NU 424 Respiratory Quiz PrepU

A. Increased intracranial pressure

Bradypnea is associated with which condition? A. Increased intracranial pressure B. Metabolic acidosis C. Pulmonary edema D. Pneumonia

B. deviation from the midline.

During assessment of the respiratory system, the nurse inspects and palpates the trachea in order to assess: trachea? A. evidence of muscle weakness. B. deviation from the midline. C. color of the mucous membranes. D. evidence of exudate.

B. Chest tube drainage, 190 mL/hr

The nurse is caring for a client following a thoracotomy. Which finding requires immediate intervention by the nurse? A. Moderate amounts of colorless sputum B. Chest tube drainage, 190 mL/hr C. Heart rate, 112 bpm D. Pain of 5 on a 1-to-10 scale

A. Iodine allergy

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? A. Iodine allergy B. Bleeding C. Inflammation D. Dysrhythmias

A. Aspiration C. Infection A. Aspiration Injury to the laryngeal nerve

The nurse is mentoring a new graduate nurse. Today, the two of you are caring for a client with a new tracheostomy. The new graduate nurse asks what the complications of tracheostomy are. What would the nurse respond? Select all that apply. A. Aspiration Injury to the laryngeal nerve B. Infection C. Penetration of the anterior tracheal wall D. Absence of secretions

E Bupropion SR C. Nicotine gum D. Nortriptyline

The nurse is reviewing first-line pharmacotherapy for smoking abstinence with a client diagnosed with COPD. The nurse correctly includes which medications? Select all that apply. A. Varenicline B. Clonidine C. Nicotine gum D. Nortriptyline E Bupropion SR

A. Decreased gag reflex D. Increased presence of collagen in alveolar walls E. Decreased presence of mucus

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.) A. Decreased gag reflex B. Decreased alveolar duct diameter C. Increased presence of mucus D. Increased presence of collagen in alveolar walls E. Decreased presence of mucus

B. Barrel-shaped chest

Which assessment finding would be most consistent with advanced emphysema? A. Dependent edema B. Barrel-shaped chest C. Aortic bruit D. Epigastric pain

B. PET

Which diagnostic imaging modality is more accurate than computed tomography in detecting malignancies? A. MRI B. PET C. Gallium scan D. Pulmonary angiography

A. The lungs eliminate carbonic acid by blowing off more CO2.

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

A. Impotence B. Arrhythmias C. Insomnia D. Loud snoring E. Excessive daytime sleepiness

Which of the following are clinical manifestations associated with obstructive sleep apnea (OSA)? Select all that apply. A. Impotence B. Arrhythmias C. Insomnia D. Loud snoring E. Excessive daytime sleepiness

A. Esophageal reflux

Which of the following is a common irritant that acts as a trigger of asthma? A. Esophageal reflux B. Peanuts C. Molds D. Aspirin sensitivity

C. Bronchitis

Which of the following is a leading cause of chronic obstructive pulmonary disease (COPD) exacerbation? A. Common cold B. Asthma C. Bronchitis D. Pneumonia

C. Pulse Oximetry

Which of the following is a noninvasive method of continuously monitoring the oxygen saturation of hemoglobin (SaO2)? A. Sputum studies B. Arterial blood gas analysis C. Pulse oximetry D. Pulmonary function testing

C. Nonrebreathing mask

Which oxygen administration device has the advantage of providing a high oxygen concentration? A. Face tent B. Venturi mask C. Nonrebreathing mask D. Catheter

C. Consolidation

Which term refers to lung tissue that has become more solid in nature as a result of a collapse of alveoli or an infectious process? A. Empyema C. Bronchiectasis C. Consolidation D. Atelectasis

C. Orthopnea

Which term will the nurse use to document the inability of a client to breathe easily unless positioned upright? A. Hemoptysis B. Dyspnea C. Orthopnea D. Hypoxemia

D. Report decreased congestion.

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 A. Increase fluid intake. B. Use a room vaporizer to loosen secretions. C. Assume an upright position to facilitate drainage. D. Report decreased congestion.

A. Use of accessory muscles

A nurse assesses a client's respiratory status. Which observation indicates that the client is having difficulty breathing? A. Pursed-lip breathing B. Controlled breathing C. Diaphragmatic breathing D. Use of accessory muscles

C. First thing in the morning

A sputum study has been ordered for a client who has developed coarse chest crackles and a fever. At what time should the nurse best collect the sample? A. After a period of exercise B. Immediately after a meal C. First thing in the morning D. At bedtime

A. Nonrebreather mask

A client abruptly sits up in bed, reports having difficulty breathing and has an arterial oxygen saturation of 88%. Which mode of oxygen delivery is most likely to reverse these manifestations? A. Nonrebreather mask B. Simple mask C. Nasal Cannula D. Face Tent

D. Two to 3 weeks after initiation of bacteriocidal drugs

A client diagnosed with tuberculosis (TB) is taking medication for the treatment of TB. The nurse should instruct the client that he will be safe from infecting others approximately how long after initiation of the chemotherapy regimen? A. After completion of 6 months of bacteriocidal drugs B. Within 48 hours after initiation of bacteriocidal drugs C. Results vary with each client, so it is difficult to predict D. Two to 3 weeks after initiation of bacteriocidal drugs

A. The maximal volume of air exhaled from the point of maximal inspiration

A client has a diagnosis of multiple sclerosis. The nurse is aware that neuromuscular disorders such as multiple sclerosis may lead to a decreased vital capacity. What does vital capacity measure? A. The maximal volume of air exhaled from the point of maximal inspiration B. The volume of air in the lungs after a maximal inspiration C. The maximal volume of air inhaled after normal expiration D. The volume of air inhaled and exhaled with each breath

C. Apply pressure to the puncture site after the procedure. D. Complete a respiratory assessment after the procedure. E. Educate the client about the need to cleanse the thoracic area.

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. A. Place the client in the prone position. B. Prepare the client for magnetic resonance imaging after the procedure to verify tube placement. C. Apply pressure to the puncture site after the procedure. D. Complete a respiratory assessment after the procedure. E. Educate the client about the need to cleanse the thoracic area.

D. They help prevent cardiac arrhythmias.

A client in acute respiratory distress is brought to the emergency department. After endotracheal (ET) intubation and initiation of mechanical ventilation, the client is transferred to the intensive care unit. Before suctioning the ET tube, the nurse hyperventilates and hyperoxygenates the client. What is the rationale for these interventions? A. They help prevent pneumothorax. B. They help prevent subcutaneous emphysema. C. They help prevent pulmonary edema. D. They help prevent cardiac arrhythmias.

D. "When an endotracheal tube is left in too long it can damage the lining of the windpipe."

A client in the ICU has had an endotracheal tube in place for 3 weeks. The health care provider has ordered that a tracheostomy tube be placed. The client's family wants to know why the endotracheal tube cannot be left in place. What would be the nurse's best response? A. "The physician may feel that mechanical ventilation will have to be used long-term." B. "It is much harder to breathe through an endotracheal tube than a tracheostomy." C. "Long-term use of an endotracheal tube diminishes the normal breathing reflex." D. "When an endotracheal tube is left in too long it can damage the lining of the windpipe."

A. Administration of antibiotics

A client is being treated in the ED for respiratory distress coupled with pneumonia. The client has no medical history. However, the client works in a coal mine and smokes 10 cigarettes a day. The nurse anticipates which order based on the client's immediate needs? A. Administration of antibiotics B. Completion of a 12-lead ECG C. Client education: avoidance of irritants like smoke and pollutants D. Administration of corticosteroids and bronchodilators

B. a possible hematologic problem.

A client is chronically short of breath and yet has normal lung ventilation, clear lungs, and an arterial oxygen saturation SaO2 of 96% or better. The client most likely has: A. a psychosomatic disorder. B. a possible hematologic problem. C. left-sided heart failure. D. poor peripheral perfusion.

D. Expect coughing when using the spirometer properly.

A client is postoperative and prescribed an incentive spirometer (IS). The nurse instructs the client to: A. Use the spirometer twice every hour. B. Maintain a supine position to use the spirometer. C. Inhale and exhale rapidly with the spirometer. D. Expect coughing when using the spirometer properly.

B. Oxygen saturation of 90%

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

C. Encourage coughing to mobilize secretions.

A client is recovering from thoracic surgery needed to perform a right lower lobectomy. Which of the following is the most likely postoperative nursing intervention? A. Assist with positioning the client on the right side. B. Restrict intravenous fluids for at least 24 hours. C. Encourage coughing to mobilize secretions. D. Make sure that a thoracotomy tube is linked to open chest drainage.

C. Left-sided heart failure

A client presents to the ED reporting severe coughing episodes. The client states that "the episodes are more intense at night." The nurse should suspect which of the following conditions based on the client's primary report? A. Emphysema B. Bronchitis C. Left-sided heart failure D. Chronic obstructive pulmonary disorder (COPD)

C. Position the client in the prone position

A client suspected of developing acute respiratory distress syndrome (ARDS) is experiencing anxiety and agitation due to increasing hypoxemia and dyspnea. A nurse would implement which intervention to improve oxygenation and provide comfort for the client? A. Administer small doses of pancuronium B. Assist the client into a chair C. Position the client in the prone position D. Force fluids for the next 24 hours

A. Wear appropriate protective equipment when around airborne irritants and dusts. C. Do not smoke, or quit smoking if currently smoking.

A client who has recently started working in a coal mine is concerned the effects on long-term health. How does the nurse advise the client to prevent occupational lung disease? Select all that apply. A. Wear appropriate protective equipment when around airborne irritants and dusts. B. Schedule an annual lung x-ray to monitor health. C. Do not smoke, or quit smoking if currently smoking. D. Try to find another occupation as soon as possible.

C. Encourage the client to cough

A client who is post-thoracotomy is retaining secretions. What is the nurse's initial intervention? A. Perform postural drainage B. Perform nasotracheal suctioning C. Encourage the client to cough D. Perform chest physiotherapy

A. Encourage deep breathing exercises. D. Monitor pulmonary status as directed and needed. E. Regularly assess the client's vital signs every 2 to 4 hours.

A client who is undergoing thoracic surgery has a nursing diagnosis of "Impaired gas exchange related to lung impairment and surgery" on the nursing care plan. Which of the following nursing interventions would be appropriately aligned with this nursing diagnosis? Select all that apply. A. Encourage deep breathing exercises. B. Maintain an open airway. C. Monitor and record hourly intake and output. D. Monitor pulmonary status as directed and needed. E. Regularly assess the client's vital signs every 2 to 4 hours.

A. To decrease the work of breathing B. To reduce stress on the myocardium D. To provide adequate transport of oxygen in the blood

A client who must begin oxygen therapy asks the nurse why this treatment is necessary? What would the nurse identify as the goals of oxygen therapy? Select all that apply. A. To decrease the work of breathing B. To reduce stress on the myocardium C. To clear respiratory secretions D. To provide adequate transport of oxygen in the blood E. To provide visual feedback to encourage the client to inhale slowly and deeply

B. Substernal pain E. Dyspnea D. Fatigue

A client with COPD has been receiving oxygen therapy for an extended period. What symptoms would be indicators that the client is experiencing oxygen toxicity? Select all that apply. A. Bradycardia B. Substernal pain C. Mood swings D. Fatigue E. Dyspnea

B. Angina

A client with asthma is being treated with albuterol (Proventil). Which of the findings from the client's history would indicate to the nurse the need to administer this drug with caution? A. Peptic ulcer disease B. Angina C. Bronchospasm D. Raynaud's disease

C. give the nebulizer treatment herself.

A client with chronic obstructive pulmonary disease tells a nurse that he feels short of breath. The client's respiratory rate is 36 breaths/minute and the nurse auscultates diffuse wheezes. His arterial oxygen saturation is 84%. The nurse calls the assigned respiratory therapist to administer an ordered nebulizer treatment. The therapist says, "I have several more nebulizer treatments to do on the unit where I am now. As soon as I'm finished, I'll come and assess the client." The nurse's most appropriate action is to: A. notify the primary physician immediately. B. administer the treatment by metered-dose inhaler. C. give the nebulizer treatment herself. D. stay with the client until the therapist arrives.

D. A tracheostomy

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? A. A chest tube C. An endotracheal tube C. A feeding tube D. A tracheostomy

B. Decreased diffusion capacity for oxygen

A gerontologic nurse is analyzing the data from a client's focused respiratory assessment. The nurse is aware that the amount of respiratory dead space increases with age. What is the effect of this physiologic change? A. Decreased shunting of blood B. Decreased diffusion capacity for oxygen C. Increased diffusion of gases D. Increased ventilation

A. Infection

A medical nurse has admitted a client to the unit with a diagnosis of failure to thrive. The client has developed a fever and cough, so a sputum specimen has been obtained. The nurse notes that the sputum is greenish and that there is a large quantity of it. The nurse notifies the client's physician because these symptoms are suggestive of what? A. Infection B. Pneumothorax C. Pulmonary edema D. Lung tumors

C. Instructed the client to hold the breath

A new nurse auscultates adventitious breath sounds but is not sure what to document and confers with an experienced nurse. This experienced nurse documents a pleural friction rub. Which of the following did the experienced nurse do during her assessment to identify the rub? A. Listened over the upper posterior lung surface B. Used percussion to verify the sounds C. Instructed the client to hold the breath D. Instructed the client to cough

C. Unresponsive arterial hypoxemia.

A nurse is aware that the diagnostic feature of ARDS is sudden: A. Diminished alveolar dilation. B. Tachypnea C. Unresponsive arterial hypoxemia. D. Increased PaO2

D. using a cuffed tracheostomy tube.

A nurse is caring for a client who has a tracheostomy tube and who is undergoing mechanical ventilation. The nurse can help prevent tracheal dilation, a complication of tracheostomy tube placement, by: A. using the minimal-leak technique with cuff pressure less than 25 cm H2O. B. keeping the tracheostomy tube plugged. C. suctioning the tracheostomy tube frequently. D. using a cuffed tracheostomy tube.

C. Tonsils

A nurse is caring for a client who has frequent upper respiratory infections. Which structure is most helpful in protecting against infection? A. Turbinates B. Sinus cavity C. Tonsils D. Cilia

B. Relief of dyspnea D. Increased expiratory flow rate

A nurse is caring for a client with COPD. The client's medication regimen has been recently changed and the nurse is assessing for therapeutic effect of a new bronchodilator. Therapeutic effects of this medication would include which of the following? Select all that apply. A. Increased respiratory rate B. Relief of dyspnea C. Increased viscosity of lung secretions D. Increased expiratory flow rate E. Negative sputum culture

A. Control the rate and depth of respirations B. Release air trapped in the lungs D. Prevent airway collapse

A nurse is caring for a client with COPD. While reviewing breathing exercises, the nurse instructs the client to breathe in slowly through the nose, taking in a normal breath. Then the nurse asks the client to pucker his lips as if preparing to whistle. Finally, the client is told to exhale slowly and gently through the puckered lips. The nurse teaches the client this breathing exercise to accomplish which goals? Select all that apply. A. Control the rate and depth of respirations B. Release air trapped in the lungs C. Strengthen the diaphragm D. Prevent airway collapse E. Condition the inspiratory muscles

A. "Before you do the exercise, I'll give you pain medication if you need it."

A nurse is teaching a client about using an incentive spirometer. Which statement by the nurse is correct? A. "Before you do the exercise, I'll give you pain medication if you need it." B. "Don't use the incentive spirometer more than 5 times every hour." C. "You need to start using the incentive spirometer 2 days after surgery." D. "Breathe in and out quickly."

A. Respiratory acidosis from airway obstruction

A nursing student understands that emphysema is directly related to which of the following? A. Respiratory acidosis from airway obstruction B. Hypercapnia resulting from decreased carbon dioxide tension C. Diminished alveolar surface area D. Hypoxemia secondary to impaired oxygen diffusion

B. Pleurisy

A patient describes his chest pain as knife-like on inspiration. Which of the following is the most likely diagnosis? A. A lung infection B. Pleurisy C. Bacterial pneumonia D. Bronchogenic carcinoma

C. The patient will have an insertion of a tracheostomy tube.

A patient in the ICU has been orally intubated and on mechanical ventilation for 2 weeks after having a severe stroke. What action does the nurse anticipate the physician will take now that the patient has been intubated for this length of time? A. The patient will begin the weaning process. B. The patient will be extubated and a nasotracheal tube will be inserted. C. The patient will have an insertion of a tracheostomy tube. D. The patient will be extubated and another endotracheal tube will be inserted.

D. Anemic hypoxia

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? A. Hypoxic hypoxia B. Histotoxic hypoxia C. Stagnant hypoxia D. Anemic hypoxia

A. A partial rebreathing mask

A patient is to receive an oxygen concentration of 70%. What is the best way for the nurse to deliver this concentration? A. A partial rebreathing mask B. A nasal cannula C. A Venturi mask D. An oropharyngeal catheter

B. Enalapril (Vasotec)

A patient prescribed a medication for hypertension started taking it 3 days ago and arrives in the emergency department with an edematous face and tongue and having a difficult time speaking. What medication is the nurse aware of that may produce this type of side effect? A. Metoprolol succinate (Toprol XL) B. Enalapril (Vasotec) C. Valsartan (Diovan) D. Amlodipine (Norvasc)

A. A lung volume reduction

A patient 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. A lung volume reduction B. A wedge resection C. A sleeve resection D. Lobectomy

B. Oxygen supports combustion.

A patient with emphysema is placed on continuous oxygen at 2 L/min at home. Why is it important for the nurse to educate the patient and family that they must have No Smoking signs placed on the doors? A. Oxygen prevents the dispersion of smoke particles. B. Oxygen supports combustion. C. Oxygen is combustible. D. Oxygen is explosive.

B. "The cells are denied adequate oxygen because most of the oxygen in the body is transported by the hemoglobin in red blood cells."

A student nurse is caring for a client who is severely anemic. The instructor asks the student how anemia affects the transport of oxygen to the cells. What would be the student's best answer? A. "The cells get oxygen from the plasma." B. "The cells are denied adequate oxygen because most of the oxygen in the body is transported by the hemoglobin in red blood cells." C. "The cells are denied adequate oxygen because most of the oxygen in the body is transported by the white blood cells." D. "The cells have to work harder with the decreased oxygen levels."

B. Regular breathing where the rate and depth increase, then decrease

A student nurse is working with a client who is diagnosed with head trauma. The nurse has documented Cheyne-Stokes respirations. The student would expect to see which of the following? A. Periods of normal breathing followed by periods of apnea B. Regular breathing where the rate and depth increase, then decrease C. Period of cessation of breathing D. Irregular breathing at 14 to 18 breaths per minute

B. Cancer....Infection?

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? A. Cancer B. Infection C. Trauma D. Emphysema

D. Trauma

A thorascentesis is performed to obtain a sample of pleural fluid or a biopsy specimen from the pleural wall for diagnostic purposes. What does bloody fluid results indicate? A. Infection B. Malignancy C. Emphysema D. Trauma

A. encourage coughing and deep breathing.

After undergoing a left thoracotomy, a client has a chest tube in place. When caring for this client, the nurse must: A. encourage coughing and deep breathing. B. report fluctuations in the water-seal chamber. C. clamp the chest tube once every shift. D. milk the chest tube every 2 hours.

C. Bilateral lower lobes

If concern exists about fluid accumulation in a client's lungs, what area of the lungs will the nurse focus on during assessment? A. Posterior bronchioles B. Anterior bronchioles C. Bilateral lower lobes D. Left lower lobe

B. Rock quarry worker D. Miner

In the prevention of occupational lung diseases, the nurse would direct preventive teaching to which high-risk occupations? Select all that apply. A. Nurse B. Rock quarry worker C. Mechanic D. Miner E. Banker F. Mechanic

A. Hypotension

On arrival at the intensive care unit, a critically ill client suffers respiratory arrest and is placed on mechanical ventilation. The physician orders pulse oximetry to monitor the client's arterial oxygen saturation (SaO2) noninvasively. Which vital sign abnormality may alter pulse oximetry values? A. Hypotension B. Tachypnea C. Fever D. Tachycardia

B. Tidal Volume

The amount of air inspired and expired with each breath is called: A. Vital capacity. B. Tidal volume. C. Dead-space volume. D. Residual volume.

D. Positions the inhaler 1 to 2 inches away from his open mouth

The client is prescribed albuterol (Ventolin) 2 puffs as a metered-dose inhaler. The nurse evaluates client learning as satisfactory when the client A. Holds the breath for 5 seconds after administering the medication B. Immediately repeats the second puff after the first puff C. Carefully holds the inhaler upright without shaking it D. Positions the inhaler 1 to 2 inches away from his open mouth

B. Dyspnea and fatigue disproportionate to pulmonary function abnormalities D. Right ventricular enlargement E. Elevated plasma brain natriuretic peptide (BNP) A. Enlargement of central pulmonary arteries

The diagnosis of pulmonary hypertension associated with chronic obstructive pulmonary disease (COPD) is suspected when which of the following is noted? Select all that apply. A. Enlargement of central pulmonary arteries B. Dyspnea and fatigue disproportionate to pulmonary function abnormalities C. Left ventricular hypertrophy D. Right ventricular enlargement E. Elevated plasma brain natriuretic peptide (BNP)

C. To exchange oxygen and CO2 between the atmospheric air and the blood and between the blood and the cells

The instructor of the pre-nursing physiology class is explaining respiration to the class. What does the instructor explain is the main function of respiration? A. To move O2 out of the atmospheric air and into the retained air B. To move CO2 out of the atmospheric air and into the expired air C. To exchange oxygen and CO2 between the atmospheric air and the blood and between the blood and the cells D. To exchange atmospheric air between the blood and the cells

B. Pleural Friction Rub

The nurse auscultates lung sounds that are harsh and cracking, sounding like two pieces of leather being rubbed together. The nurse would be correct in documenting this finding as A. sibilant wheezes. B. pleural friction rub. C. crackles. D. sonorous wheezes.

A. Normal Lung Function

The nurse identifies which finding to be most consistent prior to the onset of acute respiratory distress? A. Normal lung function B. Slow onset of symptoms C. Chronic lung disease D. Loss of lung function

B. 2.0 to 2.5

The nurse is administering anticoagulant therapy with heparin. What International Normalized Ratio (INR) would the nurse know is within therapeutic range? A. 0.5 to 1.0 B. 2.0 to 2.5 C. 1.5 to 2.5 D. 3.0 to 3.5

D. Perform a swallowing assessment

The nurse is assessing a client who frequently coughs after eating or drinking. How should the nurse best follow up this assessment finding? A. Assess the client's nutritional status. B. Obtain a sputum sample. C. Inspect the client's tongue and mouth. D. Perform a swallowing assessment.

A. Faint breath sounds with prolonged expiration

The nurse is assessing the respiratory status of a client who is experiencing an exacerbation of her emphysema symptoms. When preparing to auscultate, what breath sounds should the nurse anticipate? A. Faint breath sounds with prolonged expiration B. Absence of breath sounds C. Faint breath sounds with fine crackles D. Wheezing with discontinuous breath sounds

C. Hypovolemia secondary to leakage of fluid into the interstitial spaces

The nurse is caring for a client in the ICU admitted with ARDS after exposure to toxic fumes from a hazardous spill at work. The client has become hypotensive. What is the cause of this complication to the ARDS treatment? A. Increased cardiac output from high levels of PEEP therapy B. Severe and progressive pulmonary hypertension C. Hypovolemia secondary to leakage of fluid into the interstitial spaces D. Pulmonary hypotension due to decreased cardiac output

A. 20 minutes

The nurse is caring for a client in the ICU who required emergent endotracheal (ET) intubation with mechanical ventilation. The nurse receives an order to obtain arterial blood gases (ABGs) after the procedure. The nurse recognizes that ABGs should be obtained how long after mechanical ventilation is initiated? A. 20 minutes B. 10 minutes C. 15 minutes D. 25 minutes

D. Assume a left side-lying position while in bed

The nurse is caring for a client reporting chest discomfort. The client's diagnosis at admission is left lower lobe pneumonia. Which strategy will the nurse instruct the client to use to help alleviate the discomfort? A. Complete deep breathing exercises when chest discomfort occurs B. Lay on the right side C. Request narcotic medication when pain is experienced D. Assume a left side-lying position while in bed

C. Increased respiratory effort D. Nasalflaring with abdominal retractions A. Arterial blood gases reporting a PaCO2 of 48 and a PaO2 of 84 E. Lung sounds of wheezing

The nurse is caring for a client who is demonstrating signs of increased respiratory distress related to laryngeal obstruction. The nurse is calling the physician to report on the client's condition. Which of the following will the nurse report? Select all that apply. A. Arterial blood gases reporting a PaCO2 of 48 and a PaO2 of 84 B. Administration of a corticosteroid inhaler for quick relief C. Increased respiratory effort D. Nasalflaring with abdominal retractions E. Lung sounds of wheezing F. A decreased respiratory rate

D. manages decreased energy levels.

The nurse is caring for a client who is scheduled for a bronchoscopy. The nurse understands that it is important to provide the required information and appropriate explanations for any diagnostic procedure to a client with a respiratory disorder in a way that A. ensures adequate rest periods. B. manages respiratory distress. C. aid the client's caregivers. D. manages decreased energy levels.

B. Ineffective Airway Clearance related to increased secretions E. Impaired Gas Exchange related to shallow breathing and anxiousness

The nurse is caring for a client with a new tracheostomy. Which of the following nursing diagnoses are priorities? Select all that apply. A. Disturbed Body Image B. Ineffective Airway Clearance related to increased secretions C. Risk for Infection related to operative incision and tracheostomy tube placement D. Knowledge Deficit related to care of the tracheostomy tube and surrounding site E. Impaired Gas Exchange related to shallow breathing and anxiousness

C. Between 20 and 25 mm Hg

The nurse is caring for a client with an endotracheal tube who is on a ventilator. When assessing the client, the nurse knows to maintain what cuff pressure to maintain appropriate pressure on the tracheal wall? A. Between 25 and 30 mm Hg B. Between 10 and 15 mm Hg C. Between 20 and 25 mm Hg D. Between 15 and 20 mm Hg

B. Oxyhemoglobin circulates to the body tissue. C. Adequate red blood cells are needed for oxygen transport. B. Oxyhemoglobin circulates to the body tissue.

The nurse is caring for a client with hypoxemia of unknown cause. Which of the following oxygen transport considerations does the nurse identify as crucial to circulate oxygen in the body system? Select all that apply. A. High blood pressure disrupts oxygen transport. B. Oxyhemoglobin circulates to the body tissue. C. Adequate red blood cells are needed for oxygen transport. D. Oxygen is dissolved. E. All systemic oxygen is available for diffusion.

C. Indomethacin

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? A. Meperidine sulfate B. Acetaminophen C. Indomethacin D. Morphine sulfate

B. Blood Gases

The nurse is caring for an adolescent client injured in a snowboarding accident. The client has a head injury, a fractured right rib, and various abrasions and contusions. The client has a blood pressure of 142/88 mm Hg, pulse of 102 beats/minute, and respirations of 26 breaths/minute. Which laboratory test best provides data on a potential impairment in ventilation? A. Serum alkaline phosphate B. Blood gases C. Blood chemistry D. Complete blood count

B. It prolongs exhalation.

The nurse is educating a patient with COPD about the technique for performing pursed-lip breathing. What does the nurse inform the patient is the importance of using this technique? A. It will assist with widening the airway. B. It prolongs exhalation. C. It will prevent the alveoli from overexpanding. D. It increases the respiratory rate to improve oxygenation.

B. Frequently evaluate progress. D. Hold the breath at the end of inspiration for a few seconds. E. Cough frequently.

The nurse is educating the patient in the use of a mini-nebulizer. What should the nurse encourage the patient to do? (Select all that apply.) A. Prolong the expiratory phase after using the nebulizer. B. Frequently evaluate progress. C. Take rapid, deep breaths. D. Hold the breath at the end of inspiration for a few seconds. E. Cough frequently.

C. The patient will be expected to lie under the camera. D. The imaging time will amount to 20 to 40 minutes. E. A mask will be placed over the nose and mouth during the test.

The nurse is instructing a patient who is scheduled for a perfusion lung scan. What should be included in the information about the procedure? (Select all that apply.) A. The patient will be expected to be NPO for 12 hours prior to the procedure. B. An injection will be placed into the lung during the procedure. C. The patient will be expected to lie under the camera. D. The imaging time will amount to 20 to 40 minutes. E. A mask will be placed over the nose and mouth during the test.

B. Using elastic stockings, especially when decreased mobility would promote venous stasis C. Encouraging a liberal fluid intake D. Applying a sequential compression device E. Assisting the patient to do leg elevations above the level of the heart

The nurse is planning the care for a patient at risk of developing pulmonary embolism. What nursing interventions should be included in the care plan? (Select all that apply.) A. Instructing the patient to dangle the legs over the side of the bed for 30 minutes, four times a day B. Using elastic stockings, especially when decreased mobility would promote venous stasis C. Encouraging a liberal fluid intake D. Applying a sequential compression device E. Assisting the patient to do leg elevations above the level of the heart

C. Places clean tracheostomy ties then removes soiled ties after the new ties are in place

The nurse is preparing to perform tracheostomy care for a client with a newly inserted tracheostomy tube. Which action, if preformed by the nurse, indicates the need for further review of the procedure? A. Puts on clean gloves; removes and discards the soiled dressing in a biohazard container B. Dries and reinserts the inner cannula or replaces it with a new disposable inner cannula C. Places clean tracheostomy ties then removes soiled ties after the new ties are in place D. Cleans the wound and the plate with a sterile cotton tip moistened with hydrogen peroxide

A. Previous history of smoking B. Occupational and environmental influences C. Previous history of lung disease in the patient or family

The nurse is taking a respiratory history for a patient who has come into the clinic with a chronic cough. What information should the nurse obtain from this patient? (Select all that apply.) A. Previous history of smoking B. Occupational and environmental influences C. Previous history of lung disease in the patient or family D. Financial ability to pay the bill E. Social support

B. Sustains positive end expiratory pressure (PEEP) C. Decreases hypoxemia D. Decreases patient anxiety

The nurse is using an in-line suction kit to suction a patient who is intubated and on a mechanical ventilator. What benefits does inline suction have for the patient? (Select all that apply.) A. Prevents aspiration B. Sustains positive end expiratory pressure (PEEP) C. Decreases hypoxemia D. Decreases patient anxiety E. Increases oxygen consumption

B. Pulmonary angiography D. Lung scan B. Pulmonary angiography

The nurse is working on a busy respiratory unit. In caring for a variety of clients, the nurse must be knowledgeable of diagnostic studies. With which diagnostic studies would the nurse screen the client for an allergy to iodine? Select all that apply. A. Fluoroscopy B. Pulmonary angiography C. Chest x-ray D. Lung scan E. Bronchoscopy F. Pulmonary functions test

D. Respiratory acidosis.

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

D. Fat (pulmonary) embolus

The orthopedic nurse caring for a client in traction for a femur fracture knows to monitor the client for which of the following? A. DVT B. Bed sores C. Pneumonia D. Fat (pulmonary) embolus

A. BP 122/80, HR 116, R 24, pale and clammy skin, temp 101.3 degrees F

The wife of a patient who was admitted 3 days ago with an exacerbation of chronic obstructive pulmonary disease (COPD) states that she is worried about her husband because he appears to be breathing "really hard." The nurse performs a respiratory assessment. Which of the following findings would indicate a need for further interventions? (Select all that apply.) A. BP 122/80, HR 116, R 24, pale and clammy skin, temp 101.3 degrees F B. Patient states, "It always seems like I just can't catch my breath." C. BP 122/82, HR 102, R 24, noted barrel chest D. Pale, paper-thin skin, O2 at 2L/min via nasal cannula

B. 22 mm Hg

Which is a correct endotracheal tube cuff pressure? A. 13 mm Hg B. 22 mm Hg C. 16 mm Hg D. 19 mm Hg

A. Cyanosis

Which is a late sign of hypoxia? A. Cyanosis B. Restlessness C. Somnolence D. Hypotension

A. Increased thickness of alveolar sacs B. Increased residual volume D. Decreased elasticity of the alveolar sacs C. Increased diameter of alveolar ducts

Which of the following are age-related structural and functional changes that occur in the respiratory system? Select all that apply. A. Increased thickness of alveolar sacs B. Increased residual volume C. Increased diameter of alveolar ducts D. Decreased elasticity of the alveolar sacs E. Decreased dead space F. Decreased pulmonary compliance

B. Wheezes

While auscultating the lungs of a client with asthma, the nurse hears a continuous, high-pitched whistling sound on expiration. The nurse will document this sound as which of the following? A. Crackles B. Wheezes C. Pleural friction rub D. Rhonchi

C. Manage decreased energy levels

Why is it important for a nurse to provide required information and appropriate explanations of diagnostic procedures to patients with respiratory disorders? A. Aid the caregivers of the client B. Manage respiratory distress C. Manage decreased energy levels D. Ensure adequate rest periods

D. "Conditions such as chronic bronchitis cause thickening of the bronchial mucosa so it makes it harder to breathe."

You are caring for a client admitted with chronic bronchitis. The client is having difficulty breathing, and the family asks you what causes this difficulty. What would be your best response? A. "Anytime there is a chronic disease process it is hard for the person to breathe." B. "Having a chronic respiratory disease scars the lung and affects the effort it takes to breathe." C. "In this particular case your family member is just overly tired and having problems breathing." D. "Conditions such as chronic bronchitis cause thickening of the bronchial mucosa so it makes it harder to breathe."