Adult Health 1 NCLEX Respiratory
A client who has undergone outpatient nasal surgery is ready for discharge and has nasal packing in place. Which of the following discharge instructions would be appropriate for the client? A) Avoid activities that elicit the Valsalva maneuver B) Take aspirin to control nasal discomfort C) Avoid brushing the teeth until the nasal packing is removed D) Apply heat to the area to control the swelling
A) Avoid activities that elicit the Valsalva maneuver
Bed rest is prescribed for a client with pneumonia during the acute phase of the illness. The nurse should determine the effectiveness of bed rest by assessing the clients: A) Decreased cellular demand for oxygen B) Reduced episodes of coughing C) Diminished pain when breathing deeply D) Ability to expectorate secretions more easily
A) Decreased cellular demand for oxygen
A nurse is teaching a client about taking antihistamines. Which of the following instructions should the nurse include in their teaching plan? select all that apply A) Operating machinery and driving may be dangerous while taking antihistamines. B) Continue taking antihistamines even if a nasal infection develops C) The effects of antihistamines is not felt until a day later D) Do not use alcohol with antihistamines E) Increase fluid intake to 2,000mL/day
A) Operating machinery and driving may be dangerous while taking antihistamines. D) Do not use alcohol with antihistamines E) Increase fluid intake to 2,000mL/day Antihistamines have an anticholinergic and drying effect and reduce nasal, salivary, and lacrimal gland Hypersection (runny nose, tearing and itching eyes).
The nurse is planning to teach a client with COPD how to cough effectively. Which of the following instructions should be included? A) Take a deep abdominal breath, bend forward and cough 3-4 times on exhalation B) Lie flat on back, splint the thorax, take 2 deep breaths and cough C) Take several rapid, shallow breaths and then cough forcefully D) Assume a side-lying position, extend the arm over the head, and alternate deep breathing with coughing
A) Take a deep abdominal breath, bend forward and cough 3-4 times on exhalation
The nurse assess the respiratory status of a client who is experiencing an exacerbation of COPD secondary to an upper respiratory tract infection. Which of the following findings would be expected? A) Normal breath sounds B) Prolonged inspiration C) Normal chest movement D) Coarse crackles and rhonchi
D) Coarse crackles and rhonchi
Which of the following is significant data to gather from a client who has been diagnosed with pneumonia? select all that apply A) Quality of breath sounds B) Presence of bowel sounds C) Occurrence of chest pain D) Amount of peripheral edema E) Color of nail beds
A) Quality of breath sounds C) Occurrence of chest pain E) Color of nail beds
The nurse should teach clients that the most common route of transmitting tubercle bacilli from person to person is through contaminated: A) Dust particles B) Droplet nuclei C) Water D) Eating utensils
B) Droplet nuclei
The nurse interprets which of the following as an early sign of ARDS in a client at risk? A) Elevated carbon dioxide level B) Hypoxia not responding to oxygen therapy C) Metabolic acidosis D) Severe, unexplained electrolyte imbalance
B) Hypoxia not responding to oxygen therapy
Which of the following statements should indicate to the nurse that the client has understood the discharge instructions provided after her nasal surgery? A) I should not shower until my packing is removed B) I will take stool softeners and modify my diet to prevent constipation C) Coughing every 2 hours is important to prevent respiratory complications D) It is important to blow my nose each day to remove the dried secretions
B) I will take stool softeners and modify my diet to prevent constipation
A client with allergic rhinitis is instructed on the correct technique for using an intranasal inhaler. Which of the following statements would demonstrate to the nurse that the client understands the instructions? A) "I should limit the use if the inhaler to early morning and bedtime use." B) "It is important not to shake the canister because that can damage the spray device." C) "I should hold one nostril closed while I insert the spray into the other nostril." D) "The inhaler tip is inserted into the nostril and pointed toward the inside nostril wall."
C) "I should hold one nostril closed while I insert the spray into the other nostril."
Which of the following symptoms is common in patients with active TB? A) Weight loss B) Increased appetite C) Dyspnea on exertion D) Mental status changes
C) Dyspnea on exertion
Clients who have had active TB are at risk for recurrence. Which of the following increases that risk? A) Cool and damp weather B) Active exercise and exertion C) Physical and emotional stress D) Rest and inactivity
C) Physical and emotional stress
Which of the following measures would most likely be successful in reducing pleuritic chest pain in a client with pneumonia? A) Encourage the client to breathe shallowly B) Have the client practice abdominal breathing C) Offer the client incentive spirometry D) Teach the client to splint the rib cage when coughing
D) Teach the client to splint the rib cage when coughing
Which of the following indicated that the client with COPD who has been discharged to home understands her care plan? A) The client promises to do pursed-lip breathing at home B) The client states actions to reduce pain C) The client says that she will use oxygen via a nasal cannula at 5L/min D) The client agrees to call her doctor if dyspnea on exertion increases
D) The client agrees to call her doctor if dyspnea on exertion increases
An elderly client had posterior packing inserted to control a severe nosebleed. After insertion of packing, the client should be closely monitored for which of the following complications? A) Vertigo B) Bell's palsy C) Hypoventilation D) Loss of gag reflex
C) Hypoventilation
Which of the following diets would be most appropriate for a client with COPD? A) Low fat, low cal diet B) Bland, soft diet C) Low sodium diet D) High-cal, high-protein diet
D) High-cal, high-protein diet
What is the rationale the supports multi-drug treatment for clients with TB? A) Multiple drugs potentiate the drugs' actions B) Multiple drugs reduce undesirable drug adverse effects C) Multiple drugs allow reduced drug dosages to be given D) Multiple drugs reduce development of resistant strains of the bacteria
D) Multiple drugs reduce development of resistant strains of the bacteria
Which of the following mental status changes may occur when a client is first experiencing hypoxia? A) Coma B) Apathy C) Irritability D) Depression
C) Irritability
The nurse is teaching a client how to manage a nosebleed. Which of the following instructions would be appropriate to give the client? A) Tilt your head backward and pinch your nose B) Lie down flat and place an ice compress over the bridge of the nose C) Blow your nose gently with your neck flexed D) Sit down, lean forward, and pinch the soft portion of your nose
D) Sit down, lean forward, and pinch the soft portion of your nose
Which of the following is an expected outcome of pursed-lip breathing for clients with emphysema? A) To promote oxygen intake B) To strengthen the diaphragm C) To strengthen the intercostal muscles D) to promote carbon dioxide elimination
D) to promote carbon dioxide elimination
When developing a discharge plan to manage the care of a patient with COPD, the nurse should advise the client to expect to: A) Develop respiratory infections easily B) Maintain current status C) Require less supplemental oxygen D) Show permanent improvement
A) Develop respiratory infections easily
Which of the following assessments should be a priority immediately after nasal surgery? A) Assessing the clients pain B) Inspecting for periorbital ecchymosis C) Assessing respiratory status D) Measuring the intake and output
C) Assessing respiratory status
The nurse teaches the client how to instill nose drops. Which of the following techniques is correct? A) The client uses sterile technique when handling the dropper B) The client blows the nose gently before instilling drops C) The client uses a new dropper for each instillation D) The client sits in a semi-Fowlers position with the head tilted forward after administration of the drops
B) The client blows the nose gently before instilling drops
Which of the following conditions can place a client at risk for ARDS? A) Septic shock B) COPD C) Asthma D) Heart Failure
A) Septic shock
A 27 yo Female has had elective nasal surgery for a deviated septum. Which of the following would indicate that bleeding was occurring even if the nasal drip pad remained dry and intact? A) Nausea B) Repeated swallowing C) Increased respiratory rate D) Increased pain
B) Repeated swallowing
The nurse is teaching a client who has been diagnosed with TB how to avoid spreading the disease to family members. Which statement(s) by the client indicate(s) that he has understood the nurses instructions? select all that apply A) "I will need to dispose of my old clothing when I return home" B) "I should always cover my mouth and nose when sneezing" C) "It is important that I isolate myself from my family when possible" D) "I should use paper tissues to cough in and dispose of them immediately" E) "I can use regular plates and utensils whenever I eat"
B) "I should always cover my mouth and nose when sneezing" D) "I should use paper tissues to cough in and dispose of them immediately" E) "I can use regular plates and utensils whenever I eat"
Which of the following activities should the nurse teach the client to implement after the removal of nasal packing on the second post-op day? A) Avoid cleaning the nares until swelling has subsided B) Apply water-soluble jelly to lubricate the nares C) Keep a nasal drip pad in place to absorb secretions D) Use a bulb syringe to gently irrigate nares
B) Apply water-soluble jelly to lubricate the nares
Which of the following interventions should the nurse anticipate in a client who has been diagnosed with ARDS? A) Tracheostomy B) Use of a nasal cannula C) Mechanical ventilation D) Insertion of a chest tube
C) Mechanical ventilation
A client with pneumonia is experiencing pleuritic chest pain. The nurse should assess the client for: A) A mild but constant aching in the chest B) Severe midsternal pain C) Moderate pain that worsens on inspiration D) Muscle spasm pain that accompanies coughing
C) Moderate pain that worsens on inspiration
Which of the following family members exposed to TB would be at highest risk for contracting the disease? A) 45- year old mother B) 17 - year old daughter C) 8 - year old son D) 76- year old grandmother
D) 76- year old grandmother
The nurse should place a client being admitted to the hospital with suspected TB on which type of isolation? A) Standard Precaution B) Contact precaution C) Droplet precaution D) Airborne precaution
D) Airborne precaution
A client with DVT suddenly develops dyspnea, tachypnea and chest discomfort. Which should the nurse do first? A) Elevate the head of the bed 30-45 degrees B) Encourage the client to cough and deep breathe C) Auscultate the lungs to detect abnormal breath sounds D) Contact the physician
A) Elevate the head of the bed 30-45 degrees
The nurse in the peri-op area is prepping the client for surgery and notices the client looks sad. The client says "I'm scared of having cancer. Its so horrible and I brought it on myself. I should have quit smoking years ago." Which would be the nurses best response to the client? A) "It's okay to be scared. What is it about cancer that you're afraid of?" B) "It's normal to be scared. I would be too. We'll help you through it." C) "Don't be so hard on yourself. You don't know if your smoking caused the cancer." D) "So you feel guilty because you smoked?"
A) "It's okay to be scared. What is it about cancer that you're afraid of?"
When caring for a client who is receiving an aminoglycoside antibiotic, the nurse should monitor which of the following lab values? A) Serum sodium B) Serum potassium C) Serum creatinine D) Serum calcium
C) Serum creatinine
The nurse should include which of the following instructions in the teaching plan for a client with chronic sinusitis? A) Avoid the use of caffeinated beverages B) Perform postural drainage every day C) Take hot showers twice daily D) Report a temperature of 102 deg F (28.9 deg C) or higher
C) Take hot showers twice daily
The nurse administers two 325mg aspirin q 4 hrs to a client with pneumonia. The nurse should evaluate the outcome of administering the drug by assessing which of the following? select all that apply A) Decreased pain when breathing B) Prolonged clotting time C) Decreased temperature D) Decreased respiratory rate E) Increased ability to expectorate secretions
A) Decreased pain when breathing C) Decreased temperature
Which of the following physical assessment findings are normal for a client with COPD? A) Increased anteroposterior chest diameter B) Underdeveloped neck muscles C) Collapsed neck veins D) Increased chest excursions with respiration
A) Increased anteroposterior chest diameter
A client is being discharged with nasal packing in place. The nurse should instruct the client to: A) Perform frequent mouth care B) Use normal saline nose drops daily C) Sneeze and cough with mouth closed D) Gargle every 4 hours with salt water
A) Perform frequent mouth care
The nurse reviews an ABG report for a client with COPD: pH 7.35: PCO2 62, PO2 70, HCO3 34; The nurse shouls A) Apply a 100% non-rebreather mask B) Assess the vital signs C) Reposition the client D) Prepare for intubation
B) Assess the vital signs
The clients ABG values are as follows: pH 7.31, PaO2 80 mm Hg, PaCO2 65 mm HG, HCO3 36 mEq/L. The nurse should assess the client for? A) Cyanosis B) Flushed skin C) Irritability D) Anxiety
B) Flushed skin
A client with COPD is experiencing dyspnea and has a low PaO2 level. The nurse plans to administer oxygen as ordered. Which of the following statements is true concerning oxygen administration to a client with COPD? A) High oxygen concentrations will cause coughing and dyspnea B) High oxygen concentrations may inhibit the hypoxic stimulus to breathe C) Increased oxygen use will cause the client to become dependant on oxygen D) Administration of oxygen is contraindicated in clients who are using bronchodilators
B) High oxygen concentrations may inhibit the hypoxic stimulus to breathe
The nurse teaches a client with COPD to asses for S/S of R-sided heart failure. Which of the following S/S should be included in the teaching plan? A) Clubbing of nail beds B) HTN C) Peripheral edema D) Increased appetite
C) Peripheral edema
A client with allergic rhinitis asks the nurse what he should do to decrease his symptoms. Which of the following instructions would be appropriate for the nurse to give the client? A) "Use your nasal decongestant spray regularly to help clear your nasal passages." B) "Ask the doctor for antibiotics. Antibiotics will help decrease the secretions." C) "It is important to increase your activity. A daily brisk walk will help promote drainage." D) "Keep a diary of when your symptoms occur. This can help you identify what precipitates your attacks."
D) "Keep a diary of when your symptoms occur. This can help you identify what precipitates your attacks."
After nasal surgery the client expresses concern about how to decrease facial pain and swelling while recovering at home. Which of the following discharge instructions would be most effective for decreasing pain and edema? A) Take analgesics every 4 hours around the clock B) Use corticosteroid spray as needed to control symptoms C) Use a bedside humidifier while sleeping D) Apply cold compress to the area
D) Apply cold compress to the area
The nurse is planning to give pre-op instructions to a client who will be undergoing rhinoplasty. Which of the following instructions should be included? A) After surgery, nasal packing will be in place 7-10 days B) Normal saline drops will need to be administered pre-operatively C) The results of the surgery will be immediately obvious post-operatively D) Aspirin-containing medications should not be taken for 2 weeks before surgery
D) Aspirin-containing medications should not be taken for 2 weeks before surgery
The cyanosis that accompanies bacterial pneumonia is primarily caused by which of the following: A) Decreased cardiac output B) Pleural effusion C) Inadequate peripheral circulation D) Decreased oxygenation of the blood
D) Decreased oxygenation of the blood
Pseudoephedrine (Sudafed) has been ordered as a nasal decongestant. Which of the following is a possible adverse effect of this drug? A) Constipation B) Bradycardia C) Diplopia D) Restlessness
D) Restlessness
A nurse is completing a health history for a client who has been taking echinacea for a head cold. the client ask, "why isnt this helping me feel better?" Which one of the following responses by the nurse would be most accurate? A) "There is limited information as to the effectiveness of herbal products." B) "Antibiotics are the agents needed to treat a head cold." C) "The head cold should be gone within a month." D)"Combining herbal products with prescription anti-viral medication is sure to help you."
A) "There is limited information as to the effectiveness of herbal products." There is no strong research evidence to warrant recommendations of herbal products for management of colds; further study is needed to show evidence of therapeutic effects and indications. Antibiotics are effective against bacteria; the head cold may have a viral cause. An uncomplicated upper respiratory tract infection subsides within 2 to 3 weeks. There may be a drug-drug interaction with herbal products and prescriptions
After a thorocotomy, the nurse instructs the client to perform deep-breathing exercises. Which of the following is an expected outcome of these exercises? A) Deep breathing elevates the diaphragm, which enlarges the thorax and increases the lung surface available for gas exchange B) Deep breathing increases blood flow to the lungs to allow them to recover from the trauma of surgery C) Deep breathing controls the rate of air flow to the remaining lobe so that it will not become hyperinflated D) Deep breathing expands the alveoli and increases the lung surface available for ventilation
D) Deep breathing expands the alveoli and increases the lung surface available for ventilation
Which of the following would be an expected outcome for a client recovering from an upper respiratory tract infection? A) Maintain a fluid intake of 800 mLs every 2 hours B) Experience chills only once a day C) Cough productively without chest discomfort D) Experience less nasal obstruction and discharge
D) Experience less nasal obstruction and discharge
Which of the following interventions would be most likely to prevent the development of ARDS? A) Teaching cigarette smoking cessation B) Maintaining adequate serum potassium levels C) Monitoring clients for S/S of hypercapnia D) Replacing fluids adequately during hypovolemic states
D) Replacing fluids adequately during hypovolemic states
When teaching a client to deep breathe effectively after a lobectomy, the nurse should instruct the client to do which of the following? A) Contract the abdominal muscles, take a slow deep breath through the nose and hold it for 3-5 seconds, then exhale B) Contract the abdominal muscles, take a deep breath through the mouth, and then exhale slowly as if trying to blow out a candle C) Relax the abdominal muscles, take a slow deep breath through the nose, hold it for 3-5 seconds and then exhale D) Relax the abdominal muscles, take a deep breath and then slowly exhale over 10 seconds
A) Contract the abdominal muscles, take a slow deep breath through the nose and hold it for 3-5 seconds, then exhale
