323 Exam 1 PrepU

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

Bullae

A nurse consulting with a nutrition specialist knows it's important to consider a special diet for a client with chronic obstructive pulmonary disease (COPD). Which diet is appropriate for this client? Full-liquid High-protein 1,800-calorie ADA Low-fat

High-protein

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

Inflamed airways obstruct airflow. Mucus secretions block airways. Overinflated alveoli impair gas exchange.

Upon assessment, the nurse suspects that a client with COPD may have bronchospasm. What manifestations validate the nurse's concern? Select all that apply. Compromised gas exchange Decreased airflow Wheezes Jugular vein distention Ascites

Compromised gas exchange Decreased airflow Wheezes

our client has a history of hoarseness lasting longer than 2 weeks. The client is now complaining of feeling a lump in their throat. What would you suspect this client has? Cancer of the pharynx Laryngeal cancer Laryngeal polyps Cancer of the tonsils

Laryngeal cancer

For a client with pleural effusion, what does chest percussion over the involved area reveal? Absent breath sounds Dullness over the involved area Friction rub Fluid presence

Dullness over the involved area

During assessment of a patient with OSA (obstructive sleep apnea) , the nurse documents which of the following characteristic signs that occurs because of repetitive apneic events? Pulmonary hypotension Hypercapnia Systemic hypotension Increased smooth muscle contractility

Hypercapnia

The nurse is caring for a client who underwent a laryngectomy. Which intervention will the nurse initially complete in an effort to meet the client's nutritional needs? Initiate enteral feedings. Offer plenty of thin liquids. Encourage sweet foods. Liberally season foods.

Initiate enteral feedings.

x A client is admitted to the facility with a productive cough, night sweats, and a fever. Which action is most important in the initial care plan? Assessing the client's temperature every 8 hours Placing the client in respiratory isolation Monitoring the client's fluid intake and output Wearing gloves during all client contact

Placing the client in respiratory isolation

The nurse is caring for a client who had a recent laryngectomy. Which of the following is reflected in the nursing plan of care? Develop an alternate method of communication. Encourage oral nutrition on the second postoperative day. Maintain the client in a low-Fowler's position. Assess the tracheostomy cuff for leaks.

Develop an alternate method of communication.

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. pneumothorax. hemothorax. consolidation.

pleural effusion.

What is histamine, a mediator that supports the inflammatory process in asthma, secreted by? Eosinophils Lymphocytes Mast cells Neutrophils

Mast cells

Which statement indicates a client understands teaching about the purified protein derivative (PPD) test for tuberculosis? "I will come back in 1 week to have the test read." "If the test area turns red that means I have tuberculosis." "I will avoid contact with my family until I am done with the test." "Because I had a previous reaction to the test, this time I need to get a chest X-ray."

"Because I had a previous reaction to the test, this time I need to get a chest X-ray."

"Because I am prescribed a corticosteroid-containing MDI, I will rinse my mouth with water after use." "I can't use a spacer or holding chamber with the MDI." "I will take a slow, deep breath in after pushing down on the MDI." "I will shake the MDI container before I use it."

"I can't use a spacer or holding chamber with the MDI."

A patient who wears contact lenses is to be placed on rifampin for tuberculosis therapy. What should the nurse tell the patient? "Only wear your contact lenses during the day and take them out in the evening before bed." "You should switch to wearing your glasses while taking this medication." "The physician can give you eye drops to prevent any problems." "There are no significant problems with wearing contact lenses."

"You should switch to wearing your glasses while taking this medication."

The nurse is educating a patient who will be started on an antituberculosis medication regimen. The patient asks the nurse, "How long will I have to be on these medications?" What should the nurse tell the patient? 3 months 3 to 5 months 6 to 12 months 13 to 18 months

6 to 12 months

A patient with COPD requires oxygen administration. What method of delivery does the nurse know would be best for this patient? A nasal cannula An oropharyngeal catheter A nonrebreathing mask A Venturi mask

A Venturi mask

Which statement describes emphysema? A disease of the airways characterized by destruction of the walls of overdistended alveoli A disease that results in reversible airflow obstruction, a common clinical outcome Presence of cough and sputum production for at least a combined total of 2 to 3 months in each of two consecutive years Chronic dilatation of a bronchus or bronchi

A disease of the airways characterized by destruction of the walls of overdistended alveoli

A surgeon completes a total laryngectomy. Postoperatively, the nurse explains to the patient's family that: One vocal cord was removed along with a portion of the larynx. The voice was spared and a tracheostomy would be in place until the airway was established. A permanent tracheal stoma would be necessary. A portion of the vocal cord was removed.

A permanent tracheal stoma would be necessary.

You are a nurse caring for a client who has just had a tracheostomy. What should you monitor frequently? Airway patency Level of consciousness Psychologic status Pain level

Airway patency

A client with asthma is prescribed a short acting beta-adrenergic (SABA) for quick relief. Which of the following is the most likely drug to be prescribed? Ipratropium bromide Fluticasone propionate Ipratropium bromide and albuterol sulfate Albuterol

Albuterol

In which statements regarding medications taken by a client diagnosed with COPD do the drug name and the drug category correctly match? Select all that apply. Albuterol is a bronchodilator. Dexamethasone is an antibiotic. Cotrimoxazole is a bronchodilator. Ciprofloxacin is an antibiotic. Prednisone is a corticosteroid.

Albuterol is a bronchodilator. Ciprofloxacin is an antibiotic. Prednisone is a corticosteroid.

A client has undergone a left hemicolectomy for bowel cancer. Which activities prevent the occurrence of postoperative pneumonia in this client? Administering oxygen, coughing, breathing deeply, and maintaining bed rest Coughing, breathing deeply, maintaining bed rest, and using an incentive spirometer Coughing, breathing deeply, frequent repositioning, and using an incentive spirometer Administering pain medications, frequent repositioning, and limiting fluid intake

Coughing, breathing deeply, frequent repositioning, and using an incentive spirometer

Wound drains, inserted during the laryngectomy, stay in place until what criteria are met? The stoma is healed, about 6 weeks after surgery. The surgical site is dry with encrustations. Drainage is <30 mL/day for 2 consecutive days. The patient is able to assist with his own suctioning.

Drainage is <30 mL/day for 2 consecutive days.

What is the reason for chest tubes after thoracic surgery? Draining secretions, air, and blood from the thoracic cavity is necessary. Chest tubes allow air into the pleural space. Chest tubes indicate when the lungs have re-expanded by ceasing to bubble. Draining secretions and blood while allowing air to remain in the thoracic cavity is necessary.What is the reason for chest tubes after thoracic surgery? Draining secretions, air, and blood from the thoracic cavity is necessary.

Draining secretions, air, and blood from the thoracic cavity is necessary.

Late symptoms of laryngeal cancer include which of the following. Select all that apply. Dysphagia Dyspnea Persistent hoarseness Sore throat Burning in throat

Dysphagia Dyspnea Persistent hoarseness

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

Dyspnea

The diagnosis of pulmonary hypertension associated with chronic obstructive pulmonary disease (COPD) is suspected when which of the following is noted? Select all that apply. Dyspnea and fatigue disproportionate to pulmonary function abnormalities Right ventricular enlargement Elevated plasma brain natriuretic peptide (BNP) Enlargement of central pulmonary arteries Left ventricular hypertrophy

Dyspnea and fatigue disproportionate to pulmonary function abnormalities Right ventricular enlargement Elevated plasma brain natriuretic peptide (BNP) Enlargement of central pulmonary arteries

You are doing preoperative teaching with a client scheduled for laryngeal surgery. What should you teach this client to help prevent atelectasis? Monitor for signs of dysphagia. Provide meticulous mouth care every 4 hours. Caution against frequent coughing. Encourage deep breathing every 2 hours.

Encourage deep breathing every 2 hours.

A client hospitalized with pneumonia has thick, tenacious secretions. Which intervention should the nurse include when planning this client's care? Turning the client every 2 hours Elevating the head of the bed 30 degrees Encouraging increased fluid intake Maintaining a cool room temperature

Encouraging increased fluid intake

The nurse is obtaining a health history from a client on an annual physical exam. Which documentation should be brought to the physician's attention? Epistaxis, twice last week Aphonia following a football game Hoarseness for 2 weeks Laryngitis following a cold

Hoarseness for 2 weeks

The nurse has instructed a client on how to perform pursed-lip breathing. The nurse recognizes the purpose of this type of breathing is to accomplish which result? Promote more efficient and controlled ventilation and to decrease the work of breathing Improve oxygen transport; induce a slow, deep breathing pattern; and assist the client to control breathing Promote the strengthening of the client's diaphragm Promote the client's ability to take in oxygen

Improve oxygen transport; induce a slow, deep breathing pattern; and assist the client to control breathing

Which community-acquired pneumonia demonstrates the highest occurrence during summer and fall? Legionnaires disease Streptococcal (pneumococcal) pneumonia Mycoplasma pneumonia Viral pneumonia

Legionnaires disease

A client is postoperative immediately following a total laryngectomy. The client's respirations are 32 breaths/minute, shallow, and noisy. The tracheostomy pad is moist with mucus. Pulse oximetry is 88%. The client's eyes are wide open, and the client appears apprehensive. What is a priority nursing concern? Ineffective airway clearance Anxiety Ineffective breathing pattern Impaired gas exchange

Ineffective airway clearance

A nurse is teaching a client with emphysema how to perform pursed-lip breathing. The client asks the nurse to explain the purpose of this breathing technique. Which explanation should the nurse provide? It helps prevent early airway collapse. It increases inspiratory muscle strength. It decreases use of accessory breathing muscles. It prolongs the inspiratory phase of respiration.

It helps prevent early airway collapse.

The nurse is educating a patient with COPD about the technique for performing pursed-lip breathing. What does the nurse inform the patient is the importance of using this technique? It prolongs exhalation. It increases the respiratory rate to improve oxygenation. It will assist with widening the airway. It will prevent the alveoli from overexpanding.

It prolongs exhalation.

A client is being seen in the emergency department for exacerbation of chronic obstructive pulmonary disease (COPD). The first action of the nurse is to administer which of the following prescribed treatments? Oxygen through nasal cannula at 2 L/minute Intravenous methylprednisolone (Solu-Medrol) 120 mg Ipratropium bromide (Alupent) by metered-dose inhaler Vancomycin 1 gram intravenously over 1 hour

Oxygen through nasal cannula at 2 L/minute

A patient comes to the clinic for the third time in 2 months with chronic bronchitis. What clinical symptoms does the nurse anticipate assessing for this patient? Chest pain during respiration Sputum and a productive cough Fever, chills, and diaphoresis Tachypnea and tachycardia

Sputum and a productive cough

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 Cardiac tamponade Flail chest Pulmonary contusion

Tension pneumothorax

Once the patient has been cleared for oral feedings, post laryngectomy, the nurse knows to prepare: Clear, warm liquids to slowly stimulate peristalsis. Soft, pureed foods, similar in consistency to baby food. Solid foods, so chewing can be reestablished to stimulate salivation. Thick liquids that are easy to swallow.

Thick liquids that are easy to swallow.

The nurse is caring for a patient who had a total laryngectomy and has drains in place. When does the nurse understand that the drains will most likely be removed? When the patient has less than 30 mL for 2 consecutive days When the patient states that there is discomfort and requests removal When the drainage tube comes out In 1 week when the patient no longer has serous drainage

When the patient has less than 30 mL for 2 consecutive days

When a client has undergone a laryngectomy and there is evidence of wound breakdown, the nurse monitors the client very carefully because of the high risk for carotid artery hemorrhage. pulmonary embolism. dehydration. pneumonia.

carotid artery hemorrhage.

A client admitted with pneumonia has a history of lung cancer and heart failure. A nurse caring for this client recognizes that he should maintain adequate fluid intake to keep secretions thin for ease in expectoration. The amount of fluid intake this client should maintain is: 1.4 L. 2 L. 3 L. unspecified.

1.4 L.

Which of the following is the most effective treatment for obstructive sleep apnea (OSA)? Continuous positive airway pressure (CPAP) Bilevel positive airway pressure (BiPAP) Mechanical ventilation Oxygen by nasal cannula

Continuous positive airway pressure (CPAP)

x Select the nursing diagnosis that would warrant immediate health care provider notification. Ineffective airway clearance related to excessive mucus production secondary to retained secretions and inflammation Acute pain related to upper airway irritation secondary to an infection Deficient fluid volume related to decreased fluid intake and increased fluid loss secondary to diaphoresis associated with a fever Deficient knowledge regarding prevention of upper airway infections, treatment regimens, the surgical procedure, or postoperative care

Ineffective airway clearance related to excessive mucus production secondary to retained secretions and inflammation

A client has a history of chronic obstructive pulmonary disease (COPD). Following a coughing episode, the client reports sudden and unrelieved shortness of breath. Which of the following is the most important for the nurse to assess? Lung sounds Skin color Heart rate Respiratory rate

Lung sounds

A nurse administers albuterol (Proventil), as ordered, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect? Respiratory rate of 22 breaths/minute Dilated and reactive pupils Urine output of 40 ml/hour Heart rate of 100 beats/minute

Respiratory rate of 22 breaths/minute