med surd respi

a nurse is planning postoperative education for a client who will undergo a radical neck dissection for cancer of the larynx. the nurse should include which of the following topics a. NPO status b. alternative method of communication c. endotracheal intubation--laryngectomy or tracheostomy d. changes in body image e. swallowing exercises

NPO status alternative method of communication changes in body image swallowing exercises

a nurse is reviewing the lab result of a client who has metabolic alkalosis. which of the following laborating value should the nurse expect a. ph 7.31. HCO3-22, PaCO2 50(respiratory acidosis) b. PH 7.48, HCO3-23 mEq/L, paCO2 25 mmHg (respiratory alkalosis) c. PH 7.32, HCO3-18 mEq/L, paCO2 40 mmHg (metabolic acidosis) d.PH 7.49, HCO3-32 mEq/L, paCO2 40 mmHg (metabolic alkalisis)

PH 7.49, HCO3-32 mEq/L, paCO2 40 mmHg

a nurse on a medical-surgical unit is caring for 4 clients. which of the following client should the nurse monitor for crepitus (crackling sound resulting from air trapped under the skin, can be palpated following a pneumothorax)

a client who has a chest tube following a pneumothorax

a nurse is providing teaching to a client who has a chronic cough and is scheduled for a bronchoscopy. which of the following statement indicates an understanding of the teaching.

a tissue sample might be obtained during the procedure

a nurse in the emergency department is assessing a client for closed pneumothorax and significant bruising of the left chest following a motor vehicle crash. the client reports severe left chest pain on inspiration. the nurse should assess the client for which of the following manifestations of pneumothorax a. absence of breath sounds b. expiratory wheezing c. inspiratory stridor d. rhonchi

absence of breath sounds

a nurse is developing a teaching plan for a client about preventing acute asthma attacks. which of the following points should the nurse plan to discuss first

addressing the client perception of the disease process and what might have triggered past attacks

a nurse is providing discharge instructions to a client who has a new laryngectomy. the nurse should tell the client to be careful while bathing to prevent which of the following complications a. aspiration of water b. infection of the stoma c. bleeding around the stoma d. skin breakdown around the stoma

aspiration of water

a nurse receives notification of the admission of a client who is coughing frequently and whose sputum is pink, frothy, and copious. the client has a history of night sweat, anorexia, and weight loss. which actions should the nurse take

assign the client to a private room with negative-pressure airflow wea an N95 respirator when entering the client room

a client comes to the emergency department in severe respiratory distress following left-sided blunt chest trauma. the nurse notes absent breath sounds on the client's left side and a tracheal shift to the right. for which of the following procedure should the nurse prepare the client a. tracheostomy placement b. thoracentesis c. CT scan of the chest d. chest tube insertion

chest tube insertion

a nurse is preparing a client for discharge following a bronchoscopy. which of the following assessments is the nurse's monitoring priority? a. measuring heart rate b. palpating peripheral pulses c. observing sputum for blood d. confirming the gag reflex

confirming gag reflex

a client is admitted to the emergency department following a motorcycle crash. the nurse notes a crackling sensation upon palpation of the right side of the clients chest. after notifying the provider, the nurse should document this finding as which of the following a. friction rub b. crackles c. crepitus d. tactile fremitus

crepitus

a nurse is caring for a client who smokes cigarettes' and has a new diagnosis of emphysema. how should the nurse assist the client with smoking cessation

discuss ways the client can reduce the number of cigarettes smoked per day

a nurse is providing postoperative care for a client who has 2 chest tubes in place following a lobectomy. the client asks the nurse the reason for having 2 chest tubes. the nurse should inform the client that the lower chest tube is placed for which of the following reasons. a. removing air from the pleural space b. creating access for irrigating the chest cavity c. evacuating secretions from the bronchioles and alveoli d. draining blood and fluid from the pleural space

draining blood and fluid from the pleural space

a nurse in an urgent care clinic is collecting data from a client who reports exposure to anthrax. which of the following findings is an indication of the prodromal stage of inhalation anthrax a. dry cough b. rhinitis c. sore throat d. swollen lymph nodes

dry cough

a nurse is planning care for a client who has chronic obstructive pulmonary disease (COPD) and is malnourished. which of the following recommendations to promote nutritional intake should the nurse include in the plan a. eat high-calorie foods first b. increase intake of water at meal times c. perform active range-of-motion exercises before meals d. keep saltine crackers nearby for snacking

eat high-calorie foods first

a nurse is caring for a client with pneumonia who is experiencing thick oral secretions. which of the following actions should the nurse take first a. provide chest physiotherapy b. perform oropharyngeal suction c. encourage deep-breathing and coughing d. assist the client with ambulation

encourage deep-breathing and coughing

a nurse is caring for a client who is experiencing acute opioid toxicity. which of the following actions should the nurse identify as the priority a. insert a large-bore IV catheter b. ensure an adequate airway c. obtain an accurate medication history d. prepare to administer

ensure an adequate airway

a nurse is caring for a client for whom the respiratory therapist has just removed the endotracheal tube. which of the following actions should the nurse take first a. instruct the client to cough b. administer oxygen via face mask c. evaluate the client for stridor d. keep the client in a semi-to high-fowlers position

evaluate the client for stridor

a nurse is preparing a client for a bronchoscopy. which of the following actions should the nurse take

explain that the client will receive sedation and will not remember the procedure verify that the client understands the purpose and nature of the procedure

a nurse is caring for a client who is postoperative following a rhinoplasty. which of the following findings should the nurse report to the surgeon a. nasal edema b. mouth breathing c. periorbital ecchymosis d. frequent swallowing

frequent swallowing (indicates nasal bleeding and possible hemorrhage)

a nurse is providing preoperative teaching to a client who will undergo a total laryngectomy. which of the following statements indicates that the client understands the impact of the surgery

i understand that i will have a permanent tracheostomy after the surgery

a nurse is providing discharge teaching to a client who had pulmonary embolism. which of the folowing statement indicates that the client understands the information

i will call the doctor if i see blood in my urine or stool

a nurse is providing preoperational teaching to a client who is to undergo a pneumonectomy. the client states i am afraid coughing will hurt after the surgery. which of the following statement by the nurse is appropriate

i will show you how to splint your incision while coughing

a nurse is caring for a client who has chest tube. the nurse notes that the chest tube has become disconnected from the client drainage system. which of the following actions should the nurse take

immerse the end of the chest tube in a bottle of sterile water

a nurse is caring for a client who has a 20-year history of COPD and is receiving oxygen at 2 L/min via nasal cannula. the client is dyspneic and has an oxygen saturation via pulse oximetry of 85%. which of the following actions should the nurse take

increase the oxygen flow and request an arterial blood gas determination

a nurse on a medical-surgical unit is assessing a client who recently transferred from the ICU following endotracheal extubation. which of the following findings should the nurse identify as a possible manifestation of tracheal stenosis and report to the provider a. increased coughing b. diaphragmatic breathing c. hemoptysis d. kussmaul respirations

increased coughing

a nurse is caring for a client who is receiving mechanical ventilation and develop acute respiratory distress. which of the following action should the nurse take first a. initiate bag-valve-mask ventilation b. provide the client with a communication board c. obtain a blood simple for ABG analysis d. document the ventilator settings

initiate bag-valve-mask ventilation

a nurse is assessing a client who has pharyngitis. which of the following findings is the nurse's priority to report to the provider a. elevated temperature b. swollen cervical lymph nodes c. inspiratory stridor--airway obstruction d. purulent nasal discharge

inspiratory stridor

a nurse is caring for a client who is scheduled to have his chest tube removed. which of the following actions should the nurse take

instruct the client to perform the valsalva maneuver during removal

a nurse is caring for a client who has a tracheostomy and is receiving mechanical ventilation. when the low-pressure alarm on the ventilator sounds, it indicates which of the following to the nurse a. excessive airway secretions b. leak within the ventilator's circuitry c. decreased lung compliance d. the client coughing or attempting to talk

leak within the ventilator's circuitry

a nurse is providing discharge teaching to a client who is postoperative following a rhinoplasty. which of the following instruction should the nurse include a. apply warm compresses to the face--cold compreses to decrease swelling b. take aspirin 650mg by mouth for mild pain c. close your mouth when sneezing d. lie on your back with your head elevated 30 degrees when resting

lie on your back with your head elevated 30 degrees when resting to prevent aspiration

a nurse is caring for a client who had a left lower lobectomy to treat lung cancer. which of the following factors will have a significant impact on the plan of care for this client

lung cancer usually has metastasized before the client presents with symptoms.

a nurse is assisting a provider with a comprehensive physical examination of a client. when the provider uses transilluminator, the nurse should explain to the client that this technique help evaluate which of the following structure a. lymph nodes b. maxillary sinuses c. intercoastal spaces d. salivary glands

maxillary sinuses

a nurse is planning care for a client who is postoperative following a hip arthroplasty. in the client's medical record, the nurse notes a history of chronic obstructive pulmonary disease (COPD). which of the following oxygen-delivery methods should the nurse plan to use for this client. a. simple face mask b. nonrebreather mask c. bag-valve-mask device d. nasal cannula

nasal cannula

a nurse is assessing a client who has a positive tuberculin skin test. which of the following findings indicates that the client has active tuberculosis a. rhinitis b. air hunger--pulmonary edema c. night sweats d. weight gain

night sweat

a nurse in a provider's office is assessing a client who states he was recently exposed to tuberculosis. which of the following findings is a clinical manifestation of pulmonary tuberculosis a. pericardial friction rub b. weight gain c. night sweat and fever d. cyanosis of the fingertips

night sweat and fever

a nurse is auscultating the lungs of a client who is having an acute asthma attack. which of the following should the nurse expect to hear a. soft blowing b. loud bubbling c. dry grating d. noisy wheezing

noisy wheezing

a nurse on a medical unit is caring for a client who aspirated gastric consents prior to admission. the nurse administer 100% oxygen by nonrebreather mask after the client reports severe dyspnea. which of the following finding is a clinical manifestation of acute respiratory distress syndrome (ARDS) a. tympanic temperature 38 (100.4) b. pao2 50 mmhg c. rhonchi d. hypopnea

pao2 50 mmhg

a nurse is preparing to assist a provider with an arterial blood withdrawal form client radial artery for ABG measurement. which of the following actions should the nurse plan to take

perform an allen's test prior to obtaining the specimen

a nurse is caring for a client who has chronic obstructive pulmonary disease (COPD) and is experiencing shortness of breath. which of the following actions should the nurse perform first a. monitor the client arterial blood gas results b. instruct the client to perform controlled coughing c. teach the client how to use pursed-lip breathing d. place the client in an upright position

place the client in an upright position

a nurse is providing instructions about pursed-lip breathing for a client who has chronic obstructive pulmonary disease (COPD) with emphysema. this breathing technique accomplishes which of the following a. increases oxygen intake b. promote carbon dioxide elimination c. uses the intercostal muscle d. strengthens the diaphragm

promote carbon dioxide elimination

a nurse is caring for an older adult client who has chronic obstructive pulmonary disease (COPD) with pneumonia. the nurse should monitor the client for which of the following acid-base imbalances a. respiratory alkalosis- exhaling CO2 in excess b. respiratory acidosis c. metabolic alkalosis-excess bicarbonate d. metabolic acidosis: decrease bicarbonate

respiratory acidosis

a nurse is caring for a client who is extremely anxious and is hyperventilating. the client's ABG result are ph 7.50, paco2 27 mmhg, and Hco3-25 meq/L. the nurse should identify that the client has which of the following acid-base imbalances a. respiratory acidosis b. metabolic acidosis c. respiratory alkalosis d. metabolic alkalosis

respiratory alkalosis

a nurse in the PACU is assessing a newly admitted client and observes intercostal retractions and a high-pitched inspiratory sound. the nurse should identify these findings as manifestations of which of the following complications a. pulmonary edema b. tension pneumothorax c. flail chest d. respiratory obstruction

respiratory obstruction

a nurse is preparing a client for thoracentesis. in which of the following positions should the nurse place the client a. lying flat on the affected side b. prone with the arms raised over the head c. supine with the head of the bed elevated d. sitting while leaning forward over the bedside table

sitting while leaning forward over the bedside table

a nurse in a medical-surgical unit is assessing a client. the nurse should identify that which of the following findings is the manifestation of pulmonary embolism a. stabbing chest pain b. calf tenderness c. elevated temperature d. bradycardia

stabbing chest pain

a nurse is caring for a client immediately following extubation. which of the following manifestations indicates that the rapid response team a. stridor(high pitched crowing sound heard during inspiration) b. coughing c. hoarseness d. extensive oral secretions

stridor

a nurse on a medical-surgical unit is caring for a client who is postoperative following a hip replacement surgery. the client reports feeling apprehensive and restless. which of the following findings should the nurse recognize as an indication of pulmonary embolism a. sudden onset of dyspnea b. tracheal deviation c. bradycardia d. difficulty swallowing

sudden onset of dyspnea

a nurse is assessing the respiratory status of a client who has COPD. which of the following manifestations should the nurse identify as an indication of impending respiratory failure a. wheezing b. bradypnea c. tachycardia d. diaphoresis

tachycardia

a nurse is planning care for a client following placement of a chest tube 1 hr ago. which of the following actions should the nurse include in the plan of care

tape all connections between the chest tube and drainage system

a nurse is caring for a client who is postoperative following a thoracic lobectomy. the client has a chest tube in place: 1 in the lower portion of the thorax and the other higher on the chest wall. when a family member ask why the client has 2 chest tubes, which of the following responses should the nurse make

the lower tube will drain blood, and the higher tube will remover air

a nurse is caring for a client who has a tracheostomy with an inflated cuff in place. which of the following findings indicates that the nurse should suction the client's airway secretions? a. the client is unable to speak\ b. the client's airway secretions were last suctioned 2hr ago c. the client coughs and expectorates a large mucous plug d. the nurse auscultates coarse crackles in the lung fields

the nurse auscultates coarse crackles in the lung fields

a nurse is preparing to administer cisplatin IV to a client who has lung cancer. the nurse should identify that which of the following findings is an adverse effect of this medication a. hallucination b. pruritus c. hand and foot syndrome d. tinnitus

tinnitus

a nurse is teaching a client with cystic fibrosis about daily chest physiotherapy. which of the following is the purpose of these treatments a. to encourage deep breaths b. to mobilize secretions in the airways c. to dilate the bronchioles d. to stimulates the cough reflex

to mobilize secretions in the airways

a nurse is providing teaching to a client about pulmonary function testing. which of the following tests measures the volume of air the lungs can hold at the end of maximum inhalation a. total lung capacity b. vital lung capacity--amount of air the client can exhale after maximum inhalation c. functional residual capacity . amount of air in the lungs after normal expiration d. residual volume-after forced expiration

total lung capacit

a nurse is caring for a client following a right pleural thoracentesis. the nurse measures a total of 35 mL of purulent drainage. which of the following findings should the nurse recognize as an indication of a tension pneumothorax a. tracheal deviation to the left b. the temperature of 38.8 (102) c. absent breath sounds on the right side d. neck vein distention e. bradypnea

tracheal deviation to the left absent breath sounds on the right side neck vein distention

a nurse is providing discharge teaching to a client who has emphysema which of the following instructions should the nurse include

try to drink at least 2-3 litter of fluid per day

a nurse is providing discharge teaching about improving gas exchange for a client who has emphysema. which of the following instruction should the nurse include in the teaching a. use pursed-lip breathing during period of dyspnea b. limit fluid inatke to 1500 per day c. practice chest breathing each day d. wear home oxygen to maintain an SaO2 of at least 94%

use pursed-lip breathing during period of dyspnea

a nurse is teaching breathing techinique to a client who has emphysema. which of the following statement indicates that the client understands the mechanics of pursed-lip breathing

when i breathe out through pursed lips, my airways don't collapse between breaths

a nurse in a clinic is providing teaching for a client who is scheduled to have a tuberculin skin test. which of the following pieces of information should the nurse include

you must return to the clinic to have the test read in 2 or 3 days

a nurse is providing preoperative teaching to a client who has lung cancer and will undergo a pneumonectomy. which of the following statements should the nurse include

you will have a chest tube in place after surgery we will frequently help you turn, cough, and breath deeply after surgery we will give you oxygen to support your breathing if you need it.