Test 1 (Resp)

Dyspnea

A patient is admitted to the hospital with pulmonary arterial hypertension. What assessment finding by the nurse is a significant finding for this patient? a) Ascites b) Dyspnea c) Hypertension d) Syncope

b) Sweat chloride concentration

Cystic fibrosis (CF) is diagnosed by clinical signs and symptoms in addition to which one of the following tests? a) Pulmonary function studies b) Sweat chloride concentration c) Arterial blood gases (ABGs) d) Lumbar puncture

d

During a disaster, the nurse sees a victim with a green triage tag. The nurse knows that the person has which type of injuries? a) Life-threatening but survivable with minimal intervention b) Extensive and chances of survival are unlikely even with definitive care c) Significant and require medical care, but can wait hours without threat to life or limb d) Minor and treatment can be delayed hours to days

pneumonectomy.

In general, chest drainage tubes are not used for the patient undergoing a) segmentectomy. b) wedge resection. c) pneumonectomy. d) lobectomy.

a

Inhalation of anthrax mimics which disease process? a) Flu b) Burns c) Bronchospasm d) Respiratory distress

Chest tube drainage of 190 mL/hr

The nurse is caring for a patient following a thoracotomy. Which of the following findings requires immediate intervention by the nurse? a) Moderate amounts of colorless sputum b) Heart rate: 112 bpm c) Pain of 5 on a 1 to 10 pain scale d) Chest tube drainage of 190 mL/hr

2 to 4

A client is receiving mechanical ventilation. How frequently should the nurse auscultate the client's lungs to check for secretions? a) Every 30 to 60 minutes b) Every 2 to 4 hours c) Every 1 to 2 hours d) Every 4 to 6 hours

Respiratory acidosis

As status asthmaticus worsens, the nurse would expect which acid-base imbalance? a) Metabolic acidosis b) Metabolic alkalosis c) Respiratory alkalosis d) Respiratory acidosis

ABG

Before weaning a client from a ventilator, which assessment parameter is the most important for the nurse to obtain? a) Fluid intake for the past 24 hours b) Baseline arterial blood gas (ABG) levels c) Electrocardiogram (ECG) results d) Prior outcomes of weaning

b

The NATO triage system uses color-coded tagging to identify severity of injuries. A patient with survivable but life-threatening injuries (i.e., incomplete amputation) would be tagged with which color? a) Green b) Red c) Yellow d) Black

The patient will return to the nursing unit with two chest tubes.

The nurse is caring for a patient who is scheduled for a lobectomy. Following the procedure, the nurse will plan care based on which of the following? a) The patient will require sedation until the chest tube (s) are removed. b) The patient will require mechanical ventilation following surgery. c) The patient will return to the nursing unit with two chest tubes. d) The patient will return from surgery with no drainage tubes.

Encourage breathing exercises

Which of the following interventions does a nurse implement for patients with empyema? a) Place suspected patients together b) Do not allow visitors with respiratory infections c) Encourage breathing exercises d) Institute droplet precautions

They help prevent cardiac arrhythmias.

client in acute respiratory distress is brought to the emergency department. After endotracheal (ET) intubation and initiation of mechanical ventilation, the client is transferred to the intensive care unit. Before suctioning the ET tube, the nurse hyperventilates and hyperoxygenates the client. What is the rationale for these interventions? a) They help prevent subcutaneous emphysema. b) They help prevent pulmonary edema. c) They help prevent cardiac arrhythmias. d) They help prevent pneumothorax.

Nonrebreather mask

A client abruptly sits up in bed, reports having difficulty breathing and has an arterial oxygen saturation of 88%. Which mode of oxygen delivery is most likely to reverse these manifestations? a) Face tent b) Nonrebreather mask c) Nasal cannula d) Simple mask

Suction the client's artificial airway.

A client with myasthenia gravis is receiving continuous mechanical ventilation. When the high-pressure alarm on the ventilator sounds, what should the nurse do? a) Suction the client's artificial airway. b) Ventilate the client with a handheld mechanical ventilator. c) Check for an apical pulse. d) Increase the oxygen percentage.

cough as the cuff is being deflated

A client with supraglottic cancer undergoes a partial laryngectomy. Postoperatively, a cuffed tracheostomy tube is in place. When removing secretions that pool above the cuff, the nurse should instruct the client to: a) exhale deeply as the nurse reinflates the cuff. b) hold the breath as the cuff is being reinflated. c) cough as the cuff is being deflated. d) take a deep breath as the nurse deflates the cuff.

Institute isolation precautions

A client with suspected severe acute respiratory syndrome (SARS) comes to the emergency department. Which physician order should the nurse implement first? a) Begin an I.V. infusion of dextrose 5% in half-normal saline solution at 100 ml/hour. b) Institute isolation precautions. c) Obtain a nasopharyngeal specimen for reverse-transcription polymerase chain reaction testing. d) Obtain a sputum specimen for enzyme immunoassay testing.

Inhaled beclomethasone (Beconase) (For mild persistent asthma, the preferred treatment is an inhaled corticosteroid, such as beclomethasone.)

A client with symptoms of mild persistent asthma is now initiating treatment. Which of the following is the preferred therapy that the nurse will teach the client to use at home? a) Oral prednisone (Deltasone) b) Inhaled beclomethasone (Beconase) c) Oral sustained-release albuterol (Proventil) d) Subcutaneous omalizumab (Xolair)

a (ARF is defined as a decrease in the PaO2 to less than (hypoxemia) and an increase in PaCO2 to greater than (hypercapnia), with an arterial pH of less than 7.35.

A nurse assesses arterial blood gas results for a patient in acute respiratory failure (ARF). Which of the following results are consistent with this disorder? a) pH 7.28, PaO2 50 mm Hg b) pH 7.36, PaCO2 32 mm Hg c) pH 7.46, PaO2 80 mm Hg d) pH 7.35, PaCO2 48 mm Hg

I do not need to rinse my mouth with this type of inhaler."

A nurse has just completed teaching with a patient who has been prescribed a meter-dosed inhaler for the first time. Which of the following statements would the nurse use to initiate further teaching and follow-up care? a) "After I breathe in, I will hold my breath for 10 seconds." b) "I do not need to rinse my mouth with this type of inhaler." c) "If I use the spacer, I know I am only supposed to push on the inhaler once." d) "I will make sure to take a slow, deep breath as I push on my inhaler."

Dyspnea and wheezing

A nurse is assessing a client who comes to the clinic for care. Which findings in this client suggest bacterial pneumonia? a) Dyspnea and wheezing b) Sore throat and abdominal pain c) Hemoptysis and dysuria d) Nonproductive cough and normal temperature

using the minimal-leak technique with cuff pressure less than 25 cm H2O.

A nurse is caring for a client who has a tracheostomy tube and who is undergoing mechanical ventilation. The nurse can help prevent tracheal dilation, a complication of tracheostomy tube placement, by: a) suctioning the tracheostomy tube frequently. b) using the minimal-leak technique with cuff pressure less than 25 cm H2O. c) keeping the tracheostomy tube plugged. d) using a cuffed tracheostomy tube.

"Before you do the exercise, I'll give you pain medication if you need it."

A nurse is teaching a client about using an incentive spirometer. Which statement by the nurse is correct? a) "You need to start using the incentive spirometer 2 days after surgery." b) "Before you do the exercise, I'll give you pain medication if you need it." c) "Don't use the incentive spirometer more than 5 times every hour." d) "Breathe in and out quickly."

Intal (Cromolyn Sodium)

A patient is being admitted to the medical-surgical unit for the treatment of an exacerbation of acute asthma. Which of the following medications is contraindicated in the treatment of asthma exacerbations? a) Xopenex (Levalbuterol HFA) b) Atrovent (Ipratropium) c) Proventil (Albuterol) d) Intal (Cromolyn Sodium)

a

A patient is being treated for status asthmaticus. What danger sign does the nurse observe that can indicate impending respiratory failure? a) Respiratory acidosis b) Metabolic acidosis c) Metabolic alkalosis d) Respiratory alkalosis

Auscultating the lungs for bilateral breath sounds

For a client with an endotracheal (ET) tube, which nursing action is the most important? a) Turning the client from side to side every 2 hours b) Auscultating the lungs for bilateral breath sounds c) Providing frequent oral hygiene d) Monitoring serial blood gas values every 4 hours

20

The nurse is caring for a patient in the ICU who required emergent endotracheal (ET) intubation with mechanical ventilation. The nurse receives an order to obtain arterial blood gases (ABGs) following the procedure. The nurse recognizes that ABGs should be obtained at which timeframe following the initiation of mechanical ventilation? a) 15 minutes b) 20 minutes c) 25 minutes d) 10 minutes

Assist control

Which of the following ventilator modes provides full ventilatory support by delivering a present tidal volume and respiratory rate? a) Pressure support b) Assist control c) SIMV d) IMV

Fibrotic changes in lungs

You are an occupational nurse completing routine assessments on the employees where you work. What might be revealed by a chest radiograph for a client with occupational lung diseases? a) Fibrotic changes in lungs b) Hemorrhage c) Damage to surrounding tissues d) Lung contusion

Hypercapnia, hypoventilation, and hypoxemia

When caring for a client with acute respiratory failure, the nurse should expect to focus on resolving which set of problems? a) Hypercapnia, hypoventilation, and hypoxemia b) Hyperoxemia, hypocapnia, and hyperventilation c) Hyperventilation, hypertension, and hypocapnia d) Hypotension, hyperoxemia, and hypercapnia

Pulmonary function studies

Which diagnostic is the most accurate in assessing acute airway obstruction? a) Arterial blood gases (ABGs) b) Chest x-ray c) Pulse oximetry d) Pulmonary function studies

Aspiration pneumonia

Which of the following is a potential complication of a low pressure in the ET cuff? a) Tracheal bleeding b) Tracheal ischemia c) Aspiration pneumonia d) Pressure necrosis

apply a dressing over the wound and tape it on three sides.

A client has a sucking stab wound to the chest. Which action should the nurse take first? a) Draw blood for a hematocrit and hemoglobin level. b) Apply a dressing over the wound and tape it on three sides. c) Prepare to start an I.V. line. d) Prepare a chest tube insertion tray.

Assesses the client's tracheostomy and lung sounds every 15 minutes

A client in the intensive care unit has a tracheostomy with humidified oxygen being instilled through it. The client is expectorating thick yellow mucus through the tracheostomy tube frequently. The nurse a) Assesses the client's tracheostomy and lung sounds every 15 minutes b) Encourages the client to cough every 30 minutes and prn c) Decreases the amount of humidity set to flow through the tracheostomy tube d) Sets a schedule to suction the tracheostomy every hour

Asbestos

A 65-year-old client who works construction, and has been demolishing an older building,is diagnosed with pneumoconiosis. The nurse is aware that his lung inflammation is most likely caused by exposure to which of the following? a) Coal dust b) Asbestos c) Pollen d) Silica

Take prescribed albuterol (Ventolin) before performing postural drainage.

A client is prescribed postural drainage because secretions are accumulating in the upper lobes of the lungs. The nurse instructs the client to: a) Hold each position for 5 minutes. b) Take prescribed albuterol (Ventolin) before performing postural drainage. c) Perform drainage 1 hour after meals. d) Lay in bed with the head on a pillow.

PH

A client presents to a physician's office complaining of dyspnea with exertion, weakness, and coughing up blood. Further examination reveals peripheral edema, crackles, and jugular vein distention. The nurse anticipates the physician will make which diagnosis? a) Empyema b) Pulmonary tuberculosis c) Pulmonary hypertension d) Chronic obstructive pulmonary disease (COPD)

At bedtime

An adult client with cystic fibrosis is admitted to an acute care facility with an acute respiratory infection. Ordered respiratory treatment includes chest physiotherapy. When should the nurse perform this procedure? a) When bronchospasms occur b) At bedtime c) Immediately before a meal d) When secretions have mobilized

IgE

Asthma is cause by which type of response? a) IgA-mediated b) IgE-mediated c) IgD-mediated d) IgM-mediated

Deflating the cuff routinely

The nurse is caring for a patient with an endotracheal tube (ET). Which of the following nursing interventions is contraindicated? a) Deflating the cuff routinely b) Deflating the cuff prior to tube removal c) Checking the cuff pressure every 6 to 8 hours d) Ensuring that humidified oxygen is always introduced through the tube

A bottle of sterile water

The nurse is assigned the care of a patient with a chest tube. The nurse should ensure that which of the following items is kept at the patient's bedside? a) A set of hemostats b) An incentive spirometer c) An Ambu bag d) A bottle of sterile water

Crackles in the lung bases

The nurse is auscultating the patient's lung sounds to determine the presence of pulmonary edema. What adventitious lung sounds are significant for pulmonary edema? a) Low-pitched rhonchi during expiration b) Crackles in the lung bases c) Sibilant wheezes d) Pleural friction rub

a b e

The nurse is educating the patient in the use of a mini-nebulizer. What should the nurse encourage the patient to do? (Select all that apply.) a) Cough frequently. b) Hold the breath at the end of inspiration for a few seconds. c) Prolong the expiratory phase after using the nebulizer. d) Take rapid, deep breaths. e) Frequently evaluate progress.

Atelectasis

The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstruction and that leads to the collapse of alveoli. What complication should the nurse monitor for? a) Pleurisy b) Atelectasis c) Emphysema d) Pneumonia

Gastrointestinal hemorrhage

The nurse should monitor a client receiving mechanical ventilation for which of the following complications? a) Pulmonary emboli b) Gastrointestinal hemorrhage c) Increased cardiac output d) Immunosuppression

The patient is hypoxic from suctioning.

The nurse suctions a patient through the endotracheal tube for 20 seconds and observes dysrhythmias on the monitor. What does the nurse determine is occurring with the patient? a) The patient is having a stress reaction. b) The patient is having a myocardial infarction. c) The patient is hypoxic from suctioning. d) The patient is in a hypermetabolic state.

d

The nursing instructor is talking with their students about botulism. The instructor tells the students that when caring for a client with botulism what condition is most likely to cause death? a) Dysarthria b) Diplopia c) Dysphagia d) Paralysis of respiratory muscles

protein

What dietary recommendations should a nurse provide a patient with a lung abscess? a) A carbohydrate-dense diet b) A diet rich in protein c) A diet low in calories d) A diet with limited fat

Both are aimed at improving the overall quality of life of a patient with COPD.

Which of the following is true about both lung transplant and bullectomy? a) Both are aimed at curing COPD. b) Both are aimed at treating end-stage emphysema. c) Both are used to treat patients with bullous emphysema. d) Both are aimed at improving the overall quality of life of a patient with COPD.

Bullae

Which of the following occupy space in the thorax, but do not contribute to ventilation? a) Lung parenchyma b) Alveoli c) Mast cells d) Bullae