Quiz on pulmonary embolism

The family of a mechanically ventilated patient receiving a chest tube asks why the tube is necessary. How should the nurse respond?

"The chest tube helps to decompress the lung and prevents further complications."

A young adult female patient with cystic fibrosis (CF) tells the nurse that she is considering trying to become pregnant. Which initial response by the nurse is best?

"Would like more information to help you with that decision?"

The nurse is preparing discharge instructions for a patient recovering from acute respiratory distress syndrome (ARDS). What should be included in this teaching? Select all that apply.

-Get the influenza immunization annually. -Practice lifestyle modifications to reduce oxygen demands. -Avoid smoking and exposure to air pollution.

The nurse is caring for a patient experiencing atelectasis of the right lower lung lobe. What intervention should the nurse include in this patient's plan of care? Select all that apply.

-Positioning on the left side -Coaching to deep-breathe and cough -Encouraging increased oral fluids

The nurse is reviewing the results of laboratory and diagnostic tests conducted on a patient experiencing respiratory dysfunction. Which result confirms the nurse's suspicion that the patient has cystic fibrosis? Select all that apply.

-Reduced total lung capacity from pulmonary function test -Chloride concentration of sweat 85 mEq/L -Oxygen saturation 82% on room air

A patient recovering from a lung transplant will have denervation of the lung tissue. What should the nurse include when planning this patient's care? Select all that apply.

-Scheduling deep breathing and coughing every 2 hours. -Performing postural drainage twice a shift. -Positioning for chest vibration and percussion twice per shift.

During an assessment the nurse suspects that a patient has chronic bronchitis. On what assessment finding is the nurse basing this clinical decision? Select all that apply.

-Smoking 1 ppd -Persistent productive cough -Wheezes and rhonchi lung sounds

The nurse realizes that the medication tiotropium bromide (Spiriva) is contraindicated for a patient with chronic obstructive pulmonary disease (COPD). What information in the patient's medical history led to this clinical decision? Select all that apply. The patient is being treated for glaucoma. The patient uses a topical steroid for psoriasis. The patient attends physical therapy three times a week. The patient is taking medication for prostatic hypertrophy. The patient limits the intake of dietary fats for weight loss.

1,4

A patient with an acute exacerbation of emphysema is prescribed 60 mg of methylprednisolone per intravenous push. The medication is available from the pharmacy as 40 mg per 1 mL. How many milliliters of the medication should the nurse administer? Calculate to the nearest tenth decimal point.

1.5 ml

The nurse instructs a patient on the use of a metered-dose inhaler for asthma medications. To demonstrate understanding of the instructions, in which order should the patient self-administer this medication? Place in order the steps of the process. Choice 1. Rinse the mouth. Choice 2. Exhale slowly and completely. Choice 3. Shake the canister vigorously for 3 to 5 seconds. Choice 4. Press and hold the canister down while inhaling deeply and slowly for 3 to 5 seconds. Choice 5. Hold the breath for 10 seconds, release the pressure on the container, remove from the mouth, and exhale.

3,2,4,5,1

A patient with asthma has a personal best peak expiratory flow rate (PEFR) of 400 L/min. When explaining the asthma action plan, the nurse will teach the patient that a change in therapy is needed when the PEFR is less than ___ L/minute.

320

A patient who nearly drowned is diagnosed with pulmonary edema and is prescribed furosemide 40 mg slow intravenous push. The medication available is a vial containing 100 mg/10 mL. How many milliliters of the medication should the nurse administer? Calculate the exact dose.

4

A chest CT scan confirms that a patient has bronchiectasis. On which problem should the nurse focus when determining the care this patient will need? Select all that apply.

Airway clearance Insufficient nutritional intake Inability to provide self-care Ineffective breathing pattern

A patient is admitted with pulmonary edema. What is important for the nurse to assess first when completing the patient's history? Select all that apply.

Cardiac history Pulmonary history

A patient is suspected of having a pulmonary embolism. Which diagnostic test should the nurse anticipate being prescribed for this patient? Select all that apply.

Chest CT with contrast Pulmonary angiogram Plasma D-dimer level

Which finding in a patient hospitalized with bronchiectasis is most important to report to the health care provider?

Cough productive of bloody, purulent mucus

A patient being mechanically ventilated suddenly develops cardiac dysrhythmias from increasingly higher PEEP. What underlying issue should the nurse suspect in this patient?

Decreased cardiac output and acidosis

A nurse is preparing to administer raloxifene to a client. Which of the following conditions is a contraindication for the administration of this medication?

Deep-vein-thrombosis

The nurse is caring for a patient who is intubated and being mechanically ventilated. Which prescription should the nurse question for this patient?

Endotracheal suctioning every hour

A patient in the clinic with cystic fibrosis (CF) reports increased sweating and weakness during the summer months. Which action by the nurse would be most appropriate?

Have the patient add dietary salt to meals.

A nurse is providing discharge teaching to a client who had a pulmonary embolism. Which of the following statements indicates that the client understands the information?

I'll call the doctor if I see any blood in my urine or stool.

A patient being mechanically ventilated requires increasing PEEP for worsening ARDS. The order for PEEP is now at 20 cm of H2O. For which finding should the nurse contact the healthcare provider?

Lung sounds greater on one side than the other

A patient diagnosed with sepsis suddenly develops dyspnea, crackles, agitation, and confusion. Which health problem should the nurse suspect this patient is developing?

Noncardiogenic pulmonary edema

A patient being mechanically ventilated develops hypotension after the respiratory therapist implements the most recent physician orders. Which ventilator mode should the nurse suspect has caused this change in the patient's status?

PEEP

A young adult patient with cystic fibrosis (CF) is admitted to the hospital with increased dyspnea. Which intervention should the nurse include in the plan of care?

Perform chest physiotherapy every 4 hours.

After an assessment the nurse is concerned that a patient is experiencing cor pulmonale associated with right-heart failure. What finding led the nurse to make this clinical decision? Select all that apply.

Ruddy cheeks Ankle edema Distended neck veins Cyanotic nail beds

A nurse in a medical-surgical unit is assessing a client. The nurse should identify that which of the following findings in a manifestation of a pulmonary embolism?

Stabbing chest pain

A patient being mechanically ventilated is exhibiting hypoxia, with a pulse oximeter reading of 88%. What should the nurse do if adventitious lung sounds are auscultated?

Suction the patient.

A patient who is intubated is exhibiting rhonchi and has a pulse oximeter of 92%, soft abdomen, heart rate of 88 bpm, and blood pressure of 98/54 mmHg. Which should the nurse complete first?

Suction the patient.

A nurse is caring for a female client who has osteoporosis and is taking raloxifene. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect of this medication?

Sudden onset of dyspnea

A nurse on a medical-surgical unit is caring for a client who is postoperative following hip replacement surgery. The client reports feeling apprehensive and restless. Which of the following findings should the nurse recognize as an indication of pulmonary embolism?

Sudden onset of dyspnea

A patient with cystic fibrosis has blood glucose levels that are consistently between 180 to 250 mg/dL. Which action will the nurse expect to implement?

Teach the patient about administration of insulin.

The nurse is caring for a patient who is receiving neuromuscular blocking agents and is mechanically ventilated. For which reason should the alarms on the ventilator be activated?

The patient cannot breathe.

A patient is being mechanically ventilated with SIMV at a rate of 25 breaths per minute. Why should the nurse question this setting?

The rate could be too high for this mode.

The chest x-ray of a patient who was recently intubated shows the endotracheal tube located in the right mainstem bronchus. What action should be taken at this time?

The tube needs to be withdrawn slightly.