Practice Questions NUR 345 Exam 1

A client is admitted to the hospital with a diagnosis of pneumonia. List the following nursing actions in the order they should be accomplished. Correct 1. Obtain data about the client's history and physical status. Correct 2. Insert an intravenous (IV) catheter to establish venous access. Incorrect 3. Administer prescribed antibiotic intravenous piggyback. Incorrect 4. Collect a sputum sample for culture and sensitivity. Correct 5. Check peak and trough levels of the antibiotic.

1, 2, 4, 3, 5

What order would the nurse follow for the assessment of the pharynx in a client with a respiratory disorder? 1. Inspect the mouth. 2. Inspect the neck symmetry. 3. Observe the rise and fall of the soft palate. 4. Assess the symmetry of enlarged tonsils, if present. 5.Palpate the lymph nodes.

1, 3, 4, 2, 5

The primary healthcare provider has prescribed fluticasone nasal spray for a client with sinusitis. Which of these instructions regarding the use of the spray are appropriate for the client? Select all that apply. 1. Use the drug on a regular basis, not PRN 2. Clear the nasal passages before using the drug 3. Discontinue use of the drug if nasal infection develops 4. Remember that driving may be dangerous because of the drug's sedative effect 5. Begin taking the drug 2 weeks before pollen season starts and use it throughout the season

1,2,3

A client with chronic obstructive pulmonary disease (COPD) reports chest congestion, especially upon awakening in the morning. What should the nurse suggest to the client? 1. Use a humidifier in the bedroom. 2.Sleep with two or more pillows. 3. Cough regularly even if the cough does not produce sputum. 4. Cough and deep breathe each night before going to sleep.

1. Use a humidifier in the bedroom.

A nurse provides smoking-cessation education to a client with chronic obstructive pulmonary disease (COPD). The nurse concludes that the client is ready to quit smoking when the client makes which statement? 1. "I'll just finish the carton that I have at home." 2. "I'll cut back to a half pack a day." 3. "I find that smoking is the only way I can relax." 4. "I should find this easy because I don't smoke when I drink."

2. "I'll cut back to a half pack a day."

Which nursing action is important when suctioning the secretions of a client with a tracheostomy? 1. Use a new sterile catheter with each insertion. 2. Initiate suction as the catheter is being withdrawn. 3. Insert the catheter until the cough reflex is stimulated. 4. Remove the inner cannula before inserting the suction catheter.

2. Initiate suction as the catheter is being withdrawn.

A nurse is caring for a client with the diagnosis of emphysema, a chronic obstructive pulmonary disease (COPD). The client is hypoxemic and also has chronic hypercarbia. Which statement reflects the oxygen needs of this client? 1 . The client may need up to 60% oxygen flow via Venturi mask. 2. The client requires lower levels of oxygen delivery, usually 1 to 3 L/min via nasal cannula. 3. The client should receive humidified oxygen delivered by a face mask. 4. The client's respiratory treatment plan should have oxygen eliminated from it.

2. The client requires lower levels of oxygen delivery, usually 1 to 3 L/min via nasal cannula.

What response provides evidence that a client with chronic obstructive pulmonary disease (COPD) understands the nurse's instructions about an appropriate breathing technique? 1. Inhales through the nose with the mouth closed 2. Increases the respiratory rate 3. Holds each breath for a second at the end of inspiration

3. Holds each breath for a second at the end of inspiration

A nurse administers oxygen at 2 L/min via nasal cannula to a client with chronic obstructive pulmonary disease (COPD). By administering a low concentration of oxygen to this client, the nurse is preventing which physiologic response? 1. Decrease in red cell formation 2. Rupture of emphysematous bullae 3. Depression in the respiratory center 4. Excessive drying of the respiratory mucosa

3. Depression in the respiratory center

hypercarbia

Increased carbon dioxide level in the bloodstream.

A client with an upper respiratory infection asks the nurse why the health care provider did not prescribe an antibiotic. What would be the best response from the nurse? 1. "I don't know. I will ask the health care provider for a prescription." 2. "Antibiotics are used to treat viruses and you have a bacterial infection." 3. "Antibiotics are ineffective for treating the bacteria that cause upper respiratory infections." 4. "Upper respiratory infections generally are caused by viruses and therefore should not be treated with antibiotics.

4. "Upper respiratory infections generally are caused by viruses and therefore should not be treated with antibiotics.

A client is admitted to the hospital for medical treatment of bronchopneumonia. Which test result should the nurse examine to help determine the effectiveness of the client's therapy? 1. Bronchoscopy 2. Pulse oximetry 3. Pulmonary function studies 4. Culture and sensitivity tests of sputum

4. Culture and sensitivity tests of sputum

Rehabilitation of a client with chronic obstructive pulmonary disease (COPD) involves strategies to decrease hospital admissions and to live a more active life. What should the nurse teach the client to do? 1. Initiate activities to eliminate infection. 2. Inhale during movements that require energy. 3. Implement breathing that uses the thoracic muscles. 4. Incorporate humidification into the home environment.

4. Incorporate humidification into the home environment.

.A nurse is suctioning a client's tracheostomy. Place the nursing actions in order of priority when performing this procedure. 1. Prepare by turning suction on to between 80 and 120 mm Hg pressure. 2. Don sterile gloves. 3. Hyperoxygenate using 100% oxygen. 4. Guide the catheter into the tracheostomy tube using a sterile-gloved hand. 5. Auscultate the lungs and check the heart rate.

5, 1, 3, 2, 4