Oxygenation Quiz

a client with COPD has a blood pH of 7.25 and a partial pressure of carbon dioxide (PCO2) of 60 mm Hg. which complication would the nurse suspect the client is experiencing? 1. metabolic acidosis 2. metabolic alkalosis 3. respiratory acidosis 4. respiratory alkalosis

3

a client with cystic fibrosis asks why the precession procedure is being performed. which rationale would the nurse give to the client? 1. it relieves bronchial spasms 2. it increases the depth of respirations 3. it loosed pulmonary secretions 4. it expels carbon dioxide from the lungs

3

a male adolescent with cystic fibrosis, whose parents are both carriers of the disease, asks the nurse, "when I have children, could they have cystic fibrosis like me?" which information would the nurse consider before responding? 1. men with cystic fibrosis usually are sterile, although sexual function is not affected 2. men with cystic fibrosis generally have a 50% chance of having children with the disease 3. women will pass this disease to their children because it is carried on the sex chromosome 4. women have a 25% chance of passing the disease to their children if their parents are carriers

1

the nurse administers albuterol to a 4 yo. which intervention would assist the nurse in evaluating the effectiveness of this medication? 1. auscultate breath sounds 2. collect a sputum sample 3. conduct a neurological examination 4. palpate chest excursion

1

the nurse is caring for a school-aged child with cystic fibrosis. which pathophysiologic factor has the greatest effect on the child's health status? 1. extremely thick mucus causing obstructed airways 2. acute inflammation of the lung parenchyma 3. endocrine glands secreting increased levels of hormones 4. increased irritability of the airways resulting in obstruction

1

which clinical finding would the nurse recognize as an early sign of cystic fibrosis in a neonate? 1. meconium ileus 2. imperforate anus 3. hemoglobin level of 20 4. total bilirubin level of 8

1

which recommendation would the nurse make to the parent of a 6 month old regarding safe sleep practices? 1. "place the infant in a supine position for sleep" 2. "avoid positioning the head on alternating sides" 3. "a prime position is more beneficial for sleeping" 4. "if the infant is restless, place it on one side to sleep"

1

which treatment would the nurse anticipate for an infant admitted with bronchitis caused by RSV? 1.humidified cool air and adequate hydration 2. postural drainage and oxygen by hood 3. bronchodilators and cough suppressants 4. corticosteroids and broad-spectrum antibiotics

1

which trigger would the nurse instruct a client to avoid to decrease the incidence os asthma attacks? (select all that apply) 1. mold 2. cold air 3. pet dander 4. air pollution 5. cigarette smoke

1, 2, 3, 4, 5

which would the nurse teach parents boat preventing SIDS? (select all that apply) 1. restrain from smoking around the infant 2. avoid co-sleeping or bed-sharing 3. position the infant on the side while sleeping 4. use soft pillows to support the infant while sleeping 5. refrain from placing stuffed toys on the infants bed

1, 2, 5

after the nurse has taught a client with asthma about use of speak flow meter, which client statements indicate that the teaching has been effective? (select all that apply) 1. "readings in the green zone mean that my asthma is under control" 2. "if I get a reading in the yellow zone, I need to stop what I'm doing and rest for a while" 3. "if I get a reading in the red zone, then I need to use the quick relief inhaler and have my family take me to the hospital" 4. "I should check the park flow readings at least twice a day until my baseline is established" 5. "I don't need to check my peak flow readings if I use the quick relief medication"

1, 3, 4

after completing parental teaching about the risk factors for SIDS, which parental statement indicates further education is required? 1. "my baby sleep in our bedroom" 2. "I keep blankets snugly around my baby during a nap" 3. "I place Tony in the cir only when my baby is awake" 4. "I give my baby a pacifier when it is time to go to bed"

2

which finding would be of most concern when the nurse assesses a client with emphysema? 1. barrel chest 2. oral cyanosis 3. pursed-lip expiration 4. respirations 26 breaths per minute

2

which assessment findings would indicate a possible asthma exacerbation? (select all that apply) 1. fever 2. stridor 3. wheezing 4. tachycardia 5. hypotension

3, 4

diagnosed with chronic obstructive pulmonary disease (COPD), a 50 yo client's clinical data after treatment is: HR of 100, BP 138/82, RR of 32, temp 98.2 F, and O2 of 80%. which vital sign obtained by the nurse indicates a positive outcome? (select all that apply) 1. radial pulse: 70 2. Temp: 98.6 3. RR: 14 4. BP 110/70 5. O2: 92%

3, 4, 5

the parent of a. child with cystic fibrosis tells the nurse they have switched to natural pancreatic enzymes because of financial issues. which response by the nurse is most appropriate? 1. "you don't need to give the enzymes now that your child is in school" 2. "natural enzymes don't have any side effects and can be taken without regard to meals" 3. "if you are using generic enzymes, you will need to give twice as many to achieve the required effect" 4. "natural enzymes are not as effective as the brand-name product. this is something you need to discuss with your health care provider"

4

this mucus gland secretions, elevated sweat electrolytes, meconium ileus, and difficulty maintaining and gaining weight are associated with which autosomal recessive disorder? 1. cerebral palsy 2. cystic fibrosis 3. muscular dystrophy 4. multiple sclerosis

2

when a client with COPD reports a 5-lb weight gain in 1 week, the nurse will assess for other signs of symptoms of which complication? 1. polycythemia 2. cor pulmonale 3. compensated acidosis 4. left ventricular failure

2

which action would the nurse include in the plan for care for a 6 month old infant with RSV who is in respiratory distress? 1. begin a clear fluid diet 2. maintain droplet and contact precautions 3. administer prescribed antibiotic immediately 4. allow parents and siblings to room in with the infant

2

a 12 yo child with cystic fibrosis is prescribed four pancrelipase capsules five times a day. the nurse explains to the child they would take the medication with meals and snacks to accomplish which goal? 1. enhance oxygenation 2. limit excretion of fats 3. facilitate nutrient utilization 4. prevent iron-deficiency anemia

3

a client is admitted to the hospital with a diagnosis of COPD. which action would the nurse take to prevent client fatigue? 1. provide small, frequent meals 2. encourage pursed-lip breathing 3. schedule nursing activities to allow for rest 4. encourage bed rest until energy level improves

3

which diagnostic test would be most useful in evaluating the effectiveness of treatment for asthma? 1. chest x-ray 2. pulmonary function tests 3. serum eosinophil counts 4. immunoglobulin E levels

2

which goal is the priority for a client with asthma who has a prescription for an inhaled bronchodilator? 1. is able to obtain pulse oximeter readings 2. demonstrates use of a metered-dose inhaler 3. knows the health care provider's office hours 4. can identify triggers that may cause wheezing

2

which client in the pulmonary clinic will the nurse plan to teach about pulmonary function testing? 1. client who has COPD 2. client who is being evaluated for lung histoplasmosis 3. client who is recovering after pulmonary embolism 4. client who hashed positive tuberculosis skin testing

1

which pathophysiological process would the nurse expect to account for growth failure in a 4 yo child with newly diagnosed cystic fibrosis? 1. impaired digestion and absorption because of the lack of pancreatic enzymes 2. dyspnea and shortness of breath, which cause anorexia and disinterest in food 3. increased bowel motility and diarrhea, which lead to inadequate absorption of nutrients 4. pulmonary obstruction, which causes an oxygen deficit and inadequate tissue nourishment

1

the nurse performs a respiratory assessment and auscultates high-pitched, creaking, and accentuated breath sounds on expiration. which term describes the findings? 1. rhonchi 2. wheezes 3. pleural friction rub 4. bronchovesicular

2

in which order would the nurse take these prescribed actions when caring for a client with COPD who is admitted with fever, increased dyspnea, and oxygen saturation of 86%? 1. start oxygen per nonrebreather mask 2. infuse ceftriaxone 1 g intravenously 3. administer acetaminophen for fever 4. obtain blood and sputum cultures

1, 4, 2, 3

which intervention is important in the care of a hospitalized toddler with cystic fibrosis? 1. discouraging coughing 2. perfomring postural drainage 3. encouraging active exercise 4. providing small, frequent feedings

2

which intervention would the nurse provide a 3-month old infant hospitalized with respiratory syncytial virus (RSV)? 1. adminsitering an antiviral agent 2. clustering care to conserve energy 3. administering a bronchodilator every four hours 4. providing an antitussive agent whenever necessary

2

an infant is admitted to the pediatric unit with bronchitis caused by RSV. which intervention would the nurse provide for the infant? (select all that apply) 1. limiting fluid intake 2. instilling saline nose drops 3. maintaining contact precautions 4. nasal suctioning to remove mucus 5. adminsitering inhaled bronchodilators

2, 3, 4

which assessment finding indicates to the nurse that a client with chronic obstructive pulmonary disease (COPD) who is receiving oxygen is retaining carbon dioxide (CO2)? (select all that apply) 1. anxiety 2. drowsiness 3. irregular pulse 4. mental confusion 5. increased respirations

2, 3, 4

which medications would the nurse anticipate teaching the parent about for a preschooler newly diagnosed with cystic fibrosis? (select all that apply) 1. steroids 2. anitbiotics 3. antihistamines 4. pancreatic enzymes 5. fat-soluble vitamins

2, 4, 5

a client with COPD is breathing rapidly and using accessory muscles of respiration. the nurse auscultates the lungs and hears crackles and wheezes. which action would the nurse take next? 1. encourage the client to take slow deep breaths and administer 5L/min oxygen per nasal cannula 2. place the client in a side-lying position and perform chest physiotherapy using clapping and vibration 3. raise the head of the bed to high-fowler position and administer 2L/min oxygen per nasal cannula 4. assist the client in assuming a position of comfort and perform postural drainage

3

the parents and two siblings of a 6-week old infant are grieving the infant's death as a result of SIDS. which short-term goal would the nurse have for this family? 1. identifying the problems that they will be facing as a result of the loss of the infant 2. accepting that there was nothing that they could have done to prevent the infant's death 3. including the infant's siblings in the events and grieving in the wake of the infant's death 4. feeling out other families who have lost infants to SIDS and obtaining support from them

3

the school nurse recommends suitable physical activity for a child with exercise-induced asthma. which statement by a parent indicates the need for additional teaching? 1. "ill sign him up for swimming lessons" 2. "shed really enjoy being on a bowling team" 3. "ill encourage him to join a youth running club" 4. "I know shed enjoy going to the gym and lifting weights"

3

when a client newly diagnosed with COPD, which action by the nurse has the highest priority? 1. teach the client how to use the prescribed inhalers 2. discuss the normal progression of the disease process 3. ask whether the client is interested in quitting smoking 4. explain the purpose of a pulmonary rehabilitation program

3

which pathophysiological abnormality is resent in cystic fibrosis? 1. dysfunction of sweat glands 2. inactivity of respiratory tract cilia 3. dysfunction of mucus-secreting glands 4. overproduction of endocrine gland activity

3

which schedule will the nurse teach a client who presented to the emergency room for an acute asthma attack at the time of discharge who is prescribed theophylline 300 mg orally to be taken daily at 9:00 AM? 1. one hour before or 2 hours after eatin g 2. at bedtime 3. at the specific time prescribed 4. daily until symptoms are gone

3

a man and woman both have cystic fibrosis. the male asks the nurse about the chances of the having a chola affected by cystic fibrosis. which response would the nurse provide? 1. "women with cystic fibrosis aren't fertile" 2. "use condoms for protection from pregnancy" 3. "your children will be carriers of cystic fibrosis" 4. "your children will have cystic fibrosis"

4

the nurse is trenching pursed-lip breathing to a client with COPD. the client asks about the benefit of the exercises. which explanation would the nurse give? 1. prevents complications that are associated with COPD 2. relieves shortness of breath by increasing the breath rate 3. increases the amount of air that the client can inhale with each breath 4. keeps the airway open longer to decrease the work that goes into breathing

4

which assessment finding in a newborn is suggestive of cystic fibrosis? 1. rapid HR 2. excessive crying 3. sternal retractions 4. abdominal distension

4

a client has COPD. to decrease the risk of CO2 intoxication (CO2 narcosis), which would the nurse do? 1. initiate pulmonary hygiene to clear air passages of trapped mucus 2. instruct to deep-breathe slowly with inhalation longer than exhalation 3. encourage continuous rapid panting to promote respiratory exchange 4. administer oxygen at a low concentration to maintain respiratory drive

4

which finding in a client with asthma exacerbation requires the most rapid action by the nurse? 1. report of chest tightness 2. heart rate of 112 beats per minute 3. expiratory wheezes in both lungs 4. markedly decreased breath sounds

4

which insect or arthropod is a common trigger for children with asthma? 1. spider 2. centipede 3. carpenter ant 4. household cockroach

4

which statement would the nurse include when educating parents on the prevention of sudden infant death syndrome (SIDS)? 1. "do not prop your infant's bottle" 2. "place an infant monitor where your baby sleeps" 3. "place your infant in an appropriately sized, rear-facing care seat" 4. "encourage your infant to use a pacifier for the first 6 months of life"

4

which parental statement would prompt the nurse to provide education for a 3 yo child with cystic fibrosis? 1. "we will need to carefully track out child's caloric intake" 2."we'll have to move to a very warm climate" 3. "out child will be taking pancreatic enzymes with meals" 4. "our child will need skin care after each bowel movement"

2

when preparing a child with asthma for discharge, which instructions would the nurse emphasize to the family? (select all that apply) 1. limit allergens in the home 2. maintain a dry home environment 3. avoid placing limits on the child's behavior expectations 4. continue the medications even if the child is asymptomatic 5. prevent exposure to infection by having the child tutored at home

1, 4

which topic would the nurse plan to include in teaching a client with a new diagnosis of asthma? 1. home oxygen therapy 2. antibiotic therapy 3. incentive spirometer use 4. use of a peak flow meter

4