Adult Health review

The nurse working in the radiology clinic is assisting with a pulmonary angiography. The nurse knows that when monitoring clients after a pulmonary angiography, what should the physician be notified about? a) Absent distal pulses b) Raised temperature in the affected limb c) Excessive capillary refill d) Flushed feeling in the client

a) Absent distal pulses

What finding by the nurse may indicate that the patient has chronic hypoxia? a) Clubbing of the fingers b) Crackles c) Cyanosis d) Peripheral edema

a) Clubbing of the fingers

Which of the following describes difficulty breathing when a patient is lying flat? a) Orthopnea b) Paroxysmal nocturnal dyspnea (PND) c) Tachypnea d) Bradypnea

a) Orthopnea

A client with left-sided heart failure complains of increasing shortness of breath and is agitated and coughing up pink-tinged, foamy sputum. The nurse should recognize these findings as signs and symptoms of: a) acute pulmonary edema. b) cardiogenic shock. c) pneumonia. d) right-sided heart failure.

a) acute pulmonary edema.

A nurse is caring for a client with heart failure. The nurse knows that the client has left-sided heart failure when he makes which statement? a) "My feet are bigger than normal." b) "I sleep on three pillows each night." c) "I don't have the same appetite I used to." d) "My pants don't fit around my waist."

b) "I sleep on three pillows each night."

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)? a) Residual volume of 1,200 mL b) Functional residual capacity of 2,300 mL c) Vital capacity of 3,000 mL d) Expiratory reserve volume of 1,100 mL

c) Vital capacity of 3,000 mL

The nurse auscultates crackles in a patient with a respiratory disorder. With what disorder would crackles be commonly heard? a) Asthma b) Collapsed alveoli c) Pulmonary fibrosis d) Bronchospasm

b) Collapsed alveoli

Which ventilation-perfusion ratio is exhibited by a pulmonary emboli? a) Silent unit b) Dead space c) Normal ratio of perfusion to ventilation d) Low ventilation-perfusion ratio

b) Dead space

Inspection of a patient's skin color is part of the assessment of the integumentary system. Cyanosis, which is a late indicator of hypoxia, is present when the unoxygenated hemoglobin level is: a) 2 g/dL b) 4 g/dL c) 5 g/dL d) 3 g/dL

c) 5 g/dL

A nurse practitioner diagnosed a patient with an infection in the maxillary sinuses. Select the area that the nurse palpated to make that diagnosis. a) On the cheeks below the eyes b) Behind the ethmoid sinuses c) Above the eyebrows d) Between the eyes and behind the nose

c) Above the eyebrows

A client with left-sided heart failure complains of increasing shortness of breath and is agitated and coughing up pink-tinged, foamy sputum. The nurse should recognize these findings as signs and symptoms of: a) pneumonia. b) right-sided heart failure. c) acute pulmonary edema. d) cardiogenic shock.

c) acute pulmonary edema.

A nurse taking care of a patient recently admitted to the ICU observes the patient coughing up large amounts of pink, frothy sputum. Auscultation of the lungs reveals course crackles to lower lobes bilaterally. Based on this assessment, the nurse recognizes this patient is developing which of the following problems? a) Acute exacerbation of chronic obstructive pulmonary disease b) Bilateral pneumonia c) Tuberculosis d) Decompensated heart failure with pulmonary edema

d) Decompensated heart failure with pulmonary edema

A nurse is caring for a client experiencing dyspnea, dependent edema, hepatomegaly, crackles, and jugular vein distention. What condition should the nurse suspect? a) Tension pneumothorax b) Pulmonary embolism c) Heart failure d) Cardiac tamponade

c) Heart failure

A nurse is preparing a client for bronchoscopy. Which instruction should the nurse give to the client? a) Don't eat. b) Don't walk. c) Don't talk. d) Don't cough.

a) Don't eat.

You are caring for a client with left-sided heart failure. When you go in to do your shift assessment, you find your client is wheezing, restless, tachycardic, and has severe apprehension. You know that these are symptoms of what? a) Acute pulmonary edema b) Pulmonary hypertension c) Cardiogenic shock d) Progressive heart failure

a) Acute pulmonary edema

A client has a nursing diagnosis of "ineffective airway clearance" as a result of excessive secretions. An appropriate outcome for this client would be which of the following? a) Lungs are clear on auscultation. b) Client reports no chest pain. c) Respiratory rate is 12 to 18 breaths per minute. d) Client can perform incentive spirometry.

a) Lungs are clear on auscultation.

An 18-year-old male client is described as having pectus carinatum. The nurse is aware that the manifestation of this condition would be: a) The sternum protrudes and the ribs are sloped backward. b) The sternum is depressed from the second intercostal space. c) The thoracic and lumbar spine have a lateral S-shaped curvature. d) The chest is rounded, ribs are horizontal, and sternum is pulled forward.

a) The sternum protrudes and the ribs are sloped backward.

The nurse is caring for a client diagnosed with asthma. While performing the shift assessment, the nurse auscultates breath sounds including sibilant wheezes, which are continuous musical sounds. What characteristics describe sibilant wheezes? a) They can be heard during inspiration and expiration. b) They result from air passing through widened air passages. c) They occur when the pleural surfaces are inflamed. d) They are heard in clients with decreased secretions.

a) They can be heard during inspiration and expiration.

A 53-year-old male is a regular client in the respiratory group where you practice nursing. As with all adults, millions of alveoli form most of the pulmonary mass. The squamous epithelial cells lining each alveolus consist of different types of cells. Which type of the alveoli cells produce surfactant? a) Type II cells b) Type I cells c) Type III cells. d) Type IV cells.

a) Type II cells

A client is returning from the operating room after inguinal hernia repair. The nurse notes that he has fluid volume excess from the operation and is at risk for left-sided heart failure. Which sign or symptom indicates left-sided heart failure? a) Right upper quadrant pain b) Jugular vein distention c) Bibasilar crackles d) Dependent edema

c) Bibasilar crackles

The patient with cardiac failure is taught to report which of the following symptoms to the physician or clinic immediately? a) Ability to sleep through the night b) Increased appetite c) Persistent cough d) Weight loss

c) Persistent cough

The nurse is discussing cardiac hemodynamics with a nursing student. The nurse explains preload to the student and then asks the student what nursing interventions might cause decreased preload. The student correctly answers which of the following? a) Application of antiembolytic stockings b) Maintaining the client's legs elevated c) Ambulation d) Administration of a vasodilating drug (as ordered by a physician)

d) Administration of a vasodilating drug (as ordered by a physician)

A patient comes to the emergency department complaining of a knifelike pain when taking a deep breath. What does this type of pain likely indicate to the nurse? a) Bronchogenic carcinoma b) Lung infarction c) Bacterial pneumonia d) Pleurisy

d) Pleurisy

The nurse is caring for a client with chronic obstructive pulmonary disease. The client calls the doctor and states having difficulty breathing and overall feeling fatigued. The nurse realizes that this client is at high risk for which condition? a) Respiratory alkalosis b) Respiratory acidosis c) Metabolic alkalosis d) Metabolic acidosis

b) Respiratory acidosis

A client develops cardiogenic pulmonary edema and is extremely apprehensive. What medication can the nurse administer with physician orders that will relieve anxiety and slow respiratory rate? a) Dopamine (Intropin) b) Nitroglycerin c) Morphine sulfate d) Furosemide (Lasix)

c) Morphine sulfate

A nurse is preparing a client with a pleural effusion for a thoracentesis. The nurse should: a) raise the arm on the side of the client's body on which the physician will perform the thoracentesis. b) raise the head of the bed to a high Fowler's position. c) assist the client to a sitting position on the edge of the bed, leaning over the bedside table. d) place the client supine in the bed, which is flat.

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

The nurse is caring for a client with heart failure. What procedure should the nurse prepare the client for in order to determine the ejection fraction to measure the efficiency of the heart as a pump? a) A chest radiograph b) A pulmonary arteriography c) Electrocardiogram d) Echocardiogram

d) Echocardiogram

A client with chronic bronchitis is admitted to the health facility. Auscultation of the lungs reveals low-pitched, rumbling sounds. Which of the following describes these sounds? a) Rales b) Bronchovesicular c) Venous hum d) Rhonchi

d) Rhonchi

With which disorder is jugular vein distention prominent? a) Heart failure b) Myocardial infarction (MI) c) Abdominal aortic aneurysm d) Pneumothorax

a) Heart failure

The nurse is caring for a patient who is scheduled for a bronchoscopy. The nurse understands that it is important to provide the required information and appropriate explanations for any diagnostic procedure to a patient with a respiratory disorder in order to do which of the following? a) Manage decreased energy levels b) Manage respiratory distress c) Ensure adequate rest periods d) Aid the caregivers of the patient

a) Manage decreased energy levels

You are working in a long-term care facility with a group of older adults with cardiac disorders. Why would it be important for you to closely monitor an older adult receiving digitalis preparations for cardiac disorders? a) Older adults are at increased risk for toxicity. b) Older adults are at increased risk for hyperthyroidism. c) Older adults are at increased risk for asthma. d) Older adults are at increased risk for cardiac arrests.

a) Older adults are at increased risk for toxicity.

The patient with cardiac failure is taught to report which of the following symptoms to the physician or clinic immediately? a) Persistent cough b) Increased appetite c) Ability to sleep through the night d) Weight loss

a) Persistent cough

The nurse is caring for a client with chronic obstructive pulmonary disease. The client calls the doctor and states having difficulty breathing and overall feeling fatigued. The nurse realizes that this client is at high risk for which condition? a) Respiratory acidosis b) Metabolic alkalosis c) Metabolic acidosis d) Respiratory alkalosis

a) Respiratory acidosis

Which ventilation-perfusion ratio is exhibited by acute respiratory distress syndrome (ARDS)? a) Silent unit b) Normal ratio of perfusion to ventilation c) Dead space d) Low ventilation-perfusion ratio

a) Silent unit

The nurse is caring for a patient diagnosed with pneumonia. The nurse will assess the patient for tactile fremitus by completing which of the following? a) Instructing the patient to take a deep breath and hold it while the diaphragm is percussed b) Asking the patient to repeat "ninety-nine" as the nurse's hands move down the patient's thorax c) Asking the patient to say "one, two, three" while auscultating the lungs d) Placing the thumbs along the costal margin of the chest wall and instructing the patient to inhale deeply

b) Asking the patient to repeat "ninety-nine" as the nurse's hands move down the patient's thorax

The nurse assessed a 28-year-old woman who was experiencing dyspnea severe enough to make her seek medical attention. The history revealed no prior cardiac problems and the presence of symptoms for 6 months' duration. On assessment, the nurse noted the presence of both inspiratory and expiratory wheezing. Based on this data, which of the following diagnoses is likely? a) Adult respiratory distress syndrome b) Asthma c) Acute respiratory obstruction d) Pneumothorax

b) Asthma

A pediatrician diagnosed a child with swollen and inflamed adenoids. The nurse practitioner confirmed the diagnosis by: a) Palpating the throat above the cricoid cartilage. b) Inspecting the roof of the nasopharynx. c) Examining the base of the oropharynx. d) Inspecting the posterior region of the epiglottis.

b) Inspecting the roof of the nasopharynx.

What happens to the diaphragm during inspiration? a) It relaxes and raises. b) It contracts and flattens. c) It contracts and raises. d) It relaxes and flattens.

b) It contracts and flattens.

A new client has been admitted with right-sided heart failure. The nurse knows to look for which of the following assessment findings when assessing this client? a) Cough b) Jugular venous distention c) Pulmonary congestion d) Dyspnea

b) Jugular venous distention

A patient is prescribed digitalis preparations. Which of the following conditions should the nurse closely monitor when caring for the patient? a) Vasculitis b) Potassium levels c) Flexion contractures d) Enlargement of joints

b) Potassium levels

The nurse is caring for a client whose respiratory status has declined since shift report. The client has tachypnea, is restless, and displays cyanosis. Which diagnostic test should be assessed first? a) Arterial blood gases b) Pulse oximetry c) Pulmonary function test d) Chest x-ray

b) Pulse oximetry

In which position should the patient be placed for a thoracentesis? a) Lateral recumbent b) Sitting on the edge of the bed c) Supine d) Prone

b) Sitting on the edge of the bed

The nurse receives an order to obtain a sputum sample from a client with hemoptysis. When advising the client of the physician's order, the client states not being able to produce sputum. Which suggestion, offered by the nurse, is helpful in producing the sputum sample? a) Tickle the back of the throat to produce the gag reflex. b) Take deep breaths and cough forcefully. c) Use the secretions present in the oral cavity. d) Drink 8 oz of water to thin the secretions for expectoration.

b) Take deep breaths and cough forcefully.

The nurse documents pitting edema in the bilateral lower extremities of the client. What does this documentation mean? a) There is excess fluid volume in the arterial system of the lower extremities. b) There is excess fluid volume in the interstitial space in areas affected by gravity. c) There is excess fluid volume in the venous system of the lower extremities. d) There is excess fluid volume in the hepatic system.

b) There is excess fluid volume in the interstitial space in areas affected by gravity.

The nurse auscultated a patient's middle lobe of the lungs for abnormal breath sounds. To do this, the nurse placed the stethoscope on the: a) Anterior surface of the left side of the chest, near the sixth rib. b) Posterior surface of the right side of the chest, near T3. c) Anterior surface of the right side of the chest, between the fourth and fifth rib. d) Posterior surface of the left side of the chest, near the sixth rib.

c) Anterior surface of the right side of the chest, between the fourth and fifth rib.

A patient arrives at the ED with an exacerbation of left-sided heart failure and complains of shortness of breath. Which of the following is the priority nursing intervention? a) Administer angiotensin II receptor blockers b) Administer diuretics c) Assess oxygen saturation level d) Administer angiotensin-converting enzyme inhibitors

c) Assess oxygen saturation level

A son brings his father into the clinic, stating that his father's color has changed to bluish around the mouth. The father is confused, with a respiratory rate of 28 breaths per minute and scattered crackles throughout. The son states this condition just occurred within the last hour. Which of the following factors indicates that the client's condition has lasted for more than 1 hour? a) Respiratory rate b) Son's statement c) Cyanosis d) Crackles

c) Cyanosis

A nurse is concerned that a client may develop postoperative atelectasis. Which nursing diagnosis would be most appropriate if this complication occurs? a) Ineffective airway clearance b) Decreased cardiac output c) Impaired gas exchange d) Impaired spontaneous ventilation

c) Impaired gas exchange

A nurse is assessing a patient with congestive heart failure for jugular vein distension (JVD). Which of the following observations is important to report to the physician? a) JVD is noted 1 cm above the sternal angle. b) No JVD is present. c) JVD is noted 3 cm above the sternal angle. d) JVD is noted at the level of the sternal angle.

c) JVD is noted 3 cm above the sternal angle.

During a pulmonary assessment, the nurse observes the chest for configuration. She identifies the findings as normal. Which of the following would be consistent with normal assessment? a) Lateral diameter less than anteroposterior diameter b) Anteroposterior diameter that equals the lateral diameter c) Lateral diameter greater than anteroposterior diameter d) Elevation of the scapula with the lateral diameter unaffected

c) Lateral diameter greater than anteroposterior diameter

A nurse is assessing a client with suspected cardiac tamponade. How should the nurse assess the client for pulsus paradoxus? a) Measure blood pressure in the right arm, then in the left arm as the client slows the pace of his inhalations and exhalations. b) Measure blood pressure in either arm with the client holding his breath, then with the client breathing normally. c) Measure the blood pressure in either arm as the client slowly exhales and then as the client breathes normally. d) Measure the blood pressure in right arm as the client inhales slowly, then measure the blood pressure in the left arm as the client exhales slowly.

c) Measure the blood pressure in either arm as the client slowly exhales and then as the client breathes normally.

The nurse is reviewing the blood gas results for a patient with pneumonia. What arterial blood gas measurement best reflects the adequacy of alveolar ventilation? a) SaO2 b) pH c) PaCO2 d) PaO2

c) PaCO2

In relation to the structure of the larynx, the cricoid cartilage is which of the following? a) Used in vocal cord movement with the thyroid cartilage b) The valve flap of cartilage that covers the opening to the larynx during swallowing c) The only complete cartilaginous ring in the larynx d) The largest of the cartilage structures

c) The only complete cartilaginous ring in the larynx

You are studying for a physiology test over the respiratory system. What should you know about central chemoreceptors in the medulla? a) They respond to changes in the O2 levels in the brain. b) They respond to changes in CO2 levels in the brain. c) They respond to changes in CO2 levels and hydrogen ion concentrations (pH) in the cerebrospinal fluid. d) They respond to changes in O2 levels and bicarbonate levels in the cerebrospinal fluid.

c) They respond to changes in CO2 levels and hydrogen ion concentrations (pH) in the cerebrospinal fluid.

You are caring for a client admitted with chronic bronchitis. The client is having difficulty breathing, and the family asks you what causes this difficulty. What would be your best response? a) "Anytime there is a chronic disease process it is hard for the person to breathe." b) "Having a chronic respiratory disease scars the lung and affects the effort it takes to breathe." c) "In this particular case your family member is just overly tired and having problems breathing." d) "Conditions such as chronic bronchitis cause thickening of the bronchial mucosa so it makes it harder to breathe."

d) "Conditions such as chronic bronchitis cause thickening of the bronchial mucosa so it makes it harder to breathe."

The nurse is instructing the client on the normal sensations, which can occur when contrast medium is infused during pulmonary angiography. Which statement, made by the client, demonstrates an understanding? a) "I will feel waves of nausea throughout the procedure." b) "I will feel light-headed when the contrast medium is introduced." c) "I will feel a dull pain when the catheter is introduced." d) "I will feel warm and an urge to cough."

d) "I will feel warm and an urge to cough."

A client with exacerbation of chronic obstructive pulmonary disease (COPD) is scheduled for a thoracentesis. Which nursing intervention would be appropriate for client saftey? a) Applying oxygen via nasal cannula b) Obtaining arterial blood gas values immediately after the procedure c) Assisting the client to a prone position d) Administering a prn cough suppressant

d) Administering a prn cough suppressant

A physician wants a study of diaphragmatic motion because of suspected pathology. What does the nurse anticipate that the physician will most likely order? a) Barium swallow b) Tomogram c) Bronchogram d) Fluoroscopy

d) Fluoroscopy

A client in the hospital informs the nurse he ?"feels like his heart is racing and can''t catch his breath." ?What does the nurse understand occurs as a result of a tachydysrhythmia? a) It causes a loss of elasticity in the myocardium. b) It increases preload. c) It increases afterload. d) It reduces ventricular ejection volume.

d) It reduces ventricular ejection volume.

A new client has been admitted with right-sided heart failure. The nurse knows to look for which of the following assessment findings when assessing this client? a) Dyspnea b) Pulmonary congestion c) Cough d) Jugular venous distention

d) Jugular venous distention

In a client with chronic bronchitis, which sign would lead the nurse to suspect right-sided heart failure? a) Bilateral crackles b) Cyanosis of the lips c) Productive cough d) Leg edema

d) Leg edema

A client is admitted to the ICU with a diagnosis of heart failure. The client is exhibiting symptoms of weakness, ascites, weight gain, and jugular vein distention. The nurse would know that the client is exhibiting signs of what kind of heart failure? a) Left-sided heart failure b) Chronic heart failure c) Acute heart failure d) Right-sided heart failure

d) Right-sided heart failure