Exam #2 Practice Test

When the nurse is assessing the older adult patient, what gerontologic changes in the respiratory system should the nurse be aware of? (Select all that apply.) -Decreased presence of mucus -Decreased gag reflex -Increased presence of mucus -Decreased alveolar duct diameter -Increased presence of collagen in alveolar walls

-Decreased gag reflex -Increased presence of collagen in alveolar walls -Decreased presence of mucus

Why would a client with COPD report feeling fatigued? Select all that apply. Muscle function gradually decreases over time in clients with COPD. The client is using all expendable energy for activities of daily living (ADLs). The client is using all expendable energy just to breathe. Lung function gradually decreases over time in clients with COPD.

-The client is using all expendable energy just to breathe. -Lung function gradually decreases over time in clients with COPD.

A client has suspected fluid accumulation in the pleural space of the lungs and is scheduled for a thoracentesis. The nurse will implement which of the following for this procedure? Select all that apply. -Apply pressure to the puncture site after the procedure. -Educate the client about the need to cleanse the thoracic area. -Prepare the client for magnetic resonance imaging after the procedure to verify tube placement. -Complete a respiratory assessment after the procedure. Place the client in the prone position.

-apply pressure to the puncture site after the procedure -educate the client about the need to cleanse the thoracic area -complete a respiratory assessment after the procedure

A client with emphysema informs the nurse, "The surgeon will be removing about 30% of my lung so that I will not be so short of breath and will have an improved quality of life." What surgery does the nurse understand the surgeon will perform? A lung volume reduction Lobectomy A sleeve resection A wedge resection

A lung volume reduction

A client with thoracic trauma is admitted to the ICU. The nurse notes the client's chest and neck are swollen and there is a crackling sensation when palpated. The nurse consequently identifies the presence of subcutaneous emphysema. If this condition becomes severe and threatens airway patency, what intervention is indicated? An endotracheal tube A chest tube A feeding tube A tracheostomy

A tracheostomy

A client presents to the ED after being in a boating accident about 3 hours ago. Now the client reports headache, fatigue, and the feeling that he "just can't breathe enough." The nurse notes that the client is restless and tachycardic with an elevated blood pressure. This client may be in the early stages of what respiratory problem? Acute respiratory failure Pneumoconiosis Pleural effusion Pneumonia

Acute respiratory failure

The nurse is caring for a client who has recurrent sinusitis. Which consideration could the nurse suggest to best decrease the frequency of infections? Gently blow the nose to eliminate nasal secretions. Place a warm cloth over the sinus area of the forehead. Administer an over-the-counter decongestant. Use an anti-allergy medication to decrease rhinitis.

Administer an over-the-counter decongestant.

A patient is brought into the emergency department with carbon monoxide poisoning after escaping a house fire. What should the nurse monitor this patient for? Hypoxic hypoxia Histotoxic hypoxia Anemic hypoxia Stagnant hypoxia

Anemic hypoxia

What is the most commonly prescribed treatment for the common cold? Antihistamines Decongestants Antitussives Expectorants

Antihistamines

While assessing an acutely ill client's respiratory rate, the nurse assesses four normal breaths followed by an episode of apnea lasting 20 seconds. How should the nurse document this finding? Biot's respiration Apnea Eupnea Cheyne-Stokes

Biot's respiration

A physician determines that a client has been exposed to someone with tuberculosis. The nurse expects the physician to order which treatment? Daily doses of isoniazid, 300 mg for 6 months to 1 year Daily oral doses of isoniazid (Nydrazid) and rifampin (Rifadin) for 6 months to 2 years Isolation until 24 hours after antitubercular therapy begins Nothing, until signs of active disease arise

Daily doses of isoniazid, 300 mg for 6 months to 1 year

A nurse is obtaining a health history from a client who reports hemoptysis for the past 2 months. The client reports occasional dyspnea. Which imaging study, ordered by the physician, will view the thoracic cavity while in motion? Magnetic resonance imaging (MRI) Chest x-ray Computed tomography (CT) scan Fluoroscopy

Fluoroscopy

The nurse should monitor a client receiving mechanical ventilation for which of the following complications? Increased cardiac output Immunosuppression Gastrointestinal hemorrhage Pulmonary emboli

Gastrointestinal hemorrhage

Which measure may increase complications for a client with COPD? Administration of antibiotics Decreased oxygen supply Administration of antitussive agents Increased oxygen supply

Increased oxygen supply

A client is receiving moderate sedation while undergoing bronchoscopy. Which assessment finding should the nurse attend to immediately? Absent cough and gag reflexes Blood-tinged secretions Oxygen saturation of 90% Respiratory rate of 13 breaths/min

Oxygen saturation of 90%

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? SaO2 pH PaO2 PaCO2 SUBMIT ANSWER

PaCo2

The nurse is performing a nutritional assessment on a client who has been diagnosed with cancer of the larynx. Which laboratory values would be assessed when determining the nutritional status of the client? Select all that apply. Protein level White blood cell count Platelet count Albumin level Glucose level

Protein level Albumin level Glucose level

Which action by the nurse is most appropriate when the client demonstrates subcutaneous emphysema along the suture line or chest dressing 2 hours after chest surgery? Apply a compression dressing to the area Report the finding to the physician immediately Record the observation Measure the patient's pulse oximetry

Record the observation

A client has a nursing diagnosis of ineffective airway clearance related to excessive mucus production. The best short-term goal is for the client to Report decreased congestion. Assume an upright position to facilitate drainage. Increase fluid intake. Use a room vaporizer to loosen secretions.

Report decreased congestion.

The nurse, caring for a patient with emphysema, understands that airflow limitations are not reversible. The end result of deterioration is: Diminished alveolar surface area. Hypercapnia resulting from decreased carbon dioxide elimination. Respiratory acidosis. Hypoxemia secondary to impaired oxygen diffusion.

Respiratory acidosis.

An adult client has just been diagnosed with small cell lung cancer. The client asks the nurse why the doctor is not offering surgery as a treatment for his cancer. What fact about lung cancer treatment should inform the nurse's response? Small cell lung cancer is self-limiting in many clients and surgery should be delayed. The cells in small cell cancer of the lung are not large enough to visualize in surgery. Small cell cancer of the lung grows rapidly and metastasizes early and extensively. Clients with small cell lung cancer are not normally stable enough to survive surgery.

Small cell cancer of the lung grows rapidly and metastasizes early and extensively.

An x-ray of a trauma client reveals rib fractures and the client is diagnosed with a small flail chest injury. Which intervention should the nurse include in the client's plan of care? Prepare the client for surgery. Immediately sedate and intubate the client. Immobilize the ribs with an abdominal binder. Suction the client's airway secretions.

Suction the client's airway secretions.

An client is described as having pectus carinatum. What would be the physical manifestation of this condition? The chest is rounded, ribs are horizontal, and sternum is pulled forward. The sternum is depressed from the second intercostal space. The sternum protrudes and the ribs are sloped backward. The thoracic and lumbar spine have a lateral S-shaped curvature.

The sternum protrudes and the ribs are sloped backward.

The mother of a client with cancer comes to the nurse concerned with her daughter's safety. She states that the dose of morphine that her daughter requires to control her pain is getting "higher and higher." As a result, the mother is afraid that her daughter will overdose. The nurse should educate the mother about what aspect of her daughter's pain management? The dose range is higher with cancer clients, and the medical team will be very careful to prevent addiction. The increased risk of overdose is an inevitable risk of maintaining adequate pain control during cancer treatment. Frequently, female clients and younger clients need higher doses of opioids to be comfortable. There is no absolute maximum opioid dose and her daughter is becoming more tolerant to the drug.

There is no absolute maximum opioid dose and her daughter is becoming more tolerant to the drug.

A client with a decreased level of consciousness is in a recumbent position. How should the nurse best assess the lung fields for a client in this position? Turn the client to enable assessment of all the patient's lung fields. Inform that physician that the client is in a recumbent position and anticipate an order for a portable chest x-ray. Avoid turning the client, and assess the accessible breath sounds from the anterior chest wall. Obtain a pulse oximetry reading, and, if the reading is low, reposition the client and auscultate breath sounds.

Turn the client to enable assessment of all the patient's lung fields.

Which homeostatic mechanism would the body of a critically ill client use to maintain normal pH? The lungs eliminate carbonic acid by blowing off more CO2. The kidneys retain more HCO3 to raise the pH. The lungs retain more CO2 to lower the pH. The lungs increase respiratory volume.

Turn the client to enable assessment of all the patient's lung fields.

For a client with advanced chronic obstructive pulmonary disease (COPD), which nursing action best promotes adequate gas exchange? Using a Venturi mask to deliver oxygen as ordered Administering a sedative as ordered Encouraging the client to drink three glasses of fluid daily Keeping the client in semi-Fowler's position

Using a Venturi mask to deliver oxygen as ordered

A mechanically ventilated client is receiving a combination of atracurium and the opioid analgesic morphine. The nurse monitors the client for which potential complication? Pneumothorax Pulmonary hypertension Venous thromboemboli Cor pulmonale

Venous thromboemboli

A thoracentesis is performed to obtain a sample of pleural fluid or a biopsy specimen from the pleural wall for diagnostic purposes. What does serous fluid indicate? Cancer Trauma Infection Emphysema

cancer

A client arrives in the emergency department reporting shortness of breath. She has 3+ pitting edema below the knees, a respiratory rate of 36 breaths per minute, and heaving respirations. The nurse auscultates the client's lungs to reveal coarse, moist, high-pitched, and non-continuous sounds that do not clear with coughing. The nurse will document these sounds as which type? Rhonchi Pleural rub Crackles Wheezes

crackles

It is important for the nurse to provide required information and appropriate explanations of diagnostic procedures to clients with respiratory disorders in order to: aid the client's caregivers. manage respiratory distress. ensure adequate rest periods. manage decreased energy levels.

manage decreased energy levels.

The nurse is caring for a client following a tonsillectomy and adenoidectomy. Two hours after the procedure, the client begins to vomit large amounts of dark blood at frequent intervals and is tachycardic and febrile. After notifying the surgeon, the nurse obtains a light, mirror, gauze, and curved hemostats. orally suctions the client, as needed. stays with and closely monitors the client. prepares for a needle aspiration.

obtains a light, mirror, gauze, and curved hemostats.

The nurse is caring for a client with a decrease in airway diameter causing airway resistance. The client experiences coughing and mucus production. Upon lung assessment, which adventitious breath sounds are anticipated? Rubs Wheezes Crackles Rhonchi

wheezes