Respiratory System Quiz
An emergency department nurse is assessing a patient who has sustained a blunt injury to the chest wall. Which of these signs would indicate the presence of a pneumothorax in this patient?
a) A low respiratory rate b) Diminished breath sounds c) A presence of a barrel chest d) A sucking sound at the site of inury b) This client has sustained a blunt or 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.
Nurse Joana is teaching a client with emphysema how to perform pursed- lip breathing. The client asks the nurse to explain the purpose of this technique. Which explanation should the nurse provide?
a. It helps prevent early airway collapse 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 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 nurse reviews the (ABG) values of a client admitted with pneumonia: Ph, 7.51; PaCO2, 28 mm Hg; PaO2, 70 mm hg; and HCO3, 24 mEq/L. What do these values indicate?
a) Resp. Alkalosis
The amount of air inspired and expired with each breath is called
a) Tidal volume Tidal volume is the amount of air inspired and expired with each breath. Residual volume is the amount of air remaining in the lungs after forcibly exhaling. Vital capacity is the max amount of air that can be moved out of the lungs after maximal inspiration and expiration. Dead-space volume is the amount of air remaining in the upper airways that never reaches the alveoli. In pathologic conditions, dead space may also exist in the lower airways
A nurse cares for a patient who has a nasogastric tube attached to low suction because of a suspected bowel obstruction. Which of the following ABG results might be expected in this patient?
a) pH 7.52, PCO2 54 mm Hg A patient on nasogastric suction is at risk of metabolic alkalosis as a result of loss of hydrochloric acide in gastric fluid.
A client acquired immunodeficiency syndrome has histoplasmosis. A nurse assesses the client for which of the following signs and symptoms?
a. Dyspnea -Histoplasmosis is an opportunistic fungal infection that can occur in the client with (AIDS). The infection begins as a respiratory infection and can progress to disseminated infection. Typical signs and symptoms include fever, dyspnea, cough, and weight loss. Enlargement of the client's lymph nodes, liver, and spleen may occur as well.
A nurse is caring for a patient hospitalized with acute exacerbation of COPD. Which of the following would the nurse expect to note on assessment of this patient?
a. Hypocapnia b. A hyperinflated chest noted on the chest x-ray c. Increased oxygen saturation with exercise d. A widened diaphragm noted on the chest x-ray b. Clinical manifestations of COPD include hypoxemia, hypercapnia, dyspnea on exertion and at rest, oxygen desaturation with exercise, and the use of accessory muscles of respiration. Chest x0rays reveal a hyperinflated chest and a flattened diaphragm if disease is advanced.
A client suffering from a narcotic overdose is seen in the ED. the client is confused, with warm flushed skin, headache, and weakness. Vital signs of ntoed are T102.6, HR 128, R 24, and BP 130/86. A blood gas analysis sample was drawn on room air, and the results are as follows: PH 7.33, PaCO2 53, PaO2 72, HCO3 24. This client is at risk for:
a. Respiratory acidosis Rationale: Narcotic overdose causes more carbonic acid levels to rise because of hyperventilation and carbon dioxide retention.
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?
b. Pneumonia Pneumonia is the most common complication of influenza. It may be either primary influenza viral pneumonia or pneumonia secondary to bacterial infection. Other complications of influenza include myositis, exacerbation of COPD, and Reye's syndrome.
An oxygen delivery system is prescribed for a client with COPD to deliver a precise oxygen concentration. Which oxygen delivery system would the nurse anticipate to be prescribed?
b. Venturi mask -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.
A nurse is suctioning fluids from a client via a tracheostomy tube. When suctioning the nurse must limit the suctioning time to a maximum of?
c. 10 seconds Hypoxemia can be caused by prolonged suctioning which stimulates the pacemaker cells in the heart. A vasovagal response may occur, causing bradycardia. The nurse must preoxygenate the client before suctioning and limit the suctioning pass to 10 seconds
A client with a chest injury has suffered a flail chest. A nurse assesses the client for which most distinctive sign of flail chest
c. Paradoxical chest movement Flail chest results from multiple rib fractures. This results in a "floating" section of ribs. Because this section is unattached to the rest of the body rib cage, this segment results in pardoxical chest movement. This means that the force of inspiration pulls the fractured segment inward, which the rest of the chest expands. Similarly, during exhalation, the segment balloons outward while the rest of the chest moves inward. This a a characteristic of a flail chest.
A nurse performs an admission assessment on a client with a diagnosis of tuberculosis. The nurse reviews the results of which diagnostic test that will confirm this diagnosis?
c. Sputum culture T.B. is definitely diagnosed through culture and isolation of Mycobacterium tuberculosis. A presumptive diagnosis is made based on a tuberculin skin test, a sputum smear that is positive for acid-fast bacteria, a chest x-ray, and histological evidence of granulomatous disease on biopsy
A male client is admitted to the health care facility for treatment of COPD. Which nursing diagnosis is most important for this client?
d) Impaired gas exchange related to airflow obstruction
Ms. Steele is a 17 year-old with intractable vomiting. She has some electrolyte abnormalities, so blood gas is obtained to assess her acid/base balance. The results are pH 7.50, CO2 36, p02 92, HCO3 27, SaO2 97 %
d. Metabolic alkalosis Ms. Steele has an uncompensated metabolic alkalosis. This is due to vomiting that results in excessive loss of stomach acid. Treatment consists of fluids, anti-emetics, and management of her electrolyte disorders.
A nurse is assessing the resp. status of a client who has suffered a fractured rib. The nurse would expect to note which of the following?
d. Pain, especially with inspiration Rib fractures are a common injury, especially to the older client, and result from a blunt injury or a fall. Typical signs and symptoms include pain and tenderness localized at the fracture site and exacerbated by inspiration and palpation, shallow respirations, splinting or guarding the chest protectively to minimize chest movement, and possible bruising at the fracture site. Paradoxical respirations are seen with a flail chest
A nurse instructs a 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:
d. Promoted carbon dioxide elimination 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 1, 2, and 3 are not the purposes of this type of breathing.
A nurse is giving discharge instructions to a client with pulmonary sarcoidosis. The nurse concludes that the client understands the information if the client reports which of the following early signs of exacerbation?
d. Shortness of breath Dry cough and dyspnea are typical signs and symptoms of pulmonary sarcoidosis. Other include sweats, fever, weight loss, and skin nodules.
A nurse is instructing a hospitalized client with a diagnosis of emphysema about measures that will enhance the effectiveness of breathing during periods of dyspnea. Which of the following positions will the nurse instruct the patient to assume?
d. Sitting on the side of the bed and learning on an overbed table -Positions that will assist the client with emphysema and with breathing include sitting up, and leaning on an overbed table, sitting up and resting the elbows on the knees, and standing and leaning against the wall.
A male client with Guillain-Barre syndrome develops respiratory acidosis as a result of reduced alveolar ventilation. Which combination of arterial blood gas (ABG) values confirms respiratory acidosis?
d. pH, 7.25; PaCO2 50 mm Hg In respiratory acidosis, ABG analysis reveals an arterial pH below 7.35 and partial pressure of arterial carbon dioxide (PaCO2) above 45 mm Hg. Therefore, the combination of a pH value of 7.25 and PaCO2 value of 50 mm Hg confirms respiratory acidosis. A pH value of 5.0 with a PaCO2 value of 30 mm Hg indicates respiratory alkalosis. Options B and C represent normal gas exchange in the lungs.
