Respiratory System practice questions

A nurse is assessing a male client with chronic airflow limitations and notes that the client has a "barrel chest." The nurse interprets that this client has which of the following forms of chronic airflow limitations? A. Emphysema B. Bronchial asthma C. Chronic obstructive bronchitis D. Bronchial asthma and bronchitis

A The client with emphysema has hyperinflation of the alveoli and flattening of the diaphragm. These lead to increased anteroposterior diameter, referred to as "barrel chest." The client also has dyspnea with prolonged expiration and has hyperresonant lungs to percussion.

The nurse in charge is teaching a client with emphysema how to perform pursed-lip breathing. The client asks the nurse to explain the purpose of this breathing technique. Which explanation should the nurse provide? A. It helps prevent early airway collapse B. It increases inspiratory muscle strength C. It decreases use of accessory breathing muscles D. It prolongs the inspiratory phase of respiration

A helps the alveoli to expand Pursed-lip breathing helps prevent early airway collapse. Learning this technique helps the client control respiration during periods of excitement, anxiety, exercise, and respiratory distress. To increase inspiratory muscle strength and endurance, the client may need to learn inspiratory resistive breathing. To decrease accessory muscle use and thus reduce the work of breathing, the client may need to learn diaphragmatic (abdominal) breathing. In pursed-lip breathing, the client mimics a normal inspiratory-expiratory (I:E) ratio of 1:2. (A client with emphysema may have an I:E ratio as high as 1:4.)

A female patient suffers adult respiratory distress syndrome as a consequence of shock. The patient's condition deteriorates rapidly, and endotracheal intubation and mechanical ventilation are initiated. When the high-pressure alarm on the mechanical ventilator, alarm sounds, the nurse starts to check for the cause. Which condition triggers the high-pressure alarm? A. Kinking of the ventilator tubing B. A disconnected ventilator tube C. An endotracheal cuff leak D. A change in the oxygen concentration without resetting the oxygen level alarm

A Conditions that trigger the high-pressure alarm include kinking of the ventilator tubing, bronchospasm or pulmonary embolus, mucus plugging, water in the tube, coughing or biting on endotracheal tube, and the patient's being out of breathing rhythm with the ventilator. A disconnected ventilator tube or an endotracheal cuff leak would trigger the low-pressure alarm. Changing the oxygen concentration without resetting the oxygen level alarm would trigger the oxygen alarm.

Which neurological patient is most likely to have abnormalities in breathing regulation?

A 34-year-old male with damage to his pons and medulla oblongata following a blow to the back of the head

A patient is admitted to the emergency room after consuming 50 acetaminophen tablets in a suicide attempt. What medication will be administered to counteract the effect of the acetaminophen?

Acetylcysteine (Mucomyst)

Which nursing diagnosis would provide the clearest indication for the administration of inhaled acetylcysteine?

Acetylcysteine reduces the viscosity of mucous secretions with the ultimate goal of allowing the client to establish and maintain a clear airway. This drug does not directly influence the pattern of breathing

2. The inner layer that surrounds the lung itself is called the? A. Parietal Pleura B. Visceral Pleura C. Pleuracardium D. Lobar Bronchi

B

When describing the benefits of second-generation H1 receptor antagonists to those of first-generation H1 receptor antagonists, the nurse should cite what advantage? A. lower cost B. decreased sedation C. absence of adverse effects D. once-weekly dosing

B

When caring for a male patient who has just had a total laryngectomy, the nurse should plan to: A. Encourage oral feeding as soon as possible B. Develop an alternative communication method C. Keep the tracheostomy cuff fully inflated D. Keep the patient flat in bed

B A patient with a laryngectomy cannot speak, yet still needs to communicate. Therefore, the nurse should plan to develop an alternative communication method. After a laryngectomy, edema interferes with the ability to swallow and necessitates tube (enteral) feedings. To prevent injury to the tracheal mucosa, the nurse should deflate the tracheostomy cuff or use the minimal leak technique. To decrease edema, the nurse should place the patient in semi-Fowler's position

On auscultation, which finding suggests a right pneumothorax? A. Bilateral inspiratory and expiratory crackles B. Absence of breaths sound in the right thorax C. Inspiratory wheezes in the right thorax D. Bilateral pleural friction rub

B In pneumothorax, the alveoli are deflated and no air exchange occurs in the lungs. Therefore, breath sounds in the affected lung field are absent. None of the other options are associated with pneumothorax. Bilateral crackles may result from pulmonary congestion, inspiratory wheezes may signal asthma, and a pleural friction rub may indicate pleural inflammation.

Rhea, confused and short breath, is brought to the emergency department by a family member. The medical history reveals chronic bronchitis and hypertension. To learn more about the current respiratory problem, the doctor orders a chest x-ray and arterial blood gas (ABG) analysis. When reviewing the ABG report, the nurses sees many abbreviations. What does a lowercase "a" in ABG value present? A. Acid-base balance B. Arterial Blood C. Arterial oxygen saturation D. Alveoli

B A lowercase "a" in an ABG value represents arterial blood. For instance, the abbreviation PaO2 refers to the partial pressure of oxygen in arterial blood. The pH value reflects the acid-base balance in arterial blood. Sa02 indicates arterial oxygen saturation. An uppercase "A" represents alveolar conditions: for example, PA02 indicates the partial pressure of oxygen in the alveoli.

On arrival at the intensive care unit, a critically ill female client suffers respiratory arrest and is placed on mechanical ventilation. The physician orders pulse oximetry to monitor the client's arterial oxygen saturation (SaO2) noninvasively. Which vital sign abnormality may alter pulse oximetry values? A. Tachypnea B. Hypotension C. Fever D. Tachycardia

B Hypotension, hypothermia, and vasoconstriction may alter pulse oximetry values by reducing arterial blood flow. Likewise, movement of the finger to which the oximeter is applied may interfere with interpretation of SaO2. All of these conditions limit the usefulness of pulse oximetry. Fever, tachypnea, and tachycardia don't affect pulse oximetry values directly.

Nurse Reynolds caring for a client with a chest tube turns the client to the side, and the chest tube accidentally disconnects. The initial nursing action is to: A. Call the physician B. Place the tube in bottle of sterile water C. Immediately replace the chest tube system D. Place a sterile dressing over the disconnection site

B If the chest drainage system is disconnected, the end of the tube is placed in a bottle of sterile water held below the level of the chest. The system is replaced if it breaks or cracks or if the collection chamber is full. Placing a sterile dressing over the disconnection site will not prevent complications resulting from the disconnection. The physician may need to be notified, but this is not the initial action.

A nurse is caring for a male client with emphysema who is receiving oxygen. The nurse assesses the oxygen flow rate to ensure that it does not exceed: A. 1 L/min B. 2 L/min C. 6 L/min D. 10 L/min

B Oxygen is used cautiously and should not exceed 2 L/min. Because of the long-standing hypercapnia that occurs in emphysema, the respiratory drive is triggered by low oxygen levels rather than increased carbon dioxide levels, as is the case in a normal respiratory system.

A male elderly client is admitted to an acute care facility with influenza. The nurse monitors the client closely for complications. What is the most common complication of influenza? A. Meningitis B. Pneumonia C. Pulmonary edema D. Septicemia

B Pneumonia is the most common complication of influenza. It may be either primary influenza viral pneumonia or pneumonia secondary to a bacterial infection. Other complications of influenza include myositis, exacerbation of chronic obstructive pulmonary disease, and Reye's syndrome. Myocarditis, pericarditis, transverse myelitis, and encephalitis are rare complications of influenza. Although septicemia may arise when any infection becomes overwhelming, it rarely results from influenza. Meningitis and pulmonary edema aren't associated with influenza.

An oxygen delivery system is prescribed for a male client with chronic obstructive pulmonary disease to deliver a precise oxygen concentration. Which of the following types of oxygen delivery systems would the nurse anticipate to be prescribed? A. Face tent B Venturi mask C. Aerosol mask D. Tracheostomy collar

B The Venturi mask delivers the most accurate oxygen concentration. It is the best oxygen delivery system for the client with chronic airflow limitation because it delivers a precise oxygen concentration. The face tent, aerosol mask, and tracheostomy collar are also high-flow oxygen delivery systems but most often are used to administer high humidity.

1. True or False: The left lung has three lobes and the right lung has two lobes. A. True B. False

B The answer is FALSE. The right lung has THREE lobes and the left lung has TWO lobes.

A female client is receiving supplemental oxygen. When determining the effectiveness of oxygen therapy, which arterial blood gas value is most important? A. Partial pressure of arterial carbon dioxide (PaCO2) B. Partial pressure of arterial oxygen (PaO2) C. pH D. Bicarbonate (HCO3-)

B The most significant and direct indicator of the effectiveness of oxygen therapy is the PaO2 value. Based on the PaO2 value, the nurse may adjust the type of oxygen delivery (cannula, venturi mask, or mechanical ventilator), flow rate, and oxygen percentage. The other options reflect the client's ventilation status, not oxygenation.

A male patient has a sucking stab wound to the chest. Which action should the nurse take first? A. Drawing blood for a hematocrit and hemoglobin level B. Applying a dressing over the wound and taping it on three sides C. Preparing a chest tube insertion tray D. Preparing to start an I.V. line

B The nurse immediately should apply a dressing over the stab wound and tape it on three sides to allow air to escape and to prevent tension pneumothorax (which is more life-threatening than an open chest wound). Only after covering and taping the wound should the nurse draw blood for laboratory tests, assist with chest tube insertion, and start an I.V. line.

The nurse assesses a male client's respiratory status. Which observation indicates that the client is experiencing difficulty breathing? A. Diaphragmatic breathing B. Use of accessory muscles C. Pursed-lip breathing D. Controlled breathing

B The use of accessory muscles for respiration indicates the client is having difficulty breathing. Diaphragmatic and pursed-lip breathing are two controlled breathing techniques that help the client conserve energy.

An emergency room nurse is assessing a male client who has sustained a blunt injury to the chest wall. Which of these signs would indicate the presence of a pneumothorax in this client? A. A low respiratory rate B. Diminished breath sounds C. The presence of a barrel chest D. A sucking sound at the site of injury

B This client has sustained a blunt or a closed chest injury. Basic symptoms of a closed pneumothorax are shortness of breath and chest pain. A larger pneumothorax may cause tachypnea, cyanosis, diminished breath sounds, and subcutaneous emphysema. Hyperresonance also may occur on the affected side. A sucking sound at the site of injury would be noted with an open chest injury.

A nurse is preparing to obtain a sputum specimen from a male client. Which of the following nursing actions will facilitate obtaining the specimen? A. Limiting fluid B. Having the client take deep breaths C. Asking the client to spit into the collection container D Asking the client to obtain the specimen after eating

B To obtain a sputum specimen, the client should rinse the mouth to reduce contamination, breathe deeply, and then cough into a sputum specimen container. The client should be encouraged to cough and not spit so as to obtain sputum. Sputum can be thinned by fluids or by a respiratory treatment such as inhalation of nebulized saline or water. The optimal time to obtain a specimen is on arising in the morning.

Nurse Eve formulates a nursing diagnosis of Activity intolerance related to inadequate oxygenation and dyspnea for a client with chronic bronchitis. To minimize this problem, the nurse instructs the client to avoid conditions that increase oxygen demands. Such conditions include: A. drinking more than 1,500 ml of fluid daily. B. being overweight C. eating a high-protein snack at bedtime D. eating more than three large meals a day

B. Conditions that increase oxygen demands include obesity, smoking, exposure to temperature extremes, and stress. A client with chronic bronchitis should drink at least 2,000 ml of fluid daily to thin mucus secretions; restricting fluid intake may be harmful. The nurse should encourage the client to eat a high-protein snack at bedtime because protein digestion produces an amino acid with sedating effects that may ease the insomnia associated with chronic bronchitis. Eating more than three large meals a day may cause fullness, making breathing uncomfortable and difficult; however, it doesn't increase oxygen demands. To help maintain adequate nutritional intake, the client with chronic bronchitis should eat small, frequent meals (up to six a day).

Dr. Jones prescribes albuterol sulfate (Proventil) for a patient with newly diagnosed asthma. When teaching the patient about this drug, the nurse should explain that it may cause: A. Nasal congestion B. Nervousness C. Lethargy D. Hyperkalemia

B. Albuterol may cause nervousness. The inhaled form of the drug may cause dryness and irritation of the nose and throat, not nasal congestion; insomnia, not lethargy; and hypokalemia (with high doses), not hyperkalemia. Otther adverse effects of albuterol include tremor, dizziness, headache, tachycardia, palpitations, hypertension, heartburn, nausea, vomiting and muscle cramps.

nurse is caring for a patient who has been prescribed a nasal decongestant. Which of the following factors should the nurse assess before administering the drug?

Blood pressue Sinus area and symptoms

Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication?

Bronchial dilation/ relaxation

. The trachea splits at the _________ to form the ____________. A. Cricoid cartilage, secondary bronchi B. Thyroid cartilage, primary bronchi C. Carina, primary bronchi D. Hilum, secondary bronchi

C

Gas exchange in the lungs occurs in the? A. Bronchioles B. Alveolar sinus C. Alveolar sacs D. Segmental Bronchi

C

Which condition would contraindicate the use of or oxymetazoline?A. nasal congestion B. cough C.hypertension D. skin rash

C

Which phrase is used to describe the volume of air inspired and expired with a normal breath? A. Total lung capacity B Forced vital capacity C Tidal volume D. Residual volume

C

For a patient with advance chronic obstructive pulmonary disease (COPD), which nursing action best promotes adequate gas exchange? A. Encouraging the patient to drink three glasses of fluid daily B. Keeping the patient in semi-fowler's position C. Using a high-flow venturi mask to deliver oxygen as prescribe D. Administering a sedative, as prescribe

C The patient with COPD retains carbon dioxide, which inhibits stimulation of breathing by the medullary center in the brain. As a result, low oxygen levels in the blood stimulate respiration, and administering unspecified, unmonitored amounts of oxygen may depress ventilation. To promote adequate gas exchange, the nurse should use a Venturi mask to deliver a specified, controlled amount of oxygen consistently and accurately. Drinking three glasses of fluid daily would not affect gas exchange or be sufficient to liquefy secretions, which are common in COPD. Patients with COPD and respiratory distress should be places in high-Fowler's position and should not receive sedatives or other drugs that may further depress the respiratory center.

A male client with chronic obstructive pulmonary disease (COPD) is recovering from a myocardial infarction. Because the client is extremely weak and can't produce an effective cough, the nurse should monitor closely for: A. Pleural effusion B. Pulmonary edema C. Atelectasis D. Oxygen toxicity

C In a client with COPD, an ineffective cough impedes secretion removal. This, in turn, causes mucus plugging, which leads to localized airway obstruction — a known cause of atelectasis. An ineffective cough doesn't cause pleural effusion (fluid accumulation in the pleural space). Pulmonary edema usually results from left-sided heart failure, not an ineffective cough. Although many noncardiac conditions may cause pulmonary edema, an ineffective cough isn't one of them. Oxygen toxicity results from prolonged administration of high oxygen concentrations, not an ineffective cough.

The nurse is teaching a male client with chronic bronchitis about breathing exercises. Which of the following should the nurse include in the teaching? A. Make inhalation longer than exhalation B. Exhale through an open mouth C. Use diaphragmatic breathing D. Use chest breathing

C In chronic bronchitis the diaphragm is flat and weak. Diaphragmatic breathing helps to strengthen the diaphragm and maximizes ventilation. Exhalation should be longer than inhalation to prevent collapse of the bronchioles. The client with chronic bronchitis should exhale through pursed lips to prolong exhalation, keep the bronchioles from collapsing, and prevent air trapping. Diaphragmatic breathing — not chest breathing — increases lung expansion.

Miriam, a college student with acute rhinitis sees the campus nurse because of excessive nasal drainage. The nurse asks the patient about the color of the drainage. In acute rhinitis, nasal drainage normally is: A. Yellow B. Green C. Clear D. Gray

C Normally, nasal drainage in acute rhinitis is clear. Yellow or green drainage indicates spread of the infection to the sinuses. Gray drainage may indicate a secondary infection.

A male adult client is suspected of having a pulmonary embolus. A nurse assesses the client, knowing that which of the following is a common clinical manifestation of pulmonary embolism? A. Decreased respirations B. Bradypnea C. Dyspnea D. Bradycardia

C The common clinical manifestations of pulmonary embolism are tachypnea, tachycardia, dyspnea, and chest pain.

A male client presents to the health care provider's office with reports of inability to breathe freely. When the nurse reviews his use of over-the-counter medications, it is discovered that the client routinely uses nasal spray three times a day for 1 year. The nurse knows that what may be causing this client's continuous nasal congestion? A. Chronic nasal polyps B. Burning of the nares secondary to chronic use of nasal sprays C. Rebound nasal swelling D. Damage of the nasal concha

C Rebound nasal swelling

Everything below is part of the lower respiratory system EXCEPT (select-all-that-apply)? A. Trachea B. Carina C. Pharynx D. Bronchioles E. Nasal cavities

C,E ARE PART OF UPPER RESPIRATORY SYSTEM

For a female patient with chronic obstructive pulmonary disease, which nursing intervention would help maintain a patent airway? A. Restricting fluid intake to 1,000 ml per day B. Enforcing absolute bed rest C. Teaching the patient how to perform controlled coughing D. Administering prescribe sedatives regularly and in large amounts

C. Controlled coughing helps maintain a patent airway by helping to mobilize and remove secretions. A moderate fluid intake (usually 2 L or more daily) and moderate activity help liquefy and mobilize secretions. Bed rest and sedatives may limit the patient's ability to maintain a patent airway, causing a high risk for infection from pooled secretions.

When providing health education to an adult who is taking an over-the-counter (OTC) combination cold and cough remedy, the nurse should encourage the client to implement what intervention to best assure medication safety?

Carefully read the label and adhere to the guidelines for use.

What is the normal pH range for arterial blood? A. 7.55 to 7.65 B. 7.50 to 7.60 C. 7 to 7.49 D. 7.35 to 7.45

D

______________ delivers unoxygenated blood to the lungs. A. Pulmonary vein B. Aorta C. Left ventricle D. Pulmonary artery

D

Nurse Ruth assessing a patient for tracheal displacement should know that the trachea will deviate toward the: A. Contralateral side in a simple pneumothorax B. Affected side in a hemothorax C. Affected side in a tension pneumothorax D. Contralateral side in hemothorax

D The trachea will shift according to the pressure gradients within the thoracic cavity. In tension pneumothorax and hemothorax, accumulation of air or fluid causes a shift away from the injured side. If there is no significant air or fluid accumulation, the trachea will not shift. Tracheal deviation toward the contralateral side in simple pneumothorax is seen when the thoracic contents shift in response to the release of normal thoracic pressure gradients on the injured side.

A male patient is admitted to the health care facility for treatment of chronic obstructive pulmonary disease. Which nursing diagnosis is most important for this patient? A. Activity intolerance related to fatigue B. Anxiety related to actual threat to health status C. Risk for infection related to retained secretions D. Impaired gas exchange related to airflow obstruction

D A patient airway and an adequate breathing pattern are the top priority for any patient, making "impaired gas exchange related to airflow obstruction" the most important nursing diagnosis. The other options also may apply to this patient but less important.

Nurse Julia is caring for a client who has a tracheostomy and temperature of 103° F (39.4° C). Which of the following interventions will most likely lower the client's arterial blood oxygen saturation? A. Encouragement of coughing B. Use of cooling blanket C. Incentive spirometry D. Endotracheal suctioning

D Endotracheal suctioning removes secretions as well as gases from the airway and lowers the arterial oxygen saturation (SaO2) level. Coughing and incentive spirometry improves oxygenation and should raise or maintain oxygen saturation. Because of superficial vasoconstriction, using a cooling blanket can lower peripheral oxygen saturation readings, but SaO2 levels wouldn't be affected

Before administering ephedrine, Nurse Tony assesses the patient's history. Because of ephedrine's central nervous system (CNS) effects, it is not recommended for: A. Patients with an acute asthma attack B. Patients with narcolepsy C. Patients under age 6 D. Elderly patients

D Ephedrine is not recommended for elderly patients, who are particularly susceptible to CNS reactions (such as confusion and anxiety) and to cardiovascular reactions (such as increased systolic blood pressure, coldness in the extremities, and anginal pain). Ephedrine is used for its bronchodilator effects with acute and chronic asthma and occasionally for its CNS stimulant actions for narcolepsy. It can be administered to children age 2 and older.

A nurse instructs a female client to use the pursed-lip method of breathing and the client asks the nurse about the purpose of this type of breathing. The nurse responds, knowing that the primary purpose of pursed-lip breathing is to: A. Promote oxygen intake B. Strengthen the diaphragm C. Strengthen the intercostal muscles D. Promote carbon dioxide elimination

D Pursed-lip breathing facilitates maximal expiration for clients with obstructive lung disease. This type of breathing allows better expiration by increasing airway pressure that keeps air passages open during exhalation. Options A, B, and C are not the purposes of this type of breathing.

A male adult patient hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis? A. Nausea or vomiting B. Abdominal pain or diarrhea C. Hallucinations or tinnitus D. Lightheadedness or paresthesia

D The patient with respiratory alkalosis may complain of lightheadedness or paresthesia (numbness and tingling in the arms and legs). Nausea, vomiting, abdominal pain, and diarrhea may accompany respiratory acidosis. Hallucinations and tinnitus rare are associated with respiratory alkalosis or any other acid-base imbalance.

Gina, a home health nurse is visiting a home care client with advanced lung cancer. Upon assessing the client, the nurse discovers wheezing, bradycardia, and a respiratory rate of 10 breaths/minute. These signs are associated with which condition? A. Semiconsciousness B. Hyperventilation C. Delirium D. Hypoxia

D depressed, hypoxia occurs, producing wheezing, bradycardia, and a decreased respiratory rate. Delirium is a state of mental confusion characterized by disorientation to time and place. Hyperventilation (respiratory rate greater than that metabolically necessary for gas exchange) is marked by an increased respiratory rate or tidal volume, or both. Semiconsciousness is a state of impaired consciousness characterized by limited motor and verbal responses and decreased orientation.

A male adult patient on mechanical ventilation is receiving pancuronium bromide (Pavulon), 0.01 mg/kg I.V. as needed. Which assessment finding indicates that the patient needs another pancuronium dose? A. Leg movement B. Finger movement C. Lip movement D. Fighting the ventilator

D. Pancuronium, a nondepolarizing blocking agent, is used for muscle relaxation and paralysis. It assists mechanical ventilation by promoting encdotracheal intubation and paralyzing the patient so that the mechanical ventilator can do its work. Fighting the ventilator is a sign that the patient needs another pancuronium dose. The nurse should administer 0.01 to 0.02 mg/kg I.V. every 20 to 60 minutes. Movement of the legs, or lips has no effect on the ventilator and therefore is not used to determine the need for another dose.

A 45-year-old female client is being seen in the physician's office for a dry, hacking cough that is keeping her up at night. The physician prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan?

Dextromethorphan works in the medulla to suppress the cough reflex.

A group of students are reviewing the mechanics of oxygen and carbon dioxide exchange in the alveoli. The students demonstrate understanding when they identify which mechanism as being responsible?

Diffusion

True or False: Inhaled oxygen travels down through the trachea, into the right and left bronchus, then into the segmental bronchi which branches even further into the lobar bronchi. True False

FALSE The answer is FALSE. Inhaled oxygen travels down through the trachea, into the right and left bronchus, then into the LOBAR BRONCHI which branches even further into the SEGMENTAL BRONCHI.

Second generation antihistamines are associated with a higher risk of sedation than first generation antihistamines. True or False?

False

A female patient presents at the clinic with a dry, nonproductive cough. The patient is diagnosed with bronchitis, and it is determined that she will need help thinning sputum so that the cough can become productive. What does the nurse expect the physician will prescribe?

Guaifenesin

Which drug is classified as an expectorant?

Guaifenesin (Robitussin)

A patient receives guaifenesin. The nurse would expect the drug to begin acting within which time frame?

Guaifenesin has an onset of action of 30 minutes.

A client experiences bronchospasm with asthma. The nurse understands that this is due to:

Histamine

A patient is using oxymetazoline (Afrin). Which condition will contraindicate the use of this adrenergic drug?

Hypertension

A male client states that he is taking medication to liquefy secretions in his respiratory tract. However, he cannot recall the name of the medication. He states that the medication is added to a nebulizer. The nurse suspects he is taking:

Mucomyst

The health care provider has ordered promethazine (Phenergan) for a client who is having a severe allergic reaction. The nurse is aware that this medication is also used to treat what condition?

Nausea and vomiting

the nurse is encouraging a client to cough frequently and complete deep breathing exercises. The nurse knows that many factors can cause a decrease of gas exchange for clients. Based on this information, what factors can cause a decrease in gas exchange? Select all that apply.

-Immobility -Pneumonia -Thoracic/pulmonary surgery

What are possible causes of acute respiratory distress syndrome (ARDS)? (Select all that apply.)

-Major burns -Cardiovascular collapse -Severe trauma -Rapid depressurization

Asthma is characterized by which clinical manifestations? (Select all that apply.)

-Reversible bronchospasm -Inflammation -Hyperactive airways

A patient, aged 82 years, is prescribed an antihistamine for the relief of allergic rhinitis. An older age predisposes the patient to a higher risk of adverse effects. Which adverse effects is a nurse more likely to observe in the patient? (Select all that apply.)

-Sedation -Dryness of throat -Confusion

Efficient respiration depends on which factors?

-The patency of the airway -The ability of respiratory gases to cross the alveolar-capillary membrane -The ability of the lungs to expand and contract

The right & left bronchus along with the pulmonary artery & vein enter into the lungs at the? A. Hilum B. Carina C. Alveolar ducts D. Right middle lobe

A

For a male client with an endotracheal (ET) tube, which nursing action is most essential? A. Auscultating the lungs for bilateral breath sounds B. Turning the client from side to side every 2 hours C. Monitoring serial blood gas values every 4 hours D. Providing frequent oral hygiene

A For a client with an ET tube, the most important nursing action is auscultating the lungs regularly for bilateral breath sounds to ensure proper tube placement and effective oxygen delivery. Although the other options are appropriate for this client, they're secondary to ensuring adequate oxygenation.

A male client admitted to an acute care facility with pneumonia is receiving supplemental oxygen, 2 L/minute via nasal cannula. The client's history includes chronic obstructive pulmonary disease (COPD) and coronary artery disease. Because of these history findings, the nurse closely monitors the oxygen flow and the client's respiratory status. Which complication may arise if the client receives a high oxygen concentration? A. Apnea B. Respiratory alkalosis C.Metabolic acidosis D. Anginal pain

A Hypoxia is the main breathing stimulus for a client with COPD. Excessive oxygen administration may lead to apnea by removing that stimulus. Anginal pain results from a reduced myocardial oxygen supply. A client with COPD may have anginal pain from generalized vasoconstriction secondary to hypoxia; however, administering oxygen at any concentration dilates blood vessels, easing anginal pain. Respiratory alkalosis results from alveolar hyperventilation, not excessive oxygen administration. In a client with COPD, high oxygen concentrations decrease the ventilatory drive, leading to respiratory acidosis, not alkalosis. High oxygen concentrations don't cause metabolic acidosis.

A black male client with asthma seeks emergency care for acute respiratory distress. Because of this client's dark skin, the nurse should assess for cyanosis by inspecting the: A. mucous membranes B. nail beds. C. lips D. earlobes

A Skin color doesn't affect the mucous membranes. The lips, nail beds, and earlobes are less reliable indicators of cyanosis because they're affected by skin color

Pseudoephedrine (Sudafed) is prescribed for a client suffering from nasal and sinus congestion. What is the most important assessment the nurse should complete before the client leaves the clinic to purchase the medication?

Obtain the client's blood pressure.

Which condition would be the result of air in the pleural space?

Pneumothorax

Which agent would the nurse instruct a client to use orally?

Pseudoephedrine Phenylephrine

Which term would the nurse use to describe the delivery of blood to the alveoli?

Pulmonary perfusion

A male client is diagnosed with chronic bronchitis. What would the nurse expect to be one of his physical reports?

Retention of secretions

A group of students are reviewing the common conditions associated with the upper respiratory tract. The students demonstrate understanding of the material when they identify what as a response to a specific antigen?

Seasonal rhinitis

True or False: During gas exchange, carbon dioxide is transported across the capillary membrane to be exhaled while oxygen is transported across the capillary membrane to attach to the red blood cells. True False

TRUE

In children, high doses of nebulized albuterol have been associated with what conditions? (Select all that apply.)

Tachycardia Hypokalemia Hyperglycemia

The client has mild, persistent asthma. The nurse anticipates the healthcare provider prescribing which daily medications?

Terbutaline, albuterol, and levalbuterol are all short-acting beta-2 agonists that are used for acute symptom relief. Fluticasone is a daily inhaled corticosteroid.

A nurse caring for a client in the hospital is being discharged today with a prescription for benzonatate (Tessalon Perles) 200 mg one capsule 3 times daily. What would the nurse tell the client about this prescription during discharge counseling? (Select all that apply.)

The client should drink plenty fluids. Benzonatate can cause GI upset and sedation.

When describing the structure of the lungs, the nurse would identify the left lung as consisting of how many lobes?

two

After reviewing information about respiratory tract disorders, a group of students demonstrate understanding of the material when they identify what as the most common cause of COPD?

Cigarette smoking

Blessy, a community health nurse is conducting an educational session with community members regarding tuberculosis. The nurse tells the group that one of the first symptoms associated with tuberculosis is: A. Dyspnea B. Chest pain C. A bloody, productive cough D. A cough with the expectoration of mucoid sputum

D One of the first pulmonary symptoms is a slight cough with the expectoration of mucoid sputum. Options A, B, and C are late symptoms and signify cavitation and extensive lung involvement.

True or False: During inhalation, the diaphragm contracts upward to create positive pressure in the chest which allows the body to inhale oxygen. True False

FALSE The answer is FALSE. During inhalation, the diaphragm contracts DOWNWARD to create NEGATIVE pressure in the chest which allows the body to inhale oxygen.

The pulmonologist sees many patients daily who suffer from a variety of respiratory disorders. What are some of the common signs and symptoms many of these patients present? (Select all that apply.)

-Mucosal congestion-Cough-Increased secretions

A nurse is preparing a presentation for a local elementary school parent group about over-the-counter cold medications and their use in children. Which would be most appropriate to include? (Select all that apply.)

Importance of reading the label for ingredients and dosage Need to follow the directions for how often to give the drug Avoidance of use in children under age 2

Sympathetic nervous system stimulation of the respiratory tract would result in:

Increased respiratory rate

Decongestants elicit their effect by which mechanisms?

Vasoconstriction of small blood vessels of the nasal membranes

When describing the action of decongestants, a nurse integrates knowledge of this class of drugs, identifying which mechanism?

Vasoconstriction of small blood vessels of the nasal membranes.

In the pulmonary unit of your hospital, the nurse has several patients who are seasonal "frequent flyers" due to exacerbation of their COPD. Especially in emphysema, the lungs lose the ability to recoil to expel air. The ability to accommodate incoming air is called:

compliance

A client, scheduled to receive one unit of packed red blood cells, has a history of an allergic reaction to a transfusion in the past. What class of medication will assist in preventing a reaction to the packed red blood cell transfusion?

antihistamines

Which would the nurse most likely expect as treatment for a pneumothorax?

chest tube insertion

Which of the following would a nurse identify as a first generation antihistamine? Select all that apply.

diphenhydramine hydroxyzine meclizine promethazine

A nurse on rounds observes that a client has been eating food rather hastily. Based on this information the nurse knows that what structure of the respiratory system prevents foreign matter from entering the lower respiratory system?

epiglottis

A patient has an increased carbon dioxide level. Which cells combine with carbon dioxide to eliminate it from the body?

erythrocytes

Cystic fibrosis is a hereditary disease that affects the respiratory system. In people with the disease, breathing performance is affected by

excessive secretions

What is the chemical mediator released in immune and inflammatory response to allergic reactions?

histamine

A patient has an increased respiratory rate. Which causes an increased respiratory rate?

increased carbon dioxide

A group of students are reviewing information about antihistamines. The students demonstrate understanding of the information when they identify which agent as a second generation antihistamine?

loratadine cetrizine

Which structure in the brain controls respiration?

medulla

A client reports experiencing severe nasal congestion since starting to use an over-the-counter (OTC) nasal decongestant spray a week ago. This symptomology most supports what possible medical condition?

rebound congestion