Q & A

A client undergoes a total laryngectomy and tracheostomy formation. On discharge, the nurse should give which instruction to the client and family?

"Family members should continue to talk to the client."

The nursing instructor is teaching students about the respiratory system. The instructor knows the teaching has been effective when a student makes which statement?

"Ventilation is the movement of air in and out of the respiratory tract."

What is an intravenous pyelogram (IVP)?

- It's an x-ray exam that uses an injection of contrast material to evaluate your kidneys, ureters and bladder and help diagnose blood in the urine or pain in your side or lower back. - It indicates the size, shape, location and excretory function of the kidneys.

A client seeks medical attention for a new onset of mid-back pain that is worse at night when lying supine. Which additional symptom(s) may the nurse use to determine if the client has pancreatic cancer? Select all that apply.

- Jaundice - Ascites - Weight loss - Epigastric pain

the nurse expects which client to be in respiratory acidosis?

- Morphine overdose - Sleep apnea - COPD - Asthma attcks - Alcohol intoxication

The nurse is providing home care education to the parents of a child recently diagnosed with cystic fibrosis. Which will the nurse include in her teaching plan? Select all that apply.

- instruction on vaccination importance. - provide information about the Cystic Fibrosis Foundation. - Monitor for hemoptysis and proper treatment. - use of a mucus clearance device.

The nurse is assessing the chest tube drainage of a client with a hemothorax following a motor vehicle accident. Which findings will be expected in a normally functioning chest tube system? Select all that apply.

- presence of an occlusive dressing over the insertion area. - tidaling in the water-seal chamber with respirations. - 100mL sanguineous blood in the drainage collection chamber. - the chest tube secured to the floor bedside the client's bed.

Rovsing's sign

- the pain felt in the right lower abdomen upon palpation of the left side of the abdomen. - A positive Rovsing's sign is indicative of acute appendicitis, characterized by inflammation, infection, or swelling of the appendix.

The nurse is educating a patient who will be started on an antituberculosis medication regimen. The patient asks the nurse, "How long will I have to be on these medications?" What should the nurse tell the patient?

6 to 12 months

What would the critical care nurse recognize as a condition that may indicate a client's need to have a tracheostomy?

A client requires permanent ventilation.

The digestion of carbohydrates is aided by

Amylase

How should the nurse best assess whether a client receiving oxygen therapy is hypoxemic?

Assess the client using pulse oximetry.

The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstruction and that leads to the collapse of alveoli. What complication should the nurse monitor for?

Atelectasis

The nurse is assessing a client with cirrhosis of the liver. Which stool characteristic would the nurse expect the client to report?

Clay-colored or whitish

A nurse would anticipate instituting contact precautions for a client with which of the following?

Clostridium difficile infection

The nurse identifies which type of jaundice in an adult experiencing a transfusion reaction?

Hemolytic

A nurse takes the initial history of a patient who is being examined for cancer of the larynx. Select the sign that is considered an early clinical indicator.

Hoarseness of more than 2 week's duration

A nurse notes that the FEV1/FVC ratio is less than 70% and the FEV1 is 40% for a patient with COPD. What stage should the nurse document the patient is in?

III

Asthma is cause by which type of response?

IgE-mediated

Why is a CXR important in diagnosing pneumonia?

It could reveal lung infiltration which is how pneumonia appears in the lung.

cholecystogram

It visualizes the gallbladder and bile duct.

Upon palpation of the sinus area, what would the nurse identify as a normal finding?

No tenderness during palpation

A client appears at the emergency department with complaints of headache, confusion, dizziness and weakness. Five minutes later the client exhibits confusion, visual changes, and chest pain. Carbon monoxide poisoning is suspected. The nurse immediately performs which action?

Places 100% oxygen via mask on the client.

The nurse is caring for a client in the intensive care unit who has been on a ventilator set on 80% FiO2 for three days. The nurse will observe the client for risk of having which condition as a result of prolonged ventilator settings with 80% FiO2?

Pulmonary fibrosis * b/c pulmonary fibrosis and oxygen toxicity are the highest risks for a client on a ventilator w/ high levels of FiO2 for more than 72 hours.

A nurse administers albuterol (Proventil), as ordered, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect?

Respiratory rate of 22 breaths/minute

The nurse is caring for a client with bacterial pneumonia who is receiving gentamicin. Which laboratory value is most important to monitor by the nurse?

Serum creatinine * tubular necrosis (primarily metabolized by kidneys).

After being sick for 3 days, a client with a history of diabetes mellitus is admitted to the hospital with diabetic ketoacidosis (DKA). The nurse should evaluate which diagnostic test results to prevent dysrhythmias?

Serum potassium level

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

Sibilant wheezes

emphysema

A disease of the airways characterized by destruction of the walls of overdistended alveoli

The Emergency Department (ED) nurse is caring for a client with a possible acid-base imbalance. The physician has ordered an arterial blood gas (ABG). What is one of the most important indications of an acid-base imbalance that is shown in an ABG?

Bicarbonate

The nurse is auscultating the patient's lung sounds to determine the presence of pulmonary edema. What adventitious lung sounds are significant for pulmonary edema?

Crackles in the lung bases

For air to enter the lungs (process of ventilation), the intrapulmonary pressure must be less than atmospheric pressure so air can be pulled inward. Select the movement of respiratory muscles that makes this happen during inspiration.

Diaphragm contracts and elongates the chest cavity.

A nurse is preparing a client for bronchoscopy. Which instruction should the nurse give to the client?

Do not eat or drink for 6 hours before the procedure.

Why is a pulmonary function test important in diagnosing pneumonia?

It differentiates b/w restrictive and obstructive forms of pneumonia.

Why is an ABG important in diagnosing pneumonia?

It informs on patient's oxygenation status (assessment and management).

Why is a sputum culture important in diagnosing pneumonia?

It will identify the causative agent and cellular changes for viral pneumonia.

Why is a blood cultures important in diagnosing pneumonia?

It will identify the causative agent.

A client hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis?

Light-headedness or paresthesia

The nurse is assessing a client's potential for pulmonary emboli. What finding indicates possible deep vein thrombosis?

Localized calf tenderness

A patient who has been treated for uric acid stones is being discharged from the hospital. What type of diet does the nurse discuss with the patient?

Low-purine diet

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?

The patient will have an insertion of a tracheostomy tube

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?

Ventilation exceeds perfusion

A client has just been diagnosed with hepatitis A. On assessment, the nurse expects to note

anorexia, nausea, and vomiting

The nurse is performing an admission assessment for a hospitalized client with a diagnosis of asthma. The nurse questions the admitting order for ipratropium bromide (Atrovent) because the client has a history of which condition?

glaucoma

Early signs of hypervolemia include

increased breathing effort and weight gain.

how does the nurse expect the client to show compensation for metabolic acidosis?

increased respiratory rate.

a productive cough of blood tinged sputum

indicates bacterial pneumonia

sudden onset of shaky chills

indicates bacterial pneumonia (streptococcal).

sob when lying down (orthopnea)

indicates decreased lung expansion.

The nurse is caring for an older adult client with enteritis who reports frequent diarrhea. Which assessment finding should the nurse anticipate?

metabolic acidosis

respiration of 30 breaths per minute (tachypnea)

sign of respiratory distress

An 82-year-old client is admitted to the hospital with a diagnosis of pneumonia. The nurse learns that the client lives alone and hasn't been eating or drinking properly. When assessing the client for dehydration, the nurse would expect to find:

tachycardia