Pharmacology: Chapter 53: Introduction to the Respiratory System
A client has been diagnosed with stenosis of the pulmonary artery that inhibits the flow of unoxygenated blood between the right ventricle and the alveoli. This client will experience impaired: a.perfusion. b.ventilation. c.expiration. d.diffusion.
ANS: A
A nurse is caring for a client with chronic bronchiectasis. The nurse should assess the client for what clinical manifestations? a.Purulent cough b.Angina c.Pigeon chest d.Pulmonary hypertension
ANS: A
The nurse is caring for a 6-year-old client with cystic fibrosis. The parents ask how the cystic fibrosis started. The nurse explains that the key feature in the presentation of cystic fibrosis includes what? a.Airway obstruction b.Blood-tinged sputum c.Bronchospasm d.Clubbing of the extremities
ANS: A
The nurse is caring for a client whose respiratory rate has increased from 21 to 32 breaths/minute. This change in status is ultimately caused by what? a.Stimulation by the medulla b.Release of respiratory stimulating hormone (RSH) from the hypothalamus c.Increased peripheral O2 levels d.Increased blood pH
ANS: A
The pediatric nurse practitioner is caring for a child who is diagnosed with cystic fibrosis (CF). The parents ask what the treatment is for because CF is considered a terminal illness. What would be the nurse's best response? a."Treatment is aimed at maintaining airway patency as much as possible." b."Treatment is aimed at lowering high levels of carbon dioxide in the blood." c."Treatment is aimed at raising oxygen levels to the extremities." d."Treatment is aimed at maintaining the child until lung transplantation can occur."
ANS: A
The nurse is aware that clients with bronchiectasis often have an underlying medical condition that increases the chance for infection. What are some of these medical conditions? Select all that apply. a. Rheumatoid arthritis b. AIDS c. Diabetes mellitus d. Hydrocephalus e. Recent organ transplant
ANS: A, B, E
The nurse is caring for a client who has just been admitted with atelectasis and anticipates which possible treatments for this client? Select all that apply. a. Chest tube b. Surgical removal of the affected lung c. Oxygen delivery d. Assisted ventilation e. Antianxiety medication
ANS: A, C, D
The nurse is caring for a client with pneumonia. The nurse would expect to see which symptoms? Select all that apply. a. Difficulty breathing b. Urinary retention c. Rash d. Fever e. Oxygen saturation of 88%
ANS: A. Difficulty breathing; D. Fever; E. Oxygen saturation of 88% Rationale: Symptoms of clients with pneumonia include fever, difficulty breathing, fatigue, noisy breath sounds, and poor oxygenation.
A client has been up all night with intense coughing spasms and asks the nurse, "How is all this coughing related to my bronchitis?" The nurse tells the client that a cough is initiated by irritation to receptors in the: a.nasal cavity. b.bronchi. c.pharynx. d.sinus cavities.
ANS: B
A client is admitted with an asthma attack caused by an allergic reaction to a medication. The nurse is aware that this severe allergic response is triggered by the immediate release of what? a.Antihistamine b.Histamine c.Epinephrine d.Surfactant
ANS: B
A client is reporting an inability to breathe nasally because of severe rhinitis. The nurse should identify what important role in breathing that is disrupted when the nasal passages are blocked? a.Phagocytosis of pathogens. b.Inspired air is warmed and humidified. c.Exhalation of carbon dioxide. d.Respiratory regulation of acid-base balance.
ANS: B
A client's microscopic, hair-like projections of the nasal cell membranes are transporting foreign substances toward the throat. What structures are performing this role? a.Goblet cells b.Cilia c.Alveolar sacs d.Sinuses
ANS: B
A nurse is caring for an 80-year-old client with pneumonia. The most appropriate nursing diagnosis for this client would be what? a.Decreased cardiac output b.Impaired gas exchange c.Ineffective health maintenance d.Risk for aspiration
ANS: B
The nurse in the clinic is caring for a client who has seasonal rhinitis and the client wants to know what causes this. What is the nurse's best response? a."You are experiencing symptoms because bacteria have entered the nose and caused a local infection." b."Your upper airways are inflamed because you inhaled an antigen, causing sneezing and watery eyes." c."Your sympathetic nervous system is responding to stress in your life, causing you to have nasal congestion." d."Your symptoms are happening because pathogens are invading the tissues in your nose and causing necrosis of the superficial cells."
ANS: B
The nurse is assessing a postoperative client whom the nurse suspects may have developed atelectasis. What assessment finding by the nurse best supports this suspicion? a.Oral temperature of 37.4°C (99.3°F) b.Crackles on lung auscultation c.Chest pain on exertion d.Hemoptysis (blood-tinged sputum)
ANS: B
The nurse is caring for a child with cystic fibrosis (CF).What should the nurse identify as the hallmark pathology of CF? a.Lung bleeding, infection, and eventual bronchiectasis b.Airway obstruction, inflammation, and tissue damage c.Atelectasis, infection, and eventual chronic obstructive pulmonary disease (COPD) d.Bronchial mucous plugging, infection, and eventual chronic obstructive pulmonary disease (COPD)
ANS: B
The nurse is developing the teaching portion of a care plan for a client with asthma. What would be an important component for the nurse to emphasize? a.Smoking up to a half a pack of cigarettes weekly is allowable. b.Chronic inhalation of nonallergic inhaled irritants can trigger an attack. c.Minor respiratory infections should not be treated. d.Activities of daily living (ADLs) should be completed in the morning hours.
ANS: B
When describing gas exchange, the nurse should teach a client that oxygen and carbon dioxide enter and leave the body by what method? a.Osmosis b.Diffusion c.Passive transport d.Active transport
ANS: B
The nurse is admitting a client with an obstructive respiratory disorder. The nurse knows this includes which disorders? Select all that apply. a. Atelectasis b. Cystic fibrosis c. Asthma d. Pneumonia e. Bronchiectasis
ANS: B, C
A client asks the nurse what causes a cold. The nurse would tell the client that the common cold is most often caused by which type of microorganism? a.Gram-positive bacteria b.Gram-negative bacteria c.Viruses d.Fungi
ANS: C
A client presents to the emergency room with an attack of acute bronchiectasis. The nurse knows that the principal pathologic finding in the diagnosis of bronchiectasis includes what? a.Increase in the red blood cell concentration in the blood b.Leakage of fluid into the alveolar interstitial spaces c.Chronic, irreversible dilation of the bronchi and bronchioles d.Obstruction of the pulmonary vasculature by a clot
ANS: C
A nurse is caring for a client with acute respiratory distress syndrome (ARDS). The nurse is aware that this disease is characterized by what? a.Accumulation of copious amounts of very thick secretions in the lungs b.Loss of elastic tissue of the lungs and destruction of alveolar walls c.Progressive loss of lung compliance and increasing hypoxia d.Reversible bronchospasm, inflammation, and hyperactive airways
ANS: C
A nurse is discussing cystic fibrosis (CF) with a couple who have just given birth to an infant with this disorder. The nurse explains that the respiratory component of this disease is caused by what? a.Bronchospasm b.Infection c.Excessive respiratory tract secretions d.Chemical irritation of the respiratory tract
ANS: C
The intensive care nurse is caring for a client with acute respiratory distress syndrome (ARDS). What is the nurse's best intervention? a.Administration of oral corticosteroids, as prescribed b.Cardiopulmonary resuscitation c.Establishing mechanical ventilation, as prescribed d.Deep breathing and coughing exercises
ANS: C
The nursing instructor is discussing the need for lubrication of the alveoli for effective gas exchange and is produced by type II cells of the alveoli. The students know that what substance is produced by type II cells of the alveoli? a.Erythrocytes b.Lymphatic fluid c.Surfactant d.Pleural fluid
ANS: C
When describing the location where gas exchange takes place, the nurse should explain the function of the: a.trachea. b.bronchioles. c.alveoli. d.bronchi.
ANS: C
The nurse is teaching a class about common upper respiratory infections to parents of preschoolers. The nurse should cite what examples? Select all that apply. a. Bronchitis b. Asthma c. Pharyngitis d. Sinusitis e. Laryngitis
ANS: C, D, E
A client presents to the clinic with a temperature of 38.6°C (101.5°F); malaise, myalgia, arthralgia, and a purulent, productive cough. The client states "The fever just started today but I have had this cough for many, many months." What would the nurse suspect the client has? a.Acute pneumonia b.Bronchitis c.Chronic obstructive pulmonary disease (COPD) d.Bronchiectasis
ANS: D
A client returns to the unit after thoracic surgery with a water-sealed chest drainage system. What should the nurse instruct the client and the family that this drainage system is used for? a.Maintaining positive chest wall pressure b.Monitoring pleural fluid c.Providing positive intrathoracic pressure d.Reexpanding the lung and restoring the negative pressure to the space between the pleura
ANS: D
The nurse is caring for a client who suffered a head injury and is now having difficulty breathing. The client should be assessed for damage to what part of the central nervous system? a.Cerebral cortex b.Cerebellum c.Hypothalamus d.Medulla oblongata
ANS: D
The nurse is providing health education for a client who is experiencing upper airway responses to mold and dust? What is the client's most likely diagnosis? a.Cystic fibrosis b.Adult respiratory distress syndrome (ARDS) c.Atelectasis d.Seasonal rhinitis
ANS: D
The nurse is teaching a group of adults about health promotion. What should the nurse recommend in order to minimize participants' risk of COPD? a.Get screen for the genetic markers for COPD b.Get the annual influenza vaccination c.Minimize exposure to dust and mold d.Avoid smoking
ANS: D
What client should the nurse monitor most closely for signs and symptoms of respiratory distress syndrome? a.A client with a 15-pack-a-year history of smoking b.A client with seasonal allergies c.A client with acquired immunodeficiency syndrome d.A premature neonate
ANS: D
While assessing a new client on the unit, the nurse notes the following: productive cough, respiratory rate of 22, oxygen saturation of 90%, afebrile, and increased secretions. The client has a 20-year history of smoking 1.5 packs of cigarettes daily. What diagnosis is most likely? a.Pneumonia b.Cystic fibrosis c.Pleural effusion d.Chronic obstructive pulmonary disease (COPD)
ANS: D
The perioperative nurse is caring for a postsurgical client and the nurse has identified a risk for atelectasis. What are the nurse's best actions to prevent the development of atelectasis? Select all that apply. a.Encourage deep breathing and coughing b. Help the client to ambulate as soon as possible c. Encourage fluid intake to liquefy secretions d. Administer prophylactic antibiotics as prescribed e. Administer corticosteroids as prescribed
ANS; A, B