Gas Exchange

671. A client with acquired immunodeficiency syndrome (AIDS) has histoplasmosis. The nurse should assess the client for which expected finding? 1. Dyspnea 2. Headache 3. Weight gain 4. Hypothermia

1. Dyspnea

662. The nurse is assessing the respiratory status of a client who has suffered a fractured rib. The nurse should expect to note which finding? 1. Slow deep respirations 2. Rapid deep respirations 3. Paradoxical respirations 4. Pain, especially with inspiration

4. Pain, especially with inspiration

694. The nurse is caring for a client with a diagnosis of influenza who first began to experience symptoms yesterday. Antiviral therapy is prescribed and the nurse provides instructions to the client about the therapy. Which statement by the client indicates an understanding of the instructions? 1. "I must take the medication exactly as prescribed." 2. "Once I start the medication, I will no longer be contagious." 3. "I will not get any colds or infections while taking this medication." 4. "This medication has minimal side effects and I can return to normal activities."

1. "I must take the medication exactly as prescribed."

658. The nurse is preparing a list of home care instructions for a client who has been hospitalized and treated for tuberculosis. Which instructions should the nurse include on the list? Select all that apply. 1. Activities should be resumed gradually. 2. Avoid contact with other individuals, except family members, for at least 6 months. 3. A sputum culture is needed every 2 to 4 weeks once medication therapy is initiated. 4. Respiratory isolation is not necessary because family members already have been exposed. 5. Cover the mouth and nose when coughing or sneezing and put used tissues in plastic bags. 6. When one sputum culture is negative, the client is no longer considered infectious and usually can return to former employment.

1. Activities should be resumed gradually. 3. A sputum culture is needed every 2 to 4 weeks once medication therapy is initiated. 4. Respiratory isolation is not necessary because family members already have been exposed. 5. Cover the mouth and nose when coughing or sneezing and put used tissues in plastic bags.

692. A client has begun therapy with theophylline (Theo-24). The nurse should plan to teach the client to limit the intake of which items while taking this medication? 1. Coffee, cola, and chocolate 2. Oysters, lobster, and shrimp 3. Melons, oranges, and pineapple 4. Cottage cheese, cream cheese, and dairy creamers

1. Coffee, cola, and chocolate

673. The nurse is taking the history of a client with occupational lung disease (silicosis). The nurse should assess whether the client wears which item during periods of exposure to silica particles? 1. Mask 2. Gown 3. Gloves 4. Eye protection

1. Mask

670. A client who is human immunodeficiency virus (HIV)-positive has had a tuberculin skin test (TST). The nurse notes a 7-mm area of induration at the site of the skin test and interprets the result as which finding? 1. Positive 2. Negative 3. Inconclusive 4. Need for repeat testing

1. Positive

664. A client has been admitted with chest trauma after a motor vehicle crash and has undergone subsequent intubation. The nurse checks the client when the high-pressure alarm on the ventilator sounds, and notes that the client has absence of breath sounds in the right upper lobe of the lung. The nurse immediately assesses for other signs of which condition? 1. Right pneumothorax 2. Pulmonary embolism 3. Displaced endotracheal tube 4. Acute respiratory distress syndrome

1. Right pneumothorax

691. Rifabutin (Mycobutin) is prescribed for a client with active Mycobacterium avium complex (MAC) disease and tuberculosis. For which side/adverse effects of the medication should the nurse monitor? Select all that apply. 1. Signs of hepatitis 2. Flulike syndrome 3. Low neutrophil count 4. Vitamin B6 deficiency 5. Ocular pain or blurred vision 6. Tingling and numbness of the fingers

1. Signs of hepatitis 2. Flulike syndrome 3. Low neutrophil count 5. Ocular pain or blurred vision

656. The nurse is caring for a client hospitalized with acute exacerbation of chronic obstructive pulmonary disease. Which finding would the nurse expect to note on assessment of this client? Select all that apply. 1. Hypocapnia 2. A hyperinflated chest noted on the chest x-ray 3. Decreased oxygen saturation with mild exercise 4. A widened diaphragm noted on the chest x-ray 5. Pulmonary function tests that demonstrate increased vital capacity

2. A hyperinflated chest noted on the chest x-ray 3. Decreased oxygen saturation with mild exercise

424. A 10-year-old child with asthma is treated for acute exacerbation in the emergency department. The nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the condition? 1. Warm, dry skin 2. Decreased wheezing 3. Pulse rate of 90 beats/minute 4. Respirations of 18 breaths/minute

2. Decreased wheezing

655. The emergency department nurse is assessing a client who has sustained a blunt injury to the chest wall. Which finding would indicate the presence of a pneumothorax in this client? 1. A low respiratory rate 2. Diminished breath sounds 3. The presence of a barrel chest 4. A sucking sound at the site of injury

2. Diminished breath sounds

668. The nurse is preparing to give a bed bath to an immobilized client with tuberculosis. The nurse should wear which item when performing this care? 1. Surgical mask and gloves 2. Particulate respirator, gown, and gloves 3. Particulate respirator and protective eyewear 4. Surgical mask, gown, and protective eyewear

2. Particulate respirator, gown, and gloves

666. The nurse is discussing the techniques of chest physiotherapy and postural drainage (respiratory treatments) to a client having expectoration problems because of chronic thick, tenacious mucus production in the lower airway. The nurse explains that after the client is positioned for postural drainage the nurse will perform which action to help loosen secretions? 1. Palpation and clubbing 2. Percussion and vibration 3. Hyperoxygenation and suctioning 4. Administer a bronchodilator and monitor peak flow

2. Percussion and vibration

685. A client has been taking isoniazid for 11⁄2 months. The client complains to the nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing which problem? 1. Hypercalcemia 2. Peripheral neuritis 3. Small blood vessel spasm 4. Impaired peripheral circulation

2. Peripheral neuritis

686. A client is to begin a 6-month course of therapy with isoniazid. The nurse should plan to teach the client to take which action? 1. Use alcohol in small amounts only. 2. Report yellow eyes or skin immediately. 3. Increase intake of Swiss or aged cheeses. 4. Avoid vitamin supplements during therapy.

2. Report yellow eyes or skin immediately.

690. The nurse has a prescription to give a client salmeterol (Serevent Diskus), two puffs, and beclomethasone dipropionate (Qvar), two puffs, by metered-dose inhaler. The nurse should administer the medication using which procedure? 1. Beclomethasone first and then the salmeterol 2. Salmeterol first and then the beclomethasone 3. Alternating a single puff of each, beginning with the salmeterol 4. Alternating a single puff of each, beginning with the beclomethasone

2. Salmeterol first and then the beclomethasone

674. An oxygen delivery system is prescribed for a client with chronic obstructive pulmonary disease to deliver a precise oxygen concentration. Which oxygen delivery system would the nurse anticipate to be prescribed? 1. Face tent 2. Venturi mask 3. Aerosol mask 4. Tracheostomy collar

2. Venturi mask

660. The nurse is preparing to suction a client via a tracheostomy tube. The nurse should plan to limit the suctioning time to a maximum of which time period? 1. 1 minute 2. 5 seconds 3. 10 seconds 4. 30 seconds

3. 10 seconds

659. The nurse is caring for a client after a bronchoscopy and biopsy. Which finding, if noted in the client, should be reported immediately to the health care provider? 1. Dry cough 2. Hematuria 3. Bronchospasm 4. Blood-streaked sputum

3. Bronchospasm

687. A client has been started on long-term therapy with rifampin (Rifadin). The nurse should provide which information to the client about the medication? 1. Should always be taken with food or antacids 2. Should be double-dosed if one dose is forgotten 3. Causes orange discoloration of sweat, tears, urine, and feces 4. May be discontinued independently if symptoms are gone in 3 months

3. Causes orange discoloration of sweat, tears, urine, and feces

669. A client has experienced pulmonary embolism. The nurse should assess for which symptom, which is most commonly reported? 1. Hot, flushed feeling 2. Sudden chills and fever 3. Chest pain that occurs suddenly 4. Dyspnea when deep breaths are taken

3. Chest pain that occurs suddenly

683. Terbutaline is prescribed for a client with bronchitis. The nurse understands that this medication should be used with caution if which medical condition is present in the client? 1. Osteoarthritis 2. Hypothyroidism 3. Diabetes mellitus 4. Polycystic disease

3. Diabetes mellitus

689. A client with tuberculosis is being started on antituberculosis therapy with isoniazid. Before giving the client the first dose, the nurse should ensure that which baseline study has been completed? 1. Electrolyte levels 2. Coagulation times 3. Liver enzyme levels 4. Serum creatinine level

3. Liver enzyme levels

684. Zafirlukast (Accolate) is prescribed for a client with bronchial asthma. Which laboratory test does the nurse expect to be prescribed before the administration of this medication? 1. Platelet count 2. Neutrophil count 3. Liver function tests 4. Complete blood count

3. Liver function tests

663. A client with a chest injury has suffered flail chest. The nurse assesses the client for which most distinctive sign of flail chest? 1. Cyanosis 2. Hypotension 3. Paradoxical chest movement 4. Dyspnea, especially on exhalation

3. Paradoxical chest movement

677. The nurse performs an admission assessment on a client with a diagnosis of tuberculosis. The nurse should check the results of which diagnostic test that will confirm this diagnosis? 1. Chest x-ray 2. Bronchoscopy 3. Sputum culture 4. Tuberculin skin test

3. Sputum culture

661. The nurse is suctioning a client via an endotracheal tube. During the suctioning procedure, the nurse notes on the monitor that the heart rate is decreasing. Which nursing intervention is most appropriate? 1. Continue to suction. 2. Notify the health care provider immediately. 3. Stop the procedure and reoxygenate the client. 4. Ensure that the suction is limited to 15 seconds.

3. Stop the procedure and reoxygenate the client.

678. The low-pressure alarm sounds on a ventilator. The nurse assesses the client and then attempts to determine the cause of the alarm. If unsuccessful in determining the cause of the alarm, the nurse should take what initial action? 1. Administer oxygen 2. Check the client's vital signs 3. Ventilate the client manually 4. Start cardiopulmonary resuscitation

3. Ventilate the client manually

240. A client with a diagnosis of asthma is admitted to the hospital with respiratory distress. Which type of adventitious lung sounds should the nurse expect to hear when performing a respiratory assessment on this client? 1. Stridor 2. Crackles 3. Wheezes 4. Diminished

3. Wheezes

667. The nurse has conducted discharge teaching with a client diagnosed with tuberculosis, who has been receiving medication for 11⁄2 weeks. The nurse determines that the client has understood the information if the client makes which statement? 1. "I need to continue drug therapy for 2 months." 2. "I can't shop at the mall for the next 6 months." 3. "I can return to work if a sputum culture comes back negative." 4. "I should not be contagious after 2 to 3 weeks of medication therapy."

4. "I should not be contagious after 2 to 3 weeks of medication therapy."

693. The nurse has just administered the first dose of omalizumab (Xolair) to a client. Which statement by the client would alert the nurse that the client may be experiencing a life-threatening effect? 1. "I have a severe headache." 2. "My feet are quite swollen." 3. "I am nauseated and may vomit." 4. "My lips and tongue are swollen."

4. "My lips and tongue are swollen."

676. The community health nurse is conducting an educational session with community members regarding the symptoms associated with tuberculosis. Which is one of the first manifestations associated with tuberculosis? 1. Dyspnea 2. Chest pain 3. A bloody, productive cough 4. A cough with the expectoration of mucoid sputum

4. A cough with the expectoration of mucoid sputum

682. A cromolyn sodium inhaler is prescribed for a client with allergic asthma. The nurse provides instructions regarding the side and adverse effects of this medication and should tell the client that which undesirable effect is associated with this medication? 1. Insomnia 2. Constipation 3. Hypotension 4. Bronchospasm

4. Bronchospasm

688. The nurse has given a client taking ethambutol (Myambutol) information about the medication. The nurse determines that the client understands the instructions if the client states he or she will immediately report which finding? 1. Impaired sense of hearing 2. Gastrointestinal side effects 3. Orange-red discoloration of body secretions 4. Difficulty in discriminating the color red from green

4. Difficulty in discriminating the color red from green

665. The nurse is assessing a client with multiple trauma who is at risk for developing acute respiratory distress syndrome. The nurse should assess for which earliest sign of acute respiratory distress syndrome? 1. Bilateral wheezing 2. Inspiratory crackles 3. Intercostal retractions 4. Increased respiratory rate

4. Increased respiratory rate

657. The nurse instructs a client to use the pursed-lip method of breathing and the client asks the nurse about the purpose of this type of breathing. The nurse responds, knowing that the primary purpose of pursed-lip breathing is to promote which outcome? 1. Promote oxygen intake 2. Strengthen the diaphragm 3. Strengthen the intercostal muscles 4. Promote carbon dioxide elimination

4. Promote carbon dioxide elimination

672. The nurse is giving discharge instructions to a client with pulmonary sarcoidosis. The nurse concludes that the client understands the information if the client indicates to report which early sign of exacerbation? 1. Fever 2. Fatigue 3. Weight loss 4. Shortness of breath

4. Shortness of breath

675. The nurse is instructing a hospitalized client with a diagnosis of emphysema about measures that will enhance the effectiveness of breathing during dyspneic periods. Which position should the nurse instruct the client to assume? 1. Sitting up in bed 2. Side-lying in bed 3. Sitting in a recliner chair 4. Sitting on the side of the bed and leaning on an overbed table

4. Sitting on the side of the bed and leaning on an overbed table