Medsurg2 Final Respiratory

Avoid picking the nose.

The nurse is caring for a patient in the emergency department for epistaxis. What information should the nurse include in patient discharge teaching as a way to prevent epistaxis?

Administer bronchodilator as ordered.

Which action should the nurse take first in caring for a client during an acute asthma attack?

Limit speech

You are a nurse doing patient education for clinic patients. A patient visits the clinic and is diagnosed with acute laryngitis. What should you instruct the patient to do?

Alternative methods of communication

You are caring for a client who has just been told they have advanced laryngeal cancer and will have to have a total laryngectomy. You are doing preoperative teaching with this client. What do you know is a subject you should cover?

Edema of the upper airway

You are caring for a client who is 42-years-old and status post adenoidectomy. You find the client in respiratory distress when you enter their room. You ask another nurse to call the physician and bring an endotracheal tube into the room. What do you suspect?

"The ET tube will maintain your airway while you're under anesthesia."

A 42-year-old female client is scheduled for endotracheal intubation prior to her surgery. Which of the following can the nurse instruct this client?

Avoid swimming

A 43-year-old client has had a laryngectomy as treatment for laryngeal cancer. After extensive education with the client and his wife regarding stoma and site care, which of the following postoperative instructions do you stress is of utmost importance to the client's health and safety?

Eustachian tubes

A 6-month-old male client and his elder brother, a 3-year-old male, are being seen in the pediatric clinic for their third middle ear infection of the winter. The mother reports they develop an upper respiratory infection and an ear infection seems quick to follow. What contributes to this event?

Chronic bronchitis

A 79-year-old female resident in the long-term care facility has been experiencing a chronic, productive cough for the last 3 months. She tells the nurse "this is just my winter cough." This client most likely has which of the following conditions?

The pons

A client experiences a head injury in a motor vehicle accident. The client's level of consciousness is declining, and respirations have become slow and shallow. When monitoring a client's respiratory status, which area of the brain would the nurse realize is responsible for the rate and depth?

Encouraging increased fluid intake

A client hospitalized with pneumonia has thick, tenacious secretions. Which intervention should the nurse include when planning this client's care?

Interference with sinus drainage

A client is being seen by the physician because of her unrelenting headache, facial tenderness, low-grade fever, and dark yellow nasal discharge. Client education is important in preventing the development of sinus infections. What event predisposes clients to sinusitis?

Paradoxical chest movement

A client is brought to the emergency department following a motor vehicle accident. Which of the following nursing assessment is significant in diagnosing this client with flail chest?

Decrease

A client who smokes is receiving theophylline orally. Because of his history of smoking, the nurse expects the health care provider to do what with the theophylline dosing?

Tension pneumothorax

A mediastinal shift occurs in which type of chest disorder?

Extremely cold temperatures

A nurse is teaching a patient newly diagnosed with asthma about the disease. Which of the following should the nurse instruct this patient to avoid because it may cause bronchoconstriction?

Early ambulation and the use of compression stockings

A nurse on a postsurgical unit is aware of the high incidence of pulmonary embolism (PE) among hospitalized patients. What nursing action has the greatest potential to prevent PE among hospital patients?

Impaired gas exchange

A nurse who works in a critical care setting is caring for an adult female patient who was diagnosed with acute respiratory distress syndrome (ARDS) and promptly placed on positive-end expiratory pressure (PEEP). When planning this patient's care, what nursing diagnosis should be prioritized?

Paradoxical chest movement

A patient admitted to the hospital following a motor vehicle crash has suffered a flail chest. A nurse assesses the patient for what most common clinical manifestation of flail chest?

The importance of adhering closely to the prescribed medication regimen

An adult patient has tested positive for tuberculosis (TB). While providing patient teaching, what information should the nurse prioritize?

Nervousness

The client uses his sympathomimetic inhaler frequently. The nurse evaluates the client for which of the following symptoms related to frequent use of the sympathomimetic inhaler?

Tachycardia

The nurse caring for a 38-year-old patient started on albuterol (Proventil) should advise the patient that they may experience what adverse effects?

Robitussin

The nurse is caring for a client with an upper respiratory disorder. The client states he have a hacky, nonproductive cough, which wakens him during the night. Which over-the-counter medication would the nurse suggest to diminish the cough during the night?

Respiratory acidosis

The nurse is caring for a client with chronic obstructive pulmonary disease. The client calls the doctor and states having difficulty breathing and overall feeling fatigued. The nurse realizes that this client is at high risk for which condition?

Few early symptoms

The nurse knows the mortality rate is high in lung cancer clients due to which factor?

• Ventilation • Gas exchange

A 13-year-old client at the pulmonary clinic where you practice nursing has an extensive history of asthma and is seeing the pulmonologist for her monthly appointment. What are the primary functions of the lungs? Choose all correct options.

The importance of adhering to the prescribed treatment regimen

A 44-year-old homeless man presented to the emergency department with hemoptysis. The patient was diagnosed with tuberculosis (TB) after diagnostic testing and has just begun treatment with INH, pyrazinamide, and rifampin (Rifater). When providing patient education, what should the nurse emphasize?

Rhonchi

A client with chronic bronchitis is admitted to the health facility. Auscultation of the lungs reveals low-pitched, rumbling sounds. Which of the following describes these sounds?

50 and 50

Acute respiratory failure (ARF) occurs when oxygen tension (PaO2) falls to less than __________ mm Hg (hypoxemia) and carbon dioxide tension (PaCO2) rises to greater than __________ mm Hg (hypercapnia).

"You should rest, increase your fluids, and take Ibuprofen."

A college student presents to the health clinical with signs and symptoms of viral rhinitis (common cold). The patient states, "I've felt terrible all week; what can I do to feel better?" Which of the following is the best response the nurse can give?

Use intermittent suctioning while slowly withdrawing and rotating the catheter

A nurse is suctioning the tracheostomy of a hospitalized client with laryngeal cancer. Which of the following nursing actions should be included in this client's plan of care?

Group A, beta-hemolytic streptococcus

A patient comes to the clinic and is diagnosed with tonsillitis and adenoiditis. What bacterial pathogen does the nurse know is commonly associated with tonsillitis and adenoiditis?

Crackles

A patient has been diagnosed with heart failure that has not yet responded to treatment. What breath sound should the nurse expect to assess on auscultation?

It prevents histamine from acting on target tissues.

A patient has been suffering from repeated sinus infections. The patient is diagnosed with allergic rhinitis. The patient is prescribed a daily antihistamine. What is the mechanism of action in the antihistamine medications?

"Fluid has built up between your lungs and the lining that surrounds your lungs."

A patient in the emergency department who presented with shortness of breath has been informed by her health care provider that her chest X-ray is suggestive of a pleural effusion. The health care provider recently outlined the proposed course of treatment, but the patient has just asked the nurse, "Can you tell me exactly what's wrong with me?" What response would be most accurate?

The urine, tears, sweat, and other body fluids will be a discolored red-orange.

A patient is administered rifampin (Rifadin). Which of the following factors should the patient be taught?

Beta2-adrenergic agonist

A patient is experiencing an acute asthma attack. What is the first-line therapy for relief of an acute asthma attack?

"The tonsils help to guard the body from invasion of organisms."

A patient is having her tonsils removed. The patient asks the nurse what function the tonsils normally serve. Which of the following would be the most accurate response?

"Determine if the drug is going to make you drowsy before you drive."

A patient is in the clinic for seasonal allergic rhinitis. Loratadine (Claritin) is prescribed. Which of the following statements will the nurse include when providing patient education concerning this drug?

Inhaled corticosteroid agents will reduce airway inflammation.

A patient is instructed on the administration of inhaled corticosteroid agents to treat asthma. How do inhaled corticosteroid agents assist in the treatment of asthma?

Increase fluid intake

A patient visits the clinic and is diagnosed with acute sinusitis. To promote sinus drainage, the nurse instructs the patient to

Pleural effusion

A physician stated to the nurse that the patient has fluid noted in the pleural space and will need a thoracentesis. The nurse would expect that the physician will document this fluid as which of the following?

Vitamin B6

The nurse caring for a patient with tuberculosis anticipates administering which vitamin with isoniazid (INH) to prevent INH-associated peripheral neuropathy?

"Lately, I have this cough that just never seems to go away."

The nurse is assessing a patient who has a 35 pack-year history of cigarette smoking. In light of this known risk factor for lung cancer, what statement should prompt the nurse to refer the patient for further assessment?

Audible stridor without using a stethoscope

The nurse is caring for a client experiencing laryngeal trauma. Upon assessment, swelling and bruising is noted to the neck. Which breath sound is anticipated?

Incentive spirometry

The nurse is caring for a patient at risk for atelectasis and chooses to implement a first-line measure to prevent atelectasis development in the patient. What is an example of a first-line measure to minimize atelectasis?

Diminished or absent breath sounds on the affected side

The nurse is caring for a patient who is scheduled for a lobectomy for a diagnosis of lung cancer. While assisting with a subclavian vein central line insertion, the nurse notes the client's oxygen saturation rapidly dropping. The patient complains of shortness of breath and becomes tachypneic. The nurse suspects a pneumothorax has developed. Further assessment findings supporting the presence of a pneumothorax include what?

The physician removes lymph nodes, muscles and tissue.

The nurse is caring for the client who presents to the clinic with hoarseness for 2 months. Further testing diagnoses laryngeal cancer with the treatment plan of a radical neck dissection. When reinforcing information provided by the physician, which nursing instruction is most correct?

"It it common to experience palpitations and flushing."

The nurse is evaluating a client's understanding of the adverse reactions related to the use of theophylline. Which of the following statements by the client demonstrates an understanding of theophylline?

Coughing

The nurse is having an information session with a women's group at the YMCA about lung cancer. What frequent and commonly experienced symptom should the nurse be sure to include in the session?

pH 7.25, Pa CO 2 48, HCO3 24

The nurse is interpreting blood gases for a patient with acute respiratory distress syndrome (ARDS). Which set of blood gas values indicates respiratory acidosis?

Hoarseness for 2 weeks

The nurse is obtaining a health history from a client on an annual physical exam. Which documentation should be brought to the physician's attention?

Albuterol

The parents of a 7-year-old boy who has just been diagnosed with allergic asthma are being taught about their son's medication regimen by the nurse. The nurse is currently teaching the parent's about the appropriate use of a "rescue drug" for acute exacerbations of their son's asthma. What drug should the nurse suggests the parents to use in these situations?

Administer intradermal injections into the children's inner forearms.

The public health nurse is administering Mantoux tests to children who are being registered for kindergarten in the community. How should the nurse administer this test?

Coughing

Which action will increase pleuritic pain?

Cocaine use

Which assessment finding puts a client at increased risk for epistaxis?

Limiting fluids

Which of the following instructions would the nurse least likely include in the teaching plan for a patient receiving an antitussive?

Pain

Which of the following is a key characteristic of pleurisy?

Acute respiratory distress syndrome

You are an ICU nurse caring for a client who was admitted with a diagnosis of smoke inhalation. You know that this client is at increased risk for which of the following?

To assess damage to the optic nerve

You are caring for a client who is post-sinus surgery. When you assess this client, you ask him how many fingers you are holding up. Why do you assess postoperative visual acuity?

Progressive loss of lung function associated with chronic disease

You are caring for a client with chronic respiratory failure. What are the signs and symptoms of chronic respiratory failure?

Heart failure

You are caring for a patient who is taking an adrenergic bronchodilator. In what disease process should adrenergic bronchodilators be used cautiously?

Encourage deep breathing every 2 hours.

You are doing preoperative teaching with a client scheduled for laryngeal surgery. What should you teach this client to help prevent atelectasis?

In the standing position

You are performing pulmonary function studies on clients in the clinic. What position do you know a client should be in to have maximum lung capacities and volumes?

Antitussives suppress coughing, and expectorants loosen bronchial secretions.

Your client asks, "What is the difference between antitussive medications and expectorants?" Your best response is:

Air leak

Constant bubbling in the water seal of a chest drainage system indicates:

Viral infections

During the winter, increased instances of acute bronchitis cause a backlog of physician appointments that spill over into ED visits. What is the most common cause of acute bronchitis infections?

• Dypsnea • Restlessness

Frequent postoperative nursing assessments are very important after upper airway surgery to prevent dangerous respiratory obstruction. Mildred Powell, a 90-year-old female, has been admitted to your hospital unit after having her peritonsillar abscess drained. What are the signs of respiratory obstruction?

Inhalation of infected aerosolized droplets

How is tuberculosis transmitted from person to person?

• Endocarditis • Rheumatic fever • Glomerulonephritis

Pharyngitis can be caused by viruses and bacteria. Very serious complications can result from bacterial pharyngitis, specifically group A streptococci. Three-year-old Lindsay O'Connell has been ill for several days and is presenting at your general practice group for a sick call. Diagnosis and treatment of strep throat is important to prevent what serious complications? Choose all correct options.

Nuchal rigidity

Stiffness of the neck or inability to bend the neck is referred to as which of the following?

Albuterol first, wait five minutes and then follow with flunisolide

The asthmatic client is being treated with two inhalers, albuterol and flunisolide. The nurse teaches the client that the two medications should be administered in what order?

Sudden onset in client who had normal lung function

The new client on the unit was admitted with acute respiratory failure. What are the signs and symptoms of acute respiratory failure?

Asking the patient to repeat "ninety-nine" as the nurse's hands move down the patient's thorax

The nurse is caring for a patient diagnosed with pneumonia. The nurse will assess the patient for tactile fremitus by completing which of the following?

Early ambulation

The perioperative nurse is writing a care plan for a patient who has returned from surgery 2 hours prior. Which measure should the nurse implement to most decrease the patient's risk of developing pulmonary emboli (PE)?

The patient holds his breath for several seconds after inhaling the medication

What action by the patient would indicate that the patient is obtaining maximum benefit from their inhaler?

A diet rich in protein

What dietary recommendations should a nurse provide a patient with a lung abscess?

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

What is the difference between respiration and ventilation?

A patient requires permanent ventilation.

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

redness and induration

When interpreting the results of a Mantoux test, the nurse explains to the patient that a reaction occurs when the intradermal injection site shows

Clean teeth with applicators

Which of the following nursing interventions should a nurse perform when caring for a patient with an endotracheal tube?

Receiving vaccination

Which of the following should a nurse encourage in patients who are at the risk of pneumococcal and influenza infections?

Dull

A client arrives at the physician's office stating dyspnea; a productive cough for thick, green sputum; respirations of 28 breaths/minute, and a temperature of 102.8° F. The nurse auscultates the lung fields, which reveal poor air exchange in the right middle lobe. The nurse suspects a right middle lobe pneumonia. To be consistent with this anticipated diagnosis, which sound, heard over the chest wall when percussing, is anticipated?

Pneumonia

In your presentation to the older adults at the Senior Center luncheon, you outline steps they can take to prevent falls in the home. Preventing falls in older adults directly correlates to preventing bone fractures. If an older adult falls and fractures one or more ribs, what is a possible complication that could develop after the fracture?

Albuterol causes relaxation of the bronchial smooth muscles.

Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication?

False

Second generation antihistamines are associated with a higher risk of sedation than first generation antihistamines.

Oropharyngeal Candida albicans infection

A female patient, age 36, is prescribed inhaled corticosteroid (ICS) for daily use. Which of the following adverse effects should the nurse closely monitor for in this patient?

Sympathomimetics

A group of students demonstrate understanding of nasal decongestants, identifying them as which of the following?

Impaired gas exchange

A nurse is caring for a client with chest trauma. Which nursing diagnosis takes the highest priority?

Atelectasis

A nurse is caring for a patient following lung surgery. The patient has a shallow, monotonous respiratory pattern and is reluctant to cough. What may the patient may be at an increased risk for?