NCLEX respiratory

A client is experiencing severe respiratory distress. Which response should the nurse expect the client to exhibit? A. Tremors B. Anasarca C. Bradypnea D. Tachycardia

D. Tachycardia

A client with emphysema experiences shortness of breath and uses pursed-lip breathing and accessory muscles of respiration. The nurse determines that the cause of the dyspnea is for which reason? A. Spasm of the bronchi that traps the air B. Increase in the vital capacity of the lungs C. Too rapid expulsion of air from the bronchioles D. Difficulty in expelling the air trapped in the alveoli

D. Difficulty in expelling the air trapped in the alveoli

During the infusion of dialysate during peritoneal dialysis, the client exhibits symptoms of severe respiratory difficulty. What should the nurse do? A. Slow the rate of the client's infusion B. Place the client in a low-Fowler position C. Auscultate the client's lungs for breath sounds D. Drain the fluid from the client's peritoneal cavity

D. Drain the fluid from the client's peritoneal cavity

A nurse is caring for a variety of clients. In which client is it most essential for the nurse to implement measures to prevent pulmonary embolism? A. A 59-year-old who had a knee replacement B. A 60-year-old who has bacterial pneumonia C. A 68-year-old who had emergency dental surgery D. A 76-year-old who has a history of thrombocytopenia

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

A patient is newly diagnosed with COPD due to chronic bronchitis. You're providing education to the patient about this disease process. Which statement by the patient indicates they understood your teaching about this condition? A. "If I stop smoking, it will cure my condition." B. "Complications from this condition can lead to pulmonary hypertension and right-sided heart failure." C. "I'm at risk for low levels of red blood cells due to hypoxia and may require blood transfusions during acute illnesses." D. "My respiratory system is stimulated to breathe due to high carbon dioxide levels rather than low oxygen levels.

B. "Complications from this condition can lead to pulmonary hypertension and right-sided heart failure."

A client with chronic obstructive pulmonary disease is admitted to the hospital with a tentative diagnosis of pleuritis. When caring for this client, what should the nurse do? A. Administer opioids frequently B. Assess for signs of pneumonia C. Give medication to suppress coughing D. Limit fluid intake to prevent pulmonary edema

B. Assess for signs of pneumonia

What is the normal value of inspiratory reserve volume? A. 0.5 L B. 1.0 L C. 1.5 L D. 3.0 L

D. 3.0 L (The normal value of inspiratory reserve volume is 3.0 L. The normal value of tidal volume is 0.5 L. The normal value of expiratory reserve volume is 1.0 L. The normal value of residual volume is 1.5 L.)

A client who just returned from surgery reports shortness of breath and chest pain. Which should the nurse initially administer? A. Supplemental oxygen B. Intravenous morphine C. Endotracheal intubation D. Sublingual nitroglycerin

A. Supplemental oxygen

A client returned to the unit following abdominal surgery. Which assessment finding should be reported to the surgeon immediately? A. Respiratory rate of 10 to 12 during deep sleep. B. Oxygen saturation drops to 90% from admission 99% saturation. C. Complaints of pain during deep breathing and coughing exercises. D. Breath sounds diminished in lung bases prior to deep breathing exercises.

B. Oxygen saturation drops to 90% from admission 99% saturation.

A patient with COPD is reporting depression and thoughts of suicide. The patient states, "I just feel like ending it all." You assess the patient's health history and note that the patient was recently started on which medication that could cause this side effect: A. Atrovent B. Prednisone C. Roflumilast D. Theophylline

C. Roflumilast

A client with an acute emphysema episode is dyspneic and anxious. To decrease the dyspnea, what is the nurse's first action? A. Increase the client's oxygen intake. B. Have the client breathe into a paper bag. C. Teach the client to do pursed-lip breathing. D. Check the client's vital signs.

C. Teach the client to do pursed-lip breathing.

A registered nurse is educating a client who has just undergone thoracentesis on the manifestations of pneumothorax. Which statements made by the client indicate effective learning? Select all that apply. A. "I'll report any instance of blue skin right away." B. "I'll report any feeling of air hunger immediately." C. "I'll report any decrease in heart rate immediately." D. "I'll call you right away if my nagging cough disappears." E. "I'll call you right away if my shallow breathing goes away."

A. "I'll report any instance of blue skin right away." B. "I'll report any feeling of air hunger immediately."

A client is on a ventilator. A nurse asks another nurse, "What should be done when condensation resulting from humidity collects in the ventilator tubing?" What is the nurse's best response? A. "Notify the respiratory therapist." B. "Empty the fluid from the tubing." C. "Decrease the amount of humidity." D. "Document the output on the record."

B. "Empty the fluid from the tubing."

A nurse is teaching a client about the use of a metered-dose inhaler with a spacer. Which statement made by the client indicates the need for further teaching? A. "I will wait for at least 1 minute between puffs." B. "I will shake the whole unit vigorously one or two times." C. "I will hold my breath for at least 10 seconds after removing the mouthpiece." Incorrect D. "I will insert the mouthpiece of the inhaler into the nonmouthpiece end of the spacer."

B. "I will shake the whole unit vigorously one or two times."

A client is diagnosed with thrombophlebitis. The client states, "I am worried about getting a clot in my lungs that will kill me." Which should be the nurse's initial response? A. Clarify the misconception B. Discuss the client's concerns C. Explain measures to prevent pulmonary emboli D. Teach recognition of early symptoms of pulmonary emboli

B. Discuss the client's concerns

A client is admitted for an exacerbation of emphysema. The client has a fever, chills, and difficulty breathing on exertion. What is the priority nursing action based on the client's history and present status? A. Checking for capillary refill B. Encouraging increased fluid intake C. Suctioning secretions from the airway Incorrect D. Administering a high concentration of oxygen

B. Encouraging increased fluid intake

A client appears anxious, exhibiting 40 shallow respirations per minute. The client complains of feeling dizzy and lightheaded and of having tingling sensations of the fingertips and around the lips. What does the nurse conclude that the client's complaints probably are related to? A. Eupnea B. Hyperventilation C. Kussmaul respirations D. Carbon dioxide intoxication

B. Hyperventilation

A nurse is caring for a client with a pneumothorax who has a chest tube attached to a closed chest drainage system. If the chest tube and closed chest drainage system are effective, what type of pressure will be reestablished? A. Neutral pressure in the pleural space B. Negative pressure in the pleural space C. Atmospheric pressure in the thoracic cavity D. Intrapulmonic pressure in the thoracic cavity

B. Negative pressure in the pleural space

In regards to question 10, which action by the patient demonstrates they know how to properly use this medication? A. The patient rinses their mouth after using the Spiriva inhaler. B. The patient rinses their mouth after using the Pulmicort inhaler. C. The patient dispenses of the inhalers. D. The patient coughs 2 times after using the Pulmicort inhaler.

B. The patient rinses their mouth after using the Pulmicort inhaler.

A nurse is suctioning a client's tracheostomy. Place the nursing actions in order of priority when performing this procedure. 1. Don sterile gloves. 2. Auscultate the lungs and check the heart rate. 3. Prepare by turning suction on to between 80 and 120 mm Hg pressure. 4. Guide the catheter into the tracheostomy tube using a sterile-gloved hand. 5. Hyperoxygenate using 100% oxygen.

2. Auscultate the lungs and check the heart rate. 3. Prepare by turning suction on to between 80 and 120 mm Hg pressure. 5. Hyperoxygenate using 100% oxygen. 1. Don sterile gloves. 4. Guide the catheter into the tracheostomy tube using a sterile-gloved hand.

A client who had a laryngectomy for cancer of the larynx is being transferred from the postanesthesia care unit to a surgical unit. Which is the most important equipment that the nurse should place in the client's room? A. Suction supplies B. Writing materials C. Tracheostomy set D. Incentive spirometer

A. Suction supplies

A client has an endotracheal tube and is receiving mechanical ventilation. Periodic suctioning is necessary, and the nurse follows a specific protocol when performing this procedure. Select in order of priority the nursing actions that should be taken when suctioning. 1. Insert the catheter without applying suction 2. Assess client's vital signs and lung sounds 3. Rotate the catheter while suction is applied 4. Activate the ventilator suction hyperoxygenation setting

2. Assess client's vital signs and lung sounds 4. Activate the ventilator suction hyperoxygenation setting 1. Insert the catheter without applying suction 3. Rotate the catheter while suction is applied

A client with chronic obstructive pulmonary disease will be taking long-term oral corticosteroid therapy. After the nurse conducts a teaching session, which statements by the client indicates that the nurse should follow up? Select all that apply. A. "My urine may become discolored." B. "I need to avoid crowds in enclosed areas." C. "I will lose weight while on this medication." D. "The medication should be taken between meals." E. "When I'm feeling better, I can stop taking this medication." F. "I will not take aspirin or ibuprofen while on this medication."

A. "My urine may become discolored." C. "I will lose weight while on this medication." D. "The medication should be taken between meals." E. "When I'm feeling better, I can stop taking this medication."

The nurse is caring for a client after a right pneumonectomy for cancer. As part of the assessment, the nurse palpates the client's trachea. What is the rationale for this assessment? A. A mediastinal shift may have occurred. B. Subcutaneous emphysema may be present. C. Tracheal edema may lead to an obstructed airway. D. The cuff of the endotracheal tube may be underinflated.

A. A mediastinal shift may have occurred.

A patient is ordered at 1400 to take Theophylline. You're assessing the patient's morning lab results and note that the Theophylline level drawn this morning reads: 15 mcg/mL. You're next nursing action is to? A. Administer the dose at 1400 as ordered B. Notify the physician for further orders C. Hold the 1400 dose D. Collect another blood sample to confirm the level

A. Administer the dose at 1400 as ordered

A nurse is teaching a client about self-management techniques for smoking cessation. Which statement made by the client indicates the need for further teaching? A. "I should list the reasons why I should stop smoking." B. "I should visit all the places where I started smoking." C. "I should remove all ashtrays and lighters." D. "I should try replacing tobacco with sugarless mints and gum."

B. "I should visit all the places where I started smoking."

A client is discharged from the hospital after receiving a lung transplant. Which medical device should the client use to monitor his or her lung function at home? A. Oximetry B. Spirometry C. Capnography D. Ventilation-perfusion

B. Spirometry

A patient is ordered by the physician to take Pulmicort and Spiriva via inhaler. How should the patient take this medication? A. The patient should use the medications every 2 hours for acute episodes of shortness of breath. B. The patient should use the Spiriva first and then 5 minutes later the Pulmicort. C. The patient should use the Pulmicort first and then the Spiriva 5 minutes later. D. The patient should use the medications at the same exact time, regardless of the order.

B. The patient should use the Spiriva first and then 5 minutes later the Pulmicort.

A client who is homeless is hospitalized for alcohol withdrawal. When considering the type of personal protective equipment that is needed for the client's care, what condition does the nurse recall that homeless persons are at risk for? A. Prostatitis B. Tuberculosis C. Osteoarthritis D. Diverticulosis

B. Tuberculosis

A client is admitted to the intensive care unit with a diagnosis of acute respiratory distress syndrome. When assessing the client, what does the nurse expect to identify? A. Hypertension B. Tenacious sputum C. Altered mental status D. Slow rate of breathing

C. Altered mental status

The term" blue bloaters" is used to describe patients with? A. Pulmonary hypertension B. Left-sided heart failure C. Chronic Bronchitis D. Emphysema

C. Chronic Bronchitis

A patient with emphysema may present with all of the following symptoms EXCEPT? A. Barrel chest B. Hyperinflation of the lungs C. Hypoventilation D. Hypercapnia

C. Hypoventilation

A patient with severe COPD is having an episode of extreme shortness of breath and requests their inhaler. Which type of inhaler ordered by the physician would provide the FASTEST relief for the patient based on this particular situation? A. Spiriva B. Salmeterol C. Symbicort D. Albuterol

D. Albuterol

The nurse suspects pneumonia in a client who underwent placement of an epistaxis catheter due to posterior nasal bleeding. Which activity of the client might have led to this condition? A. Using nasal saline sprays B. Using drugs such as aspirin C. Blowing the nose vigorously D. Applying excess petroleum jelly to the nares

D. Applying excess petroleum jelly to the nares

As a result of pulmonary tuberculosis, a client has a decreased surface area for gas exchange in the lungs. Which physiologic process does the nurse consider will be affected as a result? A. Osmosis B. Filtration C. Active transport D. Molecular diffusion

D. Molecular diffusion

True or False: COPD is reversible and tends to happens gradually.

False

After a spontaneous pneumothorax, the client becomes extremely drowsy, and the pulse and respirations increase. What do these client responses indicate to the nurse? A. Hypercapnia B. Hypokalemia C. Increased PO2 D. Respiratory alkalosis

A. Hypercapnia

A client who has a history of emphysema is transported back to the nursing unit after a radical neck dissection for cancer of the tongue. The client is receiving oxygen and an intravenous infusion. Within the first hour, the client has 50 mL of sanguineous drainage in the portable wound drainage system. Which initial action should the nurse take? A. Inspect the dressing B. Increase the oxygen flow rate C. Notify the healthcare provider D. Place the client in the supine position

A. Inspect the dressing

A client develops increased respiratory secretions because of radiation therapy to the lung, and the healthcare provider prescribes postural drainage. What client assessment leads the nurse to determine that the postural drainage is effective? A. Is free of crackles B. Has a productive cough C. Is able to expectorate saliva D. Can breathe deeply through the nose

B. Has a productive cough

A client tells the nurse that the client's chest tube is scheduled to be removed soon. Before it is removed, what is the nurse aware of? A. The drainage system will be disconnected from the chest tube. B. A chest x-ray will be performed to determine lung re-expansion. C. An arterial blood gas will be obtained to determine oxygenation status. D. The client will be sedated 30 minutes before the procedure.

B. A chest x-ray will be performed to determine lung re-expansion.

The nurse is caring for a 75-year-old client who had radical head and neck surgery. Thirty minutes after awakening from anesthesia, the client becomes agitated, disoriented, and confused. What should the nurse do? A. Notify the healthcare provider immediately of the findings. B. Administer the prescribed oxygen. C. Record the observations and continue to observe the client. D. Administer the prescribed antianxiety medication.

B. Administer the prescribed oxygen.

During a client's immediate postoperative period after a laryngectomy, what is a nursing priority? A. Provide emotional support B. Observe for signs of infection C. Keep the trachea free of secretions D. Promote a means of communication

C. Keep the trachea free of secretions

A patient is presenting with mild symptoms of pneumonia. The doctor diagnoses the patient with "walking pneumonia". From your nursing knowledge, you know this type of pneumonia is caused by what type of infectious agent? A. Fungi B. Streptococcus pneumoniae C. Mycoplasma pneumoniae D. Influenza

C. Mycoplasma pneumoniae

What should the nurse expect when assessing a client with pleural effusion? A. Crackles or rhonchi at the posterior of the lungs B. Deviation of the trachea toward the affected side C. Increased resonance on percussion of the affected area D. Reduced or absent breath sounds at the base of the lung

D. Reduced or absent breath sounds at the base of the lung

The nurse obtains a laboratory report that shows acid-fast rods in a client's sputum. Which disorder should the nurse consider may be related to these results? A. Influenza virus B. Diphtheria bacillus C. Bordetella pertussis D. Mycobacterium tuberculosis

D. Mycobacterium tuberculosis

You are providing teaching to a patient with chronic COPD on how to perform diaphragmatic breathing. This technique helps do the following: A. Increase the breathing rate to prevent hypoxemia B. Decrease the use of the abdominal muscles C. Encourages the use of accessory muscles to help with breathing D. Strengthen the diaphragm

D. Strengthen the diaphragm

Which respiratory measurement is useful in differentiating between obstructive and restrictive pulmonary dysfunction? A. Peak expiratory flow rate B. Forced vital capacity C. Forced mid-expiratory flow rate D. Forced expiratory volume/forced vital capacity ratio

D. Forced expiratory volume/forced vital capacity ratio

A nurse is providing tracheostomy care. Which action is priority? A. Place the client in the semi-Fowler position B. Maintain sterile technique during the procedure C. Monitor body temperature after the procedure is completed D. Clean the inner cannula with sterile water when it is removed

B. Maintain sterile technique during the procedure

Which order of actions should a nurse follow when performing a chest examination of a client with a pulmonary disorder? 1. Monitor the respiratory rate. 2. Observe for any abnormalities of the sternum. 3. Observe for any evidence of respiratory distress. 4. Observe the shape and symmetry of the chest.

3. Observe for any evidence of respiratory distress. 4. Observe the shape and symmetry of the chest. 2. Observe for any abnormalities of the sternum. 1. Monitor the respiratory rate.

You are providing care to a patient with COPD who is receiving medical treatment for exacerbation. The patient has a history of diabetes, hypertension, and hyperlipidemia. The patient is experiencing extreme hyperglycemia. In addition, the patient has multiple areas of bruising on the arms and legs. Which medication ordered for this patient can cause hyperglycemia and bruising? A. Prednisone B. Atrovent C. Flagyl D. Levaquin

A. Prednisone

Which nursing action is important when suctioning the secretions of a client with a tracheostomy? A. Use a new sterile catheter with each insertion. B. Initiate suction as the catheter is being withdrawn. C. Insert the catheter until the cough reflex is stimulated. D. Remove the inner cannula before inserting the suction catheter.

B. Initiate suction as the catheter is being withdrawn.

A client sustains a stab wound to the chest, and a chest tube is inserted. Later the client's chest tube appears to be obstructed. Which is the most appropriate nursing action? A. Instruct the client to cough B. Clamp the tube immediately C. Prepare for chest tube removal D. Arrange for a stat chest x-ray film

A. Instruct the client to cough

A client with a pneumothorax has a chest tube inserted and attached to a closed chest drainage system. The client asks, "Why is the tube in my chest hooked up to a contraption with water in it?" How does the nurse explain the function of the water? A. Promotes pleural drainage via gravity B. Measures the pressures in the chest wall C. Prevents reflux of air back into the chest D. Ensures bubbling in the water-seal chamber

C. Prevents reflux of air back into the chest

A client with chronic obstructive pulmonary disease (COPD) reports a 5-pound (2.3 kg) weight gain in one week. What does the nurse recall is the complication that may have precipitated this weight gain? A. Polycythemia B. Cor pulmonale C. Compensated acidosis D. Left ventricular failure

B. Cor pulmonale

A client is scheduled for a pulmonary function test. The nurse explains that during the test one of the instructions 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? A. Tidal volume B. Vital capacity C. Expiratory reserve D. Inspiratory reserve

A. Tidal volume

A client has a laryngectomy and radical neck dissection for cancer of the larynx. Two tubes from the area of the incision are connected to portable wound drainage systems. Inspection of the neck reveals moderate edema even though the drainage systems are functioning. Which clinical indicator should the nurse assess in the client? A. Crackles B. Restlessness C. Loss of the gag reflex D. Cloudy wound drainage

B. Restlessness

What clinical indicators should the nurse expect to identify when assessing an individual with a spontaneous pneumothorax? Select all that apply. A. Hematemesis B. Shortness of breath C. Unilateral chest pain D. Increased thoracic motion E. Mediastinal shift toward the involved side

B. Shortness of breath C. Unilateral chest pain

A patient is presenting with chronic obstructive pulmonary disease. The patient has a chronic productive cough with dyspnea on excretion. Arterial blood gases show a low oxygen level and high carbon dioxide level in the blood. On assessment, the patient has cyanosis in the lips and edema in the abdomen and legs. Based on your nursing knowledge and the patient's symptoms, you suspect the patient suffers from what type of COPD? A. Emphysema B. Pneumonia C. Chronic bronchitis D. Pneumothorax

C. Chronic bronchitis

A client who was discharged from the hospital after a rhinoplasty for a fractured nose complains of nasal bleeding. Which activity of the client might have led to this condition? A. Eating solid foods B. Consuming antibiotics C. Performing Valsalva maneuvers D. Using cool compresses on the nose

C. Performing Valsalva maneuvers

The nurse is reviewing the client's health history. With which diagnosis is a client most likely to exhibit hemoptysis? A. Anemia B. Pneumonia C. Tuberculosis D. Leukocytosis

C. Tuberculosis

Which of the following statements are incorrect about discharge teaching that you would provide to a patient with COPD? Select-all-that-apply: A. "It is best to eat three large meals a day that are relatively low in calories." B. "Avoid going outside during extremely hot or cold days." C. "It is important to receive the Pneumovax vaccine annually." D. "Smoking cessation can help improve your symptoms."

A. "It is best to eat three large meals a day that are relatively low in calories." C. "It is important to receive the Pneumovax vaccine annually."

A client presents to the emergency room with coughing and sudden wheezing. The nurse notes the client is progressing quickly into respiratory distress. The nurse identifies that the client is experiencing what problem? A. An acute asthma attack B. Acute bronchitis C. Left-sided heart failure D. Cor pulmonale

A. An acute asthma attack

An alarm beeps notifying you that one of your patient's oxygen saturation is reading 89%. You arrive to the patient's room, and see the patient comfortably resting in bed watching television. The patient is already on 2 L of oxygen via nasal cannula. The patient is admitted for COPD exacerbation. Your next nursing action would be: A. Continue to monitor the patient B. Increase the patient's oxygen level to 3 L C. Notify the doctor for further orders D. Turn off the alarm settings

A. Continue to monitor the patient

What is the primary responsibility of a nurse when caring for a client with a chest tube attached to a three-chamber underwater-seal drainage system? A. Ensure maintenance of the closed system B. Maintain mechanical suction to the system C. Encourage the client to deep breathe and cough D. Keep the client in the dorsal recumbent position

A. Ensure maintenance of the closed system

A nurse observes a client with acute bronchitis and emphysema sitting up in bed, appearing anxious and dyspneic. What should the nurse do first? A. Provide oxygen at 2 L per minute B. Encourage deep breathing and coughing C. Administer the prescribed sedative and encourage rest D. Suggest breathing into a paper bag for several minutes

A. Provide oxygen at 2 L per minute

What information should the nurse include in a discharge teaching plan for a client who recently had a laryngectomy? A. Limit the daily intake of fluids. B. Keep the stoma covered with a scarf. C. Only humidified air should be breathed. D. Mucus plugs can be removed with cotton-tipped swabs.

B. Keep the stoma covered with a scarf.

When assessing the breath sounds of a client with chronic obstructive pulmonary disease (COPD), the nurse hears coarse rhonchi. Which type of lung sounds will the nurse hear? A. Snorting sounds during the inspiratory phase B. Moist rumbling sounds that clear after coughing C. Musical sounds more pronounced during expiration D. Crackling inspiratory sounds unchanged with coughing

B. Moist rumbling sounds that clear after coughing

A client is admitted to the hospital with a diagnosis of emphysema. What should the nurse include when teaching the client breathing exercises? A. Spend more time inhaling than exhaling to blow off carbon dioxide B. Perform diaphragmatic exercises to improve contraction of the diaphragm C. Perform sit-ups to strengthen abdominal muscles to improve breathing D. Use abdominal exercises to limit the use of accessory muscles of respiration

B. Perform diaphragmatic exercises to improve contraction of the diaphragm

A nurse teaches a client scheduled for a tracheostomy about ways to prevent aspiration during swallowing. Which statement of the client indicates the need for further teaching? A. "I should eat smaller and more frequent meals." B. "I should avoid eating meals when I am fatigued." C. "I should drink more water and other thin liquids." D. "I should keep emergency suctioning equipment close at hand."

C. "I should drink more water and other thin liquids."

A nurse is caring for a client after abdominal surgery and encourages the client to turn from side to side and to engage in deep-breathing exercises. What complication is the nurse trying to prevent? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

C. Respiratory acidosis