Test 2 Practice Questions

Which priority nursing intervention would the nurse implement when caring for a client with pneumonia? a. Increase fluid intake b. Instruct client on breathing exercises and controlled coughing c. Encourage client to ambulate as much as possible d. Maintain a NPO status

b

Which nursing action would be most helpful in preventing transmission of influenza in crowded communities? a. Teaching correct hand-washing techniques b. Demonstrating how to cover the mouth when coughing c. Educating about the importance of having annual vaccinations d. Giving antiviral medications within 48 hours of symptom development

c

After a change-shift report, which client would the nurse assess first? a. A client with possible lung cancer who is scheduled for bronchoscopy b. A client with left pleural effusion who is scheduled for a thoracentesis c. A client with hospital- acquired pneumonia and decreased breath sounds d. A client with an acute asthma exacerbation and 85% oxygen saturation

d

When teaching a group of older adults about differences between the common cold and influenza, the nurse would educate the clients that it is most important to communicate with the health care provider about which symptom? a. Earache b. Sneezing c. Nasal stuffiness d. Elevated temp

d

When the oxygen saturation of a client pneumonia is at 89% to 90% while using a non rebreather mask, which collaborative action would the nurse anticipate? a. Administer of oxygen using a simple face mask b. Use a venturi mask for administering of high-flow oxygen c. Continued oxygen administration with the non rebreather mask d. Oxygen administration with bi-level positive airway pressure

d

Which assessment finding for a client with pneumonia would be most important for the nurse to communicate to the health care provider? a. Cough productive or rust-colored sputum b. Sharp chest pain with deep inspiration c. Oral tem 103 F d. RR 38

d

Which finding prompts the nurse to notify the health care provider when assessing a patient who has COPD, 15 minutes after an aerosolized bronchodilator has been administered? a. Barrel chest b. Clubbing of the fingers c. PaCo2 of 68 mmHg d.Oxygen saturation of 87%

d

Which client would the nurse consider to have the highest risk of pneumonia? a. Has poor nutritional status b. Uses tobacco c. Consumes alcohol regularly d. Chronic lung disease

d

Difference between cold and flu symptoms

Flu: rapid onset, systemic (fever, chills) Cold: slow coming, upper respiratory

Which infection would the nurse identify as requiring a client to be placed on droplet precautions? a. HIV b. Influenza c. TB d. MRSA

b

After a change-of-shift report, which client would the nurse assess first? a. Client with possible lung cancer who has just returned to the nursing unit after mediastinoscopy b. Client with cough whose chest x-ray shows possible active tuberculosis and needs sputum testing c. Client who has pneumococcal pneumonia and very decreased breath sounds in the right lung base d. Client who has a chest tube with rapid bubblin in the suction control chamber of the drainage system

a

An older client with shortness of breath is admitted to the hospital. The medical history reveals and a diagnosis of pneumonia 3 days ago. Which vital sign assessment would be seen as a sign that the client needs immediate medical attention? a. Oxygen saturation 89% b. Body temp 101 F c. Bp 130/80 d. RR 26

a

Which action would the nurse plan to take to prevent respiratory complications after abdominal surgery? a. Assist client to use the incentive spirometer b. Administer prescribed IV antibiotic c. Take client vital signs every 4 hours d. Auscultate breath sounds every 4 hours

a

Which organism would the nurse associate with a client reporting a fever, headache, extreme tiredness, dry cough, sore throat, runny nose, muscle aches, nausea, vomiting, and diarrhea? a. Influenza virus b. Toxoplasma gondii c. Human herpesvirus- 8 d. Cryptosporidium muris

a

Which observation by the nurse indicated a client with pneumonia is able to use an incentive spirometer correctly? SATA a. Records the volume of the air inspired b. Performs 10 breaths per session every hour c. Inhales air fully before inserting mouthpiece d. Takes a long, slow, deep breath keeping the mouthpiece in place e. Exhales deep breaths with the mouthpiece in their mouth

a,b,d

Which intervention to improve oxygenation and decrease CO2 retention will the nurse teach the patient with COPD? Select all that apply.One, some, or all responses may be correct. a. Monitoring for changes in respiratory status including rate and rhythm and tolerance of activity b. Partnering with the family in COPD management by adhering to prescribed therapies. c. Maintaining hydration to loosen secretions and suctioning frequently to eliminate build up d. Practicing diaphragmatic and pursed lip breathing to manage episodes of dyspnea e. Limiting dietary intake to avoid weight-gain, which will add to activity intolerance

a,b,d,e

Which information will the employee health nurse include when teaching about ways to prevent transmission of influenza in the workshop. SATA a. Sneeze or cough into the upper sleeve b. Avoid use of over- the counter antihistamines c. Use alcohol- based hand sanitizers after blowing the nose d. Turn the head away from others when coughing or sneezing e. Antiviral medications are the most effective means of transmission prevention

a,c,d

A client develops bacterial pneumonia and is admitted to the ER. the client's initial paO2 is 80 mmHg. When the arterial blood gases are drawn again, the level is 65. Which action must the nurse take first? a. Ensure that intubation equipment is available b. increase the oxygen flow rate per facility protocol c. Notify the health care provider to request a chest x-ray d. Recheck the arterial blood gases to verify accuracy

b

A client with COPD is admitted to the hospital with a tentative diagnosis of pleuritis. It is important for the nurse to perform which intervention? a. Administer opioids frequently b. Assess for signs of pneumonia c. Give medication to suppress coughing d. Limit fluid intake to prevent pulmonary edema

b

When a client has difficulty swallowing after a stroke, which action by the nurse would be most important in preventing pneumonia? a. Giving influenza vaccine to the client b. Having suction available during meals c. Assisting the client to take deep breaths d. Teaching about incentive spirometer use

b

When a client with pneumonia is experiencing dyspnea because of difficulty expectorating thick respiratory secretions, which action by the nurse will be most helpful? a. Administer continuous oxygen b. Offer fluids at frequent intervals c. Place the client in a high-fowler position d. Administer prescribed steroid inhaler

b

When palpating the chest during a respiratory assessment, which finding would the nurse expect in a client with pneumonia? a. Bilateral decreased chest expansion b. Increased fremitus over the affected area c. Tracheal deviation away from the affected side d. Decreased chest expansion on the affected side

b

Which preferred medication will the nurse administer to a client hospitalized with pneumococcal pneumonia? a. Penicillin G b. Ceftriaxone c. Vancomycin d. Meropenem

b

When a client in the clinic is offered the influenza vaccine states "I had the vaccination already last year, so I won't need it now," which response will the nurse give? a. The flu vaccine is recommended for everyone b. You only need 1 flu shot in your lifetime to achieve immunity c. As long as you are younger than 50 years old, you will not really need vaccination d. The immunization changes, so you need to get vaccine annually to stay protected

c

When the nurse auscultates a client's lung and hears fine, high-pitched, popping sounds in the left lower lung as the client inhales, which term would the nurse use when documenting the findings? a. Vesicular sounds b. Coarse rhonchi c. Inspiratory crackles d. Bronchial breath sounds

c

Which action would be used to decrease risk for postoperative respiratory complications in an older client with decreased vital capacity? a. Give prescribed intravenous antibiotic b. Administer oxygen per non rebreather mask c. Teach the client coughing and deep- breathing exercises d. Keep the client on the mechanical ventilation for several days

c

Which collaborative action would the nurse anticipate when caring for a client with pneumonia whose arterial blood gases are pH 7.24, PaCO2 60 mmHg, HCO3 20, PaO2 54, and O2 88%? a. Oxygen at 6 L/min by nasal cannula b. Nebulize albuterol treatment c. Intubation and mechanical ventilation d. Sodium bicarbonate intravenously

c

Which response would the nurse provide during an education session at the local community center to a question asking why influenza vaccines are needed annually? a. The influenza virus has a high level of infectivity, thus requiring an annual booster to keep rates of influenza low b. Because influenza is seasonal and has never been eradicated, the need for a vaccine is also seasonal annually c. The nature of the virus changes every year; the vaccine is developed based on the most prevalent type and variant being seen d. There are several different types of influenza viruses with differing levels of virulence, making it difficult to develop a vaccine that will be effective against all types of influenza

c

Which prescribed intervention would the nurse questions for a client who has just been diagnosed with influenza after having symptoms for 4 days? a. Loratadine b. Ibuprofen c. Oseltamivir d. Acetaminophen

c, because antiviral medications must be taken within 48 hours after onset of symptoms to be effective and the nurse would plan to discuss this medications with the health care provider before administration

Which action would the nurse take to evaluate whether interventions have been effective in treating a client's exertional dyspnea? a. Auscultate client breath sounds b. Observe respiratory effort with activity c. Obtain oxygen saturation at rest with activity d. Ask client about shortness of breath with various activities

d

Which nursing intervention will help prevent chronic fatigue in patients with COPD? a. Allowing the patient to eat, bathe, and groom himself or herself during acute exacerbations. b.Encouraging the patient to work with the arms raised. c. Suggesting that the patient avoid high energy-use tasks such as walking. d. Teaching the patient to not rush through morning activities.

d

A client is admitted to the hospital with a diagnosis of pneumonia. In which order should the following nursing action be accomplished?

data collection precedes implementation. A sputum for culture and sensitivity should be obtained before antibiotic administration. The antibiotic should be started as soon as possible to treat pneumonia. Peak and trough levels can be done only when the client has been receiving the medication. Monitoring chest x-ray results would occur throughout the client's hospital stay

A client is admitted to the hospital with a tentative diagnosis of pneumonia. The client has a high fever and is short of breath. Education related to prevention of pneumonia, oxygen via nasal cannula, an intravenous antibiotic, and blook and sputum specimens for culture and sensitivity are prescribed. In which order should these interventions be implemented?

provide oxygen via nasal cannula, obtain blood specimens for C&S, administer prescribed antibiotic, provide education about prevention of pneumonia