Quiz Gas Exchange
Mr. S is a 65-year-old male who is admitted to the telemetry unit for treatment of pneumonia of the right middle lobe. His morning assessment reveals the following data: T: 100.4, Pulse: 110, RR: 24, B/P: 108/68, and O2 saturation 89% on room air. True or False: In this patient, abnormal breath sounds are the result of rumbling of mucus within the lower airways in clients with pneumonia.
True
A patient is admitted to the emergency department with a severe exacerbation of asthma. Which finding is of most concern to the nurse
Unable to speak and sweating profusely
Which findings indicate that a patient is developing status asthmaticus? (select all that apply)
Unable to speak in complete sentences, Lack of response to conventional treatment, Extreme wheezing
Pneumonia is
a respiratory infection
A chronic incurable condition
asthma
A high-pitched, coarse whistling sound heard on auscultation
asthma manifestation
A Cromolyn sodium inhaler is prescribed for a client with allergic asthma. The nurse provides instructions regarding the side and adverse effects of the medication and should tell the client that which undesirable effect is associated with this medication?
bronchospasm
Which findings are significant data to gather from a client who has been diagnosed with pneumonia? Select all that apply. Scroll down to view the 5 answer choices.
color of nail beds, quality of breath sounds, occurrence of chest pain
A 56-year-old, normally healthy patient at the clinic, is diagnosed with bacterial community-acquired pneumonia. Before treatment is prescribed, the nurse asks the patient about an allergy to:
erythromycin
causes fever
pneumonia
Crackles heard on auscultation
pneumonia manifestation
Asthma is
reversible inflammation of the bronchioles
The client with pneumonia develops mild constipation, and the nurse administers docusate sodium as prescribed. This drug works by
softening the stool
Which finding is an expected outcome for an elderly client following treatment and recovering from bacterial pneumonia?
the ability to perform activities of daily living without dyspnea
The healthcare provider has prescribed penicillin for a client admitted to the hospital for treatment of pneumonia. Prior to administering the first dose of penicillin, the nurse should ask the client which of the following?
"Have you had a previous allergy to penicillin?"
Which statement indicates the patient with asthma requires further teaching about self-care?
"I use my corticosteroid inhaler when I feel short of breath."
The nurse is teaching a client about coughing and deep-breathing techniques to prevent postoperative complications. Which statement is most appropriate for the nurse to make to the client at this time as it relates to these techniques?
"Use of the incentive spirometer will help prevent pneumonia."
The healthcare provider has ordered Methylprednisolone 60 mg IV now. The available medication label reads 125 mg/mL. Calculate the mL the nurse will administer how many mL?
0.48 mL
The nurse is administering a Levaquin infusion and the label reads Levaquin 750 mg/150 mL. The order states to infuse over 90 minutes. Calculate the mL/hr the nurse will set the IV pump to infuse the medication.
100 mL/hr
The nurse is caring for a patient with pneumonia and the healthcare provider has ordered and IV infusion of Ciprofloxacin 400 mg IV every 8 hours. Calculate the number of mg the patient will receive in a 24-hour period.
1200 mg
The patient is suffering from community acquired pneumonia. The healthcare provider has ordered 500 mg/250 mL of Azithromycin IV piggyback to infuse over 90 minutes. Calculate the mL/hr the nurse will administer the medication on the IV pump.
167 mL/hr
The healthcare provider has ordered Dexamethasone 10 mg IV. The vial reads 20 mg/5 mL. How many mL will the nurse administer?
2.5 mL
The healthcare provider has ordered Prednisone 1.5mg/kg/day in 2 divided doses for a 97-pound patient. How many mg will the patient receive per dose?
33 mg
The nurse develops a nursing care plan for a client at risk of having hospital-acquired pneumonia. Which factor(s) places this client at highest risk for developing hospital-acquired pneumonia? Select all that apply.
A client on a ventilator, A client with dysphagia, A client with a decreased level of consciousness
During the admission assessment, a hospitalized client with pneumonia is questioning the health care provider's order for bedrest. Which statement by the nurse best explains the reason for the bedrest order?
Bed rest will reduce demand for oxygen.
A 10-year-old child with asthma is treated for acute exacerbation in the emergency department. The nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the condition?
Decreased wheezing
Mr. S is a 65-year-old male who is admitted to the telemetry unit for treatment of pneumonia of the right middle lobe. His morning assessment reveals the following data: T: 100.4, Pulse: 110, RR: 24, B/P: 108/68, and O2 saturation 89% on room air. Which diagnostic studies does the nurse anticipate for this client? Choose all that apply.
Elevated WBC's > 10,000, Sputum Culture, Chest -xray, ABG's
While providing home care instructions to the mother of a child diagnosed with right lobar pneumonia, which intervention will the registered nurse (RN) instruct her to implement? Select all that apply
Encourage child to take deep breaths frequently, Position the child on the right side frequently, Administer acetaminophen as needed for increased fever
The mother of an 5-year-old child being treated for right lower lobe pneumonia at home calls the clinic nurse. The mother tells the nurse that the child complains of discomfort on the right side and that ibuprofen is not effective. Which instruction should the nurse provide to the mother?
Encourage the child to lie on the right side
The nurse is assigned to care for a patient who has anxiety and an exacerbation of asthma. What is the primary reason for the nurse to carefully inspect the chest wall of this patient?
Evaluate the use of intercostal muscles
A patient is concerned that he may have asthma. Of the symptoms that he describes to the nurse, which ones suggest asthma or risk factors for asthma? (select all that apply)
Gastric reflux or heartburn, Obesity, Allergic rhinitis
The nurse is performing an admission assessment for a hospitalized client with a diagnosis of asthma. The nurse questions the admitting order for ipratropium bromide (Atrovent) because the client has a history of which condition?
Glaucoma
The nurse is caring for a patient with pneumonia. If a pleural effusion is developing, the nurse would expect which finding?
Localized decreased breath sounds
Which patients have the greatest risk for aspiration pneumonia? (select all that apply)
Patient with a head injury, Patient who is receiving nasogastric tube feeding, Patient with seizures
The nurse is discussing the techniques of chest physiotherapy and postural drainage (respiratory treatments) to a client having expectoration problems because of chronic thick, tenacious mucus production in the lower airway. The nurse explains that after the client is positioned for postural drainage the nurse will perform which action to help loosen secretions?
Percussion and vibration
Which clinical manifestations will the registered nurse (RN) expect to assess in a child diagnosed with pneumonia? Select all that apply.
Presence of yellow/white sputum, Mid-sternal retractions, Auscultation of crackles
The nurse instructs a client to use the pursed-lip method of breathing and evaluates the teaching by asking the client about the purpose of this type of breathing. The nurse determines that the client understands if the client states that the primary purpose of pursed-lip breathing is to promote which outcome?
Promote carbon dioxide elimination
A client has developed a hospital-acquired pneumonia. When preparing to administer cephalexin 500 mg, the nurse notices that the pharmacy sent cefazolin. What should the nurse do? Select all that apply.
Request that cephalexin be sent promptly, Contact the pharmacy and speak to a pharmacist, Return the cefazolin to the pharmacy, Verify the medication prescription as written by the healthcare provider (HCP)
Mr. S is a 65-year-old male who is admitted to the telemetry unit for treatment of pneumonia of the right middle lobe. His morning assessment reveals the following data: T: 100.4, Pulse: 110, RR: 24, B/P: 108/68, and O2 saturation 89% on room air. Which additional assessments should the nurse perform first?
Respiratory effort and use of accessory muscles, Mental status changes, Breath Sounds
The nurse is conducting preoperative teaching with a client about the use of an incentive spirometer. The nurse should include which piece of information in discussions with the client?
The best results are achieved when sitting up or with the head of the bed elevated 45 to 90 degrees
