Test 3 Review - Med surg 1

A nurse is teaching a patient how to perform flow type incentive spirometer prior to his scheduled thoracic surgery. What instruct should the nurse provide to the patient.

"Breath in deeply through the spirometer, hold your heath briefly, and then exhale."

A client exhibits a sudden and complete loss of voice and is coughing. The nurse states

"Do not smoke and avoid being around others who are smoking."

A nurse is instructing the client on the normal sensations that can occur when contrast medium is infused during pulmonary angiography. Which client statement demonstrates an understanding of the teaching?

"I will feel warm and may have chest pain"

A patient in the ICU has an endotracheal tube in place for 3 weeks. The physician ordered a tracheostomy tube to be placed. The patients family wants to know why the endotrachial tube cant be left in place. What would be the nurses best response?

"When an endotracheal tube is left in both lungs it can damage the lining of the windpipe."

Which of the following factors contribute to the underlying pathophysiology of chronic obstructive pulmonary disease (COPD)? Select all that apply. A. Inflamed airways obstruct airflow B. Mucus secretions block airways C. Over-inflated alveoli impair gas exchange D. Dry airways obstruct airflow

A, B, C

Which of the following are risk factors for the development of chronic obstructive pulmonary disease (COPD)? Select all that apply. A.Tobacco smoke B. Occupational dust C. Air pollution D. Infection E. Second-hand smoke

A, B, C, D, E

A client comes to the health clinic after a positive skin test for tuberculosis. What additional diagnostic tests should the nurse begin teaching the client? Select all that apply. A. Chest radiograph B. Complete blood count C. A repeat multiple-puncture skin test D. Complete history and physical examination E. Drug susceptibility testing

A, D, E

Which is the most common cause of symptomatic hypomagnesemia?

Alcoholism

Which is the strongest predisposing factor for asthma?

Allergies

A patient has herpes simplex infection that developed after having the common cold. What medication does the nurse anticipate will be administered for this infection?

An antiviral agent such as acyclovir

A client is diagnosed with a chronic respiratory disorder. After assessing the client's knowledge of the disorder, the nurse prepares a teaching plan. This teaching plan is most likely to include which nursing diagnosis?

Anxiety

A 42 year old patient is admitted to the ED after an assault. The patient received blunt trauma to the face and has suspected nasal fracture. Which of the following interventions should the nurse perform?

Apply ice and keep the patients head eleveated

A patients plan of care specifies postural drainage. What action should the nurse perform when providing this noninvasive therapy?

Assist the patient into a position that will allow gravity to move secretions

A perioperative nurse is caring for a Post operative patient. The patient has a shallow respiration pattern and is reluctant to cough or to begin mobilizing. The nurse should address the patients increased risk for what complication?

Atelectasis

The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstruction that leads to the collapse of alveoli. This complication is known as

Atelectasis

The nurse is caring for the client in the intensive care unit immediately after removal of the endotracheal tube. Which of the following nursing actions is most important to complete every hour to ensure that the respiratory system is not compromised?

Auscultate lung sounds

For a client with an endotracheal (ET) tube, which nursing action is the most important?

Auscultating the lungs for bilateral breath sounds

A nurse is working with a client being extubated from the ventilator. Before weaning a client from a ventilator, which assessment parameter is the most important for the nurse to obtain?

Baseline arterial blood gas (ABG) levels

After a tonsillectomy, a client is being prepared for discharge. The nurse should instruct the client to report which sign or symptom immediately?

Bleeding

An 87 year old patient has been hospitalized with pneumonia. Which nursing action would be primarily in this patients plan of care?

Cautious hydration

A nurse is developing the teaching portion of a care plan for a patient with COPD. What would be the most important component for the nurse to emphasize?

Chronic inhalation of indoor toxins can cause lung damage

As the nurse is shaving a patient who is 2 days post-op from a thyroidectomy, the patient has a spasm of the facial muscles. what should the nurse recognize this as?

Chvostek sign

Which drug is second-line pharmacotherapy for smoking abstinence?

Clonidine

The nurse is caring for a client with a serum sodium concentration of 113 mEq/L (113 mmol/L). The nurse should monitor the client for the development of which condition?

Confusion

The nurse is caring for an elderly patient in the PACU. The patient has had a bronchoscopy, and the nurse is monitoring for complications related to the administration of lidocaine. For what complication related to the administration of large doses of lidocaine in the elderly should the nurse assess?

Confusion and lethargy

a patient has returned to his room after a thyroidectomy with signs of thyroid crisis. during thyroid crisis, exaggerated hyperthyroid manifestations may lead to the development of the potentially lethal complication of?

Congestive Heart Failure

A nurse is caring for a client who has just been diagnosed with lung cancer. What is a cardinal sign of lung cancer?

Cough or change in chronic cough

A patient has been diagnosed with heart failure that has not responded to treatment. What breath sound should the nurse expect to asses on auscultation?

Crackles

A nurse is preparing a client for bronchoscopy. Which instruction should the nurse give to the client?

Do not eat or drink for 6 hours before the procedure

The nurse is assessing a patient who has a chest tube in place for the treatment of pneumothorax, the nurse observes that the water level in the water seal rises and falls in rhythm with the patients respirations. How would the nurse best respond to this assessment finding.

Document that the chest draining system us operating as intended

The occupational nurse is completing routine assessments on the employees where you work. What might be revealed by a chest radiograph for a client with occupational lung diseases?

Fibrotic changes in lungs

A patient comes to the clinic and is diagnosed with tonsillitis and adenoiditis. What bacterial pathogen does the nurse know is commonly associated with tonsillitis and adenoiditis?

Group A, beta-hemolytic streptococcus

A physician orders regular insulin 10 units I.V. along with 50 ml of dextrose 50% for a client with acute renal failure. What electrolyte imbalance is this client most likely experiencing?

Hyperkalemia

You are the surgical nurse caring for a 65 year old female patient who is postoperative day 1 following a thyroidectomy. During assessment, patient complains of tingling in her lips and fingers. She tells you she had intermittent spasm in her wrist and hand and she exhibits increased muscle tone. What electrolyte imbalance should you first suspect?

Hypocalemia

You are working on a burns unit and one of your acutely ill patients is exhibiting signs and symptoms of third spacing. Based on this change in status, you should expect the patient to exhibit signs and symptoms of what imbalance?

Hypovolemia

A nurse has been asked to give a workshop on COPD for a local community gray. The nurse emphasizes the importance of smoking has what pathophysiologic effect?

Increases the amount of mucous production

A nurse has admitted a patient with diagnosis failure to thrive. Patient developed a fever and cough, so a sputum specimen was obtained. Nurse notes that sputum is greenish and a large amount of it. The nurse notifies the patients physician because these symptoms are suggestive of what?

Infection

A patient is under going testing to see if he has a pleural effusion. Which of the nurses respiratory assessment findings would be most consistent with this diagnosis?

Lung fields dull to percussion, absent breath sounds and a pleural friction rub

A client with chronic obstructive pulmonary disease (COPD) is intubated and placed on continuous mechanical ventilation. Which equipment is most important for the nurse to keep at this client's bedside?

Manual resuscitation bag

You are an emergency room nurse caring for a trauma patient. Your patient has the following arterial blood gas results: pH 7.26, PaCO2 28, HCO3 11. How would you interpret these results

Metabolic acidosis with a compensatory respiratory alkalosis

A nurse reading a chart notes that the client had a Mantoux skin test result with no induration and a 1-mm area of ecchymosis. How does the nurse interpret this result?

Negative

A patient has had a laryngectomy and was able to retain his airway, with no difficulty swallowing. There is no split of thyroid cartilage. The nurse would record this type of laryngectomy as which of the following?

Partial laryngectomy

A physician stated to the nurse that the client has fluid in the pleural space and will need a thoracentesis. The nurse expects the physician to document this fluid as

Pleural Effusion

The patient has been brought to the ED by the paramedics, the patient is suspected of having ARDS. What intervention should the nurse first anticipate?

Preparing to assist with inhibiting the patient

The nurse is caring for a patient who has returned to the unit following a bronchoscopy. The patient is asking for something to drink. Which Criteria will determine when the nurse should allow the patient to drink fluids?

Presence of a cough and gag reflex

A nurse is teaching a client about the functions of the larynx. What should the nurse include in the teaching? Select all that apply.

Producing sound. Facilitating coughing. Protecting the lower airway from foreign objects

A patient being treted for pneumonia starts complaining of sudden SOB. An ABG is drawn. The ABG has the following values: pH 7.21, PaCO2 64 mm Hg, HCO3 24. What does the ABG reflect?

Respiratory Acidosis

A patient is being treated for status asthmaticus. What danger sign does the nurse observe that can indicate impending respiratory failure?

Respiratory acidosis

As status asthmaticus worsens, the nurse would expect which acid-base imbalance?

Respiratory acidosis

A nurse is weaning a client from mechanical ventilation. Which nursing assessment finding indicates the weaning process should be stopped?

Runs of ventricular tachycardia

The nurse is caring for a patient with lung metastases who just underwent a mediastinotomy. What should be the focus of the nurse's postprocedure care?

Shortness of breath

The patient with a chest tube is being transported to X-ray. Which complication may occur if the chest tube is clamped during transportation?

Tension pneumothorax

The client you are caring for has just been told they have advanced laryngeal cancer. What is the treatment of choice?

Total laryngectomy

A paitent rings her call bell and expresses alarm to the nurse, stating "i've just coughed up blood." That cant be." How can the nurse best determine whether the source of the blood was the patients lungs?

Try to see if the blood is frothy or filled with mucus

A patient's lung volumes and capacities were assessed to help determine the cause of a respiratory problem. Which of the following findings are indicative of chronic obstructive pulmonary disease (COPD)?

Vital capacity of 3,000 mL

A nurse is preparing a client with a pleural effusion for a thoracentesis. The nurse should:

assist the client to a sitting position on the edge of the bed, leaning over the bedside table.

what extra equipment should the nurse provide at the beside of a new post-op thyroidectomy patient?

tracheostomy tray