a mouthpiece to bring the jaw and the tongue forward while sleeping. Drink one glass of alcohol before bed. Use a bilevel positive airway pressure (BiPAP) system instead of an nCPAP system.

Use a bilevel positive airway pressure (BiPAP) system instead ofan nCPAP system. Rationale BiPAP systems are more comfortable for patients, and the patients are more likely to be compliant with treatment. Because of the patient's severe OSA, al5-pound weight loss and use of a mouthpiece are unlikely to be helpful because these are treatments for mild OSA.Alcohol consumption worsens OSA.

A nurse is providing education to a patient with severe obstructive sleep apnea (OSA) who has not been compliant with nasal continuous positive airway pressure (nCPAP) therapy. Which suggestion would be most helpful? Lose at least 15 pounds. Use a mouthpiece to bring the jaw and the tongue forward while sleeping. Drink one glass of alcohol before bed. Use a bilevel positive airway pressure (BiPAP) system instead of an nCPAP system.

Use a bilevel positive airway pressure (BiPAP) system instead ofan nCPAP system. Rationale BiPAP systems are more comfortable for patients, and the patients are more likely to be compliant with treatment. Because of the patient's severe OSA, an l5-pound weight loss and use of a mouthpiece are unlikely to be helpful because these are treatments for mild OSA. Alcohol consumption worsens OSA.

While collecting a sputum specimen, the nurse observes that a patient has difficulty expectorating sputum. Which intervention would help with collecting a good specimen? Ask the patient to rinse the mouth with water. Collect the specimen after the patient has had a meal. Use hypertonic saline aerosol mist for inhalation. Keep the patient on nothing by mouth (NPO) status.

Use hypertonic saline aerosol mist for inhalation. Rationale Applying a hypertonic saline aerosol mist helps produce a good sputum specimen when the patient has difficulty expectorating sputum during specimen collection. The patient is asked to rinse the mouth with water before expectorating to decrease contamination. Sputum specimens are collected before meals to avoid any possible emesis resulting from coughing. Patients who have difficulty producing sputum may be dehydrated; hence they are given adequate fluids, and NPO status is avoided.

While collecting a sputum specimen, the nurse observes that a patient has difficulty expectorating sputum. Which intervention would help with collecting a good specimen? ) Ask the patient to rinse the mouth with water. Collect the specimen after the patient has had a meal. Use hypertonic saline aerosol mist forinhalation. Keep the patient on nothing by mouth (NPO) status.

Use hypertonic saline aerosol mist forinhalation. Rationale Applying a hypertonic saline aerosol mist helps produce a good sputum specimen when the patient has difficulty expectorating sputum during specimen collection. The patient is asked to rinse the mouth with water before expectorating to decrease contamination. Sputum specimens are collected before meals to avoid any possible emesis resulting from coughing. Patients who have difficulty producing sputum may be dehydrated; hence they are given adequate fluids, and NPO status is avoided.

While collecting a patient's data, the nurse observes that the patient has respiratory distress caused by hypoxia. Which signs and symptoms would the nurse monitor in the patient? Select all that apply . Vertigo Clubbing Reduced fatigue Increased pulse rate Decreased blood pressure

Vertigo Clubbing Increased pulse rate Rationale Hypoxia or oxygen deficiency causes respiratory depression in the patient . The nurse should monitor symptoms such as vertigo ,clubbing ,and increased pulse rate in patients with hypoxia . Reduced fatigue and decreased blood pressure are not symptoms of hypoxia.Oxygen deficiency in the cellular tissues causes increased fatigue and elevated blood pressure in these patients.

Which patient(s) would be able to take an alpha-adrenergic decongestant safely? (Select all that apply.) a. 24-year-old woman with allergic rhinitis b. 18-year-old man with cold symptoms c. 64-year-old woman with a history of heart disease d. 70-year-old woman with glaucoma e. 56-year-old man with prostatic hypertrophy

a. 24-year-old woman with allergic rhinitis b. 18-year-old man with cold symptoms

What is albuterol (Proventil) used to treat? a. Acute bronchospasm b. Acute allergies c. Nasal congestion d. Dyspnea on exertion

a. Acute bronchospasm

Which topically active aerosol steroids are highly effective for reducing sneezing, nasal itching, stuffiness, and rhinorrhea? (Select all that apply.) a. Beclomethasone (Beconase AQ) b. Prednisone (Deltasone) c. Fluticasone (Flonase) d. Flunisolide (Nasarel) e. Budesonide (Rhinocort Aqua)

a. Beclomethasone (Beconase AQ) c. Fluticasone (Flonase) d. Flunisolide (Nasarel) e. Budesonide (Rhinocort Aqua)

The nurse caring for a patient who has a closed chest drainage system notes that there is fluctuation (tidaling) in the water seal chamber. What is the most appropriate nursing action based on this assessment? a. Document the tidaling. b. Elevate the head of the bed and notify charge nurse of malfunction of drainage system. c. Add more sterile water to the water seal chamber. d. Turn patient to the affected side.

a. Document the tidaling.

Identify the purposes of chest drainage. (Select all that apply.) a. Drains air, blood, and fluid from pleural space. b. Restores positive pressure in the chest cavity. c. Restores negative intrapleural pressure. d. Allows lung to collapse and rest. e. Allows route for medication administration.

a. Drains air, blood, and fluid from pleural space. c. Restores negative intrapleural pressure.

The nurse is preparing education for a patient who has developed rebound nasal congestion resulting from use of topical decongestants. What information will the nurse include? (Select all that apply.) a. For future topical decongestant use, follow the dosage directions daily. Do not overuse. b. Stop the topical decongestant at once. c. A decrease in congestion will occur immediately. d. Nasal steroid solutions can be used but may take several days to reduce inflammation and congestion. e. Use nasal saline spray to moisturize irritated mucosa.

a. For future topical decongestant use, follow the dosage directions daily. Do not overuse. b. Stop the topical decongestant at once. d. Nasal steroid solutions can be used but may take several days to reduce inflammation and congestion. e. Use a nasal saline spray to moisturize irritated mucosa.

The nurse describes the pathophysiologic process of an asthma attack. What is the second step in the process? a. Inflammatory process in the mast cells of the lungs b. Increase in edema and mucus production in the bronchioles c. Release of histamine d. Narrowing of the airways e. Exposure to allergen

a. Inflammatory process in the mast cells of the lungs

When does allergic rhinitis occur? (Select all that apply.) a. Nasal mucosa becomes inflamed. b. Exposure as a result of an allergen produces inflammation. c. Histamine is released following allergen exposure. d. The weather is cold during the winter. e. A person has an initial exposure to an antigen.

a. Nasal mucosa become inflamed. b. Exposure as a result of an allergen produces inflammation. c. Histamine is released following allergen exposure.

A 55-year-old man comes to the health nurse at his place of work with epistaxis. He reports he has frequent nosebleeds that he can usually control himself. What would be the most helpful assessment after the nurse has stopped the bleeding? a. Obtain blood pressure. b. Record the approximate amount of blood lost. c. Inquire about a headache. d. Record the last episode of epistaxis.

a. Obtain a blood pressure.

The nurse explains to the person with pneumonia in the left lung that is positioned in the "good lung down" offers the advantage of: (Select all that apply.) a. PaO2 rising in the good lung. b. blood flow to "bad lung" being increased. c. the dependent lung being better perfused. d. dyspnea disappearing. e. decreased hypoxia.

a. PaO2 rising in the good lung. c. the dependent lung being better perfused. e. decreased hypoxia.

Which independent nursing measures are effective in aiding a patient to expectorate? (Select all that apply.) a. Positioning in orthopneic position b. Suctioning c. Assisting to cough d. Providing hydration e. Starting IV fluids f. Starting mucolytic agents

a. Positioning in orthopneic position b. Suctioning c. Assisting to cough d. Providing hydration

Which action(s) is/are true of antihistamines? (Select all that apply.) a. Reduce inflammation locally. b. Antagonize H1 receptors. c. May be administered orally. d. Are systemically distributed. e. Reduce nasal congestion.

a. Reduce inflammation locally. b. Antagonize H1 receptors. c. May be administered orally. d. Are systemically distributed.

How will the kidneys behave in respiratory acidosis? a. Retain bicarbonate to increase the pH. b. Excrete more urine to reduce potassium. c. Concentrate the urine to conserve circulating fluid in the bloodstream. d. Lower the pH by excretion of bicarbonate.

a. Retain bicarbonate to increase the pH.

From where do the fluids of the respiratory tract originate? a. Specialized mucous glands called goblet cells b. Lymph fluid drawn across nasal membranes by osmosis c. Specialized beta cells in the islets of Langerhans d. Cells that produce aqueous humor

a. Specialized mucous glands called goblet cells

The patient with long-term emphysema is admitted with a secondary diagnosis of cor pulmonale. What should the nurse anticipate? a. The patient will present with edema of the lower extremities and extended neck veins due to hypertension of the pulmonary circulation. b. The patient will present with a dry hacking cough and chest pain due to constriction of the pulmonary vein. c. The patient will present with hypertension and a headache related to pulmonary hypertension. d. The patient will present with unlabored respiration and cyanosis around the mouth.

a. The patient will present with edema of the lower extremities and extended neck

Which preoperative teaching should a nurse include for a person scheduled for a partial laryngectomy? (Select all that apply.) a. Tracheal suction will be frequent. b. The presence of a temporary tracheotomy. c. That isolation will be required for 24 hours. d. The surgery involves the removal of a diseased vocal cord. e. Some speech will be retained. f. The sense of smell and taste will be lost.

a. Tracheal suction will be frequent. b. The presence of a temporary tracheotomy. a. Tracheal suction will be frequent. b. The presence of a temporary tracheotomy.

A college student is being seen at an outpatient clinic with reports of allergic rhinitis and conjunctivitis. The healthcare provider orders fexofenadine. When providing information regarding this medication, the nurse will include statements indicating that: a. fexofenadine is one of the least sedating antihistamines. b. tolerance will not develop. c. antihistamines are more effective if taken after histamine is released. d. histamine release will be prevented by this medication

a. fexofenadine is one of the least sedating antihistamines.

The _________ are the structures of the lung in which gas exchange occurs.

alveoli

A patient, age 54, is on a postoperative day 2 after undergoing an open cholecystectomy. Immediately after the surgery, she vomited and may have aspirated some emesis. The nurse is concerned that the patient will develop pneumonia. In planning for her care, the nurse suspects the patient may have bacterial pneumonia. atypical pneumonia. aspiration pneumonia. viral pneumonia.

aspiration pneumonia. Aspiration pneumonia occurs most commonly as a result of aspiration of vomitus when the patient is in an altered state of consciousness due to a seizure, drugs, alcohol, anesthesia, acute infection, or shock.

The older adult patient with long-term emphysema complains of sharp pleuritic pain after a severe period of coughing. The patient's heart rate and respiratory rate have increased. Auscultation reveals no breath sounds on the left side. These are signs and symptoms of what condition? a. Pulmonary embolus b. Spontaneous pneumothorax c. Early signs of unilateral pneumonia d. An attack of asthma

b. Spontaneous pneumothorax

How should the newly diagnosed patient who has been prescribed isoniazid (INH) for the treatment of active tuberculosis (TB) be advised? a. Report redness and swelling of extremities. b. Accept that the therapy is long term. c. Monitor renal function every several months. d. Rise slowly to avoid dizziness.

b. Accept that the therapy is long term.

A patient, age 69, has emphysema. On assessment, the nurse notes the presence of a "barrel chest." What does this pathology result from? a. An increase in the lateromedial area from hypertrophy of mucous glands in the bronchi b. An increased anteroposterior diameter caused by overinflation of the alveoli c. A decrease in anteroposterior diameter caused by chronic dilation of the bronchi d. A widening of the sternocostal area secondary to chronic constriction of smooth muscles in the airways leading to bronchospasms

b. An increased anteroposterior diameter caused by overinflation of the alveoli

How do leukotriene modifiers reduce the symptoms of asthma? a. By drying up mucus b. By causing bronchodilation and anti-inflammation effects c. By suppressing cough d. By liquefying mucus

b. By causing bronchodilation and anti-inflammation effects

The nurse is providing nutrition information to a patient diagnosed with a lower respiratory tract disease. What is the rationale for limiting caffeine? a. Caffeine increases the respiratory rate. b. Caffeine can result in thicker lung secretions. c. Caffeine will increase the anxiety response associated with dyspnea. d. Caffeine can cause bronchospasm.

b. Caffeine can result in thicker lung secretions.

What is the action of zafirlukast (Accolate), a leukotriene receptor antagonist? a. Dilates the alveolar sacs. b. Decreases leukotriene release. c. Inhibits histamine release. d. Increases viscosity of secretions.

b. Decreases leukotriene release.

Which principle(s) will the nurse include in a teaching plan for antihistamine therapy? (Select all that apply.) a. It is typical to experience an increase in energy. b. Dietary fiber and fluids should be increased. c. Do not take with prescription medications unless approved by a physician. d. Blurred vision is an expected adverse effect. e. Over-the-counter (OTC) medications are safe to use with any currently prescribed prescription medications.

b. Dietary fiber and fluids should be increased. c. Do not take with prescription medications unless approved by a physician. d. Blurred vision is an expected adverse effect.

The nurse is providing instruction about ipratropium (Atrovent) to a patient with chronic obstructive pulmonary disease (COPD). Which is a common adverse effect that tends to resolve with therapy? a. Anxiety b. Dry mouth c. Tachycardia d. Urine retention

b. Dry mouth

A patient is on a postoperative day 2 after undergoing a total hip replacement. The patient suddenly complains of chest pain and is coughing up blood-tinged sputum. What should be the nurse's initial intervention? a. Report signs to the charge nurse. b. Elevate head of bed and administer oxygen. c. Prevent patient from excessive coughing. d. Increase IV flow rate

b. Elevate head of bed and administer oxygen.

How would the nurse examine a patient with pleurisy document a low-pitched grating lung sound? a. Sonorous wheeze b. Friction rub c. Coarse crackles d. Crackles

b. Friction rub

Which is a serious adverse effect of decongestants? a. Hypotension b. Hypertension c. Orbital edema d. Facial flushing

b. Hypertension

What is true about activities such as walking for the patient with emphysema? a. Repair dilated alveoli. b. Increase capacity to use oxygen. c. Lessen the oxygen needs. d. Lessen metabolic oxygen needs.

b. Increase capacity to use oxygen.

What initiates the sneeze reflex? a. Stimulation of the vagus nerve b. Irritation of the nasal mucosa by foreign particulate matter c. Stimulation of the tonsils d. Enervation of the olfactory cranial nerve

b. Irritation of the nasal mucosa by foreign particulate matter

What are age-related changes in the older adult that make them at risk for respiratory diseases? (Select all that apply.) a. Moist mucous membranes b. Kyphosis c. Decrease in pulmonary blood flow d. Stasis pooling of secretions e. Reduced number of cilia

b. Kyphosis c. Decrease in pulmonary blood flow d. Stasis pooling of secretions e. Reduced number of cilia

The healthcare provider in an outpatient clinic has prescribed omalizumab (Xolair) to a patient. Which primary outcome will the nurse teach the patient to expect? a. Easier expectoration of phlegm b. Less frequent asthma exacerbations c. Increased moisture of the mucous membranes d. Liquefaction of thick secretions

b. Less frequent asthma exacerbations

What is the appropriate nursing intervention for a patient, age 40, who is diagnosed with active tuberculosis? a. Place the patient in drainage and secretion precautions. b. Place the patient in acid-fast bacillus (AFB) Isolation Precautions. c. Maintain the patient in enteric isolation. d. Place the patient in any Isolation Precautions.

b. Place the patient in acid-fast bacillus (AFB) Isolation Precautions.

What should the nurse do to keep the chest tubes from becoming occluded? a. Irrigate tubes as needed. b. Prevent dependent loops. c. Loop the tube over the bed rail. d. "Milk" the tube frequently.

b. Prevent dependent loops.

A patient problem for the patient with a new laryngectomy would be Social isolation related to impaired verbal communication related to removal of the larynx. What is an appropriate nursing intervention? a. Complete care quickly. b. Provide a pad and pencil or magic slate. c. Refrain from conversations with the patient to reduce stress level. d. Offer books or jigsaw puzzles for entertainment.

b. Provide a pad and pencil or magic slate.

What is a major advantage of video-assisted thoracoscopic surgery (VATS)? a. The surgeon can record the entire surgical procedure on a video. b. The surgeon can remove tumors of the lung through a small keyhole incision. c. The surgeon can x-ray and excise tumors in the same procedure. d. The surgeon can avoid the use of a closed chest drainage system after surgery.

b. The surgeon can remove tumors of the lung through a small keyhole incision.

A patient, age 22, is admitted with acute asthma. The patient shows a pulse oximetry level of SaO2 of 82%. How should the nurse interpret this? a. Only 82% of the red blood cells are able to use oxygen. b. There is only 82% of oxygen bound to the hemoglobin compared with the amount available. c. Eighteen percent of oxygen is not dissolved in the blood. d. The muscular respiratory effort is only 18% effective.

b. There is only 82% of oxygen bound to the hemoglobin compared with the amount

What is the reason for administering sodium chloride to a patient with emphysema? a. To increase blood sodium levels b. To decrease mucus viscosity c. To reduce metabolic needs of the body d. To decrease bronchial irritation

b. To decrease mucus viscosity

The nurse assessing an 11 year old who is having an asthma attack expects to hear adventitious sounds of: a. friction rub. b. sibilant wheezes. c. crackles. d. sonorous wheezes.

b. sibilant wheezes.

The nurse is providing counseling to a patient on cromolyn sodium (Nasalcrom) nasal spray. Information relayed to the patient will include that: (Select all that apply.) a. cromolyn must be taken immediately following exposure to the stimulus. b. the patient should blow the nose before nasal instillation. c. therapeutic effects are immediate. d. inhalation will cause coughing. e. the maximum is six sprays in each nostril daily.

b. the patient should blow the nose before nasal instillation. e. the maximum is six sprays in each nostril daily.

A patient has questions regarding a recently prescribed antitussive agent. Which response by the nurse is the best? a."It will eliminate your cough at night." b."It will reduce the frequency of your cough." c."It should be used in the morning." d."It should be taken before sleep.

b."It will reduce the frequency of your cough."

When a patient has experienced a pneumothorax, chest auscultation reveals: deep slowed respirations with equal chest movement. respiratory rate less than 16 breaths per minute. bilateral unequal breath sounds, with no breath, sounds over the affected area. equal breath sounds over the affected area.

bilateral unequal breath sounds, with no breath, sounds over the affected area.

The nurse is teaching a patient about the administration of antihistamines. The nurse will instruct the patient to take the medication at what time of day? a. PRN throughout the day b. After contact with an allergen c. 45 minutes before exposure to an allergen d. Once nasal congestion begins

c. 45 minutes before exposure to an allergen

Which instruction by the nurse is inappropriate for teaching the proper technique for the collection of a sputum specimen? a. Bring the sputum up from the lungs. b. Rinse mouth with water before expectorating in specimen cup. c. Collect specimens after meals. d. Send specimen to the lab without delay.

c. Collect specimens after meals.

The clinic nurse is assessing a patient being seen for a severe allergic reaction to environmental allergens. Which symptom should the nurse prioritize as the most important? a. Hypotension b. Urticaria c. Dyspnea d. Rhinorrhea

c. Dyspnea

The patient has advanced emphysema and complains of dyspnea and fatigue. What would the most appropriate nursing intervention be for the patient's problem of activity intolerance related to an imbalance between the oxygen supply and demand? a. Direct patient in vigorous independent ROM. b. Allow exercising until respirations are over 20 breaths/min over baseline. c. Plan care to provide optimum rest. d. Provide frequent cool showers.

c. Plan care to provide optimum rest.

What occurs in the nasal structures when cholinergic fibers are stimulated? a. Dryness of mucous membranes in the nostrils b. Bleeding in the mucous membranes in the nostrils c. Production of serous and mucous secretions in the nostrils d. Enhanced olfactory perception in the mucous membranes of the nostrils

c. Production of serous and mucous secretions in the nostrils

What can result if a patient overuses topical decongestants? a. Hypertensive crisis b. Allergic reaction c. Secondary congestion d. Permanent olfactory damage

c. Secondary congestion

How should a patient be positioned after a thoracentesis is completed and the dressing applied? a. High Fowler b. Semi-Fowler c. Side lying on unaffected side d. Prone

c. Side lying on unaffected side

A patient is seen in the emergency department. The patient had been maintained on theophylline (Theo Dur), and a blood sample reveals the serum theophylline level is subtherapeutic. Which may cause a subtherapeutic serum level? a. Cimetidine use b. Drug tolerance c. Smoking d. Overuse of the inhaler

c. Smoking

Which patient assessment indicates the most severe respiratory distress? a. Nasal flaring, symmetrical chest wall expansion, SaO2 88% b. Abdominal breathing, SaO2 97% c. Substernal retraction, SaO2 84% d. Substernal retraction, SaO2 90%

c. Substernal retraction, SaO2 84%

What is inspiratory capacity? a. The amount of air in the lung after a maximal inhalation b. The amount of air moved with each normal inhalation and expiration c. The amount of air that can be inhaled in one breath from the resting expiratory level d. The amount of air that can be forcefully exhaled after maximum inhalation

c. The amount of air that can be inhaled in one breath from the resting expiratory

A resident in a long-term care facility diagnosed with COPD has a new medication order for indacaterol. When the nurse is providing education to the resident regarding this medication, information will include that: a. it is a short-acting beta antagonist. b. the patient should wait approximately 5 minutes between inhalations. c. onset of action is within 5 minutes. d. duration of action is about 12 hours.

c. onset of action is within 5 minutes.

When assessing the SaO2 with a pulse oximeter, the nurse will place the oximeter on a finger: a. on the same side as the blood pressure cuff. b. while exercising the arm to stimulate circulation. c. that is a normal temperature. d. on the same side as an arterial catheter.

c. that is a normal temperature.

Within minutes of the initiation of a nebulizer treatment with a sympathomimetic bronchodilator, the patient turns on his call light and states that he feels "panicky" and his heart is racing. Which action will the nurse take? a. Reassure the patient this is expected. b. Add more diluents to the nebulizer. c. Administer a sedative. d. Stop treatment and notify the healthcare provider.

d. Stop treatment and notify the healthcare provider.

Premedication assessments before the use of anticholinergic bronchodilating agents should verify that the patient has no history of which condition? a. Diabetes b. Hypertension c. Liver disease d. Glaucoma

d. Glaucoma

Which important precaution should the nurse include when instructing an emphysema patient on the use of home oxygen? a. Use oxygen only when extremely short of breath. b. Keep the home oxygen regulator set on 6 L. c. Use home oxygen at night while sleeping. d. Limit to 1 to 2 L oxygen flow.

d. Limit to 1 to 2 L oxygen flow.

What process in the antigen-antibody reaction causes the symptoms of allergies? a. Release of antihistamines b. Production of antibodies c. Suppression of histamine d. Release of histamine

d. Release of histamine

The nurse traces the path of unoxygenated blood through the respiratory system to the distribution of oxygenated blood to the body. What is the second step in the reoxygenation process? a. Pulmonary artery takes blood to the capillary system of the alveoli. b. Blood enters the left atria via the pulmonary vein. c. Blood enters the left ventricle. d. Unoxygenated blood enters the right ventricle. e. Blood enters the aorta. f. CO2 diffused and oxygen infused into the blood in alveoli. g. Unoxygenated blood enters the right atrium.

d. Unoxygenated blood enters the right ventricle.

The young man who had a bronchoscopy 1 hour ago asks when he can eat. Which response would be most helpful? a. In 24 hours, but must take cold liquids for the rest of the day b. If there is no blood in his sputum c. In 8 hours after a period of nothing by mouth d. When the gag reflex returns

d. When the gag reflex returns

Does the nurse find that the arterial blood gas (ABG) results ofa the patient show uncompensated respiratory acidosis Which findings would the nurse correlate with the ABG results of the patient? Select all that apply. pH =7.2 SaO2=84% PaO2=70mm Hg PaCO 2=60mm Hg HCO3~=22mEq/L

pH =7.2 PaCO 2=60mm Hg HCO3~=22mEq/L Rationale Uncompensated respiratory acidosis involves Iow pH, high PaCOz, and normalHcO3:.The pH of the patient's blood, which is less than 7.35 (7.2) indicates acidosis. PaCO zof60 mm Hg which is higher than 45 mm Hg, also indicates acidosis. PaCO z matches the pH, making it a respiratory acidosis HCO is normal (21-28 mEq/l), which indicates that there is no compensation SaOz and the PaOz levels are low, which indicates hypoxemia. However, the ABG results of the patient show no hypoxemia.

The patient has been admitted for possible carcinoma of the larynx. The first sign or symptom that may be present in carcinoma of the larynx is often persistent hoarseness. pain in the larynx. hemoptysis. dysphagia.

persistent hoarseness.

The circulation of the lungs is through the pulmonary arteries and pulmonary veins. coronary arteries and coronary veins. celiac arteries and celiac veins. carotid arteries and jugular veins.

pulmonary arteries and pulmonary veins.

The nurse explains that the diagnostic test that can scan the chest and the abdomen in less than 30 seconds is the _____________ CT scan.

spiral

When assessing the SaO2 with a pulse oximeter, the nurse will place the oximeter on a finger: that is a good perfusion and temperature on the same side as the fracture in a sling. while exercising the arm to stimulate circulation. on the same side as the blood pressure cuff.

that is a good perfusion and temperature

The nurse prepares a patient for the procedure of a(n) __________, which will remove the fluid from around the lung to improve respiration and obtain a specimen.

thoracentesis

A patient, age 22, is admitted with acute asthma. It is important to monitor his oxygen saturation levels. The quickest way to assess his saturation of oxygen is to do a pulmonary function test. use pulse oximetry. get arterial blood gases. do a pulse pressure assessment.

use pulse oximetry.

The nurse assessing an 11-year-old who is having an asthma attack heard high-pitched, whistling adventitious sounds of: crackles. friction rub. vesicular wheezes.

Respiratory, quiz 2

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