3065 Exam 2 Prep U Study Guide
Which statement indicates a client understands teaching about the purified protein derivative (PPD) test for tuberculosis?
"Because I had a previous reaction to the test, this time I need to get a chest X-ray."
A client with chronic obstructive pulmonary disease (COPD) and cor pulmonale is being prepared for discharge. The nurse should provide which instruction?
"Weigh yourself daily and report a gain of 2 lb in 1 day."
A client with end-stage COPD and heart failure asks the nurse about lung reduction surgery. What is the best response by the nurse? A. "You are not a candidate because you have heart failure." B. "You would have a difficult time recovering from the procedure." C. "At this point, do you really want to go through something like that?" D. "You and your physician should discuss the options that are available for treatment."
"You and your physician should discuss the options that are available for treatment."
A nurse is preparing dietary recommendations for a client with a lung abscess. Which statement would be included in the plan of care?
"You must consume a diet rich in protein, such as chicken, fish, and beans."
In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to which of the following acid-base imbalances? A. Respiratory acidosis B. Metabolic acidosis C. Metabolic alkalosis D. Respiratory alkalosis
A. Respiratory acidosis
A new surgical patient has been prescribed an opioid analgesic intravenously for pain control. The nurse should be aware of which most serious adverse effect of this medication? A. Respiratory depression B. Nausea and vomiting C. Constipation D. Pruritus
A. Respiratory depression
A nurse is discussing asthma complications with a client and family. What complications should the nurse include in the teaching? Select all that apply. A. Status asthmaticus B. Atelectasis C. Respiratory failure D. Pertussis E. Thoracentesis
A. Status asthmaticus B. Atelectasis C. Respiratory failure
A 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. atelectasis. B. oxygen toxicity. C. pleural effusion. D. pulmonary edema.
A. atelectasis.
A physician orders a beta2 adrenergic-agonist agent (bronchodilator) that is short-acting and administered only by inhaler. What drug would the nurse know to administer to the client?
Albuterol
The nurse is reviewing pressurized metered-dose inhaler (pMDI) instructions with a client. Which statement by the client indicates the need for further instruction? A. "I will shake the MDI container before I use it." B. "I can't use a spacer or holding chamber with the MDI." C. "I will take a slow, deep breath in after pushing down on the MDI." D. "Because I am prescribed a corticosteroid-containing MDI, I will rinse my mouth with water after use."
B. "I can't use a spacer or holding chamber with the MDI."
The most diagnostic clinical symptom of pleurisy is: A. Fever and chills. B. Stabbing pain during respiratory movements. C. Dyspnea and coughing. D. Dullness or flatness on percussion over areas of collected fluid.
B. Stabbing pain during respiratory movements.
A client has been hospitalized for treatment of acute bacterial pneumonia. Which outcome indicates an improvement in the client's condition? A. The client exhibits restlessness and confusion. B. The client has a partial pressure of arterial oxygen (PaO2) value of 90 mm Hg or higher. C. The client exhibits bronchial breath sounds over the affected area. D. The client has a partial pressure of arterial carbon dioxide (PaCO2) value of 65 mm Hg or higher.
B. The client has a partial pressure of arterial oxygen (PaO2) value of 90 mm Hg or higher.
Upon assessment, the nurse suspects that a client with COPD may have bronchospasm. What manifestations validate the nurse's concern? Select all that apply. A. Ascites B. Wheezes C. Compromised gas exchange D. Jugular vein distention E. Decreased airflow
B. Wheezes C. Compromised gas exchange E. Decreased airflow
A nurse administers hydromorphone to a client. What serious side effect should the nurse carefully monitor for? A. renal toxicity B. respiratory depression C. seizure activity D. hypertension
B. respiratory depression
A patient is prescribed a mast cell stabilizer for the treatment of asthma. Which commonly used medication will the nurse educate the patient about? A. Budesonide B. Albuterol C. Cromolyn sodium D. Theophylline
C. Cromolyn sodium
Which should a nurse encourage in clients who are at the risk of pneumococcal and influenza infections? A. Using prescribed opioids B. Using incentive spirometry C. Receiving vaccinations D. Mobilizing early
C. Receiving vaccinations
The nurse is collaborating with a community group to develop plans to reduce the incidence of lung cancer in the community. Which of the following would be most effective?
Classes at community centers to teach about smoking cessation strategies
A nurse is assessing the injection site of a client who has received a purified protein derivative test. Which finding indicates a need for further evaluation? A. A blister B. 5-mm induration C. Reddened area D. 15-mm induration
D. 15-mm induration
The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstruction and that leads to the collapse of alveoli. What complication should the nurse monitor for? A. Pneumonia B. Pleurisy C. Emphysema D. Atelectasis
D. Atelectasis
The nurse is assisting the anesthesiologist with the insertion of an epidural catheter and the administration of an epidural opioid for pain control. What adverse effect of epidural opioids should the nurse monitor for? A. Asystole B. Tachycardia C. Hypertension D. Bradypnea
D. Bradypnea
Which of the following is the most important potential nursing diagnosis for the client receiving opiate therapy? A. Diarrhea B. Risk for injury C. Altered mobility D. Risk for impaired gas exchange
D. Risk for impaired gas exchange
Which intervention does a nurse implement for clients with empyema?
Encourage breathing exercises
Which exposure acts as a risk factor for and accounts for the majority of cases of chronic obstructive pulmonary disease (COPD)?
Exposure to tobacco smoke
An older adult is being treated with opioids for pain relief. Which of the following should the nurse strongly recommend to this client? A. Exercise regularly. B. Avoid harsh sunlight. C. Follow a bowel regimen. D. Reduce fiber intake.
Follow a bowel regimen.
Which route of administration of medication is preferred in the most acute care situations?
Intravenous
The nurse's major area of assessment for a patient receiving patient-controlled analgesia is assessment of what system? A. Cardiovascular B. Integumentary C. Neurologic D. Respiratory
Respiratory
A nurse administers albuterol (Proventil), as ordered, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect?
Respiratory rate of 22 breaths/minute
The nurse caring for a client with tuberculosis anticipates administering which vitamin with isoniazid (INH) to prevent INH-associated peripheral neuropathy? A. Vitamin B6 B. Vitamin C C. Vitamin D D. Vitamin E
Vitamin B6
Which statement describes emphysema? A. A disease that results in reversible airflow obstruction, a common clinical outcome B. A disease of the airways characterized by destruction of the walls of overdistended alveoli C. Presence of cough and sputum production for at least a combined total of 2 to 3 months in each of two consecutive years D. Chronic dilatation of a bronchus or bronchi
A disease of the airways characterized by destruction of the walls of overdistended alveoli
Which of the following is accurate regarding status asthmaticus?
A severe asthma episode that is refractory to initial therapy
Which statement would indicate that the parents of child with cystic fibrosis understand the disorder? A. "The mucus-secreting glands are abnormal." B. "There are fibrous cysts in the lungs." C. "Early treatment can stop the progression of the disease." D. "Allergic reactions cause inflammation in the lungs."
A. "The mucus-secreting glands are abnormal."
About which issue should the nurse inform clients who use pain medications on a regular basis? A. Inform the primary health care provider about the use of salicylates before any procedure, and avoid over-the-counter analgesics consistently without consulting a physician. B. Minimize fiber intake during the therapy. C. Avoid harsh sunlight for 2 hours after administering analgesic agents or salicylates. D. Consume the medications just before or along with meals.
A. Inform the primary health care provider about the use of salicylates before any procedure, and avoid over-the-counter analgesics consistently without consulting a physician.
When drafting a nursing care plan for a patient in pain, it is important for the nurse to determine if the pain is acute or chronic. Choose an example of chronic pain. A. Intervertebral disk herniation B. Angina C. A migraine headache D. Appendicitis
A. Intervertebral disk herniation
On auscultation, which finding suggests a right pneumothorax?
Absence of breath sounds in the right thorax
A patient taking isoniazid (INH) therapy for tuberculosis demonstrates understanding when making which statement? A. "It is all right if I drink a glass of red wine with my dinner." B. "It is all right if I have a grilled cheese sandwich with American cheese." C. "It is fine if I eat sushi with a little bit of soy sauce." D. "I am going to have a tuna fish sandwich for lunch."
B. "It is all right if I have a grilled cheese sandwich with American cheese."
The nurse is educating a patient who will be started on an antituberculosis medication regimen. The patient asks the nurse, "How long will I have to be on these medications?" What should the nurse tell the patient? A. 3 to 5 months B. 6 to 12 months C. 3 months D. 13 to 18 months
B. 6 to 12 months
The ICU nurse caring for a 2-year-old near drowning victim monitors for what possible complication? A. Atelectasis B. Acute respiratory distress syndrome C. Metabolic alkalosis D. Respiratory acidosis
B. Acute respiratory distress syndrome
Which of the following is a potential complication of a low pressure in the endotracheal cuff? A. Tracheal bleeding B. Aspiration pneumonia C. Pressure necrosis D. Tracheal ischemia
B. Aspiration pneumonia
The nurse is caring for a client in the hospital who has been taking an analgesic for pain related to a chronic illness and has developed a tolerance to the medication. What is the most appropriate action by the nurse? A. Inform the client that you will ask the physician to order a non-narcotic analgesic. B. Inform the client that he will not be able to receive more medication than the physician has ordered. C. Consult with the prescriber regarding the need for an increased dose of the drug and not to reduce the frequency of administration. D. Suggest a consultation with a psychiatrist to treat the client's addiction.
C. Consult with the prescriber regarding the need for an increased dose of the drug and not to reduce the frequency of administration.
A nurse is administering a purified protein derivative (PPD) test to a client. Which statement concerning PPD testing is true? A. A positive reaction indicates that the client has active tuberculosis (TB). B. The PPD can be read within 12 hours after the injection. C. A negative reaction always excludes the diagnosis of TB. D. A positive reaction indicates that the client has been exposed to the disease.
D. A positive reaction indicates that the client has been exposed to the disease.
A recent immigrant is diagnosed with pulmonary tuberculosis (TB). Which intervention is the most important for the nurse to implement with this client? A. Client teaching about the cause of TB B. Reviewing the risk factors for TB C. Client teaching about the importance of TB testing D. Developing a list of people with whom the client has had contact
D. Developing a list of people with whom the client has had contact
Which interventions does a nurse implement for clients with empyema? A. Institute droplet precautions B. Place suspected clients together C. Do not allow visitors with respiratory infection D. Encourage breathing exercises
D. Encourage breathing exercises
The nurse asks the client about a reddened area on the left arm. The client states that he was bitten by an insect, and it burned briefly. What type of pain does the nurse document this as? A. Deeper somatic pain B. Neuropathic pain C. Visceral pain D. Superficial somatic pain
D. Superficial somatic pain
The patient with a chest tube is being transported to X-ray. Which complication may occur if the chest tube is clamped during transportation? A. Pulmonary contusion B. Cardiac tamponade C. Flail chest D. Tension pneumothorax
D. Tension pneumothorax
Which technique does a nurse suggest to a patient with pleurisy for splinting the chest wall? A. Use a heat or cold application. B. Avoid using a pillow while splinting. C. Use a prescribed analgesic. D. Turn onto the affected side.
D. Turn onto the affected side.
A nurse is assisting with a subclavian vein central line insertion when the client's oxygen saturation drops rapidly. He complains of shortness of breath and becomes tachypneic. The nurse suspects the client has developed a pneumothorax. Further assessment findings supporting the presence of a pneumothorax include: A. muffled or distant heart sounds. B. paradoxical chest wall movement with respirations. C. tracheal deviation to the unaffected side. D. diminished or absent breath sounds on the affected side.
D. diminished or absent breath sounds on the affected side.
The classification of Stage II of COPD is defined as A. severe COPD. B. at risk for COPD. C. very severe COPD. D. moderate COPD. E. mild COPD.
D. moderate COPD.
The nurse is assessing an older adult patient just admitted to the hospital. Why is it important that the nurse carefully assess pain in the older adult patient? A. Older people are expected to experience chronic pain. B. Older people have a decreased pain threshold. C. Older people experience reduced sensory perception. D. Older people have increased sensory perception.
Older people experience reduced sensory perception.
A client reports abdominal pain as "8" on a pain intensity scale of 0-10 thirty minutes after receiving an opioid intravenously. Her past medical history includes partial-thickness burns to approximately 60% of her body several years ago. The nurse assesses
That the client's past experiences with pain may influence her perception of current pain
A nurse is caring for a client who is at high risk for developing pneumonia. Which intervention should the nurse include on the client's care plan?
Using strict hand hygiene
A nurse has just completed teaching with a client who has been prescribed a meter-dosed inhaler for the first time. Which statement if made by the client would indicate to the nurse that further teaching and follow-up care is necessary? A. "I do not need to rinse my mouth with this type of inhaler." B. "After I breathe in, I will hold my breath for 10 seconds." C. "If I use the spacer, I know I am only supposed to push on the inhaler once." D. "I will make sure to take a slow, deep breath as I push on my inhaler."
A. "I do not need to rinse my mouth with this type of inhaler."
A client at risk for pneumonia has been ordered an influenza vaccine. Which statement from the nurse best explains the rationale for this vaccine? A. "Viruses like influenza are the most common cause of pneumonia." B. "Influenza vaccine will prevent typical pneumonias." C. "Influenza is the major cause of death in the United States." D. "Getting the flu can complicate pneumonia."
A. "Viruses like influenza are the most common cause of pneumonia."
Nociception includes four specific processes: transduction, transmission, perception, and modulation. Which action illustrates the nociception process of pain transmission? A. A child quickly removing a hand when touching a hot object B. A surgeon making an incision to perform surgery C. A patient taking tramadol to enhance pain management D. A mother in labor utilizing imagery to reduce pain
A. A child quickly removing a hand when touching a hot object
A nurse is caring for a group of clients on a medical-surgical floor. Which client is at greatest risk for developing pneumonia? A. A client with a nasogastric tube B. A client with a history of smoking two packs of cigarettes per day until quitting 2 years ago C. A client who is receiving acetaminophen (Tylenol) for pain D. A client who ambulates in the hallway every 4 hours SUBMIT ANSWER
A. A client with a nasogastric tube
The nurse is obtaining data regarding the medication that the client is taking on a regular basis. The client states he is taking duloxetine, an antidepressant for the treatment of neuropathic pain. What type of therapy does the nurse understand the client is receiving? A. Adjuvant drug therapy B. Alternate drug therapy C. Withdrawal therapy D. Replacement drug therapy
A. Adjuvant drug therapy
Which action should the nurse take first in caring for a client during an acute asthma attack? A. Administer bronchodilator as ordered. B. Obtain arterial blood gases. C. Send for STAT chest x-ray. D. Initiate oxygen therapy and reassess pulse oximetry in 10 minutes.
A. Administer bronchodilator as ordered.
The clinic nurse is caring for a client with acute bronchitis. The client asks what may have caused the infection. What may induce acute bronchitis? A. Chemical irritation B. Drug ingestion C. Aspiration D. Direct lung damage
A. Chemical irritation
In which statements regarding medications taken by a client diagnosed with COPD do the drug name and the drug category correctly match? Select all that apply. A. Ciprofloxacin is an antibiotic. B. Cotrimoxazole is a bronchodilator. C. Albuterol is a bronchodilator. D. Dexamethasone is an antibiotic. E. Prednisone is a corticosteroid.
A. Ciprofloxacin is an antibiotic. C. Albuterol is a bronchodilator. E. Prednisone is a corticosteroid.
A nurse is caring for a client who has just been diagnosed with lung cancer. What is a cardinal sign of lung cancer? A. Cough or change in chronic cough B. Pain on inspiration C. Obvious trauma D. Shortness of breath
A. Cough or change in chronic cough
Choose the most likely reason why a nurse should question the use of Demerol for pain management in an elderly patient? There is (are): A. Decreased binding of meperidine by plasma protein. B. Decreased metabolism of medications. C. Increased susceptibility to nervous system depression. D. Changes in renal metabolism.
A. Decreased binding of meperidine by plasma protein.
What is the reason for chest tubes after thoracic surgery? A. Draining secretions, air, and blood from the thoracic cavity is necessary. B. Chest tubes allow air into the pleural space. C. Chest tubes indicate when the lungs have re-expanded by ceasing to bubble. D. Draining secretions and blood while allowing air to remain in the thoracic cavity is necessary.
A. Draining secretions, air, and blood from the thoracic cavity is necessary.
A nurse is assessing a client who comes to the clinic for care. Which findings in this client suggest bacterial pneumonia? A. Dyspnea and wheezing B. Nonproductive cough and normal temperature C. Sore throat and abdominal pain D. Hemoptysis and dysuria
A. Dyspnea and wheezing
The physician has ordered a mu opioid analgesic for a patient with pain. What drug does the nurse anticipate administering? A. Fentanyl B. Buprenex C. Stadol D. Nubain
A. Fentanyl
The occupational nurse is completing routine assessments on the employees where you work. What might be revealed by a chest radiograph for a client with occupational lung diseases? A. Fibrotic changes in lungs B. Lung contusion C. Hemorrhage D. Damage to surrounding tissues
A. Fibrotic changes in lungs
When caring for a client with acute respiratory failure, the nurse should expect to focus on resolving which set of problems? A. Hypercapnia, hypoventilation, and hypoxemia B. Hypotension, hyperoxemia, and hypercapnia C. Hyperventilation, hypertension, and hypocapnia D. Hyperoxemia, hypocapnia, and hyperventilation
A. Hypercapnia, hypoventilation, and hypoxemia
A nursing student is taking a pathophysiology examination. Which of the following factors would the student correctly identify as contributing to the underlying pathophysiology of chronic obstructive pulmonary disease (COPD)? Choose all that apply. A. Mucus secretions that block airways B. Dry airways that obstruct airflow C. Inflamed airways that obstruct airflow D. Overinflated alveoli that impair gas exchange E. Decreased numbers of goblet cells
A. Mucus secretions that block airways C. Inflamed airways that obstruct airflow D. Overinflated alveoli that impair gas exchange
A nurse reading a chart notes that the client had a Mantoux skin test result with no induration and a 1-mm area of ecchymosis. How does the nurse interpret this result? A. Negative B. Borderline C. Uncertain D. Positive
A. Negative
A client, who had an above the knee amputation of the left leg related to peripheral vascular disease from uncontrolled diabetes, complains of pain in the left lower extremity. What type of pain is the client experiencing? A. Neuropathic pain B. Visceral pain C. Referred pain D. Breakthrough pain
A. Neuropathic pain
The nurse is assigned to care for a patient with COPD with hypoxemia and hypercapnia. When planning care for this patient, what does the nurse understand is the main goal of treatment? A. Providing sufficient oxygen to improve oxygenation B. Increasing pH C. Avoiding the use of oxygen to decrease the hypoxic drive D. Monitoring the pulse oximetry to assess need for early intervention when PCO2 levels rise
A. Providing sufficient oxygen to improve oxygenation
A patient is being treated for status asthmaticus. What danger sign does the nurse observe that can indicate impending respiratory failure? A. Respiratory acidosis B. Metabolic alkalosis C. Respiratory alkalosis D. Metabolic acidosis
A. Respiratory acidosis
As status asthmaticus worsens, the nurse would expect which acid-base imbalance? A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic alkalosis D. Metabolic acidosis
A. Respiratory acidosis
A nurse is caring for a client with pain. What should the nurse monitor for when administering intravenous acetaminophen? A. hepatotoxicity B. renal toxicity C. bleeding D. gastrointestinal effects
A. hepatotoxicity
A client has a long history of diabetes mellitus and developed diabetic neuropathy more than 25 years ago. The client is without breakthrough pain at this point in time. How would this client's pain be classified? A. neuropathic and chronic B. neuropathic and acute C. nociceptive and acute D. nociceptive and chronic
A. neuropathic and chronic
How should the administration of analgesics be scheduled to provide a uniform level of pain relief to a client? A. Administering the analgesics intravenously B. Administering the analgesics on a regular basis C. Administering analgesics with increased dosage D. Administering the analgesics on an as-needed per client request
B. Administering the analgesics on a regular basis
The nurse understands that which statement is true about tolerance and addiction? A. Tolerance to opioids is uncommon. B. Although clients may need increasing levels of opioids, they are not addicted. C. Addiction to opioids commonly develops. D. The nurse must be primarily concerned about development of addiction by a client in pain.
B. Although clients may need increasing levels of opioids, they are not addicted.
A client newly diagnosed with emphysema asks the nurse to explain all about the disease. The nurse would include the following response when defining emphysema: A. Decreased sputum production with dilation of bronchioles B. An abnormal distention of the air spaces with destruction of the alveolar walls C. Increased oxygen diffusion with inflammation of the bronchioles D. Inflammation of the bronchioles with a normal distention of the air spaces
B. An abnormal distention of the air spaces with destruction of the alveolar walls
Which of the following is a leading cause of chronic obstructive pulmonary disease (COPD) exacerbation? A. Pneumonia B. Bronchitis C. Asthma D. Common cold
B. Bronchitis
An elderly client is diagnosed with pulmonary tuberculosis. Upset and tearful, he asks the nurse how long he must be separated from his family. Which nursing diagnosis is most appropriate for this client? A. Social isolation B. Deficient knowledge (disease process and treatment regimen) C. Anxiety D. Impaired social interaction
B. Deficient knowledge (disease process and treatment regimen)
A patient is admitted to the hospital with pulmonary arterial hypertension. What assessment finding by the nurse is a significant finding for this patient? A. Syncope B. Dyspnea C. Hypertension D. Ascites
B. Dyspnea
A client with suspected severe acute respiratory syndrome (SARS) comes to the emergency department. Which physician order should the nurse implement first? A. Obtain a nasopharyngeal specimen for reverse-transcription polymerase chain reaction testing. B. Institute isolation precautions. C. Begin an I.V. infusion of dextrose 5% in half-normal saline solution at 100 ml/hour. D. Obtain a sputum specimen for enzyme immunoassay testing.
B. Institute isolation precautions.
A client is being seen in the emergency department for exacerbation of chronic obstructive pulmonary disease (COPD). The first action of the nurse is to administer which of the following prescribed treatments? A. Vancomycin 1 gram intravenously over 1 hour B. Oxygen through nasal cannula at 2 L/minute C. Ipratropium bromide (Alupent) by metered-dose inhaler D. Intravenous methylprednisolone (Solu-Medrol) 120 mg
B. Oxygen through nasal cannula at 2 L/minute
A health care provider orders a beta-2 adrenergic agonist agent (bronchodilator) that is long-acting and administered only by inhaler. What medication does the nurse anticipate will be administered? A. Terbutaline B. Salmeterol C. Foradil D. Isuprel
B. Salmeterol
Which of the following is a disadvantage to using the IV route of administration for analgesics? A. No risk of respiratory depression B. Short duration C. Slower entry into bloodstream D. Long duration
B. Short duration
A client newly diagnosed with COPD tells the nurse, "I can't believe I have COPD; I only had a cough. Are there other symptoms I should know about"? Which is the best response by the nurse? A. "There are no other symptoms; however, your cough may get worse as the disease progresses." B. "As your COPD worsens, you will frequently develop respiratory infections." C. "Other symptoms you may develop are shortness of breath upon exertion and sputum production." D. "You can also expect to experience a progressive weight gain."
C. "Other symptoms you may develop are shortness of breath upon exertion and sputum production."
The client asks the nurse to explain the reason for a chest tube insertion in treating a pneumothorax. Which is the best response by the nurse? A. "Chest tube will allow air to be restored to the lung." B. "Chest tubes provide a route for medication instillation to the lung." C. "The tube will drain air from the space around the lung." D. "The tube will drain secretions from the lung."
C. "The tube will drain air from the space around the lung."
Which of the following is a disadvantage of using the transdermal route of opioid administration? A. Less costly than parenteral route B. Slightly less constipation noted than with oral opioids C. A delay in effect until the dermal layer is saturated D. A constant opioid serum level
C. A delay in effect until the dermal layer is saturated
A client is diagnosed with a chronic respiratory disorder. After assessing the client's knowledge of the disorder, the nurse prepares a teaching plan. This teaching plan is most likely to include which nursing diagnosis? A. Unilateral neglect B. Impaired swallowing C. Anxiety D. Imbalanced nutrition: More than body requirements
C. Anxiety
Which of the following nursing interventions contributes to achieving a client's goal for pain relief? A. Use all forms of available pain management techniques. B. Prevent the client from self-administering analgesics. C. Collaborate with the client about his or her goal for a level of pain relief. D. Minimize the client's description of pain or need for pain relief.
C. Collaborate with the client about his or her goal for a level of pain relief.
A young adult with cystic fibrosis is admitted to the hospital for an acute airway exacerbation. Aggressive treatment is indicated. What is the first action by the nurse? A. Gives oral pancreatic enzymes with meals B. Administers vancomycin intravenously C. Collects sputum for culture and sensitivity D. Provides nebulized tobramycin (TOBI)
C. Collects sputum for culture and sensitivity
Which nursing intervention should a nurse perform when caring for a client who is prescribed opiate therapy for pain? A. Monitor weight, vital signs, and serum glucose concentration B. Monitor blood counts and liver function tests C. Do not administer if respirations are less than 12 breaths per minute D. Avoid caffeine or other stimulants, such as decongestants
C. Do not administer if respirations are less than 12 breaths per minute
A junior-level nursing class has just finished learning about the management of clients with chronic pulmonary diseases. They learned that a new definition of COPD leaves only one disorder within its classification. Which of the following is that disorder? A. Cystic fibrosis B. Asthma C. Emphysema D. Bronchiectasis
C. Emphysema
The nurse is administering a narcotic analgesic for the control of a newly postoperative client's pain. What medication will the nurse administer to this client? A. Acetaminophen (Tylenol) B. Ibuprofen (Motrin) C. Fentanyl (Duragesic) D. Midazolam (Versed)
C. Fentanyl (Duragesic)
The nurse knows the mortality rate is high in lung cancer clients due to which factor? A. Increased incidence among the elderly B. Increase in women smokers C. Few early symptoms D. Increased exposure to industrial pollutants
C. Few early symptoms
A nurse consulting with a nutrition specialist knows it's important to consider a special diet for a client with chronic obstructive pulmonary disease (COPD). Which diet is appropriate for this client? A. 1,800-calorie ADA B. Full-liquid C. High-protein D. Low-fat
C. High-protein
A client diagnosed with acute respiratory distress syndrome (ARDS) is restless and has a low oxygen saturation level. If the client's condition does not improve and the oxygen saturation level continues to decrease, what procedure will the nurse expect to assist with in order to help the client breathe more easily? A. Increase oxygen administration B. Schedule the client for pulmonary surgery C. Intubate the client and control breathing with mechanical ventilation D. Administer a large dose of furosemide (Lasix) IVP stat
C. Intubate the client and control breathing with mechanical ventilation
The nurse is assessing a client who, after an extensive surgical procedure, is at risk for developing acute respiratory distress syndrome (ARDS). The nurse assesses for which most common early sign of ARDS? A. Inspiratory crackles B. Cyanosis C. Rapid onset of severe dyspnea D. Bilateral wheezing
C. Rapid onset of severe dyspnea
A patient comes to the clinic with fever, cough, and chest discomfort. The nurse auscultates crackles in the left lower base of the lung and suspects that the patient may have pneumonia. What does the nurse know is the most common organism that causes community-acquired pneumonia? A. Staphylococcus aureus B. Mycobacterium tuberculosis C. Streptococcus pneumoniae D. Pseudomonas aeruginosa
C. Streptococcus pneumoniae
A nurse is developing a teaching plan for a client with asthma. Which teaching point has the highest priority? A. Change filters on heating and air conditioning units frequently. B. Avoid contact with fur-bearing animals. C. Take ordered medications as scheduled. D. Avoid goose down pillows.
C. Take ordered medications as scheduled.
Resistance to a first-line antituberculotic agent in a client who has not received previous treatment is referred to as A. secondary drug resistance. B. tertiary drug resistance. C. primary drug resistance. D. multidrug resistance.
C. primary drug resistance.
When taking a client history, the nurse notes that the client is taking herbal remedies in addition to acetaminophen. Which herb, when taken in conjunction with acetaminophen, enhances the risk of bleeding? A. Kava B. Echinacea C. Willow D. Ginkgo
D. Ginkgo
A client arrives in the orthopedic clinic with complaints of twisting the right ankle while playing softball. The nurse collects data including complaints of pain and swelling in the right ankle. What intervention will the nurse provide that will decrease vasodilation and reduce localized swelling? A. Injection of a steroid into the joint space B. Warm compresses C. Elevation of the extremity D. Ice bag
D. Ice bag
Asthma is cause by which type of response? A. IgA-mediated B. IgD-mediated C. IgM-mediated D. IgE-mediated
D. IgE-mediated
A nurse is caring for a client who was admitted with pneumonia, has a history of falls, and has skin lesions resulting from scratching. The priority nursing diagnosis for this client should be: A. Risk for falls. B. Impaired tissue integrity. C. Ineffective breathing pattern. D. Ineffective airway clearance.
D. Ineffective airway clearance.
Which phase of pain transmission occurs when the one is made aware of pain? A. Transmission B. Transduction C. Modulation D. Perception
D. Perception
A nurse documents the presence of chronic pain on an electronic health record. Choose a description that could be used. The pain can be: A. Separate from any central or peripheral pathology. B. Rapidly occurring and subsiding with treatment. C. Attributed to a specific cause. D. Prolonged in duration.
D. Prolonged in duration.
Which of the following is a true statement with regards to the preventative approach to the use of analgesics? A. Larger doses of medication are needed. B. It promotes tolerance to analgesic agents C. The use increases peaks and troughs in the serum level. D. Smaller doses of medication are needed.
D. Smaller doses of medication are needed.
A patient comes to the clinic for the third time in 2 months with chronic bronchitis. What clinical symptoms does the nurse anticipate assessing for this patient? A. Chest pain during respiration B. Tachypnea and tachycardia C. Fever, chills, and diaphoresis D. Sputum and a productive cough
D. Sputum and a productive cough
The nurse is interpreting blood gases for a client with acute respiratory distress syndrome (ARDS). Which set of blood gas values indicates respiratory acidosis? A. pH 7.87, PaCO2 38, HCO3 28 B. pH 7.47, PaCO2 28, HCO3 30 C. pH 7.49, PaCO2 34, HCO3 25 D. pH 7.25, PaCO2 48, HCO3 24
D. pH 7.25, PaCO2 48, HCO3 24
A client is admitted with generalized abdominal pain, nausea, vomiting, and hypotension. The client has not passed stool in over 1 week and has been in pain for the past 4 days. Which type of pain would you expect the client to be experiencing? A. neuropathic B. chronic C. deeper somatic D. visceral
D. visceral