Respiratory Practice Questions

A nurse assesses a patient who is prescribed fluticasone (Flovent) and notes oral lesions. What action would the nurse take? A. Encourage oral rinsing after fluticasone administration. B. Obtain an oral specimen for culture and sensitivity. C. Start the patient on a broad-spectrum antibiotic. D. Document the finding as a known side effect.

A

A nurse cares for a patient with a 40-year smoking history who is experiencing distended neck veins and dependent edema. Which physiologic process would the nurse correlate with this patient's history and clinical manifestations? A. Increased pulmonary pressure creating a higher workload on the right side of the heart B. Exposure to irritants resulting in increased inflammation of the bronchi and bronchioles C. Increased number and size of mucous glands producing large amounts of thick mucus D. Left ventricular hypertrophy creating a decrease in cardiac output

A

The nurse instructs a patient on the steps needed to obtain a peak expiratory flow rate. In which order would these steps occur? 1. "Take as deep a breath as possible." 2. "Stand up (unless you have a physical disability)." 3. "Place the meter in your mouth, and close your lips around the mouthpiece." 4. "Make sure the device reads zero or is at base level." 5. "Blow out as hard and as fast as possible for 1 to 2 seconds." 6. "Write down the value obtained." 7. "Repeat the process two additional times, and record the highest number in your chart." A. 4, 2, 1, 3, 5, 6, 7 B. 3, 4, 1, 2, 5, 7, 6 C. 2, 1, 3, 4, 5, 6, 7 D. 1, 3, 2, 5, 6, 7, 4

A

A nurse teaches a patient who has chronic obstructive pulmonary disease. Which statements related to nutrition would the nurse include in this patient's teaching? (Select all that apply.) A. "Avoid drinking fluids just before and during meals." B. "Rest before meals if you have dyspnea." C. "Have about six small meals a day." D. "Eat high-fiber foods to promote gastric emptying." E. "Increase carbohydrate intake for energy."

A, B, C

A home health nurse evaluates a patient who has chronic obstructive pulmonary disease. Which assessments would the nurse include in this patient's evaluation? (Select all that apply.) A. Examination of mucous membranes and nail beds B. Measurement of rate, depth, and rhythm of respirations C. Auscultation of bowel sounds for abnormal sounds D. Check peripheral veins for distention while at rest E. Determine the patient's need and use of oxygen

A, B, E

A nurse plans care for a patient who has chronic obstructive pulmonary disease and thick, tenacious secretions. Which interventions would the nurse include in this patient's plan of care? (Select all that apply.) A. Ask the patient to drink 2 L of fluids daily. B. Add humidity to the prescribed oxygen. C. Suction the patient every 2 to 3 hours. D. Use a vibrating positive expiratory pressure device. E. Encourage diaphragmatic breathing.

A, B, E

A nurse cares for a patient who is prescribed an intravenous prostacyclin agent. What actions would the nurse take to ensure the patient's safety while on this medication? (Select all that apply.) A. Keep an intravenous line dedicated strictly to the infusion. B. Teach the patient that this medication increases pulmonary pressures. C. Ensure that there is always a backup drug cassette available. D. Start a large-bore peripheral intravenous line. E. Use strict aseptic technique when using the drug delivery system.

A, C, E

A nurse administers medications to a patient who has asthma. Which medication classification is paired correctly with its physiologic response to the medication? A. Bronchodilator—stabilizes the membranes of mast cells and prevents the release of inflammatory mediators B. Cholinergic antagonist—causes bronchodilation by inhibiting the parasympathetic nervous system C. Corticosteroid—relaxes bronchiolar smooth muscles by binding to and activating pulmonary beta2 receptors D. Cromone—disrupts the production of pathways of inflammatory mediators

B

A nurse cares for a patient with arthritis who reports frequent asthma attacks. What action would the nurse take first? A. Review the patient's pulmonary function test results. B. Ask about medications the patient is currently taking. C. Assess how frequently the patient uses a bronchodilator. D. Consult the provider and request arterial blood gases.

B

A pulmonary nurse cares for patients who have chronic obstructive pulmonary disease (COPD). Which patient would the nurse assess first? A. A 46-year-old with a 30-pack-year history of smoking B. A 52-year-old in a tripod position using accessory muscles to breathe C. A 68-year-old who has dependent edema and clubbed fingers D. A 74-year-old with a chronic cough and thick, tenacious secretions

B

After teaching a patient how to perform diaphragmatic breathing, the nurse assesses the patient's understanding. Which action demonstrates that the patient correctly understands the teaching? A. The patient lays on his or her side with his or her knees bent. B. The patient places his or her hands on his or her abdomen. C. The patient lays in a prone position with his or her legs straight. D. The patient places his or her hands above his or her head.

B

While assessing a patient who is 12 hours postoperative after a thoracotomy for lung cancer, a nurse notices that the lower chest tube is dislodged. Which action by the nurse is best? A. Assess for drainage from the site. B. Cover the insertion site with sterile gauze. C. Contact the provider and obtain a suture kit. D. Reinsert the tube using sterile technique.

B

A nurse assesses a patient who has a chest tube. For which manifestations would the nurse immediately intervene? (Select all that apply.) A. Production of pink sputum B. Tracheal deviation C. Sudden onset of shortness of breath D. Pain at insertion site E. Drainage of 75 mL/hr

B, C

A nurse assesses a patient with chronic obstructive pulmonary disease. Which questions would the nurse ask to determine the patient's activity tolerance? (Select all that apply.) A. "What color is your sputum?" B. "Do you have any difficulty sleeping?" C. "How long does it take to perform your morning routine?" D. "Do you walk upstairs every day?" E. "Have you lost any weight lately?"

B, C, E

A nurse is teaching a patient how to perform pursed-lip breathing. Which instructions would the nurse include in this teaching? (Select all that apply.) A. "Open your mouth and breathe deeply." B. "Use your abdominal muscles to squeeze air out of your lungs." C. "Breath out slowly without puffing your cheeks." D. "Focus on inhaling and holding your breath as long as you can." E. "Exhale at least twice the amount of time it took to breathe in."

B, C, E

A nurse assesses a patient who has a mediastinal chest tube. Which symptoms require the nurse's immediate intervention? (Select all that apply.) A. Production of pink sputum B. Tracheal deviation C. Pain at insertion site D. Sudden onset of shortness of breath E. Drainage greater than 70 mL/hr F. Disconnection at Y site

B, D, E, F

A nurse cares for a female patient who has a family history of cystic fibrosis. The patient asks, "Will my children have cystic fibrosis?" How would the nurse respond? A. "Since many of your family members are carriers, your children will also be carriers of the gene." B. "Cystic fibrosis is an autosomal recessive disorder. If you are a carrier, your children will have the disorder." C. "Since you have a family history of cystic fibrosis, I would encourage you and your partner to be tested." D. "Cystic fibrosis is caused by a protein that controls the movement of chloride. Adjusting your diet will decrease the spread of this disorder."

C

A nurse cares for a patient who has developed esophagitis after undergoing radiation therapy for lung cancer. Which diet selection would the nurse provide for this patient? A. Spaghetti with meat sauce, ice cream B. Chicken soup, grilled cheese sandwich C. Omelet, soft whole-wheat bread D. Pasta salad, custard, orange juice

C

A nurse cares for a patient who is infected with Burkholderia cepacia. What action would the nurse take first when admitting this patient to a pulmonary care unit? A. Instruct the patient to wash his or her hands after contact with other people. B. Implement droplet precautions and don a surgical mask. C. Keep the patient isolated from other patients with cystic fibrosis. D. Obtain blood, sputum, and urine culture specimens.

C

A nurse cares for a patient who tests positive for alpha1-antitrypsin (AAT) deficiency. The patient asks, "What does this mean?" How would the nurse respond? A. "Your children will be at high risk for the development of chronic obstructive pulmonary disease." B. "I will contact a genetic counselor to discuss your condition." C. "Your risk for chronic obstructive pulmonary disease is higher, especially if you smoke." D. "This is a recessive gene and would have no impact on your health."

C

A nurse cares for a patient with chronic obstructive pulmonary disease (COPD) who appears thin and disheveled. Which question would the nurse ask first? A. "Do you have a strong support system?" B. "What do you understand about your disease?" C. "Do you experience shortness of breath with basic activities?" D. "What medications are you prescribed to take each day?"

C

A nurse cares for a patient with chronic obstructive pulmonary disease (COPD). The patient states that he no longer enjoys going out with his friends. How would the nurse respond? A. "There are a variety of support groups for people who have COPD." B. "I will ask your provider to prescribe you with an antianxiety agent." C. "Share any thoughts and feelings that cause you to limit social activities." D. "Friends can be a good support system for patients with chronic disorders."

C

A nurse is teaching a patient who has cystic fibrosis (CF). Which statement would the nurse include in this patient's teaching? A. "Take an antibiotic each day." B. "Contact your provider to obtain genetic screening." C. "Eat a well-balanced, nutritious diet." D. "Plan to exercise for 30 minutes every day."

C

After teaching a patient who is prescribed a long-acting beta2 agonist medication, a nurse assesses the patient's understanding. Which statement indicates that the patient comprehends the teaching? A. "I will carry this medication with me at all times in case I need it." B. "I will take this medication when I start to experience an asthma attack." C. "I will take this medication every morning to help prevent an acute attack." D. "I will be weaned off this medication when I no longer need it."

C

After teaching a patient who is prescribed salmeterol (Serevent), the nurse assesses the patient's understanding. Which statement by the patient indicates a need for additional teaching? A. "I will be certain to shake the inhaler well before I use it." B. "It may take a while before I notice a change in my asthma." C. "I will use the drug when I have an asthma attack." D. "I will be careful not to let the drug escape out of my nose and mouth."

C

The nurse instructs a patient on how to correctly use an inhaler with a spacer. In which order would these steps occur? 1. "Press down firmly on the canister to release one dose of medication." 2. "Breathe in slowly and deeply." 3. "Shake the whole unit vigorously three or four times." 4. "Insert the mouthpiece of the inhaler into the nonmouthpiece end of the spacer." 5. "Place the mouthpiece into your mouth, over the tongue, and seal your lips tightly around the mouthpiece." 6. "Remove the mouthpiece from your mouth, keep your lips closed, and hold your breath for at least 10 seconds." A. 2, 3, 4, 5, 6, 1 B. 3, 4, 5, 1, 6, 2 C. 4, 3, 5, 1, 2, 6 D. 5, 3, 6, 1, 2, 4

C

A nurse assesses a patient with asthma and notes bilateral wheezing, decreased pulse oxygen saturation, and suprasternal retraction on inhalation. What actions would the nurse take? (Select all that apply.) A. Administer prescribed salmeterol (Serevent) inhaler. B. Assess the patient for a tracheal deviation. C. Administer oxygen to keep saturations greater than 94%. D. Perform peak expiratory flow readings. E. Administer prescribed albuterol (Proventil) inhaler.

C, E

A nurse assesses several patients who have a history of asthma. Which patient would the nurse assess first? A. A 66-year-old patient with a barrel chest and clubbed fingernails B. A 48-year-old patient with an oxygen saturation level of 92% at rest C. A 35-year-old patient who has a longer expiratory phase than inspiratory phase D. A 27-year-old patient with a heart rate of 120 beats/min

D

A nurse cares for a patient who had a chest tube placed 6 hours ago and refuses to take deep breaths because of the pain. What action would the nurse take? A. Ambulate the patient in the hallway to promote deep breathing. B. Auscultate the patient's anterior and posterior lung fields. C. Encourage the patient to take shallow breaths to help with the pain. D. Administer pain medication and encourage the patient to take deep breaths.

D

A nurse cares for a patient who has a chest tube. When would this patient be at highest risk for developing a pneumothorax? A. When the insertion site becomes red and warm to the touch B. When the tube drainage decreases and becomes sanguineous C. When the patient experiences pain at the insertion site D. When the tube becomes disconnected from the drainage system

D

A nurse cares for a patient who has a pleural chest tube. What action would the nurse take to ensure safe use of this equipment? A. Strip the tubing to minimize clot formation and ensure patency. B. Secure tubing junctions with clamps to prevent accidental disconnections. C. Connect the chest tube to wall suction at the level prescribed by the provider. D. Keep padded clamps at the bedside for use if the drainage system is interrupted.

D

A nurse evaluates the following arterial blood gas and vital sign results for a patient with chronic obstructive pulmonary disease (COPD): Arterial Blood Gas Results and Vital Signs pH = 7.32 Heart rate = 110 beats/min PaCO2 = 62 mm Hg Respiratory rate = 12 breaths/min PaO2 = 46 mm Hg Blood pressure = 145/65 mm Hg HCO3- = 28 mEq/L (28 mmol/L) Oxygen saturation = 76% What action would the nurse take first? A. Administer a short-acting beta2 agonist inhaler. B. Document the findings as normal for a patient with COPD. C. Teach the patient diaphragmatic breathing techniques. D. Initiate oxygenation therapy to increase saturation to 92%.

D

The nurse is caring for a patient who is prescribed a long-acting beta2 agonist. The patient states, "The medication is too expensive to use every day. I only use my inhaler when I have an attack." How would the nurse respond? A. "You are using the inhaler incorrectly. This medication should be taken daily." B. "If you decrease environmental stimuli, it will be okay for you to use the inhaler only for asthma attacks." C. "Tell me more about your fears related to feelings of breathlessness." D. "It is important to use this type of inhaler every day. Let's identify potential community services to help you."

D