PRACTICE QUIZ-EXAM2

Which of the following clinical manifestations in a client taking a nonselective beta-blocking agent should the nurse explore as a complication of drug therapy? Headache Nonproductive cough Postural hypotension Wheezing

Wheezing Nonselective beta blockers can cause bronchoconstriction and impair respiratory effort. Clients with pre-existing pulmonary problems should not take nonselective beta-blocking agents, and clients who develop bronchoconstriction should have the therapy changed.

Which of the following is not a strategy for preventing ventilator-associated pneumonia? -Aseptic technique during suctioning -Elevating the head of the bed -Maintaining adequate pressure in the cuff of the endotracheal tube -Routine administration of antibiotics to all intensive care unit patients who are intubated

routine administration

Which of the following positions would not be well tolerated in the patient with acute respiratory failure? Supine with the bed flat Side lying with head of bed elevated Sitting in a chair High-Fowler's

supine with bed flat

The patient alerts the nurse that he is experiencing chest pain. He states that he has had this before and it usually lasts about 20 minutes and goes away. He states the doctor told him that it was Prinzmetal Angina. What medication should the nurse administer from the list of PRN medications for the patient's chest pain. Metoprolol Captopril Nifedipine Aspirin

Aspirin This is the medication to treat unstable angina, but not the best medication for prinzmetal angina.

Why is the administration of aspirin recommended along with nitroglycerin when a client is experiencing angina-like chest pain? Aspirin inhibits platelet aggregation and clot formation. Aspirin has cardiotonic properties and improves contraction. Aspirin has analgesic properties without sedation. Aspirin can trigger vasodilation and improve blood flow.

Aspirin inhibits platelet aggregation and clot formation. Taking aspirin at the first sign of chest pain can disrupt blood clotting and reduce the risk of a coronary thrombosis.

A patient's blood pressure drops from 120/76 to 90/60 as soon as positive end-expiratory pressure is initiated for the treatment of hypoxemia. What is the most likely cause of this decrease in blood pressure? -Decrease in cardiac output -Neurogenic shock -Increase in venous return -Hypovolemic shock

Decrease in cardiac output

A patient arrives to the ER complaining of 8/10 "crushing" chest pain. What should the nurse ask the patient before giving nitroglycerin sublingual? Have you ever had chest pain before? Have you taken any erectile dysfunction medications in the last 24 hours? Have you taken nitroglycerin before? Have you had an aspirin today?

Have you taken any erectile dysfunction medications in the last 24 hours?

The post-percutaneous transluminal coronary angioplasty client complains of severe chest pain. What is the nurse's best action? Administer sublingual nitroglycerin. Notify the physician. Administer IV morphine as ordered PRN. Perform a standard 12-lead ECG.

Notify the physician

The physician orders the following mechanical ventilation settings for a patient. The patient's spontaneous respiratory rate is 22 breaths/min. What arterial blood gas abnormality may occur if the patient continues to be tachypneic at these ventilator settings? Settings: Tidal volume 800 mL FIO2 0.50 Respiratory rate 14 breaths/min Mode Assist/control Positive end-expiratory pressure 10 cm -Respiratory alkalosis -Metabolic alkalosis -Respiratory acidosis -Metabolic acidosis

Respiratory alkalosis

Which of the following treatments may be used to dissolve a thrombus that is lodged in the pulmonary artery? Thrombolytics Aspirin Embolectomy Heparin

Thrombolytics

Which of the following therapies may be ordered to increase oxygen-carrying capacity? --Blood transfusions --Sedatives --Corticosteroids --Bronchodilators

blood transfusions

The basic underlying pathophysiology of acute respiratory distress syndrome results from: damage to the right mainstem bronchus. --damage to the type II pneumocytes, which produce surfactant. --decreased capillary permeability. --a decrease in the number of white blood cells available.

damage to the type II pneumocytes, which produce surfactant.

Which of the following would be the highest priority nursing concern if prone positioning is ordered to treat the patient with acute respiratory distress syndrome? -Maintenance of adequate cardiac output -Management and protection of the airway -Prevention of skin breakdown -Psychological support to patient and family

management and protection of the airway

When the ventilator alarm sounds, the nurse finds the patient lying in bed holding the endotracheal tube (ET). The first intervention by the nurse is to --position the patient in a left lateral position. --manually ventilate the patient with 100% oxygen. --call the health care provider to immediately to reinsert the tube. --leave to activate the hospital's rapid response team.

manually ventilate

Which set of arterial blood gases would the nurse expect to find in a client who developed a pulmonary embolism 6 hours ago? -pH 7.30, HCO3- 22 mEq/L, PCO2 60 mm Hg, PO2 66 mm Hg -pH 7.38, HCO3- 22 mEq/L, PCO2 45 mm Hg, PO2 96 mm Hg -pH 7.47, HCO3- 23 mEq/L, PCO2 25 mm Hg, PO2 82 mm Hg -pH 7.30, HCO3- 28 mEq/L, PCO2 65 mm Hg, PO2 75 mm Hg

pH 7.30, HCO3- 22 mEq/L, PCO2 60 mm Hg, PO2 66 mm Hg

Neuromuscular blocking agents are used in the management of some ventilated patients. Their primary mode of action is: --analgesia --sedation --anticonvulsant --paralysis

paralysis