Ch. 27 Evolve

The nurse is providing education on preventing pulmonary disorders at a community health fair. Which of these groups does the nurse target? Select all that apply. a. Bakers b. Coal miners c. Electricians d. Furniture refinishers e. Plumbers f. Potters

a. Bakers b. Coal miners d. Furniture refinishers f. Potters

The RN has received report about four clients. Which client needs the most immediate assessment? a. Client with acute asthma who has an oxygen saturation of 89% by pulse oximetry b. Client admitted 3 hours ago for a scheduled thoracentesis in 30 minutes c. Client with bronchogenic lung cancer who returned from bronchoscopy 3 hours ago d. Client with pleural effusion who has decreased breath sounds at the right base

a. Client with acute asthma who has an oxygen saturation of 89% by pulse oximetry

The home health nurse is assigned to visit these clients when a change in agency staffing requires that one of the clients be rescheduled for a visit on the following day. Which client will be best to reschedule? a. Client with emphysema who has been on home oxygen for a month and has SpO2 levels of 91% to 93% b. Client with history of a cough, weight loss, and night sweats who has just had a positive Mantoux test c. Client with newly diagnosed pleural effusion who needs an admission visit and an initial intake assessment d. Client with percutaneous lung biopsy yesterday who called in to report increased dyspnea

a. Client with emphysema who has been on home oxygen for a month and has SpO2 levels of 91% to 93%

The nurse is caring for a client with heart failure and acute kidney injury. For which of these breath sounds will the nurse assess? a. Crackles b. Rhonchi c. Pleural friction rub d. Wheeze

a. Crackles

A client is admitted to the medical floor with a new diagnosis of lung cancer. How will the nurse initially assist the client in managing the anxiety associated with the new diagnosis? a. Encourage the client to ask questions and verbalize concerns. b. Provide privacy for the client to be alone to deal with his or her own feelings. c. Medicate the client with diazepam for anxiety every 8 hours. d. Provide journals about cancer treatment.

a. Encourage the client to ask questions and verbalize concerns.

A client with asthma reports shortness of breath. Which of these findings does the nurse anticipate when assessing this client's chest? a. Expiratory wheezing not cleared by coughing b. Bronchial breath sounds over the trachea c. Crackles throughout the lung fields d. Bronchovesicular breath sounds in the lung bases

a. Expiratory wheezing not cleared by coughing

The nurse in the medical clinic is performing an assessment on an older adult client. Which finding requires further assessment by the nurse? a. Inability to state name and date of birth b. Slight kyphoscoliosis c. Soft speaking voice d. Need to rest after activity

a. Inability to state name and date of birth

The nurse is preparing a client with possible pulmonary embolism for a CT scan with contrast. Prior to the scan, which of these assessment questions is essential for the nurse to ask? a. "Do you take supplements containing vitamin K?" b. "Did you take metformin today?" c. "Are you allergic to peanuts?" d. "Have you had shortness of breath recently?"

b. "Did you take metformin today?"

Which assessment finding in the client with exacerbation of emphysema requires intervention by the nurse? a. Barrel-shaped chest b. Bronchial breath sounds heard at the bases c. Hyperresonance to percussion of the chest d. Ribs lying horizontal

b. Bronchial breath sounds heard at the bases

The nurse is assessing a client with chronic bronchitis who smoked 3 packs of cigarettes daily for 32 years. How does the nurse document pack-year history of smoking in the medical record? a. Client has a 32 pack-year history b. Client has a 96 pack-year history c. Client smoked 3 packs for years d. Client was a passive smoker for 32 years

b. Client has a 96 pack-year history

The nurse is preparing the client for a diagnostic bronchoscopy. Which nursing intervention is essential for the nurse to perform prior to the procedure? a. Obtain informed consent. b. Ensure the client has had nothing by mouth. c. Review dietary and medication allergies. d. Perform aggressive chest physiotherapy.

b. Ensure the client has had nothing by mouth.

When caring for a client who has just undergone thoracentesis, which of these interventions does the nurse perform first? a. Encourage coughing and deep breathing. b. Schedule an immediate chest x-ray. c. Document the volume of removed fluid in the medical record. d. Set up a water seal drainage unit.

b. Schedule an immediate chest x-ray.

The emergency department nurse is assessing a client who believes he has sustained a pneumothorax after an outpatient thoracentesis earlier today. For which of these symptoms will the nurse assess? Select all that apply. a. Slowing heart rate b. Sensation of air hunger c. Tracheal deviation d. Pain on the unaffected side e. Blue discoloration of the lips

b. Sensation of air hunger c. Tracheal deviation e. Blue discoloration of the lips

The nurse in a life care community for geriatric clients is providing education to a group of residents on expected changes during aging. Which of these activities does the nurse encourage the older adult to perform to maintain respiratory function? a. Stay in bed to prevent fatigue. b. Walk as tolerated each day. c. Consume adequate calcium. d. Perform oral hygiene twice daily.

b. Walk as tolerated each day

A client is admitted to the surgical floor with chest pain, shortness of breath, and hypoxemia after having a knee replacement. What primary assessment will the nurse make while preparing the client for a computed tomography (CT) scan? a. "Do you have any metal anywhere in your body?" b. "Do you have diabetes?" c. "Are you allergic to iodine or shellfish?" d. "Do you drink alcohol regularly?"

c. "Are you allergic to iodine or shellfish?"

The nurse is caring for a client who just returned from an open lung biopsy and has a prescription for morphine by client controlled analgesia (PCA). Which of these actions to detect early opioid induced respiratory depression does the nurse recommend? a. Continuous pulse oximetry b. Serial arterial blood gas measurements c. Continuous capnography d. Apnea monitoring

c. Continuous capnography

The nurse in the outpatient clinic is scheduling a client for pulmonary function tests. When teaching the client about pulmonary function testing (PFT), which point is essential for the nurse to emphasize? a. Administer bronchodilator medication on call. b. Encourage clear fluid intake 12 hours before the procedure. c. Ensure the client does not smoke for 6 hours before the test. d. Provide supplemental oxygen.

c. Ensure the client does not smoke for 6 hours before the test.

The nurse is caring for four clients who came to the emergency department with a productive cough. Which of these clients requires immediate intervention by the nurse? a. The client with blood in the sputum b. The client with mucoid sputum c. The client with pink, frothy sputum d. The client with yellow sputum

c. The client with pink, frothy sputum

Which client does the charge nurse on the medical-surgical unit assign to an RN who has floated from the postanesthesia care unit (PACU)? a. Client with possible ulcer who just returned from an endoscopy b. Client with emphysema who needs teaching about pulmonary function testing c. Client with pancreatitis who needs a preoperative chest x-ray d. Client who had 1200 mL of pleural fluid removed by thoracentesis

d. Client who had 1200 mL of pleural fluid removed by thoracentesis

The nurse is working in an urgent care clinic where four clients are waiting to be seen. Which client needs to be evaluated first by the nurse? a. Client who is short of breath after walking up two flights of stairs b. Client with a 10 mm area of redness on the arm after receiving purified protein derivative (Mantoux) skin test c. Client with sore throat and fever of 102.2°F (39°C) oral d. Client who is speaking in three-word sentences and has an SpO2 of 90%

d. Client who is speaking in three-word sentences and has an SpO2 of 90%

A client has returned to the medical surgical unit after a bronchoscopy. Which nursing task is best for the charge nurse to delegate to the experienced unlicensed assistive personnel (UAP)? a. Assess breath sounds. b. Offer clear liquids when gag reflex returns. c. Determine level of consciousness. d. Monitor blood pressure and pulse.

d. Monitor blood pressure and pulse.

The RN and the LPN/LVN are working together to provide care for a group of clients on a medical surgical unit. Which of these actions is most appropriate for the RN to perform? a. Administer purified protein derivative (PPD) for tuberculosis testing. b. Assess vital signs and the puncture site one day post thoracentesis. c. Monitor oxygen saturation using pulse oximetry every 4 hours. d. Plan client and family teaching regarding upcoming pulmonary function testing.

d. Plan client and family teaching regarding upcoming pulmonary function testing.