Respiratory 1: (Nurs 309)

A nurse is caring for a variety of clients. For which client is it most essential for the nurse to implement measure to prevent pulmonary embolism? 1. 59-year old who had a knee replacement. 2. 60-year old who has bacterial pneumonia. 3. 68-year old who had emergency dental surgery. 4. 76-year old who has a history of thrombocytopenia.

1. 59-year old who had a knee replacement.

A nurse is instructing a client to use an incentive spirometer.Which client action indicates the need for further instruction? 1. Blowing vigorously into the mouthpiece. 2. Getting into a chair to use the spirometer. 3. Inspired forcibly above a typical inspiration. 4. Using lips to form a seal around the mouthpiece.

1. Blowing vigorously into the mouthpiece.

A client states that the HCP said the tidal volume is slightly diminished and asks the nurse what this means. Which explanation should the nurse provide about the volume of air being measured to determine tidal volume? 1. Exhaled after there is a normal inspiration. 2. Exhaled forcibly after regular expiration. 3. Inspired forcibly above typical inspiration. 4. Trapped in the alveoli after a maximum expiration.

1. Exhaled after there is a normal inspiration.

The UAP tells the nurse that a patient who is receiving oxygen at a flow rate of 6 L/min by nasal cannula is reporting nasal passage discomfort. What intervention should the nurse suggest to the UAP to improve the patient's comfort for this problem? 1. Humidify the patient's oxygen. 2. Use a simple face mask instead of a nasal cannula. 3. Provide the patient with an extra pillow. 4. Have the patient sit up in a chair at the bedside.

1. Humidify the patient's oxygen.

A nurse is caring for a group of clients on a medical-surgical unit. Which client is at the highest risk for developing a pulmonary embolism? 1. Obese client with leg trauma. 2. Pregnant client with acute asthma. 3. Client with diabetes who has cholecystitis. 4. Client with pneumonia who is immunodeficient.

1. Obese client with leg trauma.

The nurse is admitting a patient for whom a diagnosis of pulmonary embolus must be ruled out. The patient's history and assessment reveal all of these findings Which finding supports the diagnosis of pulmonary embolus? 1. The patient was recently in a motorcycle crash. 2. The patient participated in an aerobic exercise group program for 6 months. 3. The patient gave birth to her youngest child 1 year ago. 4. The patient was on best rest of six hours after a diagnostic procedure.

1. The patient was recently in a motorcycle crash.

A client is scheduled for a pulmonary function test. The nurse explains that during the test one of the instructions of the respiratory therapist will give the client is to breathe normally. What should the nurse teach is being measured when the client follows these directions? 1. Tidal volume. 2. Vital capacity. 3. Expiratory reserve. 4. Inspiratory reserve.

1. Tidal volume.

A nurse assess that several clients have low oxygen saturation levels. Which client would benefit the most from receiving oxygen via nasal cannula? 1. Has an upper respiratory infection. 2. Receives many visitors while sitting in a chair. 3. Has a nasogastric tube for gastric decompression. 4. Exhibits dry oral mucous membranes from mouth breathing.

2. Receives many visitors while sitting in a chair.

A nurse uses abdominal-thoracic thrusts when an older adult in a senior center chokes on a piece of meat. Which air volume is the basis of efficacy of the abdominal thrusts to expel the foreign object in the larynx? 1. Tidal 2. Residual 3. Vital capacity 4. Inspiratory reserve

2. Residual

Levofloxacin (Levaquin) 750 mg IVPB is prescribed for a client with pneumonia. The dose is available in 150 mL of 5% dextrose and is to infuse over 90 minutes. The administration set has a drop factor of 15 gtt/mL. At how many drops per hour should the nurse regulate the IVPB to infuse? Record your answer using the nearest whole number.

25 gtt/min

A nurse identifies that a client's hemoglobin level is decreasing and is concerned about tissue hypoxia. An increase in what diagnostic test result indicates that an acceleration in oxygen dislocation from hemoglobin? 1. pH 2. PO2 3. PCO2 4. HCO3

3. PCO2

A patient with a diagnosis of sleep apnea has a problem with sleep deprivation related to a disrupted sleep cycle. Which action should the nurse delegate to the UAP? 1. Discussing weight-loss strategies such as diet and exercise with the patient. 2. Teaching the patient how to set up the bilevel positive airway pressure (BiPAP) machine before sleeping. 3. Reminding the patient to sleep on his side instead of his back. 4. Administering modafinil to promote daytime wakefulness.

3. Reminding the patient to sleep on his side instead of his back.

After surgery a client develops a DVT and a pulmonary embolus. heparin via continuous drip at 1200 units/hour is prescribed. Several hours later, vancomycin 55 mg IV every 12 hours is prescribed. The client has one IV site: a peripheral line in the left forearm. What action should the nurse take? 1. Stop the heparin, flush the line, and administer the vancomycin. 2. Use a piggyback set up to administer the vancomycin into the heparin. 3. Start another IV line for the vancomycin and continue the heparin as prescribed. 4. Hold the vancomycin and tell the HCP that the drug is incompatible with heparin.

3. Start another IV line for the vancomycin and continue the heparin as prescribed.

Which intervention for a patient with a pulmonary embolus would the RN assign to the LPN/LVN on the patient care team? 1. Evaluating the patient's reports of chest pain. 2. Monitoring laboratory values for changes in oxygenation. 3. Assessing for symptoms of respiratory failure. 4. Auscultating the lungs for crackles.

4. Auscultating the lungs for crackles.

A client is admitted with atelectasis. Which clinical manifestation does the nurse expect to identify when assessing this client? 1. Slow, deep respirations. 2. Normal oral temperature. 3. Dry, unproductive cough. 4. Diminished breath sounds.

4. Diminished breath sounds.

A client is admitted to the hospital with a diagnosis of pneumonia. List the following nursing actions in the order they should be accomplished: 1. Check peak and trough levels of the antibiotic. 2. Insert an IV catheter to establish venous access. 3. Collect a sputum sample for culture and sensitivity. 4. Administer the prescribed antibiotic IV piggyback. 5. Obtain data about the client's history and physical.

5. Obtain data about the client's history and physical. 2. Insert an IV catheter to establish venous access. 3. Collect a sputum sample for culture and sensitivity. 4. Administer the prescribed antibiotic IV piggyback. 1. Check peak and trough levels of the antibiotic.

A nurse is caring for a client is respiratory distress. The HCP orders oxygen via a nonrebreather mask. Which mask should the nurse obtain to implement the oxygen order? See picture from pg. 777 in Red NCLEX book.

Option #4