Adaptive Quizzing: Med Surg "Respiratory"

A client is admitted to the intensive care unit with a diagnosis of adult respiratory distress syndrome. Which clinical finding should the nurse expect when assessing this client?

Altered mental status

After a thoracentesis for pleural effusion, a client returns to the outpatient clinic for a follow-up visit. The nurse suspects a recurrence of pleural effusion when the client says:

"I get a sharp, stabbing pain when I take a deep breath."

A nurse assesses a newly admitted client with a diagnosis of pulmonary tuberculosis (TB). Which clinical findings support this diagnosis? Select all that apply.

*Fatigue *Hemoptysis *Night sweats

Oxygen given to clients during stage 4 of chronic obstructive pulmonary disease (COPD) should be administered in which manner?

1 to 2 L via nasal cannula to keep SaO2 above 90%.

A client who is to be admitted for minor surgery has a chest radiograph as part of the presurgical physical. The nurse is notified that the radiograph reveals that the client has pulmonary tuberculosis. What evidence of tuberculosis is provided by the radiograph?

Cavities caused by caseation

A client has chronic obstructive pulmonary disease (COPD) and cor pulmonale. When teaching about nutrition, the nurse instructs the client to:

Eat small meals six times a day to limit oxygen needs

A client is admitted to the hospital with a diagnosis of laryngeal cancer. What is a common early sign of laryngeal cancer for which the nurse should assess this client?

Hoarseness

The nurse is caring for a client who has metabolic acidosis as a result of severe dehydration. The type of respirations that the nurse expects the client to exhibit is:

Kussmaul's breathing

A nurse assesses a client who is experiencing profound (late) hypovolemic shock. When monitoring the client's arterial blood gas results, what response does the nurse expect?

Metabolic Acidosis

A nurse is providing education to a co-worker who is caring for a client who is scheduled to have a thoracentesis for a pleural effusion. Which statement would be appropriate for the nurse to include?

Rapid removal of large amounts of pleural fluid may precipitate cardiovascular collapse.

When caring for a client on mechanical ventilation, the nurse should monitor for which signs of hyperventilation?

Respiratory alkalosis

A client has a chest tube inserted to treat a right hemopneumothorax. In which position should the nurse place the client to facilitate chest drainage?

Right side-lying

Immediately after a thoracentesis, a client's right lung collapses. A chest tube is inserted and is attached to a three-chamber closed drainage system. What does the nurse assess about the fluid when the chest tube is functioning properly?

Rises in the tube of the water seal chamber during inspiration.

After resection of a lower lobe of the lung, a client has excessive respiratory secretions. Which independent nursing action should the nurse implement?

Turning and positioning

A client with acquired immunodeficiency syndrome (AIDS) and Cryptococcus pneumonia frequently is incontinent of feces and urine and produces copious sputum. When providing care for this client, the nurse's priority is to:

Use gown, mask, and gloves when bathing the client

A client sustains a crushing injury to the lower left leg, and a below-the-knee amputation is performed. For which common clinical manifestations of a pulmonary embolus should the nurse assess this client? Select all that apply.

*Unilateral chest pain *Acute onset of dyspnea

The nurse is caring for a client after a right pneumonectomy for cancer. As part of the assessment, the nurse palpates the client's trachea. What is the rationale for this assessment?

A mediastinal shift may have occurred.

The nurse is caring for a 75-year-old client who had radical head and neck surgery. Thirty minutes after awakening from anesthesia, the client becomes agitated, disoriented, and confused. The nurse should:

Administer the prescribed oxygen

What nursing action will limit hypoxia when suctioning a client's airway?

Apply suction only after catheter is inserted.

A nurse is caring for several clients in the intensive care unit. Which is the greatest risk factor for a client to develop acute respiratory distress syndrome (ARDS)?

Aspirating gastric contents

A client who experienced smoke inhalation has a negative chest x-ray and arterial blood gases that demonstrate PaO2 of 70 mm Hg, PaCO2 of 45 mm Hg, and pH of 7.35. What intervention should the nurse anticipate will be prescribed by the health care provider?

Breathing exercises

A client's respiratory status may be affected after abdominal surgery. The nurse documents the behavioral objective for this client. What statement is a behavioral objective?

Demonstrates the technique of coughing and deep breathing.

What breathing exercises should the nurse teach a client with the diagnosis of emphysema?

Diaphragmatic exercises to improve contraction of the diaphragm.

A client who was recently diagnosed with emphysema develops a malignancy in the right lower lobe of the lung, and a lobectomy is performed. After surgery, the client is receiving oxygen by nasal cannula at 2 L per minute. Blood gas results demonstrate respiratory acidosis. What should be the initial nursing intervention?

Encourage deep breathing

The primary responsibility of a nurse when caring for a client with a chest tube attached to a three-chamber underwater-seal drainage system is to:

Ensure maintenance of the closed system

After a laryngectomy a client is concerned about improving the ability to communicate. What topic should the nurse include in a teaching plan for the client?

Esophageal speech

What is the most effective way for the nurse to loosen respiratory secretions for a client with an endotracheal tube?

Humidify the prescribed oxygen.

After a spontaneous pneumothorax, the client becomes extremely drowsy, and pulse and respirations increase. What do these client responses indicate to the nurse?

Hypercapnia

A client with a coronary occlusion is experiencing chest pain and distress. The nurse administers oxygen to:

Increase oxygen concentration to heart cells.

A client is receiving dexamethasone (Decadron) to treat acute exacerbation of asthma. For what side effect should the nurse monitor the client?

Increased blood glucose

The nurse provides instructions to a client who will be using an incentive spirometer postoperatively. During the client's return demonstration, the nurse concludes that the teaching has been effective when the client:

Inhales deeply through the mouthpiece, holds the breath for two seconds, and then exhales

As a result of pulmonary tuberculosis, a client has a decreased surface area for gas exchange in the lungs. Which physiologic process does the nurse consider will be affected as a result?

Molecular diffusion

A client admitted to the hospital with a diagnosis of chronic obstructive pulmonary disease (COPD) has received a prescription for a medication that is delivered via a nebulizer. When teaching about use of the nebulizer, the nurse should teach the client to:

Seal the lips around the mouthpiece and breathe in and out taking slow, deep breaths