PCC2 ATI Respiratory Practice (Exam 2)

A nurse is admitting a client who has active tuberculosis to a room on a medical-surgical unit. Which of the following room assignments should the nurse make for the client? a. A room with air exhaust directly to the outdoor environment b. A room with another nonsurgical client c. A room in the ICU d. A room that is within view of the nurses' station

a. A room with air exhaust directly to the outdoor environment A room with air exhaust directly to the outside environment eliminates contamination of other client-care areas. This type of ventilation system is referred to as an airborne infection isolation room.

A nurse is admitting a client who is having an exacerbation of his asthma. When reviewing the provider's orders, the nurse recognizes that clarification is needed for which of the following medications? a. Propranolol b. Theophylline c. Montelukast d. Prednisone

a. Propranolol Medications that block beta-2 receptors, such as propanolol, are contraindicated in clients with asthma.

A nurse is assessing a client who has COPD. The nurse should expect the client's chest to be which of the following shapes? a. pigeon b. funnel c. kyphotic d. barrel

d. barrel Clients who have COPD use accessory muscles to assist with respiratory effort. The use of those accessory muscles causes the chest wall to eventually increase in anterior-posterior diameter, making it appear barrel shaped.

A nurse is teaching a client who has asthma how to use a metered dose inhaler (MDI). The nurse identifies the sequence of steps the client should follow

1. Inhale deeply and exhale completely 2. Place her lips firmly around the mouthpiece 3. Breathe in deeply over 2-3 seconds while pushing down the canister 4. hold her breath for 10 seconds 5. exhale slowly through pursed lips 6. wait 60 seconds between each puff

A nurse is teaching a client who has tuberculosis and is to start combination drug therapy. Which of the following medications should the nurse plan to administer? SATA a. Rifampin b. Isoniazid c. Acyclovir d. Pyrazinamide e. Montelukast

a. Rifampin b. Isoniazid d. Pyrazinamide

A nurse is teaching a client who has asthma about how to use an albuterol inhaler. Which of the following actions by the client indicates an understanding of the teaching? a. The client holds his breath for 10 seconds after inhaling the medication. b. The client takes a quick inhalation while releasing the medication from the inhaler. c. The client exhales as the medication is released from the inhaler. d. The client waits 10 min between inhalations.

a. The client holds his breath for 10 seconds after inhaling the medication. The medication should be retained in the lungs for a minimum of 10 seconds so the maximum amount of the dosage can be delivered properly to the airways. To use the inhaler, the client exhales normally just prior to releasing the medication, inhales deeply as the medication is released, then holds the medication in the lungs for approximately 10 seconds prior to exhaling.

A nurse is assessing a client who has pulmonary tuberculosis. Which of the following findings should the nurse expect? a. lethargy b. high-grade fever c. weight gain d. dry cough

a. lethargy Manifestations of pulmonary tuberculosis include lethargy and fatigue.

A nurse in a provider's office is assessing a client. The nurse should identify that which of the following findings are manifestations of pulmonary tuberculosis? SATA a. night sweats b. low-grade fever c. weight gain d. flushed cheeks e. blood in sputum

a. night sweats b. low-grade fever e. blood in sputum

A nurse is teaching a client who has been taking prednisone to asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects? a. hyperglycemia b. Adrenocortical insufficiency c. Severe dehydration d. Rebound pulmonary congestion

b. Adrenocortical insufficiency Prednisone, a corticosteroid, is similar to cortisol, the glucocorticoid hormone produced by the adrenal glands. It relieves inflammation and is used to treat certain forms of arthritis, severe allergies, autoimmune disorders, and asthma. Administration of glucocorticoids can suppress production of glucocorticoids, and an abrupt withdrawal of the drug can lead to a syndrome of adrenal insufficiency.

A home health nurse visits a client who has COPD and receives oxygen at 2L/min via nasal cannula. The client reports difficulty breathing. Which of the following actions is the nurse's priority? a. Increase the oxygen flow to 3 L/min. b. Assess the client's respiratory status. c. Call emergency services for the client. d. Have the client cough and expectorate secretions.

b. Assess the client's respiratory status. The first action the nurse should take using the nursing process is to collect data from the client. The nurse should immediately assess the client's respiratory status before determining the appropriate interventions.

A nurse in a clinic is collecting a history from a client who reports that a member of his family just received a diagnosis of pulmonary tuberculosis. The nurse should expect the provider will prescribe which of the following diagnostic tests first? a. Sputum culture for acid-fast bacillus (AFB) b. Nucleic acid amplification test (NAAT) c. CT scan d. Chest x-ray

b. Nucleic acid amplification test (NAAT) The CDC recommends that the NAAT test replace other diagnostic screening tests for tuberculosis. The test is performed on a client's sputum.

A nurse on a medical-surgical unit is performing an admission assessment of a client who has COPD with emphysema. The client reports that he has a frequent productive cough and is short of breath. The nurse should anticipate which of the following assessment findings for this client? a. respiratory alkalosis b. increased anteroposterior diameter of the chest c. Oxygen saturation level 96% d. Petechiae on chest

b. increased anteroposterior diameter of the chest The nurse should anticipate an increased anteroposterior diameter of the chest (barrel chest) because of chronic hyperinflation of the lungs.

A nurse is providing teaching to a client who has asthma and a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide? a. Check the pulse after medication administration. b. Take the medication with meals. c. Rinse the mouth after administration. d. Limit caffeine intake.

c. Rinse the mouth after administration. Use of glucocorticoids by metered dose inhaler can allow a fungal overgrowth in the mouth. Rinsing the mouth after administration can lessen the likelihood of this complication

A nurse in a community health center is assessing the results of a tuberculin skin test she performed for a client. Which of the following results indicates exposure to and possible infection with TB? a. 4 mm erythema b. 5 mm induration c. 10 mm wheal d. 15 mm induration

d. 15 mm induration A positive reaction to a tuberculin skin test is an induration (a hardened area) that is 10 mm or greater in diameter. The nurse should measure the area of induration, not any accompanying erythema or swelling.

A nurse is teaching a client who has a new diagnosis of asthma. Which of the following medications should the nurse instruct the client to use to abort an acute asthma attack a. Beclomethasone b. Salmeterol c. Formoterol d. Albuterol

d. Albuterol Albuterol is an inhaled short-acting beta2 agonist (beta2-adrenergic agonist) used as a rescue medication to relieve an acute asthma attack. Albuterol dilates the airways, decreases wheezing, and improves oxygenation.

A nurse is caring for a client who has chronic obstructive pulmonary disease (COPD). The client tells the nurse, "I can feel the congestion in my lungs, and I certainly cough a lot, but I can't seem to bring anything up". Which of the following actions should the nurse take to help this client with tenacious bronchial secretions? a. Maintaining a semi-Fowler's position as often as possible b. Administering oxygen via nasal cannula at 2 L/min c. Helping the client select a low-salt diet d. Encouraging the client to drink 2 to 3 L of water daily

d. Encouraging the client to drink 2 to 3 L of water daily COPD is a term for two diseases of the respiratory system: chronic bronchitis and emphysema. Maintaining hydration through the consumption of adequate fluids will help liquefy thick secretions and facilitate their expectoration.

A nurse is developing a plan of care for a client who has COPD. The nurse should include which of the following interventions in the plan? a. Restrict the client's fluid intake to less than 2 L/day. b. Provide the client with a low-protein diet. c. Have the client use the early-morning hours for exercise and activity. d. Instruct the client to use pursed-lip breathing

d. Instruct the client to use pursed-lip breathing Pursed-lip breathing lengthens the expiratory phase of respiration and also increases the pressure in the airway during exhalation. This action reduces airway resistance and decreases trapped air for clients who have COPD.

A nurse is auscultating the breath sounds of a client who has asthma. When the client exhales, the nurse hears a continuous high-pitched squeaking sound. The nurse should document this as which of the following adventitious breath sounds? a. Crackles b. Rhonchi c. Stridor d. Wheezes

d. Wheezes Wheezes are continuous, high-pitched squeaking sounds, first evident on expiration, but possibly evident on inspiration as the airway obstruction of asthma worsens. Wheezes are often audible without a stethoscope.

A nurse is caring for a client who has active pulmonary tuberculosis (TB) and a new prescription for IV rifampin. The nurse should instruct the client that they should expect to experience which of the following manifestations while taking this medication? a. constipation b. black-colored stools c. staining teeth d. red-colored urine

d. red-colored urine Rifampin is used in combination with other medicines to treat TB. Rifampin will cause the urine, stool, saliva, sputum, sweat, and tears to turn reddish-orange to reddish-brown.