Assignment #3 PART 2

Naloxone 0.4 mg IV bolus to a client who has opioid-induced respiratory depression. Available is naloxone injection 0.2 mg/ml. How many ml should the nurse administer per dose?

2 mL

5 mg/kg PO every 12 hr for 5 days. The client weighs 88 lb. How many mg should the nurse administer per dose?

200mg

A nurse is caring for a client who has pneumonia and a prescription for oxygen therapy at 5 L/min via nasal cannula. Which of the following actions should the nurse take? A. Attach a humidifier bottle to the base of the flow meter. B. Remove the nasal cannula while the client eats. C. Secure the oxygen tubing to the bed sheet near the client's head. D. Apply petroleum jelly to the nares as needed to soothe mucous membranes

A. Attach a humidifier bottle to the base of the flow meter.

A nurse is assessing a client who has a pneumothorax with a chest tube in place. For which of the following findings should the nurse notify the provider? A. Movement of the trachea toward the unaffected side B. Bubbling of the water in the water seal chamber with exhalation C. Crepitus in the area above and surrounding the insertion site D. Eyelets are not visible

A. Movement of the trachea toward the unaffected side

A nurse is assessing a client who has asthma. Which of the following areas should the nurse evaluate as the most reliable indicator of central cyanosis? A. Oral mucosa B. Conjunctivae C.Ear lobes D. Soles of the feet

A. Oral mucosa

A nurse is admitting a client who is having an exacerbation of his asthma. When reviewing the provider's orders, the nurse recognizes that clarification is needed for which of the following medications? A. Propranolol B. Theophylline C. Montelukast D. Prednisone

A. Propranolol

1. A nurse is caring for a client who has a chest tube in a place to a closed chest draining system. Which of the following findings should indicate to the nurse that the client's lung has re-expanded? A. Oxygen saturation of 95% B. No fluctuations in the water seal chamber C. No reports of pleuritic chest pain D. Occasional bubbling in the water-seal chamber

B. No fluctuations in the water seal chamber

A nurse in a provider's office is assessing an older adult client whose son reports that the client has been sick with a respiratory illness for the past 6 days. Which of the following assessment findings is a manifestation of pneumonia in the older adult client? A. Bradycardia B. Night sweats C. Confusion D. Narrowed pulse pressure

C. Confusion

1. A nurse is caring for a client who has pneumonia. Which of the following actions should the nurse take to promote thinning of respiratory secretions? A. Encourage the client to ambulate frequently. B. Encourage coughing and deep breathing. C. Encourage the client to increase fluid intake. D. Encourage regular use of the incentive spirometer.

C. Encourage the client to increase fluid intake.

A nurse is caring for a client who has chest tube connected to a closed drainage system and needs to be transported to the x-ray department. Which of the following actions should the nurse take? A. Clamp the chest tube prior to transferring the client to a wheelchair. B. Disconnect the chest tube from the drainage system during transport. C. Keep the drainage system below the level of the client's chest at all times. D. Empty the collection chamber prior to transport.

C. Keep the drainage system below the level of the client's chest at all times.

A nurse is providing discharge instructions to a client who has asthma and is about to start taking theophylline (Theo-24). The nurse should tell the client that this medication might cause which of the following adverse effects? A. Drowsiness B. Constipation C. Oliguria D. Tachycardia

D. Tachycardia

A nurse is caring for a client who has emphysema. Which of the following findings should the nurse expect to assess in this client? a. Dyspnea b. Bradycardia c. Barrel chest d. Clubbing of the fingers e. Deep respirations

a. Dyspnea c. Barrel chest d. Clubbing of the fingers

1. A nurse is teaching a client who has asthma how to use a metered-dose inhaler (MDI). The nurse identifies the sequence of steps the client should follow. a. Inhale deeply and then exhale completely b. Place lips firmly around mouthpiece c. Breathe in deeply over 2-3 seconds while pushing down on the canister d. Hold breath for 10 seconds e. Exhale slowly through pursed lips f. Wait 60 seconds between each puff

a. Inhale deeply and then exhale completely b. Place lips firmly around mouthpiece c. Breathe in deeply over 2-3 seconds while pushing down on the canister d. Hold breath for 10 seconds e. Exhale slowly through pursed lips f. Wait 60 seconds between each puff

A college health nurse interprets the peak expiratory flow rate for a student who has asthma and finds that the student is in the yellow zone of his asthma action plan. The nurse should be base her actions on which of the following information? a. The student should use his quick-relief inhaler. b. The student's asthma is not well controlled. c. The student's peak flow is 50% to 80% of his best peak flow. d. The student needs to go to the hospital. d. The nurse should obtain a second expiratory flow rate.

a. The student should use his quick-relief inhaler. b. The student's asthma is not well controlled. c. The student's peak flow is 50% to 80% of his best peak flow. d. The nurse should obtain a second expiratory flow rate.

A nurse is assessing the respiratory pattern of an older adult client who is receiving end-of-life care. Which of the following assessment findings should the nurse identify as Cheyne-stokes respirations? A. Breathing ranging from very deep to very shallow with periods of apnea B. Shallow to normal breaths alternating with periods of apnea C. Rapid respirations that are unusually deep and regular D. An inability to breathe without dyspnea unless sitting upright

A. Breathing ranging from very deep to very shallow with periods of apnea

A nurse in an emergency department is preparing to administer theophylline by continuous intravenous (IV) infusion to a client who is an experiencing an asthma attack. Which of the following actions should the nurse take? A. Infuse the medication with an IV pump. B. Cover the IV container with dark paper. C. Administer a test dose first. D. Infuse the medication at 35 mg/min.

A. Infuse the medication with an IV pump.

A nurse is teaching a client who has asthma about how to use an albuterol inhaler. Which of the following actions by the client indicates an understanding of the teaching? A. The client holds his breath for 10 seconds after inhaling the medication. B. The client takes a quick inhalation while releasing the medication from the inhaler. C. The client exhales as the medication is released from the inhaler. D. The client waits 10 min between inhalations.

A. The client holds his breath for 10 seconds after inhaling the medication.

A nurse is providing discharge teaching to a client who has asthma and new prescriptions for cromolyn and albuterol, both by nebulizer. Which of the following statements by the client indicates an understanding of the teaching? A. "If my breathing begins to feel tight, I will use the cromolyn immediately." B. "I will be sure to take the albuterol before taking the cromolyn." C. "I will use both medications immediately after exercising." D. "I will administer the medications 10 minutes apart."

B. "I will be sure to take the albuterol before taking the cromolyn."

A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects A. Hyperglycemia B. Adrenocortical insufficiency C. Severe dehydration D. Rebound pulmonary congestion

B. Adrenocortical insufficiency

A nurse in an urgent care center is caring for a client who is having an acute asthma exacerbation. Which of the following actions is the nurse's highest priority? A. Initiating oxygen therapy B. Providing immediate rest for the client C. Positioning the client in high-Fowler's D. Administering a nebulized beta-adrenergic

D. Administering a nebulized beta-adrenergic

A nurse is teaching a client who has a new diagnosis of asthma. Which of the following medications should the nurse instruct the client to use to abort an acute asthma attack? A. Beclomethasone B. Salmeterol C. Formoterol D. Albuterol

D. Albuterol

A nurse in a clinic sees a client who has an acute asthma exacerbation. Which of the following medications should reduce the symptoms? A. Cromolyn via metered-dose inhaler B. Montelukast orally C. Budesonide via dry-powder inhaler D. Albuterol via jet nebulizer

D. Albuterol via jet nebulizer

A nurse is caring for a client who has streptococcal pneumonia and a prescription for penicillin G by intermittent IV bolus. 10 minutes into the infusion of the third dose, the client reports that the IV site itches and that he feels dizzy and short of breath. Which of the following actions should the nurse take first? A. Stop the infusion. B. Call the client's provider. C. Elevate the head of the bed. D. Auscultate the client's breath sounds.

A. Stop the infusion.

1. A home health nurse visits a client who has COPD and receives oxygen at 2 L/min via nasal cannula. The client reports difficulty breathing. Which of the following actions is the nurse's priority? A. Increase the oxygen flow to 3 L/min. B. Assess the client's respiratory status. C. Call emergency services for the client. D. Have the client cough and expectorate secretions.

B. Assess the client's respiratory status.

A nurse on a medical-surgical unit is performing an admission assessment of a client who has COPD with emphysema. The client reports that he has a frequent productive cough and is short of breath. The nurse should anticipate which of the following assessment findings for this client? A. Respiratory alkalosis B. Increased anteroposterior diameter of the chest C. Oxygen saturation level 96% D. Petechiae on chest

B. Increased anteroposterior diameter of the chest

The nurse is assessing a client who has COPD. The nurse should expect the client's chest to be which of the following shapes? A. Pigeon B. Funnel C. Kyphotic D. Barrel

D. Barrel

A nurse in the emergency department is assessing an older adult client who has community-acquired pneumonia. Which of the following findings should the nurse expect? A. Unequal pupils B. Hypertension C. Tympany upon chest percussion D. Confusion

D. Confusion

A nurse is caring for a client who has chronic obstructive pulmonary disease (COPD). The client tells the nurse, "I can feel the congestion in my lungs, and I certainly cough a lot, but I can't seem to bring anything up." Which of the following actions should the nurse take to help this client with tenacious bronchial secretions? A. Maintaining a semi-Fowler's position as often as possible B. Administering oxygen via nasal cannula at 2 L/min C. Helping the client select a low-salt diet D. Encouraging the client to drink 2 to 3 L of water daily

D. Encouraging the client to drink 2 to 3 L of water daily

A nurse is implementing a plan of care for a client who has AIDS with recurring pneumonia. Which of the following actions should the nurse take? A. Encourage fluid intake of 1500 mL/day. B. Position head of bed at 10 degrees. C. Cough and deep breathe every 8 hr. D. Obtain a sputum culture.

D. Obtain a sputum culture.

1. A nurse is evaluating teaching on a client who has a new prescription for montelukast to treat asthma. Which of the following statements by the client indicates an understanding of the teaching? A. "I'll rinse my mouth after taking this medication." B. "I'll take this medication when I get an asthma attack." C. "I'll take this medication once a day in the evening." D. "I'll use a spacer device when I inhale this medication."

C. "I'll take this medication once a day in the evening."

A nurse is assessing a client for hypoxemia during an asthma attack. Which of the following manifestations should the nurse expect? A. Nausea B. Dysphagia C. Agitation D. Hypotension

C. Agitation

A client is planning to perform nasotracheal suction for a client who has COPD and an artificial airway. Which of the following actions should the nurse take? A. Perform suctioning for up to four passes. B. Apply suction to the catheter when advancing it into the trachea. C. Preoxygenate the client with 100% oxygen for up to 3 min. D. Limit each suction pass to 25 seconds.

C. Preoxygenate the client with 100% oxygen for up to 3 min.

A nurse is providing teaching to a client who has asthma and a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide? A. Check the pulse after medication administration. B. Take the medication with meals. C. Rinse the mouth after administration. D. Limit caffeine intake.

C. Rinse the mouth after administration.

A nurse is developing a plan of care for a client who has COPD. The nurse should include which of the following interventions in the plan? A. Restrict the client's fluid intake to less than 2 L/day. B. Provide the client with a low-protein diet. C. Have the client use the early-morning hours for exercise and activity. D. Instruct the client to use pursed-lip breathing.

D. Instruct the client to use pursed-lip breathing.

A nurse is providing discharge teaching to a client who has asthma and a new prescription for fluticasone/salmeterol. For which of the following adverse effects should the nurse instruct the client to report to the provider? A. Sedation B. Increased appetite C. White coating in the mouth D. Dry oral mucous membranes

C. White coating in the mouth

A nurse is performing chest physiotherapy on a client who has a respiratory infection. To increase the velocity and turbulence of the air the client exhales, which of the following techniques should the nurse use? A. Postural drainage B. Nebulization C. Percussion D. Vibration

D. Vibration

A nurse is auscultating the breath sounds of a client who has asthma. When the client exhales, the nurse hears continuous high-pitched squeaking sounds. The nurse should document this as which of the following adventitious breath sounds? A. Crackles B. Rhonchi C. Stridor D. Wheezes

D. Wheezes