Thanksgiving test 4

The client with chronic obstructive pulmonary disease (COPD) is taking theophylline. The nurse should instruct the client to report which of the following signs of theophylline toxicity? Select all that apply. a. Nausea. b. Vomiting. c. Seizures. d. Insomnia. e. Vision changes.

a. Nausea. b. Vomiting. c. Seizures d. Insomnia.

A client with a history of asthma is admitted to the emergency department. the nurse notes that the client is dyspneic with a respiratory of 35 breaths/min. nasal flaring and use of accessory muscles. auscultation of the lung fields reveals greatly diminished breath sounds. what should the nurse do first? a.Initiate oxygen therapy and reassess the client in 10 minutes. b.Draw blood for an ABG analysis and send the client for a chest x-ray. c.Encourage the client to relax and breathe slowly through the mouth d.Administer ordered bronchodilators

d.Administer ordered bronchodilators

For a client with rib fractures and a pneumothorax, the healthcare provider (HCP) prescribes morphine sulfate, 1 to 2 mg/h, given IV as needed for pain. The nursing care goal is to provide adequate pain control so that the client can breathe effectively. Which finding indicates the goal has been met? A. pain rating of 0 to 2 on a scale of 0 to 10 by the client B. decreased client anxiety C. respiratory rate of 26 breaths/min D. PaO2 of 70 mm Hg (9.31 kPa)

A. pain rating of 0 to 2 on a scale of 0 to 10 by the client

A client undergoes surgery to repair lung injuries. Postoperative prescriptions include the transfusion of one unit of packed red blood cells at a rate of 60 mL/h. How long will this transfusion take to infuse? A. 2 hours B. 4 hours C. 6 hours D. 8 hours

B. 4 hours

The nurse interprets which finding as an early sign of acute respiratory distress syndrome (ARDS) in a client at risk? A. elevated carbon dioxide level B. hypoxia not responsive to oxygen therapy C. metabolic acidosis D. sever, unexplained electrolyte imbalance

B. hypoxia not responsive to oxygen therapy

A patient is receiving an aminoglycoside antibiotic for an infection. The nurse should monitor which lab value? A: Serum Sodium B: Serum Potassium C:Serum Creatinine D: Serum calcium

C:Serum Creatinine

Which family member exposed to tuberc losis would be at highest risk for contracting the disease? A. 45-year-old mother B. 17-year-old daughter C. 8-year-old son D. 76-year-old grandmother

D. 76-year-old grandmother

Which of the following diets would be most appropriate for a client with chronic obstructive pulmonary disease (COPD)? A. Low-fat, low-cholesterol diet. B. Bland, soft diet. C. Low-sodium diet. D. High-calorie, high-protein diet.

D. High-calorie, high-protein diet.

When developing a discharge plan to manage the care of a client with COPD, the nurse should anticipate that the client will do which of the following? a. Develop infections easily b. Maintain current status c. Require less supplemental oxygen d. Show permanent improvement

a. Develop infections easily

A client is prescribed metaproterenol via a metered-dose inhaler, two puffs every 4 hours. The nurse instructs the client to report adverse effects. Which of the following are potential adverse effects of metaproterenol? a. Irregular heartbeat. b. Constipation. c. Pedal edema. d. Decreased pulse rate.

a. Irregular heartbeat.

The nurse is evaluating the effectiveness of a teaching plan for a client recovering from an upper respiratory tract infection. Which is an expected outcome of the plan? a: Maintain a fluid intake of 100 mL every 24 hours b: have a temperature below 100 F c: Cough productively without chest discomfort d:Experience less nasal obstruction and discharge

d:Experience less nasal obstruction and discharge

Which of the following health promotion activities should the nurse include in the discharge teaching plan for a client with asthma? 1. Incorporate physical exercise as tolerated into the daily routine 2. Monitor peak flow numbers after meals and at bedtime. 3. Eliminate stressors in the work and home environment. 4. Use sedatives to ensure uninterrupted sleep at night.

1. Incorporate physical exercise as tolerated into the daily routine

The nurse teaches a client with chronic obstructive pulmonary disease (COPD) to assess for signs and symptoms of right-sided heart failure. Which of the following signs and symptoms should be included in the teaching plan? A. Clubbing of nail beds B. Hypertension. 3. Peripheral edema .4. Increased appetite.

3. Peripheral edema

The nurse assesses the respiratory status of a client who is experiencing an exacerbation of chronic obstructive pulmonary disease (COPD) secondary to an upper respiratory tract infection. Which of the following findings would be expected? A. Normal breath sounds. B. Prolonged inspiration. 3. Normal chest movement. 4. Coarse crackles and rhonchi.

4. Coarse crackles and rhonchi.

The nurse is planning to teach a client with COPD how to cough effectively. Which of the following instructions should be included? A .Take three deep abdominal breath, bend forward, and cough while saying the word "who" on exhalation. B .Lie flat on back, splint the thorax, take two deep breaths and cough. C Take several rapid, shallow breaths and then cough forcefully. D .Assume a side-lying position, extend the arm over the head, and alternate deep breathing with coughing.

A .Take three deep abdominal breath, bend forward, and cough while saying the word "who" on exhalation.

The nurse is teaching the client how to use a metered-dose inhaler (MDI) to administer a corticosteroid. Which of the following indicates that the client is using the MDI correctly? Select all that apply A The inhaler is held upright B The head is tilted down while inhaling the medicine C The client waits 5 minutes between puffs D The client rinses the mouth with water following administration E The client lies supine for 15 minutes following administration

A The inhaler is held upright D The client rinses the mouth with water following administration

A nurse is teaching a client about taking antihistamines. Which of the following instructions should the nurse include in the teaching plan? Select all that apply. A. Operating machinery and driving may be dangerous while taking antihistamines. B. Continue taking antihistamines even if nasal infection develops. C. The effect of antihistamines is not felt until a day later. D. Do not use alcohol with antihistamines E. Increase fluid intake to 2,000 mL/day.

A,D,E A. Operating machinery and driving may be dangerous while taking antihistamines. D. Do not use alcohol with antihistamines. E. Increase fluid intake to 2,000 mL/day.

A client is admitted to the hospital with a diagnosis of bacterial pneumonia. While obtaining the client's health history, the nurse learns that the client has osteoarthritis, follows a vegetarian diet, and is very concerned with cleanliness. Which of the following would most likely be a predisposing factor for the diagnosis of pneumonia? A. Age. B. Osteoarthritis. C. Vegetarian diet. D. Daily bathing.

A. Age.

A client experiencing a severe asthma attack has the following arterial blood gas results: pH 7.33; Pco2 48 mm Hg (6.4 kPa); Po2 58 mm Hg (7.7 kPa); HCO3 26 mEq/L (26 mmol/L). Which prescription should the nurse implement first? A. Albuterol Nebulizer B chest X-ray C Ipratropium inhaler D. Sputum culture

A. Albuterol Nebulizer

A client, diagnosed with acute pancreatitis 5 days ago, is experiencing respiratory distress. Which finding should the nurse report to the healthcare provider? A. Arterial oxygen level of 46 mm Hg (6.1 kPa) B. respirations of 12 breaths/min C. lack of adventitious lung sounds D. Oxygen saturation of 96% on room air

A. Arterial oxygen level of 46 mm Hg (6.1 kPa)

The nurse is providing follow-up to a client with tuberculosis who does not regularly take the prescribed medication. Which nursing action would be most appropriate for this client? A. Ask the client's spouse to supervise the daily administration of the medications. B. Visit the client weekly to verify compliance with taking the medication. C. Notify the healthcare provider (HCP) of the Client's noncompliance, and request a different prescription. D. Remind the client that tuberculosis can be fatal if not treated promptly

A. Ask the client's spouse to supervise the daily administration of the medications.

The nurse is caring for a group of clients on the pulmonary unit. The nurse can delegate which task to the unlicensed assistive personnel (UAP)? A. Assisting a client with adjusting his or her nasal cannula B. Making adjustments to flow rates based on client responses C. Monitoring a client for adverse effects of oxygen therapy D. Assessing a client for the best method of oxygen delivery

A. Assisting a client with adjusting his or her nasal cannula

A confused client with carbon monoxide poisoning experiences dizziness when ambulating to the bathroom. The nurse should: A. Check on the client at regular intervals to ascertain the need to use the bathroom. B. Put all four side rails up on the bed. C. Request that the client's roommate put the call light on when the client is attempting to get out of bed. D. Ask the unlicensed personnel to place restraints on the client's upper extremities.

A. Check on the client at regular intervals to ascertain the need to use the bathroom.

When assessing a client with chest trauma, the nurse notes that the client is taking small breaths at first, then bigger breaths, and then a couple of small breaths, then 10 to 20 seconds of no breaths. The nurse should record the breathing pattern as: A. Cheyne-Stokes respiration. B. hyperventilation. C. obstructive sleep apnea. D. Biot's respiration.

A. Cheyne-Stokes respiration.

Which of the following findings would most likely indicate the presence of a respiratory infection in a client with asthma? A. Cough productive of yellow sputum. B. Bilateral expiratory wheezing. C. Chest tightness. D. Respiratory rate of 30 breaths/ minute.

A. Cough productive of yellow sputum.

The nurse administers two 325 mg aspirin every 4 hours to a client with pneumonia. The nurse should evaluate the outcome of administering the drug by assessing which of the following? Select all that apply. A. Decreased pain when breathing. B. Prolonged clotting time. C. Decreased temperature. D. Decreased respiratory rate. E. Increased ability to expectorate secretions.

A. Decreased pain when breathing. C. Decreased temperature.

The nurse is caring for a client who has been placed on droplet precautions. Which protective gear is required to take care of this client. Select all that apply A. Gloves B. Gown. C. Surgical Mask D. Glasses. E. Respirator

A. Gloves B. Gown. C. Surgical Mask D. Glasses.

Which technique for administering the Mantoux test is correct? A. Hold the needle and syringe almost parallel to the client's skin. B. Pinch the skin when inserting the needle. C. Aspirate before injecting the result of an medication. D. Massage the site after injecting the medication.

A. Hold the needle and syringe almost parallel to the client's skin.

A client has the following arterial blood gas values:pH 7.52PaO2 50 mm Hg (6.7 kPa)PaCO2 28 mm Hg (3.72 kPa)HCO3 24 mEq/L (24 mmol/L)Based upon the client's PaO2, which conclusion would be accurate? A. The client is severely hypoxic B. The Oxygen level is low but poses no risk for the client C. The client's PaO2 level is within normal range D. The client requires oxygen therapy with very low oxygen concentrations

A. The client is severely hypoxic

The nurse is a member of a team that is planning a client-centered, community-based approach to care of clients with chronic obstructive pulmonary disease (COPD). In which areas should the team focus on improving quality of care and delivery? Select all that apply. A. The community B. Clinical information system C. Delivery system design D. administrative leadership E. acute care setting

A. The community B. Clinical information system C. Delivery system design

A client newly diagnosed with tuberculosis (TB) is being admitted with the prescription for "isolation precautions for tuberculosis." The nurse should assign the client to which type of room? A. a room at the end of the hall for privacy B. a private room to implement airborne precautions C. a room near the nurses' station to ensure confidentiality D. a room with windows to allow sunlight

A. a room at the end of the hall for privacy

A client with acute respiratory distress syndrome (ARDS) is on a ventilator. The client's peak inspiratory pressures and spontaneous respiratory rate are increasing, and the PO2 is not improving. Using the SBAR technique for communication, the nurse calls the healthcare provider with the recommendation for: A. initiating IV sedation B. starting a high-protein diet C. providing pain medication D. increasing the ventilator rate

A. initiating IV sedation

A client with acute respiratory distress syndrome (ARDS) has fine crackles at lung bases, and the respirations are shallow at a rate of 28 breaths/ min. The client is restless and anxious. In addition to monitoring the arterial blood gas results, what should the nurse do? Select all that apply. A. monitor serum creatinine and blood urea nitrogen levels. B. administer a sedative. C. Keep the head of the bed flat. D. Administer humidified oxygen E. Auscultate the lungs.

A. monitor serum creatinine and blood urea nitrogen levels. D. Administer humidified oxygen E. Auscultate the lungs.

A client is undergoing a thoracentesis. What should the nurse monitor the client for during and immediately after the procedure? Select all that apply. A. pneumothorax B. subcutaneous emphysema C. tension pneumothorax D. pulmonary edema E. infection

A. pneumothorax B. subcutaneous emphysema C. tension pneumothorax D. pulmonary edema

A client has been in an automobile accident. and the nurse is assessing the client for possible pneumothorax. The nurse should assess the client for: A. sudden, sharp chest pain. B. wheezing breath sounds over affected side. C. hemoptysis. D. cyanosis.

A. sudden, sharp chest pain.

Which is a priority goal for the client with chronic obstructive pulmonary disease (COPD)? A: Maintaining functional ability B: Minimizing chest pain C: Increasing carbon dioxide levels in the blood D: Better elimination of carbon dioxide

A: Maintaining functional ability

A nurse is completing the health history for a client who has been taking echinacea for a head cold. The client asks, "Why isn't this helping me feel better?" Which of the following responses by the nurse would be the most accurate? A. "There is limited information as to the effectiveness of herbal products. B. "Antibiotics are the agents needed to treat a head cold. C "The head cold should be gone within the month. D. "Combining herbal products with prescription antiviral medications is sure to help you."

A: There is limited information as to the effectiveness of herbal products

A client with newly diagnosed chronic obstructive disease is to be discharged home with oxygen per nasal prongs. Which teaching points should the nurse include in this client's discharge plan? Select all that apply. A: Apply pertroleum jelly on lips and nose to prevent dryness and irritation. B: Avoid areas where people are smoking cigarettes or cigars C: increase oxygen flow at night during hours of sleep D: Place gauze between the ears and oxygen tubing to prevent skin irritation E: Request a large, pressurized oxygen tank for use during car travel F: Avoid use of a microwave oven when using oxygen.

B Avoid areas where poeple are smoking cigarettes or cigars D: Place gauze between the ears and oxygen tubing to prevent skin irritation

The nurse is teaching a client who has been diagnosed with tuberculosis how to avoid spreading the disease to family members. Which statements indicate that the client has understood the nurse's instructions? Select all that apply, A. "I will need to dispose of my old clothing when I return home. B. "I should always cover my mouth and nose when sneezing. C. "It is important that I isolate myself from family when possible." D. "I should use paper tissues to cough in and dispose of them promptly." E. "I will avoid crowds."

B. "I should always cover my mouth and nose when sneezing. D. "I should use paper tissues to cough in and dispose of them promptly."

The nurse has received a change of shift report on clients. Which client should the nurse assess first? A. a client with COPD with a Pa02 of 56mm who is being discharged home on oxygen. B. A client with asthma with respirations of 36 breaths whose wheezing has diminished C. A client with asthma who has a heart rate of 90 bpm and whose beta blocker is schedules to be administered now D. A client who is schedules for an angiogram now and is ready to be transported.

B. A client with asthma with respirations of 36 breaths whose wheezing has diminished

A nurse has received report on four clients. Which client would the nurse visit first? A. a client with CHF who has gained 2 pounds overnight. B. A client with tuberculosis who raised 50 Ml of sanguinous sputum over the past 2 hours. C. A client with C. Difficile who continues to have loose, foul stools D. A client with COPD who last report of oxygen saturation was 91%

B. A client with tuberculosis who raised 50 Ml of sanguinous sputum over the past 2 hours.

A client has a positive reaction to the Man- toux test. The nurse interprets this reaction to mean that the client has: A. Active tuberculosis. B. Been exposed to Mycobacterium tuberculosis C. Developed a resistance to tubercle bacilli. D. Developed passive immunity to tuberculosis.

B. Been exposed to Mycobacterium tuberculosis

A client with chronic obstructive pulmonary disease (COPD) is experiencing dyspnea and has a low PaO2 level. The nurse plans to administer oxygen as ordered. Which of the following statements is true concerning oxygen administration to a client with COPD? A. High oxygen concentrations will cause coughing and dyspnea. B. High oxygen concentrations may inhibit the hypoxic stimulus to breathe. C. Increased oxygen use will cause the client to become dependent on the oxygen. D. Administration of oxygen is contraindicated in clients who are using bronchodilators

B. High oxygen concentrations may inhibit the hypoxic stimulus to breathe.

A young adult is admitted to the emergency department after an automobile accident. The client has severe pain in the right chest from contact with the steering wheel. What should the nurse do first? A. Reduce the client's anxiety B. Maintain adequate oxygenation. C. Decrease chest pain D. Maintain adequate circulating volume

B. Maintain adequate oxygenation.

A client who has been diagnosed with tuberculosis has been placed on drug therapy. The medication regimen includes rifampin. Which instruction should the nurse give the client about effects of rifampin? Select all that apply. A. Have eye examinations every 6 months. B Maintain follow-up monitoring of liver enzymes. C. Decrease protein intake in the diet. D. Avoid alcohol intake. E. The urine may have an orange color.

B. Maintain follow-up monitoring of liver enzymes. D. Avoid alcohol intake. E. The urine may have an orange color.

A client with bacterial pneumonia is to be started on I.V. antibiotics. Which of the following diagnostic tests must be completed before antibiotic therapy begins A. Urinalysis. B. Sputum culture. C. Chest radiograph D. Red blood cell count.

B. Sputum culture.

Which of the following is an expected outcome for an elderly client following treatment for bacterial pneumonia? A. A respiratory rate of 25 to 30 breaths/ minute. B. The ability to perform activities of daily living without dyspnea. C. A maximum loss of 5 to 10 lb of body weight. D. Chest pain that is minimized by splinting the rib cage.

B. The ability to perform activities of daily living without dyspnea.

The nurse teaches the client how to instill nose drops. Which of the following techniques is correct? A. The client uses sterile technique when handling the dropper. B. The client blows the nose gently before instilling drops. C. The client uses a new dropper for each instillation. D. The client sits in a semi-Fowler's position with the head tilted forward after administration of the drops.

B. The client blows the nose gently before instilling drops.

A client has developed a hospital-acquired pneumonia. When preparing to administer cephalexin 500 mg, the nurse notices that the pharmacy sent cefazolin. What should the nurse do? Select all that apply. A. Administer the Cefazolin B. Verify the medication order as written by the by the health care provider. (HCP). C. Contact the pharmacy and speak to a pharmacist D.Request that cephalexin be sent promptly E.Return the cefazolin to the pharmacy

B. Verify the medication order as written by the by the health care provider. (HCP). C. Contact the pharmacy and speak to a pharmacist D.Request that cephalexin be sent promptly E.Return the cefazolin to the pharmacy

The nurse should teach the client with asthma that which of the following is one of the most common precipitating factors of an acute asthma attack? A. Occupational exposure to toxins. B. Viral respiratory infections. C. Exposure to cigarette smoke. D. Exercising in cold temperatures.

B. Viral respiratory infections

When teaching a client with chronic obstructive pulmonary disease to conserve energy, the nurse should teach the client to lift objects: A. While inhaling through an open mouth. B. While exhaling through pursed lips. C. After exhaling but before inhaling. D. While taking a deep breath and holding it.

B. While exhaling through pursed lips.

A client with chronic obstructive pulmonary disease has a signed living will with a DNR request. While the wife was visiting the client, he has a cardiac arrest. the wife requested the client be resuscitated immediately. When the nurse hesitated to start resuscitation procedures, the wife threatened to sue the hospital. what should the nurse do? Select all that apply A. Call the code for fear of being suid by the wife B. carry out the written DNR request and client wishes C. Calmly remind the wife of the clients wishes and DNR request D. Notify the nurse manager of the situation E. Call the chaplain to come and remain with the wife F. Notify the health care provider

B. carry out the written DNR request and client wishes C. Calmly remind the wife of the clients wishes and DNR request D. Notify the nurse manager of the situation E. Call the chaplain to come and remain with the wife F. Notify the health care provider

A client with tuberculosis is taking isoniazid (INH). To help prevent development of peripheral neuropathies, the nurse should instruct the client to: A.adhere to a low-cholesterol diet. B. supplement the diet with pyridoxine (vitamin B.) C. get extra rest. D. avoid excessive sun exposure.

B. supplement the diet with pyridoxine (vitamin B.)

The client with tuberculosis is to be discharged home with nursing follow-up. Which aspect of nursing care will have the highest priority? A. offering the client emotional support. B. teaching the client about the disease and its treatment C. coordinating various agency services D. assessing the client's environment for sanitation

B. teaching the client about the disease and its treatment

The nurse reviews an arterial blood gas report for a client with chronic obstructive pulmonary disease (COPD). The results are as follows: pH 7.35; PCO2 70; HCO3 34 mEq/L. What should the nurse do first? A.Apply a 100% nonrebreather mask B.Assess the vital signs C.Reposition the client D.Prepare for intubation

B.Assess the vital signs

In which areas of the United States and Canada is the incidence of tuberculosis highest? A. rural farming areas B.inner-city areas C. areas where clean water standards are low D. suburban areas with significant industrial pollution

B.inner-city areas

For a client with asthma, the health care provider (HCP) prescribes albuterol, two puffs twice a day via MDI, and beclomethasone, two puffs twice a day via MDI. The nurse should instruct the client to administer: A: Take the medications 1 hour apart, 2 times a day. B: Take the albuterol first and follow with beclomethasone 2 times a day. C: Take the albuterol on awakening and alternate the medications every D : Take the beclomethasone inhaler first and follow with albuterol.

B: Take the albuterol first and follow with beclomethasone 2 times a day.

A client is experiencing an acute asthmatic attack. prior to treatment with levalbuterol, respieration were 40 breaths/min pulse 132 beats per minute, oxygen saturation 86% on room air, and with audible wheezing. Which findings indicate achievement of the desired outcome of asthma treatment? A. decreased peak expiratory flow rate (PEF) B wheezing inaudible with diminished breath sounds C pulse 96 bpm and sp02 92% on room air D. Inspiratory cycle twice as long as the expiratory cycle

C pulse 96 bpm and sp02 92% on room air

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

C. "You have developed a fungal infection from your medication. It will need to be treated with an antifungal agent."

A nurse is assessing a client with chronic emphysema. Which finding requires immediate intervention? A.Using pursed-lip breathing and prolong expiration B. Circumoral cyanosis C. Crackles auscultated posteriorly halfway up the left lung D. Appearance of a "barrel chest"

C. Crackles auscultated posteriorly halfway up the left lung

A client with pneumonia has a temperature of 102.6 ° F (39.2 ° C), is diaphoretic, and has a productive cough. The nurse should include which of the following measures in the plan of care? A. Position changes every 4 hours B.. Nasotracheal suctioning to clear secretions. C. Frequent linen changes D. Frequent offering of a bedpan.

C. Frequent linen change

The nurse is instructing a client with acute asthma who is taking short-term corticosteroid therapy. The nurse should tell the client that steroids will have which expected outcome. Steroids will:· A. Promote bronchodilation· B. Act as an expectorant C. Have an anti-inflammatory effect D. Prevent development of respiratory infections

C. Have an anti-inflammatory effect

The nurse observes a client using a metered-dose inhaler to aid in management of asthma. Which actions indicated that the client needs further instruction? Select all that apply. A. Shakes the MDI before using B. Exhales before starting to use the MDI C. Inspired rapidly when dispensing the medication from the MDI D. Holds the breath for 3 seconds after inhaling with the MDI E. Cleans the inhaler and canister in soapy water before using again in rapid succession

C. Inspired rapidly when dispensing the medication from the MDI D. Holds the breath for 3 seconds after inhaling with the MDI E. Cleans the inhaler and canister in soapy water before using again in rapid succession

While making rounds, the nurse finds a client with COPD sitting in a wheelchair, slumped over a lunch tray. After determining the client is unresponsive and calling for help, the nurse's first action should be to: A. Push the code blue button. B. Call the rapid response team. C. Open the clients airways D. Call for a defribillator

C. Open the clients airways

The nurse administers theophylline (Theo-Dur) to a client. To evaluate the effectiveness of this medication, which of the following drug actions should the nurse anticipate? A. Suppression of the client's respiratory infection. B. Decrease in bronchial secretions. C. Relaxation of bronchial smooth muscle. D. Thinning of tenacious, purulent sputum.

C. Relaxation of bronchial smooth muscle.

The nurse should include which of the following instructions in the teaching plan for a client with chronic sinusitis? A. Avoid the use of caffeinated beverages. B. Perform postural drainage every day. C. Take hot showers twice daily. D. Report a temperature of 102°F (38.9°C) or higher.

C. Take hot showers twice daily.

The nurse has placed the intubated client with Acute Respiratory Distress Syndrome (ARDS) in prone position for 30 minutes. Which factors would require the nurse to discontinue prone positioning and return the client to the supine position? Select all that apply A. The family is coming to visit. B. The client has increased secretions requiring frequent suctioning C. The SpO2 and Po2 have decreased. D. The client is tachycardic with drop in blood pressure. E. The face has increased skin breakdown and edema.

C. The SpO2 and Po2 have decreased. D. The client is tachycardic with drop in blood pressure. E. The face has increased skin breakdown and edema.

A client with rib fractures and a pneumothorax has a chest tube inserted that is connected to a water seal chest tube drainage system. The nurse notes that the fluid in the water seal column is fluctuating with each breath that the client takes. What is the significance of this fluctuation? A. An obstruction is present in the chest tube. B. The client is developing subcutaneous emphysema. C. The chest tube system is functioning properly. D. There is a leak in the chest tube system.

C. The chest tube system is functioning properly.

The nurse should caution sexually active female clients taking isoniazid (INH) that the drug: A. increases the risk of vaginal infection B. has mutagenic effects on ova. C. decreases the effectiveness of hormonal contraceptives. D. inhibits ovulation.

C. decreases the effectiveness of hormonal contraceptives.

A client is receiving streptomycin in the treatment regimen of tuberculosis. The nurse should assess for: A. decreased serum creatinine. B. difficulty swallowing. C. hearing loss. D. IV infiltration.

C. hearing loss.

A client had a Mantoux test result of an 8-mm induration. The test is considered positive when the client: A. lives in a long-term care facility B. has no known risk factors C. is immunocompromised D. works as a healthcare provider (HCP) in a hospital.

C. is immunocompromised

Clients who have had active tuberculosis are at risk for recurrence. Which condition increases that risk? A. cool and damp weather B. active exercise and exertion C. physical and emotional stress D. rest and inactivity

C. physical and emotional stress

A nurse should interpret which finding as an early sign of a tension pneumothorax in a client with chest trauma? A. diminished bilateral breath sounds B. muffled heart sounds C. respiratory distress D. tracheal deviation

C. respiratory distress

Which of the following mental status changes may occur when a client with pneumonia is first experiencing hypoxia? A. Coma. B. Apathy C.. Irritability. D. Depression.

C.. Irritability.

A client with allergic rhinitis is instructed on the correct technique for using an intranasal inhaler. Which of the following statements would demonstrate to the nurse that the client understands the instructions? A. "I should limit the use of the inhaler to early morning and bedtime use. B "It is important to not shake the canister because that can damage the spray device. C. "I should hold one nostril closed while I insert the spray into the other nostril. D. "The inhaler tip is inserted into the nostril and pointed toward the inside nostril wall."

C: "I should hold one nostril closed while I insert the spray into the other nostril."

An elderly client admitted with pneumonia and dementia has attempted several times to pull out the IV and Foley catheter. After trying other options, the nurse obtains a prescription for bilateral soft wrist restraints. Which nursing action is most appropriate? A: Reevaluate the need for restraints and document weekly. B: Perform circulation checks to bilateral upper extremities each shift. C: Attach the ties of the restraints to the bed frame. D: Ensure the restraint prescription has been signed by the health care provider (HCP) within 72 hours.

C: Attach the ties of the restraints to the bed frame.

Which information should the nurse include in a teaching plan for the client newly diagnosed with chronic obstructive pulmonary disease? select all that apply? A: Pulmonary rehabilitation programs offer very little benefit. B: Pneumococcal vaccination is contraindicated for clients with lung disease C: High humidity increases the effort of breathing D: A bronchodilator with metered dose inhaler should be readily available E: Smoking cessation is important to slow or stop disease progression

C: High humidity increases the effort of breathing D: A bronchodilator with metered dose inhaler should be readily available E: Smoking cessation is important to slow or stop disease progression

A client with allergic rhinitis asks the nurse what to do to decrease the rhinorrhea. Which of the following instructions would be appropriate for the nurse to give the client? A. "Use your nasal decongestant spray regularly to help clear your nasal passages." B. "Ask the doctor for antibiotics. Antibiotics will help decrease the secretion." C. "It is important to increase your activity. A daily brisk walk will help promote drainage." D. "Keep a diary of when your symptoms occur. This can help you identify what precipitates your attacks."

D. "Keep a diary of when your symptoms occur. This can help you identify what precipitates your attacks."

Which of the following measures would most likely be successful in reducing pleuritic chest pain in a client with pneumonia? A. Encourage the client to breathe shallowly. B. Have the client practice abdominal breathing. C. Offer the client incentive spirometry. D. Teach the client to splint the rib cage when coughing.

D. Teach the client to splint the rib cage when coughing.

Which finding would suggest pneumothorax in a trauma victim? A. pronounced crackles B. inspiratory wheezing C. dullness on percussion D. absent breath sounds

D. absent breath sounds

The nurse should use which type of precautions for a client being admitted to the hospital with suspected tuberculosis? A. hand hygiene B. contact precautions C. droplet precautions D. airborne precaution

D. airborne precaution

The nurse is caring for a client with bacterial pneumonia. The effectiveness of the client's oxygen therapy can be best determined by the: A. client's level of consciousness B. absence of cyanosis C. client's respiratory rate D. arterial blood gas values.

D. arterial blood gas values.

the nurse is planning care for a client with crushing chest injury. the client is in an intensive care unit and the clients vital signs have not stabilized. which finding puts the client at risk for acute respiratory distress syndrome ( ARDS) A. History of smoking B. low serum potassium C. hypercapnia D. hypovolemia

D. hypovolemia

To improve the oxygenation of a client with acute respiratory distress syndrome (ARDS) who is receiving mechanical ventilation, the nurse should place the client in which position? A. supine B. semi-Fowler's C. Lateral side D. prone

D. prone

The health care provider (HCP) has prescribed pseudoephedrine. The nurse should instruct the client about which possible adverse effect of this drug? A. constipation B. bradycardia C. diplopia D. restlessness

D. restlessness

To promote effective airway clearance in a client with acute respiratory distress, what should the nurse do? A. administer oxygen every 2 hours B. turn the client every 4 hours C. administer sedatives to promote rest D. suction if cough is ineffective

D. suction if cough is ineffective

Which statement indicates that the client with chronic obstructive pulmonary disease who has been discharged to home understands the care plan? The client... A: plans to avoid direct contact with family and friends B: can state actions to reduce pain C: will use oxygen via a nasal cannula at 5 L D: Agrees to call the health care provider if dyspnea on exertion increases

D: Agrees to call the health care provider if dyspnea on exertion increases

The nurse is instructing the client with chronic obstructive pulmonary disease to do pursed lip breathing what is the expected outcome of this exercise? A: Improved oxygen intake B: Deeper diaphragmatic breathing C: Stronger intercostal muscles D: Better elimination of carbon dioxide

D: Better elimination of carbon dioxide

When instructing clients on how to decrease the risk of developing chronic obstructive pulmonary disease, the nurse should A: Participate regularly in aerobic exercise B: maintain a high protein diet C: avoid exposure to people with known respiratory infections D: abstain from cigarette smoking

D: abstain from cigarette smoking