CH 6- CH11 NUR2120
autologous (Ch6)
originating within an individual
Allogenic (Ch6)
originating within another
rust colored sputum (CH8)
pneumococcal pneumonia
Pink, frothy sputum may be an indication of (CH8) a lung abscess. pulmonary edema. an infection. bronchiectasis.
pulmonary edema
frothy pink sputum (Ch8)
pulmonary edema
The nurse is caring for a client with kidney stones who is complaining of severe pain. What type of pain does the nurse understand this client is experiencing? (Ch7) Somatic Pain Visceral Pain Neuropathic Pain Chronic Pain
visceral pain
Which of the following is accurate regarding status asthmaticus? (Ch11) A) A severe asthma episode that is refractory to initial therapy B) Patients have a productive cough. C) Usually occurs with warning D) Usually does not progress to severe obstruction
A) A severe asthma episode that is refractory to initial therapy
A client with exacerbation of chronic obstructive pulmonary disease (COPD) is scheduled for a thoracentesis. Which nursing intervention would be appropriate for client saftey? (CH8) A) Administering a prn cough suppressant B) Assisting the client to a prone position C) Obtaining arterial blood gas values immediately after the procedure D) Applying oxygen via nasal cannula
A) Administering a prn cough suppressant
The nurse is caring for a client diagnosed with pneumonia. The nurse assesses the client for tactile fremitus by completing which action? (CH8) A)Asking the client to repeat "ninety-nine" as the nurse's hands move down the client's thorax B)Asking the client to say "one, two, three" while the nurse auscultates the lungs C)Instructing the client to take a deep breath and hold it while the diaphragm is percussed D)Placing the thumbs along the costal margin of the chest wall and instructing the client to inhale deeply
A) Asking the clients to say "one,two, three" while the nurse auscultate the lungs
After a tonsillectomy, a client is being prepared for discharge. The nurse should instruct the client to report which sign or symptom immediately? (Ch9) A) Bleeding B) Difficulty swallowing C) Throat pain D) Difficulty talking
A) Bleeding
Which intervention does a nurse implement for clients with empyema? (Ch10) A) Encourage breathing exercises B) Place suspected clients together C) Institute droplet precautions D) Do not allow visitors with respiratory infections
A) Encourage breathing exercises
A 55-year-old client is scheduled for spirometry testing for evaluation of chronic obstructive pulmonary disease (COPD). The nurse (CH11) Asks the client, "What are your allergies?" Explains to the client not to eat or drink before the spirometry test States that various blood tests must also be done Tells the client that arterial blood gas is performed after spirometry testing
Asks the client "What are your allergies?"
Which of the following is a potential complication of a low pressure in the endotracheal cuff? (Ch10) Aspiration pneumonia Tracheal bleeding Tracheal ischemia Pressure necrosis
Aspiration pneumonia
The nurse assessed a 28-year-old woman who was experiencing dyspnea severe enough to make her seek medical attention. The history revealed no prior cardiac problems and the presence of symptoms for 6 months' duration. On assessment, the nurse noted the presence of both inspiratory and expiratory wheezing. Based on this data, which of the following diagnoses is likely? (Ch8) Acute respiratory obstruction Adult respiratory distress syndrome Pneumothorax Asthma
Asthma
What are considered carcinogens? (CH6) Parasites Medical procedures Dietary substances Defective genes
Dietary substances
A junior-level nursing class has just finished learning about the management of clients with chronic pulmonary diseases. They learned that a new definition of COPD leaves only one disorder within its classification. Which of the following is that disorder? (Ch11) Asthma Bronchiectasis Cystic fibrosis Emphysema
Emphysema
The client is receiving a vesicant antineoplastic for treatment of cancer. Which assessment finding would require the nurse to take immediate action? (CH6) Extravasation Stomatitis Nausea and vomiting Bone pain
Extravasation The nurse needs to monitor IV administration of antineoplastics (especially vesicants) to prevent tissue necrosis to blood vessels, skin, muscles, and nerves. Stomatitis, nausea/vomiting, and bone pain can be symptoms of the disease process or treatment mode but does not require immediate action.
A nurse is caring for a client who has frequent upper respiratory infections. Which structure is most helpful in protecting against infection? (CH8) Cilia Sinus cavity Tonsils Turbinates
Tonsils Tonsils and adenoids do not contribute to respiration but protect against infection. Palatine tonsils are composed of lymphoid tissue. Cilia are fine hairs that move particles and liquid, preventing irritation and contamination of the airway. Sinuses are nasal cavity structures. Turbinates warm and add moisture to the inspired air.
The nurse evaluates teaching as effective when a female client states that she will (CH6) Use sunscreen when outdoors. Decrease tobacco smoking from one pack/day to half a pack/day. Exercise 30 minutes 3 times each week. Obtain a cancer history from her parents.
Use sunscreen when outdoors
The herpes simplex virus type 1 (HSV-1), which produces a cold sore (fever blister), has an incubation period of (CH9) A) 2 to 12 days. B) 20 to 30 days. C) 1 to 3 months. D) 3 to 6 months.
A) 2 to 12 days
A client finished a course of antibiotics for laryngitis but continues to experience persistent hoarseness. Which symptom would cause the nurse to suspect laryngeal cancer? (CH9) A) a feeling of swelling at the back of the throat B) weight loss C) discomfort when drinking cold liquids D) headaches in the morning
A) A feeling of swelling at the back of the throat
After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention? (CH6) Serving small portions of bland food Encouraging rhythmic breathing exercises Administering metoclopramide and dexamethasone as ordered Withholding fluids for the first 4 to 6 hours after chemotherapy administration
Administering metoclopramide and dexamethasone as ordered
A public health nurse works with numerous patients who live with chronic obstructive pulmonary disease (COPD) in the community and has seen firsthand the effects of many of the risk factors underlying the disease. Which of the following public health initiatives addresses the most salient risk factor for COPD? (CH11) Close follow-up of older adults who have a history of pneumonia Allergy screening for elementary school students A lung health awareness program at a large industrial complex An anti-smoking campaign in a junior high school
An anti-smoking campaign in a junior high school
The nurse is providing client teaching for a client undergoing chemotherapy. What dietary modifications should the nurse advise? (CH6) Eat wholesome meals. Avoid spicy and fatty foods. Avoid intake of fluids. Eat warm or hot foods.
Avoid spicy and fatty foods
The nurse is assigned the care of a 30-year-old client diagnosed with cystic fibrosis (CF). Which nursing intervention will be included in the client's care plan? (CH11) A) Restricting oral intake to 1,000 mL/day B) Providing the client a low-sodium diet C) Performing chest physiotherapy as ordered D) Discussing palliative care and end-of-life issues with the client
C) Performing chest physiotherapy as ordered
What is histamine, a mediator that supports the inflammatory process in asthma, secreted by? (CH11) A) Eosiniphils B) Lymphocytes C) Mast cells D) Neutrophils
C) Mast cells
The nurse has instructed the client to use a peak flow meter. The nurse evaluates client learning as satisfactory when the client (Ch11) Exhales hard and fast with a single blow Inhales deeply and holds the breath Records in a diary the number achieved after one breath Sits in a straight-back chair and leans forward
Exhales hard and fast with a single blow
A client has been diagnosed with acute rhinosinusitis caused by a bacterial organism. What antibiotic of choice for treatment of this disorder does the nurse anticipate educating the client about? (CH9) A) Amoxicillin-clavulanic acid B) Cephalexin C) Cefuroxime D) Clarithromycin
A) Amoxicillin- clavulanic acid
A patient comes to the clinic complaining of a possible upper respiratory infection. What should the nurse inspect that would indicate that an upper respiratory infection may be present? (CH9) A) The nasal mucosa B) The buccal mucosa C) The frontal sinuses D) The tracheal mucosa
A) The nasal mucosa
You are caring for a client status post lung resection. When assessing your client you find that the bubbling in the water-seal chamber for the chest tubes is more than you expected. What should you check when bubbling in the water-seal chamber is excessive? (Ch10) A) See if the chest tube is clogged. B) See if the wall suction unit has malfunctioned. C) See if a kink has developed in the tubing. D) See if there are leaks in the system.
D) See if there are any leaks in the system
Which of the following is an age-related change associated with the lung? (CH8) A) Increased thickness of the alveolar membranes B) Increased elasticity of alveolar sacs C) Decreased diameter of alveoli ducts D) Decreased collagen of alveolar membranes
A) Increased thickness of the alveolar membranes
A patient diagnosed with diabetic ketoacidosis would be expected to have which type of respiratory pattern? (CH8) A) Kussmaul respirations B) Cheyne-Stokes C) Biot's respirations D) Apnea
A) Kussmaul respirations Kussmaul respirations are seen in patients with diabetic ketoacidosis. In Cheyne-Stokes respiration, rate and depth increase, then decrease until apnea occurs. Biot's respiration is characterized by periods of normal breathing (3 to 4 breaths) followed by a varying period of apnea (usually 10 to 60 seconds).
A client experiences a head injury in a motor vehicle accident. The client's level of consciousness is declining, and respirations have become slow and shallow. When monitoring a client's respiratory status, which area of the brain would the nurse realize is responsible for the rate and depth? (CH8) A) The pons B) The frontal lobe C) Central sulcus D) Wernicke's area
A) The pons The inspiratory and expiratory centers in the medulla oblongata and pons control the rate and depth of ventilation. When injury occurs or increased intracranial pressure results, respirations are slowed. The frontal lobe completes executive functions and cognition. The central sulcus is a fold in the cerebral cortex called the central fissure. The Wernicke's area is the area linked to speech.
A client hospitalized with pneumonia has thick, tenacious secretions. Which intervention should the nurse include when planning this client's care? (Ch10) A) Turning the client every 2 hours B) Elevating the head of the bed 30 degrees C) Encouraging increased fluid intake D) Maintaining a cool room temperature
C) Encouraging increased fluid intake
A nurse caring for a patient with a pulmonary embolism understands that a high ventilation-perfusion ratio may exist. What does this mean for the patient? (CH8) A)Perfusion exceeds ventilation. B)There is an absence of perfusion and ventilation. C)Ventilation exceeds perfusion. D) Ventilation matches perfusion.
C) Ventilation exceeds perfusion
The nurse is caring for a patient who had a total laryngectomy and has drains in place. When does the nurse understand that the drains will most likely be removed? (CH9) A) When the patient has less than 30 mL for 2 consecutive days B) When the patient states that there is discomfort and requests removal C) When the drainage tube comes out D) In 1 week when the patient no longer has serous drainage
A) When the patient has less than 30 ml for 2 consecutive days Wound drains, inserted during surgery, may be in place to assist in removal of fluid and air from the surgical site. Suction also may be used, but cautiously, to avoid trauma to the surgical site and incision. The nurse observes, measures, and records drainage. When drainage is less than 30 mL/day for 2 consecutive days, the physician usually removes the drains.
A client will be undergoing a bronchoscopy. Which statement shows that the client understands the procedure? (CH8) A) "It sounds like the different drugs will make this much easier to stand." B)"At least I can eat normally again as soon as this is over." C) "If I cough up bloody mucus the next day, I need to call 911." D) "If the tube goes through my nose, why will my throat hurt
A) it sounds like the different drugs will make this much easier to stand
A patient with a diagnosis of prostate cancer is receiving radiation therapy, a treatment that has resulted in stomatitis. To best manage this patient's stomatitis, the nurse should: (CH6) Encourage the patient's family to bring in mouthwash for the patient. Arrange for a low-residue diet for the patient and provide small, frequent meals. Provide a hypertonic solution for the patient to gargle. Encourage the patient to use an oral swab rather than a regular toothbrush.
Encourage the patient to use an oral swab rather than a regular toothbrush
The nurse is caring for a client with suspected ARDS with a pO2 of 53. The client is placed on oxygen via face mask and the PO2 remains the same. What does the nurse recognize as a key characteristic of ARDS? (CH10) A)Unresponsive arterial hypoxemia B) Diminished alveolar dilation C) Tachypnea D) Increased PaO2
A) Unresponsive arterial hypoxemia
Which vitamin is usually administered with isoniazid (INH) to prevent INH-associated peripheral neuropathy? (Ch10) A) Vitamin B6 B) Vitamin C C) Vitamin D D) Vitamin E
A) Vitamin B6
A 66-year-old man is receiving radiation therapy and chemotherapy for the treatment of small cell lung cancer. The nurse has assessed him many times since he was admitted to the hospital. This morning, he admits that his greatest challenge he is currently facing is his overwhelming fatigue. How should the nurse respond to this patient's statement? (CH6) "Your fatigue is actually a sign that your body is redirecting its energies toward healing and away from more common functions like mobility." "I'm sure you'll agree that fatigue, even when it's severe, is much preferable to pain. It's fortunate that your pain is now well-controlled." "That must be incredibly difficult for you. How would you rate your fatigue if you had to give it a number from 1 to 10?" "That's entirely normal, given what your body is going through and how much treatment you're currently getting."
"That must be incredibly difficult for you. How would you rate your fatigue if you had to give it a number from 1 to 10?"
A nurse is preparing to apply an ice pack to the client's knee after surgery to assist with pain control. When using this therapy, the nurse would apply the ice for: (Ch7) 20 minutes. 30 minutes. 45 minutes. 60 minutes.
20 minutes
A nurse is administering supplemental oxygen to a client with COPD. The nurse assesses the oxygen saturation level to evaluate the client's status. Which reading would the nurse identify as being appropriate to reduce the risk of vital organ damage in this client? (CH11) 82% 86% 89% 92%
92%
High or increased compliance occurs in which disease process? (CH8) A) Emphysema B) Pneumothorax C) Pleural effusion D) ARDS
A) Emphysema High or increased compliance occurs if the lungs have lost their elasticity and the thorax is overdistended, as in emphysema. Conditions associated with decreased compliance include pneumothorax, pleural effusion, and acute respiratory distress syndrome (ARDS).
A client is being seen in the emergency department for exacerbation of chronic obstructive pulmonary disease (COPD). The first action of the nurse is to administer which of the following prescribed treatments? (Ch11) A) Oxygen through nasal cannula at 2 L/minute B) Intravenous methylprednisolone (Solu-Medrol) 120 mg C) Ipratropium bromide (Alupent) by metered-dose inhaler D) Vancomycin 1 gram intravenously over 1 hour
A) Oxygen through nasal cannula at 2L/min
A nurse assesses arterial blood gas results for a patient in acute respiratory failure (ARF). Which results are consistent with this disorder? (Ch10) A) pH 7.28, PaO2 50 mm Hg B) pH 7.46, PaO2 80 mm Hg C) pH 7.36, PaCO2 32 mm Hg D) pH 7.35, PaCO2 48 mm Hg
A) PH 7.28, PaO2 50 mm Hg
In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to which of the following acid-base imbalances? (Ch11) A) Respiratory acidosis B) Respiratory alkalosis C) Metabolic alkalosis D) Metabolic acidosis
A) Respiratory acidosis
Which diagnostic test is used to confirm the diagnosis of maxillary and frontal sinusitis? (CH9) A) Sinus aspirates B) CT scan C) Sinus x-rays D) MRI
A) Sinus aspirates Sinus aspirates may be obtained to confirm the diagnosis of maxillary and frontal sinusitis and identify the pathogen. Sinus x-rays and CT scans may be obtained for patients with frontal headaches, in refractory cases, and if complications are suspected.
The nurse is caring for a patient admitted with chronic obstructive pulmonary disease. During assessment, the nurse finds that the patient is experiencing a change in his respiratory and mental status. The nurse is aware that the most accurate measurement of the concentration of oxygen in the patient's blood is what? (CH8) A capillary blood sample Pulse oximetry An arterial blood gas (ABG) study Assessment of the patient's nail beds
ABG study
Emphysema (CH11)
Abnormal enlargement of the air-spaces beyond the terminal bronchioles with destruction of the walls of the alveoli
pink tinged sputum (CH8)
lung tumor
What dietary recommendations should a nurse provide a client with a lung abscess? (Ch10) A) A diet low in calories B) A diet rich in protein C) A carbohydrate-dense diet D) A diet with limited fat
B) A diet rich in protein
A patient's history, physical exam, and pulmonary function testing have culminated in a diagnosis of chronic obstructive bronchitis. The nurse who is providing care for this patient will understand that the effects of the disease are primarily attributable to: (CH11) A) Autoimmune of alveoli B) Chronic mucus hypersecretion C) A reduction in oxygen binding sites on erythrocytes D) Decreased respiratory drive
B) Chronic mucus hypersecretion In patients with chronic obstructive bronchitis, chronic mucus hypersecretion causes lung function decline, exacerbations, and infections. The disease does not have an autoimmune etiology and is not caused by a reduction in respiratory drive. As well, red cells do not lack oxygen binding sites in patients with bronchitis.
A client is prescribed two sprays of a nasal medication twice a day. The nurse is teaching the client how to self-administer the medication and instructs the client to (Ch9) Wait 10 seconds before administering the second spray. Tilt the head back when activating the spray of the medication. Clean the medication container once each day. Blow the nose before applying medication into the nares.
Blow the nose before applying medication into the nares. The nurse instructs the client to blow the nose before administering the nasal medication. The client should keep the head upright, not tilted back. The client should wait at least 1 minute before administering the second spray and clean the container after each use.
Which assessment finding puts a client at increased risk for epistaxis? (CH9) A) Use of a humidifier at night B) Hypotension C) Cocaine use D) History of nasal surgery
C) Cocaine use
Which occurs when fluid accumulates in the pericardial space and compresses the heart? (Ch6) Cardiac tamponade Superior vena cava syndrome (SVCS) SIADH DIC
Cardiac tamponade
Mitosis (CH6)
Cell division occurs
The clinic nurse is caring for a client with acute bronchitis. The client asks what may have caused the infection. What may induce acute bronchitis? (CH10) Aspiration Drug ingestion Chemical irritation Direct lung damag
Chemical irritation
Which primary cancer treatment goal is prolonged survival and containment of cancer cell growth? (Ch6) Control Cure Palliation Prevention
Control
After diagnosing a client with pulmonary tuberculosis, the physician tells family members that they must receive isoniazid (INH [Laniazid]) as prophylaxis against tuberculosis. The client's daughter asks the nurse how long the drug must be taken. What is the usual duration of prophylactic isoniazid therapy? (CH10) A) 3 to 5 days B) 1 to 3 weeks C)2 to 4 months D) 6 to 12 months
D) 6-12 mo
A client with asthma is prescribed a short acting beta-adrenergic (SABA) for quick relief. Which of the following is the most likely drug to be prescribed? (CH11) A) Ipratropium bromide B) propionate C) Ipratropium bromide and albuterol sulfate D) Albuterol
D) Albuterol
Which statement indicates a client understands teaching about the purified protein derivative (PPD) test for tuberculosis? (Ch10) A) "I will come back in 1 week to have the test read." B) "If the test area turns red that means I have tuberculosis." C) "I will avoid contact with my family until I am done with the test." D) "Because I had a previous reaction to the test, this time I need to get a chest X-ray."
D) Because I had a previous reaction to the test, this time I need to get a chest x-ray
Upon palpation of the sinus area, what would the nurse identify as a normal finding? (CH8) A) Light not going through the sinus cavity B) Pain sensation behind the eyes C)Tenderness during palpation D) No sensation during palpation
D) No sensation during palpation
A nursing student understands that emphysema is directly related to which of the following? (CH11) A) Diminished alveolar surface area B) Hypercapnia resulting from decreased carbon dioxide tension C) Hypoxemia secondary to impaired oxygen diffusion D) Respiratory acidosis from airway obstruction
D) Respiratory acidosis from airway obstruction
S phase (CH6)
DNA synthesis occurs
The nurse working on a gerontology unit admits a 77-year-old with recent shortness of breath. The nurse knows that the amount of respiratory dead space increases with age. What do these changes result in? (CH8) Increased diffusion of gases Decreased diffusion capacity for oxygen Decreased shunting of blood Increased ventilation
Decreased diffusion capacity for o2
Your patient has recently completed her first round of chemotherapy in the treatment of lung cancer. When reviewing this morning's blood work, what findings would be suggestive of myelosuppression? (CH6) Decreased sodium levels and decreased potassium levels Increased creatinine and blood urea nitrogen (BUN) Decreased platelets and red blood cells Increased white blood cells and c-reactive protein (CRP)
Decreased platelets and red blood cells
The nurse is assessing a patient complaining of severe pain. What physiologic indicator does the nurse recognize as significant of acute pain? (CH7) Diaphoresis Bradycardia Hypotension Decreased respiratory rate
Diaphoresis
Pulmonary edema (CH10)
Excess fluid in the lungs foamy, frothy, and often blood tinged pink excretions crackles heard upon auscultation
Diffusion (CH8)
Exchange of oxygen and carbon dioxide at the alveolar-capillary membrane)
A patient will be having an endoscopic procedure with a diagnostic biopsy. What type of biopsy does the nurse explain will remove an entire piece of suspicious tissue? (CH6) Excisional biopsy Incisional biopsy Needle biopsy Punch biopsy
Excosional biopsy
Synergic (Ch6)
From identical twin
Epistaxis (Ch9)
Hemorrhage from the nose, is caused by the rupture of tiny, distended vessels Management: apply direct pressure, upright with head tilted forward, pinch soft outer portion of the nose for 5-10 minutes Avoid: rigorous exercise, spicy food, tobacco, forceful nose blowing, high altitudes, and nasal trauma
A client arrives in the orthopedic clinic with complaints of twisting the right ankle while playing softball. The nurse collects data including complaints of pain and swelling in the right ankle. What intervention will the nurse provide that will decrease vasodilation and reduce localized swelling? (CH7) Warm compresses Ice bag Elevation of the extremity Injection of a steroid into the joint space
Ice bag
Asthma is cause by which type of response? (CH11) IgE-mediated IgA-mediated IgD-mediated IgM-mediated
IgE-mediated
A nurse is concerned that a client may develop postoperative atelectasis. Which nursing diagnosis would be most appropriate if this complication occurs? (Ch8) Ineffective airway clearance Impaired gas exchange Decreased cardiac output Impaired spontaneous ventilation
Impaired gas exchange
The nurse has been asked to give a workshop on chronic obstructive pulmonary disease (COPD) for a local community group. When talking about what can be done for patients with COPD, the nurse encourages a COPD patient not to smoke because smoking has what effect? (Ch11) Increases the amount of mucus production Deoxygenates the hemoglobin Shrinks the alveoli in the lungs Collapses the alveoli in the lungs
Increases the amount of mucus production
BIPAP (Ch9)
Independent control of inspiratory and expiratory pressure while providing pressure support ventilation
The nurse is caring for a patient who has been in a motor vehicle accident. The patient has been diagnosed with pleurisy. What is the preferred treatment for pain caused by pleurisy? (CH10) Morphine sulfate Meperidine sulfate Acetaminophen Indomethacin
Indomethacin
Pneumonia (CH10)
Infection that inflames the air sacs in one or both lungs
Medication used in asthma treatment (CH11)
Inhaled short acting beta agonist and peak flow meter
A client has been newly diagnosed with emphysema. The nurse should explain to the client that by definition, ventilation: (Ch8) is breathing air in and out of the lungs. is when the body changes oxygen into CO2. provides a blood supply to the lungs. helps people who cannot breathe on their own.
Is breathing air in and out of the lungs
What disadvantages of chemotherapy should the patient be informed about prior to starting the regimen? (CH6) It attacks cancer cells during their vulnerable phase. It functions against disseminated disease. It causes a systemic reaction. It targets normal body cells as well as cancer cells.
It targets normal body cells as well as cancer cells
currant jelly sputum (Ch8)
Klebsiella pneumoniae
A client has a history of chronic obstructive pulmonary disease (COPD). Following a coughing episode, the client reports sudden and unrelieved shortness of breath. Which of the following is the most important for the nurse to assess? (Ch11) Lung sounds Skin color Heart rate Respiratory rate
Lung sounds
Ventilation (Ch8)
Movement of air from the atmosphere to the alveoli
A patient is taking vincristine, a plant alkaloid for the treatment of cancer. What system should the nurse be sure to assess for symptoms of toxicity? (CH6) Gastrointestinal system Nervous system Pulmonary system Urinary system
Nervous system
Your patient is receiving carmustine, a chemotherapy agent. A significant side effect of this medication is thrombocytopenia. What symptom would the nurse assess for in a patient at risk for thrombocytopenia? (CH6) Interrupted sleep pattern Hot flashes Nose bleed Increased weight
Nose bleed
An increase in the red blood cell concentration in the blood is termed which of the following? (CH11) Polycythemia Emphysema Asthma Bronchitis
Polycythemia
CPAP (Ch9)
Positive pressure to airways throughout resp cycle, preventing collapse
G2 phase (CH6)
Premitotic phase; DNA synthesis is complete, mitotic spindle forms
G1 phase (Ch6)
RNA and protein synthesis occur
COPD risk factors (CH11)
SMOKING, environmental tobacco smoke, occupational dust and chemicals, infection, indoor and outdoor air pollution
You are an oncology nurse and have just begun infusion of a patient's first dose of doxorubicin (Adriamycin) for the treatment of the patient's soft-tissue sarcoma. Shortly after beginning the infusion, the patient complains of pain at the infusion site, which is now swollen and reddened, and the IV pump has alarmed with a report of occlusion. As a result, you suspect extravasation. What action should you prioritize? (CH6) Stop the infusion and remove the patient's IV cannula. Slow the infusion and take the patient's vital signs. Discontinue the infusion and infuse a flush of normal saline. Stop the infusion and aspirate from the patient's IV line.
Stop the infusion and aspirate from the patients IV line If extravasation is suspected, the medication administration should be stopped immediately. The nurse should attempt to aspirate any residual drug from the IV line prior to removal of the IV cannula. A flush would exacerbate potential tissue damage.
Pulmonary TB tests (CH10)
TB skin test, QFT-G test
A client is scheduled for abdominal surgery and states that he is afraid of postoperative pain. The best nursing action is to inform the client About activities that would distract him from pain That the nurse will notify the surgeon of his fear How anxiety could increase his pain perception That medication will be prescribed for pain relief
That medication will be prescribed for pain relief
The nursing instructor is discussing the difference between normal cells and cancer cells with the pre-nursing class in pathophysiology. What would the instructor cite as a characteristic of a cancer cell? (CH6) Malignant cells contain more fibronectin. The cell membrane of malignant cells contains proteins called tumor-specific antigens. Chromosomes are commonly found to be strong. Nuclei of cancer cells are large and regularly shaped.
The cell membrane of malignant cells contains proteins called tumor-specific antigens.
A client arrives at the physician's office stating 2 days of febrile illness, dyspnea, and cough. Upon assisting the client into a gown, the nurse notes that the client's sternum is depressed, especially on inspiration. Crackles are noted in the bases of the lung fields. Based on inspection, which will the nurse document? (CH8) The client has a funnel chest. The client has chronic respiratory disease. The client has pneumonia in the bases. The client needs a cough suppressant.
The client has a funnel chest
Atelectasis (Ch10)
The collapse of alveoli
The nurse caring for a 74-year-old man who has just returned to the surgical unit following surgery for a total knee replacement received report from the PACU. Part of the report had been passed on from the preoperative assessment, in which the patient stated that he has "gotten confused" in the past when he takes pain medications. The nurse should recognize which of the following principles of pain management among older adults? (CH7) A) The elderly may require lower doses of medication and are easily confused with new medications. B) The elderly may have altered absorption and metabolism, which prohibits the use of opioids. C) The elderly may be confused following surgery, a fact that is related to normal aging and unrelated to the medication. D) The elderly may require a higher initial dose of pain medication followed by a tapered dose.
The elderly may require lower doses of medication and are easily confused with new medications
A patient in an acute-care setting is being monitored closely after recently experiencing status asthmaticus. The nurse who is providing care for the patient has been assessing the patient's respiratory status frequently and has just completed auscultation of the patient's breath sounds. The nurse notes that the patient's breath sounds are significantly quieter than during the previous assessment. How should the nurse best interpret this assessment finding? (CH11) The patient's upper airways are responding to bronchodilators. The patient's respiratory wheeze is resolving. The patient's airflow may be severely limited. The patient is in the early stages of a pulmonary infection.
The patients airflow may be severely limited
Which of the following is a true statement with regards to the nursing process of pain control? (CH7) The use of physiologic signs to indicate pain is unreliable. Formulate treatment plans based on behaviors. Usually all patients exhibit the same pain behaviors. Nonverbal expressions of pain are reliable indicators of the quality of pain.
The use of physiological signs to indicate pain is unreliable
Pleurisy (Ch10)
Tissue that surrounds the lungs becomes inflamed. Sharp (Knife like) chest pain that worsens during breathing
The nurse is discussing immediate postoperative communication strategies with a client scheduled for a total laryngectomy. What information will the nurse include? (CH9) "After surgery you will have a sore throat, but you will be able to speak." "You can use writing or a communication board to communicate." "After surgery you will have to use an electric larynx to communicate." "A speech therapist will evaluate you and recommend a system of communication after surgery."
You can use writing or a communication board to communicate
Pulmonary TB (CH10)
active infection of the lungs spread airborne or by droplet 4 drug regimen
Status asthmaticus (ch11)
acute exacerbation of asthma that is severe at its onset or progresses rapidly despite standard therapy, and remains unresponsive to initial treatment with broncholdilators. Occur during sleep when airway inflammation and hyper-responsiveness are at their peak.
Perfusion (Ch8)
blood flow to alveoli so gas can be exchanged
ARDS (acute respiratory distress syndrome) (Ch10)
capillaries of tiny blood vessels, surrounding your air sacs cant properly exchange co2 for O2 hypoxemic- decreased o2, co2 is close to normal Hypercapnic- increased co2, near normal or not enough o2
COPD diagnosis (Ch11)
diagnostic criteria are FEV1 of less than 80% and an FEV1/FVC ration of less than 70%
COPD common manifestations (CH11)
dyspnea, chronic cough, sputum production
Emphema (Ch10)
is an accumulation of thick, purulent fluid (pus), within the pleural space and is a type of pleural effusion
A nurse is caring for a client with pain. What should the nurse monitor for when administering intravenous acetaminophen? (CH7) hepatotoxicity renal toxicity bleeding gastrointestinal effects
Hepatotoxicity
The patient is having pulmonary function studies performed. The patient has a spirometry test and has a FEV1/FVC ratio of 60%. This finding suggests: (Ch11) A) Strong exercise tolerance. B) Exhalation volume is normal. C) Healthy lung volumes. D) Obstructive lung disease.
D) Obstructive lung disease Spirometry is used to evaluate airflow obstruction, which is determined by the ratio of forced expiration volume in 1 second to forced vital capacity. Obstructive lung disease is a FEV1/FVC ratio less than 70%.
What is the purpose of the vascular and ciliated mucous lining of the nasal cavities? (CH8) A) Cool and dry expired air B) Move mucus to the back of the throat C) Moisten and filter expired air D) Warm and humidify inspired air
D) Warm and humidify inspired air
A nurse notes that the FEV1/FVC ratio is less than 70% and the FEV1 is 25% for a patient with COPD. What stage should the nurse document the patient is in? (Ch11) I II III IV
IV
For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the care plan? (Ch6) Administering aspirin if the temperature exceeds 102° F (38.8° C) Inspecting the skin for petechiae once every shift Providing for frequent rest periods Placing the client in strict isolation
Inspecting the skin for petechiae once every shift
The nurse is in the radiology unit of the hospital. The nurse is caring for a client who is scheduled for a lung scan. The nurse knows that lung scans need the use of radioisotopes and a scanning machine. Before the perfusion scan, what must the client be assessed for? (CH8) Bleeding Iodine allergy Dysrhythmias Inflammation
Iodine allergy During lung scans, a radioactive contrast medium is administered intravenously for the perfusion scan. Before the perfusion scan, nurses must assess the client to check for allergies to iodine. Laryngoscopy determines inflammation. Dysrhythmias and bleeding are possible complications of mediastinoscopy.
In which phase of the cell cycle does cell division occur? (CH6) Mitosis G1 phase S phase G2 phase
Mitosis
The classification of Stage II of COPD is defined as (CH11) at risk for COPD. moderate COPD. severe COPD. very severe COPD. mild COPD.
Moderate COPD Stage II is moderate COPD. Stage 0 is at risk for COPD. Stage I is mild COPD. Stage III is severe COPD. Stage IV is very severe COPD.
A nurse is caring for a client who is receiving chemotherapy and has a platelet count of 30,000/mm3. Which statement by the client indicates a need for additional teaching? (CH6) "I floss my teeth every morning." "I use an electric razor to shave." "I take a stool softener every morning." "I removed all the throw rugs from the house."
"I floss my teeth every morning."
The nurse is providing care for a number of patients who are receiving treatment for health problems that have a respiratory etiology. Which of the following patients is most likely to benefit from the administration of a PO or IV diuretic? (CH8) A patient who presents with a barrel chest A patient who has crackles on auscultation A patient who has a sibilant wheeze A patient who has recently complained of chest pain
A patient who has crackles on auscultation Crackles are generally secondary to fluid in the airways or alveoli. Consequently, diuretic may be of benefit in the treatment of some of the health problems associated with the development of crackles. A barrel chest is associated with emphysema, which is treated with diuretics. As well, wheezes and chest pain are not assessment findings that normally suggest a need for diuresis.
A patient has a Mantoux skin test prior to being placed on an immunosuppressant for the treatment of Crohn's disease. What results would the nurse determine is not significant for holding the medication? (Ch10) A) 0 to 4 mm B) 5 to 6 mm C) 7 to 8 mm D) 9 mm
A) 0 to 4 mm
In which phase of the cell cycle does RNA and protein synthesis occur? (Ch6) G1 phase S phase G2 phase Mitosis
G1 phase
Which of the following is a reliable source for quantifying pain? (CH7) The client's vital signs The nature of the client's injury or condition The client's description of the pain The extent of the client's injury
The clients description of the pain
The nurse is caring for a client who is in respiratory distress. The physician orders arterial blood gases (ABGs) to determine various factors related to blood oxygenation. What site can ABGs be obtained from? (CH8) A puncture at the radial artery The trachea and bronchi The pleural surfaces A catheter in the arm vein
A puncture in the radial artery ABGs determine the blood's pH, oxygen-carrying capacity, levels of oxygen, CO2, and bicarbonate ion. Blood gas samples are obtained through an arterial puncture at the radial, brachial, or femoral artery. A client also may have an indwelling arterial catheter from which arterial samples are obtained. Blood gas samples are not obtained from the pleural surfaces or trachea and bronchi.
The patient with a chest tube is being transported to X-ray. Which complication may occur if the chest tube is clamped during transportation? (Ch10) A) Tension pneumothorax B) Cardiac tamponade C) Flail chest D) Pulmonary contusion
A) Tension pneumothrax
A 72-year-old patient who was admitted to the hospital for a total hip arthroplasty has developed increasing dyspnea and leukocytosis over the past 48 hours and has been diagnosed with hospital-acquired pneumonia (HAP). The choice of antibiotic therapy for this patient will be primarily based on which of the nurse's assessments? (Ch10) A) Auscultation and percussion of the patient's thorax B) Collection of a sputum sample for submission to the hospital laboratory C) Analysis of the patient's leukocytosis and the white blood cell (WBC) differential D) Assessment of the patient's activities of daily living
B) Collection of a sputum for submission to the hospital laboratory Choice of antibiotic therapy is based primarily on the patient's history and the results of sputum cultures. Blood work and chest auscultation confirm the diagnosis of pneumonia but do not typically inform the choice of antibiotic.
The nurse enters the room of a client who is being monitored with pulse oximetry. Which of the following factors may alter the oximetry results? (CH8) A) Placement of the probe on an earlobe B) Diagnosis of peripheral vascular disease C) Reduced lighting in the room D) Increased temperature of the room
B) Diagnosis of peripheral vascular disease
A patient with a diagnosis of acute rhinosinusitis has approached the nurse and asked for advice about "rinsing out my sinuses with saltwater," a treatment that was suggested by a friend. The nurse's response should be premised on which of the following statements? (CH9) A) Saline rinses have the potential to damage the mucosa of the sinuses. B) Nasal saline lavage can help to improve the patency of the sinuses. C) Nasal saline lavage can result in rebound congestion. D) Rinsing with saline has been shown to be ineffective in clearing the sinuses of mucus.
B) Nasal saline lavage can help to improve the patenccy of the sinuses
You are caring for a client who has been diagnosed with viral pneumonia. You are making a plan of care for this client. What nursing interventions would you put into the plan of care for a client with pneumonia? (Ch10) A) Give antibiotics as ordered. B) Place client on bed rest. C) Encourage increased fluid intake. D) Offer nutritious snacks 2 times a day.
C) Encourage increased fluid intake
The nurse is assessing a patient in respiratory failure. What finding is a late indicator of hypoxia? (CH8) A) Clubbing of fingers B) Cyanosis C) Crackles D) Restlessness
B) Cyanosis Cyanosis, a bluish coloring of the skin, is a very late indicator of hypoxia. The presence or absence of cyanosis is determined by the amount of unoxygenated hemoglobin in the blood. Cyanosis appears when there is at least 5 g/dL of unoxygenated hemoglobin.
A nurse is concerned that a client may develop postoperative atelectasis. Which nursing diagnosis would be most appropriate if this complication occurs? (CH8) A) Ineffective airway clearance B) Impaired gas exchange C) Decreased cardiac output D) Impaired spontaneous ventilation
B) Impaired gas exchange
Mrs. Unger is a 53-year-old woman who was diagnosed with breast cancer following a process that began with abnormal screen mammography results. Mrs. Unger, her oncologist, and surgeon have agreed on a mastectomy as treatment and have discussed the importance of rigorously assessing whether her cancer has metastasized. What action will best detect possible metastasis of Mrs. Unger's breast cancer? (CH6) Serial bone marrow biopsies Biopsy of the axillary lymph nodes Careful grading of the tumor cells Gauging her response to radiation therapy
Biopsy of the axillary lymph nodes
The nurse is caring for a client who had a recent laryngectomy. Which of the following is reflected in the nursing plan of care? (CH9) A) Develop an alternate method of communication. B) Encourage oral nutrition on the second postoperative day. C) Maintain the client in a low-Fowler's position. D) Assess the tracheostomy cuff for leaks.
A) Develop an alternate method of communication
The nurse is caring for a client who underwent a laryngectomy. Which intervention will the nurse initially complete in an effort to meet the client's nutritional needs? (CH9) A) Initiate enteral feedings. B) Offer plenty of thin liquids. C) Encourage sweet foods. D) Liberally season foods.
A) Initiate enteral feedings
To help prevent infections in clients with COPD, the nurse should recommend vaccinations against two bacterial organisms. Which of the following are the two vaccinations? (CH11) A) Streptococcus pneumonia and Haemophilus influenzae B)Streptococcus pneumonia and varicella C) Haemophilus influenzae and varicella D) Haemophilus influenzae and Gardasil
A) Streptococcus pneumonia and Haemophilus influenzae
A nursing student understands the importance of the psychosocial aspects of disease processes. When working with a patient with COPD, the student would rank which of the following nursing diagnoses as the MOST important when analyzing the psychosocial effects? (CH11) A) Disturbed sleep pattern related to cough B) Ineffective coping related to anxiety C) High risk for ineffective therapeutic regimen management related to lack of knowledge D) Activity intolerance related to fatigue
B) Ineffective coping related to anxiety Any factor that interferes with normal breathing quite naturally induces anxiety, depression, and changes in behavior. Constant shortness of breath and fatigue may make the patient irritable and apprehensive to the point of panic. Although the other choices are correct, the most important psychosocial nursing diagnosis for a patient with COPD is ineffective coping related to a high level of anxiety.
The nurse is caring for a client in the physician's office with a potential sinus infection. The physician orders a diagnostic test to identify if fluid is found in the sinus cavity. Which diagnostic test, written by the physician, is specifically ordered for this purpose? (CH9) A) CBC with differential B) Transillumination of the sinus C) Nasal culture D) Magnetic resonance imaging (MRI)
B) Transillimination of the sinus Transillumination and x-rays of the sinuses may show a change in the shape of or confirms that there is fluid in the sinus cavity. CBC with differential can note an elevated white blood cell count but not confirm fluid in the sinus cavity. A nasal culture can note bacteria in the nares. An MRI is an expensive procedure which is not typically prescribed for a potential infection and not specifically ordered to identify fluid in the sinus cavity.
A nurse is caring for a group of clients on a medical-surgical floor. Which client is at greatest risk for developing pneumonia? (Ch10) A) A client with a history of smoking two packs of cigarettes per day until quitting 2 years ago B) A client who ambulates in the hallway every 4 hours C) A client with a nasogastric tube D) A client who is receiving acetaminophen (Tylenol) for pain
C) A client with a nasogastric tube
A client recently diagnosed with laryngeal cancer and awaiting a laryngectomy was encouraged to attend a support group prior to surgery. The client asked the nurse about the name of the laryngeal speech method where the client speaks with the assistance of a surgically implanted device. The nurse is correct to provide teaching on which method? (CH9) A) Esophageal speech B) An artificial larynx C) A tracheoesophageal puncture D) An electronic voice box
C) A tracheoesophageal puncture
