ATI Respiratory Questions

A nurse is assessing a client following a gunshot wound to the chest. For which of the following findings should the nurse monitor to detect a pneumothorax? (Select all that apply)

1. Tachypnea 2. Deviation of the trachea 5. Pleuritic pain

A nurse is providing teaching to a patient about pulmonary function tests. Which of the following tests measures the volume of air the lungs can hold at the end maximum inhalation:

1. Total lung capacity

A nurse is assisting with a thoracentesis. Which of the following actions is appropriate for the nurse to take when assisting with this procedure: (Select all that apply)

1. Wear goggles and mask during the procedure 2. Cleanse the area with an antiseptic solution 5. Apply pressure to the site after the needle is withdrawn

A nurse is caring for a client who has a new prescription for heparin therapy. Which of the following statements by the client should indicate an immediate concern for the nurse?

2. "I take antacids several time a day."

A nurse is reinforcing teaching with a patient on the purpose of taking a bronchodilator. Which of the following patient statements indicates an understanding of the teaching?

2. "I take this medication to prevent asthma attacks."

A nurse is providing discharge teaching to a patient who has COPD and a new prescription for albuterol. Which of the following statements by the patient indicates an understanding of the teaching?

3. "I can have an increase in my heart rate while taking this medication.

A nurse is providing discharge teaching to a patient who has a new prescription for prednisone for asthma. Which of the following patient statements indicates an understanding of the teaching:

3. "I will take my medication with meals."

A nurse is caring for a patient who has a new diagnosis of TB and has been placed on a multimedication regimen. Which of the following instructions should the nurse give the patient related to ethambutol?

3. "Watch for any changes in vision."

A nurse is preparing to administer a new prescription for isoniazid to a patient who has TB. The nurse should instruct the patient to report which of the following findings as an adverse effect of the medication?

3. "You might notice tingling of your hands."

A nurse is preparing a patient for a thoracentesis. In which of the following positions should the nurse place the patient:

4. Sitting while leaning forward over the bedside table -- this position maximizes the space between the patient's ribs and allows for aspiration of accumulated fluid and air.

A nurse is caring for a patient who has a tracheostomy with an inflated cuff in place. Which of the following findings indicates that the nurse should suction the patient's airway secretions:

4. The nurse auscultates course crackles in the lung field.

A nurse is preparing to administer cisplatin IV to a patient with lung cancer. The nurse should identify that which of the following findings is an adverse effect of this medication?

4. Tinnitis An adverse effect of cisplatin is ototoxicity, which can cause tinnitis.

A nurse working in the ED is caring for a patient following a chest trauma. Which of the following findings indicates a tension pneumothorax:

4. Tracheal deviation to the unaffected side A tension pneumothorax results from free air filling the chest cavity, causing the lung to collapse and forcing the trachea to deviate to the unaffected side.

A nurse is caring for a patient who is postoperative and is hypoventilating secondary to general anesthesia effects and incisional pain. Which of the following ABG values support the nurse's suspicion of respiratory acidosis:

4. pH 7.30, PO2 80 mm Hg, PaCO2 55 mm Hg, HCO3 22 mEq/L

A nurse is discharging a patient who has COPD. Upon discharge, the patient is concerned that he will never be able to leave his house now that he is on continuous oxygen. Which of the following is an appropriate response by the nurse?

1. "There are portable oxygen delivery systems that you can take with you."

A nurse is reviewing the health records of five clients. Which of the following clients are at risk for developing respiratory distress syndrome? (Select all that apply)

1. A client who experienced a near-drowning incident. 2. A client following coronary artery bypass graft surgery. 4. A client who has dyphagia. 5. A client who experienced a drug overdose.

A nurse is caring for a group of clients. Which of the following clients are at risk for a PE? (Select all that apply)

1. A client who has a BMI of 30 3. A client who has a fractured femur. 5. A client who has chronic atrial fibrillation

A nurse in the emergency department is assessing a patient for a closed pneumothorax and significant bruising of the left chest following a MVA. The client reports severe left chest pain on inspiration. The nurse should assess the patient for which of the following manifestations of a pneumothorax:

1. Absence of breath sounds

A nurse in an urgent care clinical is collecting data from a patient who reports exposure to anthrax. Which of the following findings is an indication of the prodromal stage of inhalation anthrax:

1. Dry cough

A nurse is caring for a patient following a throacentesis. Which of the following manifestations should the nurse recognize as risks for complications? (Select all that apply)

1. Dyspnea

A nurse is planning care for a patient who has COPD and is malnourished. Which of the following recommendations to promote nutritional intake should the nurse include in the plan:

1. Eat high-calorie foods first

A nurse is planning care for a patient following the insertion of a chest tube and drainage system. Which of the following should be included in the plan of care? (Select all that apply)

1. Encourage the patient to cough every 2 hours 2. Check for continuous bubbling in the suction chamber 5. Obtain a chest x-ray A chest x-ray is obtained following the procedure to verify chest tube placement.

A nurse is caring for a client who is receiving vecuronium for acute respiratory distress syndrome. Which of the following medications should the nurse anticipate administering with this medication? (Select all that apply)

1. Fentanyl 3. Midazolam

A nurse is caring for a client who is to receive thrombolytic therapy. Which of the following factors should the nurse recognize as a contraindication to the therapy?

1. Hip arthroplasty 2 weeks ago

A nurse is caring for a patient who has acute respiratory distress syndrome. Which of the following assessment findings indicates a decline in the patient's condition:

1. Increase in respiratory rate

A nurse is preparing to care for a patient following chest tube placement. Which of the following items should be available in the patient's room? (Select all that apply)

1. Oxygen 2. Sterile water 5. Occlusive dressing

A nurse is caring for a patient who is scheduled for a throacentesis. Which of the folowing supplies should the nurse ensure are in the patient's room? (Select all that apply)

1. Oxygen equipment 3. Pule oximeter 4. Sterile dressing

A nurse is providing information about TB to a group of patients at a local community center. Which of the following manifestations should the nurse include in the teaching? (Select all that apply)

1. Persistent cough 3. Fatigue 4. Night sweats 5. Purulent sputum

A nurse is caring for a patient who is scheduled for a thoracentesis. Prior to the procedure, which of the following actions should the nurse take:

1. Position the client in an upright position, leaning over the bedside table.

A nurse on a med-surg unit is caring for a patient who is postoperative following a hip replacement surgery. The patient reports feeling apprehensive and restless. Which of the follow findings should the nurse recognize as an indication of a PE:

1. Sudden onset of dyspnea

A home health nurse is teaching a patient who has active TB. The provider has prescribed the following medication regiment: isoniazid 250 mg PO daily, rifampin 500 mg PO daily, pyrazinamide 750 mg PO daily, and ethambutol 1 mg PO daily. Which of the following patient statements indicate the client understands the teaching? (Select all that apply)

2. "I will wash my hands each time I cough." 3. "I will wear a mask when I am in a public area."

A nurse is orienting a newly licensed nurse on the purpose of administering vecuronium to a client who has ARDS. Which of the following statements by the newly licensed nurse indicates understanding of the teaching?

2. "This medication is given to facilitate ventilation." Vecuronium is a neuromuscular blocking agent given to facilitate ventilation and decrease oxygen consumption.

A nurse is teaching a patient who has TB. Which of the following statements should the nurse include in the teaching?

2. "You will need to provide sputum samples every 4 weeks to monitor the effectiveness of the medication."

A nurse is caring for a patient who has a chest tube and drainage system in place. The nurse observes that the chest tube was accidentally removed. Which of the following actions should the nurse take first?

2. Apply sterile gauze to the insertion site

A nurse is assessing a patient who has a chest tube in place following a thoracic surgery. Which of the following findings indicates a need for intervention:

2. Continuous bubbling in the water seal chamber. Continuous bubbling in the water seal chamber suggests an air leak.

A nurse in the emergency department is assessing a client who has a suspected flail chest. Which of the following findings should the nurse expect? (Select all that apply)

2. Cyanosis 3. Hypotension 4. Dyspnea 5. Paradoxic chest movement

A nurse is assessing a patient who has emphysema. The nurse should report which of the following assessment findings:

2. Elevated temperature Patients who have emphysema are at risk for development of pneumonia and other respiratory infections. A nurse should report an elevated temperature to the provider.

A nurse is assessing a patient who has a history of asthma. Which of the following factors should the nurse identify as a risk for asthma?

2. Environmental allergies

A nurse is assessing a patient who has a chest tube and drainage system in place. Which of the following are expected findings? (Select all that apply)

2. Gentle constant bubbling in the suction control chamber 3. Rise and fall in the level of water in the water seal chamber with inspiration and expiration

A nurse is reviewing the prescriptions for a client who has a pneumothorax. Which of the following actions should the nurse perform first?

2. Obtain a large-bore IV needle for decompression.

A nurse on a medical unit is caring for a patient who apirated gastric contents prior to admission. The nurse administers 100% oxygen by nonbreather mask after the patient reports severe dyspnea. Which of the following findings is a clinical manifestation of acute respiratory distress syndrome (ARDS):

2. PaO2 50 mm Hg The patient who has manifestations of ARDS has a low PaO2 level even with the administration of oxygen. Hypoxemia after treatment with oxygen is a manifestation of ARDS.

A nurse is assessing a client who has a PE. Which of the following manifestations should the nurse expect to find? (Select all that apply)

2. Pleural friction rub 4. Petechiae 5. Tachycardia

A nurse is caring for a patient who has COPD. Which of the following findings should the nurse report to the provider:

2. Productive cough with green sputum -- it indicates an infection

A nurse is providing instructions about pursed-lip breathing for a patient who has COPD with emphysema. The nurse should explain that this breathing technique accomplishes which of the following:

2. Promotes carbon dioxide elimination

A nurse is planning care for a client who has severe acute respiratory distress system (SARS). Which of the following actions should be included in the plan of care for this client? (Select all that apply)

2. Provide supplemental oxygen 4. Administer of bronchodilators 5. Maintain ventilatory support

A nurse is caring for an elderly patient who suffers from COPD with pneumonia. The nurse should monitor the patient for which of the following acid-base imbalances?

2. Respiratory acidosis Respiratory acidosis is a common complication of COPD. This complication occurs because patients who have COPD are unable to exhale carbon dioxide due to a loss of elastic recoil in the lungs.

A nurse is reviewing ABG laboratory results of a patient who is in respiratory distress. The results are pH 7.47, PaCO2 32 mm Hg, HCO3 22 mm Hg. The nurse should recognize that the client is experiencing which of the following acid-base imbalances:

2. Respiratory alkalosis

A nurse is developing a teaching plan for a patient about preventing acute asthma attacks. Which of the following points should the nurse plan to discuss first:

2. The patient's perception of the disease process and what might have triggered attacks in the past

A nurse is teaching about daily chest physiotherapy with a patient who has cystic fibrosis. The nurse should instruct the patient that which of the following is the purpose of the treatments:

2. To mobilize secretions in the airways The purpose of chest physiotherapy is to loosen the patient's secretions and promote drainage of secretions from the lungs. Chest physiotherapy includes percussion, vibration, and promotion of drainage by gravity.

A nurse is caring for a patient who is in respiratory distress and requires endotracheal suctioning. Which of the following actions should the nurse take:

2. Use a rotating motion to remove the suction catheter

A nurse in the emergency department is caring for a patient who is having an acute asthma attack. Which of the following assessments indicates that the respiratory status is declining? (Select all that apply)

2. Wheezing 3. Retraction of sternal muscles 5. PVCs

A nurse is reviewing prescriptions for a client who has acute dyspnea and diaphoresis. The client states she is anxious and is unable to get enough air. Vital signs are heart rate 117/min, respirations 38/min, temperature 101.2 F, and blood pressure 100/54 mm Hg. Which of the following nursing actions is the priority?

3. Administer oxygen therapy.

A nurse in the emergency department is assessing a client who was in a MVA. Findings include absent breath sounds in the left lower lobe with dyspnea, blood pressure 118/68 mm Hg, heart rate 124/min, respirations 38/min, temperature 101.4 F, and SaO2 92% on room air. Which of the following actions should the nurse take first?

3. Administer oxygen via a high-flow mask.

A nurse is caring for a patient receiving mechanical ventilation. The low pressure alarm sounds. Which of the following should the nurse recognize as a cause for the alarm:

3. Artificial airway cuff leak

A nurse is caring for a patient following the insertion of a chest tube. The nurse should plan to have which of the following items in the patient's room:

3. Container of sterile water

A patient is admitted to the emergency department following a motorcycle crash. The nurse notes a crackling sensation upon palpation on the right side of the patient's chest. After notifying the provider, the nurse should document the finding as which of the following:

3. Crepitus Crepitus, also called subcutaneous emphysema, is a coarse crackling sensation that the nurse can feel when palpating the skin surface over the patient's chest. Crepitus indicates an air leak into the subcutaneous tissue, which is often a clinical manifestation of a pneumothorax.

A nurse is preparing to administer a dose of a new prescription of prednisone to a patient who has COPD. The nurse should monitor for which of the following adverse effects of this medication? (Select all that apply)

3. Fluid retention 5. Black, tarry stools

A nurse in a provider's office is assessing a patient who states he was recently exposed to TB. Which of the following findings is a clinical manifestation of pulmonary TB:

3. Night sweats Night sweats and fevers are clinical manifestations of TB.

A nurse is preparing to assist a provider to withdraw arterial blood from a patient's radial artery for measurement of ABG. Which of the following actions should the nurse plan to take?

3. Perform an Allen's test prior to obtaining the specimen. The nurse should ensure that circulation to the hand is adequate from the ulnar artery in case the radial artery is injured from the blood draw. The most common site for withdrawal of arterial blood gases is the radial artery.

A nurse is planning care for a patient who has COPD. Which of the following interventions should the nurse include in the plan of care:

3. Provide a diet high in calories and protein

A nurse is planning to instruct a patient on how to perform pursed-lip breathing. Which of the following should the nurse include in the plan of care?

3. Take a deep breath in through your nose.

A nurse is planning care for a patient following placement of a chest tube 1 hour ago. Which of the following actions should the nurse include in the plan of care:

3. Tape all of the connections between the chest tube and the drainage system

A nurse is caring for a patient who has bacterial pneumonia. The nurse should expect which of the following assessment findings:

3. Temperature 38.8 C ( 101.8 F) An elevated temperature is an expected finding for a patient who has bacterial pneumonia.

A nurse is discharging a patient who has pulmonary TB and is to start therapy with rifampin. The nurse should plan to include which of the following in the patient's teaching plan:

3. Urine and other secretions will be orange. Rifampin will turn urine and other secretions orange.

A nurse in a clinic is providing teaching for a patient who is to have a tuberculin skin test. Which of the following information should the nurse include:

3. You must return to the clinic to have the test read in 2 to 3 days.

A nurse is instructing a patient on the use of an incentive spirometer. Which of the following statements by the client indicates an understanding of the teaching."

4. "I will take in a deep breath and hold it before exhaling."

A nurse is reviewing discharge instructions for a client who experienced a pneumothorax. Which of the following statements should the nurse use when teaching the client?

4. "Notify your provider if you experience a productive cough."

A nurse is caring for a patient with a PE. Which of the following interventions is the priority:

4. Administer heparin via continuous IV fusion

A nurse is caring for a patient 2 hours after admission. The patient has an SaO2 of 91% exhibits audible wheezes, and is using accessory muscles when breathing. Which of the following classes of medications should the nurse expect to administer?

4. Beta 2 agonist

A nurse is assessing a patient following a bronchoscopy. Which of the following findings should the nurse report to the provider:

4. Bronchospasms

A nurse is providing preoperative teaching to a patient who is to undergo a pneumoectomy. The patient states "I am afraid it will hurt to cough after surgery." Which of the following statements by the nurse is appropriate:

4. I will show you how to splint your incision while you cough.

A nurse is preparing discharge teaching to a patient who is postoperative following a rhinoplasty. Which of the following instructions should the nurse include:

4. Lie on your back with your head elevated 30 degrees while resting The nurse should instruct the patient to rest in the semi-fowlers position to prevent aspiration of nasal secretions.

A nurse is caring for a patient who has acute respiratory failure. Which of the following laboratory findings should the nurse expect:

4. PaO2 58 mm Hg

A nurse is assisting a provider with the removal of a chest tube. Which of the following should the nurse instruct the patient to do?

4. Perform the Valsalva maneuver