prepU - perfusion & oxygenation Q's
The nurse schedules a pulmonary function test to measure the amount of air left in a client's lungs at maximal expiration. What test does the nurse order? A - Total lung capacity (TLC) B - Residual Volume (RV) C - Tidal volume (TV) D - Forced Expiratory Volume (FEV)
B - Residual Volume (RV)
The nurse auscultates the lungs of a client with asthma who reports shortness of breath, sore throat, and congestion. Which finding does the nurse expect to document? A - Absent breath sounds in lower lobes B - Stridor C - Wheezing D - Crackles
C - Wheezing
A client is being admitted from the emergency room reporting shortness of breath, wheezing, and coughing. What would the nurse formulate as an appropriate nursing diagnosis? A - Acute Dyspnea B - Bronchial Pneumonia C - Asthma Attack D - Ineffective Airway Clearance
D - Ineffective Airway Clearance
A 50-year-old client with hypertension is being treated with a diuretic. The client reports muscle weakness and falls easily. The nurse should assess which electrolyte? A - Calcium B - Chloride C - Phosphorous D - Potassium
D - Potassium
A client is diagnosed with hypoxia related to emphysema. The client's adult child will be assisting the client with daily hygiene. How will the nurse explain positioning of the client to the caregiver? A - "An upright, sitting position is the best for daily hygiene so a lightweight chair that can be used in and out of the shower works best to help your parent breathe easier and allow you to assist." B - "Place your parent at the sink to allow teeth brushing and stand outside of the shower to help if needed." C - "Whichever position helps your parent feel most comfortable and will allow you to help with hygiene is fine." D - "A standing position works best to allow your parent to move around in the bathroom and to allow you to help your parent in and out of the shower."
A - "An upright, sitting position is the best for daily hygiene so a lightweight chair that can be used in and out of the shower works best to help your parent breathe easier and allow you to assist."
A client with a history of chronic obstructive pulmonary disease (COPD) has been ordered oxygen at 3 L/min as needed for treatment of dyspnea. What delivery mode is most appropriate to this client's needs? A - nasal cannula B - simple mask C - partial rebreather mask D - nonrebreather mask
A - nasal cannula
An adult client is discharged to home with a prescription for oxygen at 2 L/min. Which method of oxygen delivery should the nurse use in this situation? A - nasal cannula B - oxygen mask C - oxygen tent D - oxygen hood
A - nasal cannula
A nurse is assigned to care for a client admitted to the health care facility with the diagnosis of atelectasis. When interviewing the client, the nurse would anticipate a history of: A - pneumonia. B - alcohol use. C - croup. D - asthma.
A - pneumonia.
Upon auscultation of a client's lung fields, the nurse hears a continuous high-pitched sound on expiration. These are characteristics of which adventitious breath sound? A - wheezes B - fine crackles C - pleural friction rub D - stertorous breathing
A - wheezes
The nurse is teaching the client with a pulmonary disorder about deep breathing. The client asks, "Why is it important to start by breathing through my nose, then exhaling through my mouth?" Which appropriate response would the nurse give this client? A - "If you breathe through the mouth first, you will swallow germs into your stomach." B - "Breathing through your nose first will warm, filter, and humidify the air you are breathing." C - "Breathing through your nose first encourages you to sit up straighter to increase expansion of the lungs during inhalation." D - "We are concerned about you developing a snoring habit, so we encourage nasal breathing first."
B - "Breathing through your nose first will warm, filter, and humidify the air you are breathing."
What assessments would a nurse make when auscultating the lungs? A - abnormal chest structures B - air flow through the respiratory passages C - presence of edema D - volume of air exhaled or inhaled
B - air flow through the respiratory passages
The nurse assesses a client and detects the following findings: difficulty breathing, increased respiratory and pulse rates, and pale skin with regions of cyanosis. What condition would the nurse suspect as causing these respiratory alterations? A - Perfusion B - Atelectasis C - Hypoxia D - Hyperventilation
C - Hypoxia
Which breathing technique(s) will the nurse teach to the client who has hypoxemia and hypercarbia? Select all that apply. A - deep breathing B - diaphragmatic breathing C - apply nasal strips D - pursed-lip breathing E - incentive spirometry
D - pursed-lip breathing E - incentive spirometry
The nurse is assessing a newborn in the nursery. The nurse notes the infant has episodes in which breathing ceased for 20 seconds on 2 occasions. The nurse correctly recognizes this condition as: A - apnea. B - orthopnea. C - dyspnea. D - hypercapnia.
A - apnea.
A client has edema of the feet and ankles, along with crackles in the lower lobes and a frothy, productive cough. The client is suffering from: A - lung cancer. B - myocardial infarction. C - congestive heart failure. D - pulmonary embolism.
C - congestive heart failure.
The nurse auscultates a client with soft, high-pitched popping breath sounds on inspiration. The nurse documents the breath sounds heard as: A - crackles. B - wheezes. C - vesicular. D - bronchovesicular.
A - crackles.
A nurse is assessing a client's pain. The nurse notes which database finding that is indicative of acute pain? A - increased blood pressure B - decreased pulse rate C - pupil constriction D - decreased respiratory rate
A - increased blood pressure
A nurse is preparing a client who has diabetes mellitus for surgery, the nurse should be aware of what surgical risk associated with this disease? A - respiratory depression from anesthesia B - fluid and electrolyte imbalance C - slow wound healing D - altered metabolism and excretion of drugs
C - slow wound healing
The nurse is suctioning a client's tracheostomy when the tracheostomy becomes dislodged and the nurse is unable to replace it easily. What is the nurse's most appropriate response? A - Cover the tracheostomy stoma and apply oxygen by nasal cannula B - Page the respiratory therapist STAT. C - Assess the client's respiratory status and check vital signs every 1 minute for the next hour. D - Maintain the client's oxygenation and alert the health care provider immediately.
D - Maintain the client's oxygenation and alert the health care provider immediately.
Which teaching about the oxygen analyzer is important for the nurse to provide to a client using oxygen? A - It determines whether the client is getting enough oxygen. B - It prescribes oxygen concentration. C - It decreases dry mucous membranes via delivering small water droplets. D - It regulates the amount of oxygen received.
A - It determines whether the client is getting enough oxygen.
A client requires low-flow oxygen. How will the oxygen be administered? Select all that apply. A - Simple oxygen mask B - Nasal cannula C - Partial rebreather mask D - Venturi mask E - Humidified venturi mask
A - Simple oxygen mask B - Nasal cannula C - Partial rebreather mask
Which measure would the nurse implement for prevention of deep vein thrombosis (DVT) in a postoperative client? A - Place graduated compression stockings on the client. B - Assist the client with ambulation hourly C - Elevate bilateral legs when the client is lying in bed. D - Educate the client about the use of an incentive spirometer.
A - Place graduated compression stockings on the client.
A school-age child is admitted to the emergency room with a possible concussion following a collision when playing football. After the collision, the parents state that he was "knocked out" for a few minutes before recognizing his surroundings. What is the priority assessment when the nurse first sees the client? A - Initiation of a peripheral intravenous (IV) line for fluid administration B - Assessment of vital signs and respiratory status C - Evaluation of all of his cranial nerves D - Assessment of head circumference
B - Assessment of vital signs and respiratory status
The nurse is assessing a newly admitted client. Auscultation of the client's lungs reveals the presence of discontinuous, popping sounds during inspiration over the lower lung fields. How does the nurse document this finding? A - sibilant wheeze B - sonorous wheeze C - friction rub D - crackles
D - crackles
A health care provider orders the collection of a sputum specimen from a client with a suspected bacterial infection. Which action best ensures a usable specimen? A - Discard the first sputum produced by the client. B - Instruct the client to inhale deeply and then cough. C - Have the client clear the nose and throat and gargle with salt water before beginning the procedure. D - Place the client in the dorsal recumbent position to collect the specimen.
B - Instruct the client to inhale deeply and then cough.
Which client would the nurse consider at risk for low blood pressure? A - client with high blood viscosity B - client with low blood volume C - client with decreased elasticity of walls of arterioles D - client with a strong pumping action of blood into the arteries
B - client with low blood volume reasoning - low blood volume (occurs from hemorrhaging) causes hypotension (low BP)
A 56-year-old client with Mexican heritage has a diagnosis of heart failure. The nurse's morning lung assessment of the client reveals crackles in the mid to lower lungs and respiratory rate of 32. The nurse notices that the client is restless, and his skin has an ashen appearance. Which nursing action is the priority intervention? A - Assess fluid intake. B - Assess capillary refill. C - Measure the pulse oximetry. D - Limit the client's activity.
C - Measure the pulse oximetry.
A nurse is assessing the blood pressure of a team of healthy athletes at the heath care facility. Which observation can be made by the nurse and athletes by measuring the blood pressure? A - the volume of air entering the lungs B - the ability of the arteries to stretch C - the thickness of circulating blood D - the oxygen levels in the blood
B - the ability of the arteries to stretch reasoning - measuring BP helps to assess the efficiency of pt circulatory system. BP measurements reflect ability of arteries to stretch, volume of circulating blood & amount of resistance heart must overcome when it pumps blood