Respiratory Quiz questions

When developing a preventative plan of care for a patient at risk for developing chronic obstructive pulmonary disease (COPD), which of the following should be incorporated? Cancer prevention Smoking cessation Weight reduction Cholesterol management

Smoking cessation

A charge nurse is reviewing the care of a client who has a chest tube connected to a water seal drainage system in place following thoracic surgery with a nurse. Which of the statements by the nurse indicates an understanding of when to notify the provider? "I will notify the provider if there is a fluctuation of drainage in the tubing with inspiration." "I will notify the provider if there is continuous bubbling in the water seal chamber." "I will notify the provider if there is drainage of 60 milliliters in the first hour after surgery." "I will notify the provider if there are several small, dark-red blood clots in the tubing."

"I will notify the provider if there is continuous bubbling in the water seal chamber." Continuous bubbling in the water seal chamber suggests an air leak and requires notification of the provider. The nurse should check the system for external, correctable leaks while waiting for instructions from the provider.

You are the nurse taking care of a 40-year old African-American female who complains of fatigue and shortness of breath. Her physical exam is remarkable for erythema nodosum on the bilateral lower extremities. A chest x-ray is performed that demonstrates bilateral hilar infiltrates. She lives and works in a suburb, has not traveled outside of the United States recently, and does not work in a healthcare setting. Which of the following is the most likely diagnosis?​ ​ Pharyngitis​ Meningitis​ Lung cancer​ Tuberculosis​ Sarcoidosis​

"Sarcoidosis." Sarcoidosis is the correct answer as this inflammatory condition is frequently found in African-American women in their 40's who present with fatigue and shortness of breath among other symptoms, who also have erythema nodosum on the lower extremities, and have bilateral hilar infiltrates on chest x-ray. This constellation of findings is highly suggestive of sarcoidosis. Sarcoidosis results in the formation of numerous non-necrotizing granulomas, most commonly found in the lungs, that can play a role in the symptoms experienced by these patients. Other findings suggestive of sarcoidosis include elevated serum calcium levels with normal serum PTH levels.​ Tuberculosis can present in a similar manner to sarcoidosis, however given the patient's suburban living environment, lack of a travel history, and lack of healthcare exposure, the likelihood of being exposed to tuberculosis is very low, making sarcoidosis a more likely etiology.​ While lung cancer can present as shortness of breath with infiltration in chest x-ray, in a relatively young otherwise healthy patient who also has erythema and in whom the hilar infiltrates are bilateral, sarcoidosis would be a more likely etiology.​ The patient does not have any findings consistent with meningitis (leg rash in meningitis is petechial, not erythema nodosum) or pharyngitis

a nurse is assessing a client who has bacterial pneumonia. Which of the following manifestations?

-increased fremitus -low sp02 -elevated temp -tachypnea

The nurse is taking the history of a client with occupational lung disease (silicosis). The nurse should assess whether the client wears which item during periods of exposure to silica particles?​​ 1. Mask​ 2. Gown​ 3. Gloves​ 4. Eye protection​

1. Mask​​Rationale: Silicosis results from chronic, excessive inhalation of particles of free crystalline silica dust. The client should wear a mask to limit inhalation of this substance, which can cause restrictive lung disease after years of exposure. Options 2, 3, and 4 are not necessary.​ ​

A 20-year-old patient has been brought to the emergency department by ambulance after being found with an apparent gunshot wound to the chest. Place the following components of the rapid assessment of thoracic injuries in the correct order in which the nurse should perform them. 1Assess the patient for hypothermia or hyperthermia 2Assess the patient's vital signs 3Assess the patency of the patient's airway 4Assess the patient's level of consciousness 5Assess the character and quality of the patient's breathing pattern

1Assess the patient for hypothermia or hyperthermia 2Assess the patient's vital signs 3Assess the patency of the patient's airway 4Assess the patient's level of consciousness 5Assess the character and quality of the patient's breathing pattern

A nurse is preparing to administer phenylephrine to a client. The nurse should identify that which manifestation is an adverse effect of this drug? Headache Sleepiness Hypotension Constipation

Headache Oral sympathomimetics stimulate the adrenergic receptors, causing blood vessel constriction, which can cause nervousness, headache, blurred vision, and tremors.

The emergency department nurse is assessing a client who has sustained a blunt injury to the chest wall. Which finding would indicate the presence of a pneumothorax in this client?​​ 1. A low respiratory rate​ 2. Diminished breath sounds​ 3. The presence of a barrel chest​ 4. A sucking sound at the site of injury

2. Diminished breath sounds​​ Rationale: 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.

A nurse notes that the FEV1/FVC ratio is less than 70% and the FEV1 is 25% for a patient with COPD. What stage should the nurse document the patient is in? I IV II III

IV

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 who ambulates in the hallway every 4 hours C. A client with a history of smoking two packs of cigarettes per day until quitting 2 years ago D. A client who is receiving acetaminophen (Tylenol) for pain

A client with a nasogastric tube Nasogastric, orogastric, and endotracheal tubes increase the risk of pneumonia because of the risk of aspiration from improperly placed tubes. Frequent oral hygiene and checking tube placement help prevent aspiration and pneumonia. Although a client who smokes is at increased risk for pneumonia, the risk decreases if the client has stopped smoking. Ambulation helps prevent pneumonia. A client who receives opioids, not acetaminophen, has a risk of developing pneumonia because respiratory depression may occur.

Which terms means an increase in the red blood cell concentration in the blood? A. Polycythemia B. Asthma C. Bronchitis D. Emphysema

A. Polycythemia

A nurse is teaching a client about the adverse effects of pseudoephedrine. Which of the following should the nurse include? Restlessness Bradycardia Insomnia Muscle pain Anxiety

Restlessness tachycardia insomnia numbness in extremities anxiety

A nurse is caring for a patient with a confirmed diagnosis of metabolic alkalosis. The nurse understands that the central chemoreceptors play a role in compensating for this acid-base imbalance. Which of the following changes in ventilation is expected as a compensatory response to metabolic alkalosis?​ A) Increased respiratory rate and depth (hyperventilation) ​ B) Decreased respiratory rate and depth (hypoventilation) ​ C) No change in respiratory rate or depth ​ D) Increased sensitivity to low oxygen levels (hypoxia)​ ​

B) In metabolic alkalosis, where there is an excess of bicarbonate ions (HCO3-) in the blood, the central chemoreceptors respond by decreasing respiratory rate and depth (hypoventilation). This hypoventilation helps retain carbon dioxide (CO2), which can combine with water to form carbonic acid (H2CO3), helping to decrease blood pH and compensate for the alkalosis.​

A nurse is monitoring plasma drug levels in a client who is taking theophylline. Which drug finding should the. nurse expect to see if the client's drug level indicates toxicity?

Seizures Constipation Normal sinus rhythm Somnolence Seizures are likely when plasma drug levels of theophylline, a methylxanthine, are higher than 30 mcg/mL, which indicates toxicity.

Which of the following statements best describes the pathophysiology of asthma?​ A) Asthma is primarily an infectious disease caused by bacteria or viruses. ​ B) Asthma results from irreversible damage to the lung tissue due to chronic inflammation.​ C) Asthma is characterized by intermittent, reversible airway obstruction and bronchial hyperresponsiveness. ​ D) Asthma is primarily a disorder of the cardiovascular system, leading to reduced oxygen supply to the lungs

C) Asthma is a chronic respiratory condition characterized by intermittent and reversible airway obstruction. It is primarily caused by inflammation of the airways, which leads to bronchial hyperresponsiveness, excessive mucus production, and airway narrowing. While infections can exacerbate asthma symptoms, asthma itself is not primarily an infectious disease (Option A). Asthma is not characterized by irreversible lung damage, although long-term uncontrolled asthma can lead to airway remodeling (Option B). It is not primarily a disorder of the cardiovascular system (Option D).​

The nurse is discussing dietary changes for a client with chronic obstructive pulmonary disease. Which advice should the nurse include?​ ​ A. Follow a high-carbohydrate diet.​ B. Eat more red meat​ C. Increase dairy products.​ D. Follow a low-salt diet.​

D

Which vaccine should a nurse encourage a client with chronic obstructive pulmonary disease (COPD) to receive? A.Varicella B.Human papilloma virus (HPV) C.Hepatitis B D.Influenza

Influenza

The nurse is providing care for an adult patient who has a diagnosis of chronic obstructive pulmonary disease (COPD). Which of the following principles should the nurse apply when managing this patient's supplementary oxygen? A. Supplementary oxygen should be used with caution with COPD patients in order to avoid depressing the respiratory drive. B. Supplementary oxygen is vital in the management of COPD and should never be withheld from patients who may benefit from it. C. Supplementary oxygen should be provided to COPD patients at the highest concentration that they can comfortably tolerate. D. Room air is preferable to supplementary oxygen for COPD patients because this stimulates respiratory function.

Supplementary oxygen is vital in the management of COPD and should never be withheld from patients who may benefit from it.

A nurse is teaching a client about montelukast. Which of the following instructions should the nurse include? Use a spacer to improve inhalation. Take the drug at the onset of bronchospasm. Rinse mouth to prevent an oral fungal infection. Take the drug once a day in the evening.

Take the drug once a day in the evening. Montelukast, a leukotriene modifier, is most effective when taken once per day in the evening.

For a client with chronic obstructive pulmonary disease, which nursing intervention helps maintain a patent airway? A. Teaching the client how to perform controlled coughing B. Restricting fluid intake to 1,000 ml/day C. Administering ordered sedatives regularly and in large amounts D. Enforcing absolute bed rest

Teaching the client how to perform controlled coughing

A client is admitted to the health care facility with active tuberculosis (TB). What intervention should the nurse include in the client's care plan? A.Wearing a gown and gloves when providing direct care B.Instructing the client to wear a mask at all times C.Keeping the door to the client's room open to observe the client D.Wearing a disposable particulate respirator that fits snugly around the face

Wearing a disposable particulate respirator that fits snugly around the face

A nurse is caring for a client who is receiving mechanical ventilation when the low pressure alarm sounds. Which situation is a possible cause for this? excess secretions kinks in tubing artificial airway cuff leak biting on endotracheal tube

artificial airway cuff leak - low pressure high pressure: excess secretions, kinks in tubing cause obstruction, biting on endotracheal tube

Client post op has a RR of 9/min. Which of the following ABG values indicate respiratory acidosis? pH 7.50, PO2 95 mm Hg, PaCO2 25 mm Hg, HCO3- 22 mEq/L pH 7.50, PO2 87 mm Hg, PaCO2 35 mm Hg, HCO3- 30 mEq/L pH 7.30, PO2 90 mm Hg, PaCO2 35 mm Hg, HCO3- 20 mEq/L pH 7.30, PO2 80 mm Hg, PaCO2 55 mm Hg, HCO3- 22 mEq/L

pH 7.30, PO2 80 mm Hg, PaCO2 55 mm Hg, HCO3- 22 mEq/L These ABG values indicate respiratory acidosis. The pH is less than 7.35 and the PaCO2 is greater than 45 mm Hg, which indicates respiratory acidosis.

A nurse is teaching a client about the use of mucolytic to treat a cough. The nurse should include that mucolytic has which of the following therapeutic effects? Suppresses the cough stimulus Reduces inflammation Thins and loosens mucus Dries secretions

Thins and loosens mucus Mucolytics make mucus less viscous to increase a cough's productivity.

A nurse is teaching a client about ipratropium. The nurse should include that this drug has which of the following adverse effects? SATA Muscle tremors Urinary retention Dry mouth Insomnia Tachycardia

Urinary retention dry mouth insomnia

Which of the following are clinical manifestations associated with obstructive sleep apnea (OSA)? Select all that apply. A. Arrhythmias B. Insomnia C. Loud snoring D. Impotence E. Excessive daytime sleepiness

A. Arrhythmias B. Insomnia C. Loud snoring D. Impotence E. Excessive daytime sleepiness

A nurse is teaching a client who has a RX for albuterol via inhaler and fluticasone via inhaler for asthma management. For which of the following reasons should the nurse instruct the client to use the albuterol inhaler before using the fluticasone inhaler? Albuterol will increase the absorption of fluticasone. Albuterol will decrease inflammation. Albuterol will reduce nasal secretions. Fluticasone will reduce the adverse effects of albuterol.

Albuterol will increase the absorption of fluticasone. Albuterol, an inhaled, short-acting beta2 agonist, causes bronchodilation, which will increase the absorption of fluticasone, an inhaled glucocorticoid.

A nurse is teaching a client about using intranasal glucorticoids. Which of the following instruction should the nurse give? Start at a low dose and gradually increase it. Take the drug as needed for nasal congestion. Allow at least 2 weeks for the full therapeutic effect. Use the drug prior to exercise.

Allow at least 2 weeks for the full therapeutic effect. It can take 2 or 3 weeks to see the full therapeutic effect of intranasal glucocorticoids.

A nurse is educating a patient with asthma about the use of albuterol. Which of the following statements best describes the primary mechanism of action of albuterol in the treatment of asthma?​ A) Albuterol acts as an anti-inflammatory agent, reducing airway inflammation. ​ B) Albuterol relaxes bronchial smooth muscles, resulting in bronchodilation. ​ C) Albuterol promotes the elimination of mucus from the airways. ​ D) Albuterol inhibits the release of histamine in response to allergens.​

B) Albuterol is a short-acting beta-2 adrenergic agonist bronchodilator commonly used in the treatment of asthma. Its primary mechanism of action is to relax bronchial smooth muscles in the airways, leading to bronchodilation. This results in the widening of the air passages, making it easier for the patient to breathe during an asthma attack or when experiencing bronchoconstriction.​

A clinician is providing teaching for inhaled corticosteroid technique. Which information should be included in teaching?​ ​ A."Inhale as quickly and as deeply as possible when you take a puff."​ B."Skip using the spacer in emergencies. They are not necessary."​ C."Shake the canister then press the canister down, breathe in slowly and deeply, hold your breath for 10 few seconds and then slowly exhale."​ D."It is not necessary to rinse your mouth after using your inhaler."​ E.Use as many puffs, as quickly as you want, as necessary to control symptoms. ​ F.Headaches, palpitations, and dizziness are adverse reactions and should be reported.​ ​

C

A nurse is caring for a patient diagnosed with Community-Acquired Pneumonia (CAP). Which of the following pathogens is most commonly responsible for the development of CAP in otherwise healthy adults?​ A) Mycobacterium tuberculosis ​ B) Haemophilus influenzae ​ C) Streptococcus pneumoniae ​ D) Pseudomonas aeruginosa​

C) In otherwise healthy adults with Community-Acquired Pneumonia (CAP), Streptococcus pneumoniae (pneumococcus) is the most common pathogen responsible for the infection. This bacterium is a leading cause of bacterial pneumonia in community settings.​

A pediatric nurse is conducting patient education with a 13-year-old girl who has just been diagnosed with asthma. What subject should the nurse prioritize when teaching this patient and her parents about the management of asthma? A. Demonstrating the use of continuous positive airway pressure (CPAP) B. Techniques for managing long-term oxygen therapy C. The appropriate use of antibiotics in the treatment of asthma D. Identification of the triggers that exacerbate her asthma

Identification of the triggers that exacerbate her asthma For patients who are newly diagnosed with asthma, it is important to identify the specific triggers that precipitate exacerbations. Antibiotics, CPAP, and long-term oxygen therapy are not central components of the management of asthma.

A nurse is teaching a client who is beginning fluticasone propionate/salmeterol therapy. Which of the following instruction should the nurse include? Take the drug as needed for acute asthma. Follow a low-sodium diet. Use an alternate-day dosing schedule. Increase weight-bearing activity.

Increase weight-bearing activity. Weight-bearing activity can help minimize bone loss, which is an adverse effect of fluticasone propionate/salmeterol, an inhaled glucocorticoid and inhaled long-acting beta2 agonist (LABA) combination medication.

A client had a tracheostomy two hours ago. The nurse assesses the client and finds the client's breathing is shallow, with a respiratory rate of 30. The nurse notes increased mucus production around the tracheostomy and on the dressing. What are the priority nursing concern(s)? Select all that apply. Ineffective airway clearance Infection risk Knowledge deficiency Impaired gas exchange Altered body image perception

Ineffective airway clearance Impaired gas exchange

A nurse is assessing for acute respiratory distress syndrome ARDS. which following should the nurse report? Decreased bowel sounds Oxygen saturation 92% CO2 24 mEq/L Intercostal retractions

Intercostal retractions The nurse should report intercostal retractions to the provider because this finding indicates increasing respiratory compromise in a client who has ARDS.

A client with a chest injury has suffered flail chest. The nurse assesses the client for which ​most distinctive sign of flail chest? ​​1. Cyanosis​ 2. Hypotension​ 3. Paradoxical chest movement ​4. Dyspnea, especially on exhalation

Paradoxical chest movement​​ Rationale: 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 bony rib cage, this segment results in paradoxical chest movement. This means that the force of inspiration pulls the fractured segment inward, while the rest of the chest expands. Similarly, during exhalation, the segment balloons outward while the rest of the chest moves inward. This is a characteristic sign of flail chest.

A nurse should identify that dextromethorphan can have which of the following effects when combined with morphine? Reduced antitussive effect of dextromethorphan Potentiation of depression of CNS actions Increased renal reabsorption of the dextromethorphan Delayed analgesic effect of the opioid

Potentiation of depression of CNS actions Combining dextromethorphan with an opioid, such as morphine, increases the risk for decreased respirations and other depressed CNS responses.

A black client is in acute respiratory distress (ARDS). Because of this client's skin tone, the nurse should assess for cyanosis by inspecting the:​A. Lips​ B. Mucous membranes​ C. Nail beds​ D. Earlobes

B. Mucous membranes​​Skin color doesn't affect the mucous membranes. The lips, nail beds, and earlobes are less reliable indicators of cyanosis because they're affected by skin color.​ ​

A nurse is caring for a patient who presents with symptoms of hypoxemia. Which of the following is the primary pathological process that contributes to the development of hypoxemia?​ A) Impaired oxygen diffusion across the alveolar-capillary membrane ​ B) Increased red blood cell production ​ C) Elevated blood pressure ​ D) Decreased carbon dioxide levels in the blood​ ​

A) Hypoxemia is primarily caused by impaired oxygen diffusion across the alveolar-capillary membrane in the lungs. This impairment can result from various factors, such as lung diseases, ventilation-perfusion imbalances, or diffusion abnormalities, leading to reduced oxygen uptake by the blood.​

A nurse is teaching a client about chronic obstructive pulmonary disease (COPD). Which information should the nurse include? SATA​ ​ A. COPD exacerbations cause shortness of breath and increased sputum production.​ B. After a flare-up, the lung tissue returns to normal.​ C. COPD is a respiratory disorder that has components of chronic bronchitis and emphysema​ D. COPD is a curable disease.​ Intermittent flare-ups of the symptoms are expected.

A,C,E

A nurse educator is reviewing the indications for chest drainage systems with a group of medical nurses. What indications should the nurses identify? Select all that apply. A. Need for postural drainage B. Pleurisy C. Chest trauma resulting in pneumothorax D. Post thoracotomy E. Spontaneous pneumothorax

C. Chest trauma resulting in pneumothorax D. Post thoracotomy E. Spontaneous pneumothorax

The nurse is aware that the clinical manifestations of atelectasis are correlated to the severity of the affected collapse. Which of the following indications are consistent with a smaller, affected area? Select all that apply. A. Decreased tactile fremitus B. Egophony (E to A sound change when auscultating from compressed lung) C. Crackles D. Asymmetry of the chest E. Trachea deviation toward the ateliotic area F. Decreased breath sounds

A. Decreased tactile fremitus C. Crackles F. Decreased breath sounds For a small atelectatic area, findings include crackles, decreased breath sounds, and decreased tactile fremitus over the affected lung area(s). For a large atelectatic area, findings include trachea deviation toward the atelectatic area, decreased fremitus, bronchial breath sounds, egophony (secondary to lobar or lung collapse), and asymmetry of the chest.

A client had a tracheostomy two hours ago. The nurse assesses the client and finds the client's breathing is shallow, with a respiratory rate of 30. The nurse notes increased mucus production around the tracheostomy and on the dressing. What are the priority nursing concern(s)? Select all that apply. A. Impaired gas exchange B. Ineffective airway clearance C. Knowledge deficiency D. Altered body image perception E. Infection risk

A. Impaired gas exchange B. Ineffective airway clearance The client with a new tracheostomy tube has increased secretions, which may become dried and occlude or plug the airway, requiring frequent suctioning. Impaired gas exchange and airway clearance are priority nursing concerns. Infection, knowledge deficit, and altered body image are concerns, but not priorities.

The nurse is caring for a client who is demonstrating signs of increased respiratory distress related to laryngeal obstruction. The nurse is calling the physician to report on the client's condition. Which of the following will the nurse report? Select all that apply. A. Lung sounds of wheezing B. Increased respiratory effort C. Nasal flaring with abdominal retractions D. Arterial blood gases reporting a PaCO2 of 48 and a PaO2 of 84 E. A decreased respiratory rate F. Administration of a corticosteroid inhaler for quick relief

A. Lung sounds of wheezing B. Increased respiratory effort C. Nasal flaring with abdominal retractions D. Arterial blood gases reporting a PaCO2 of 48 and a PaO2 of 84

In the prevention of occupational lung diseases, the nurse would direct preventive teaching to which high-risk occupations? Select all that apply. A. Rock quarry worker B. Mechanic C. Banker D. Miner E. Nurse F. Stone cutter

A. Rock quarry worker D. Miner F. Stone cutter

A nurse is caring for a client who is having difficulty mobilizing thick respiratory secretions. Which of the following drugs should the nurse expect to administer to the client? Ipratropium Beclomethasone Acetylcysteine Azelastine

Acetylcysteine is a mucolytic that loosens thick respiratory secretions.

A client with a pulmonary embolus has the following arterial blood gas (ABG) values: pH, 7.49; partial pressure of arterial oxygen (PaO2), 60 mm Hg; partial pressure of arterial carbon dioxide (PaCO2), 30 mm Hg; bicarbonate (HCO3-) 25 mEq/L. What should the nurse do first? A. Administer oxygen by nasal cannula as ordered. B. Instruct the client to breathe into a paper bag. C. Auscultate breath sounds bilaterally every 4 hours. D. Encourage the client to deep-breathe and cough every 2 hours.

Administer oxygen by nasal cannula as ordered. When a pulmonary embolus places a client at risk for oxygen deprivation, the body compensates by hyperventilating. This causes respiratory alkalosis, as reflected in the client's ABG values. However, the most significant ABG value is the PaO2 value of 60 mm Hg, which indicates hypoxemia. To manage hypoxemia, the nurse should increase oxygenation by administering oxygen via nasal cannula as ordered. Instructing the client to breathe into a paper bag would cause depressed oxygenation when the client re-inhaled carbon dioxide. Auscultating breath sounds or encouraging deep breathing and coughing wouldn't improve oxygenation.

Mrs. Fawcett is a 70-year-old woman who has a diagnosis of emphysema and who receives long-term oxygen therapy. She has presented to the emergency department because she states that she is experiencing an exacerbation of her chronic obstructive pulmonary disease (COPD), and she is in visible respiratory distress. How can the nurse best assess Mrs. Fawcett's dyspnea? A. Ask her to rate her shortness of breath on a scale of 0 to 10. B. Auscultate her anterior and posterior lung fields. C. Observe her activity tolerance and assess her skin tone. D. Measure her SpO2 by pulse oximetry and assess her respiratory rate.

Ask her to rate her shortness of breath on a scale of 0 to 10. Dyspnea is a subjective symptom. Thus, it is best assessed by asking the patient to rate it on a scale. Chest auscultation, pulse oximetry, skin tone, and activity tolerance are all valid and relevant assessment parameters for this patient but none accurately gauges the patient's experience of dyspnea.

A nurse answers a call light and finds a client anxious, short of breath, reporting chest pain, and having a blood pressure of 88/52 mm Hg on the cardiac monitor. What action by the nurse takes priority?​ a. Assess the clients lung sounds.​ b. Notify the Rapid Response Team.​ c. Provide reassurance to the client.​ d. Take a full set of vital signs.​

B ~ This client has manifestations of a pulmonary embolism, and the most critical action is to notify the Rapid Response Team for speedy diagnosis and treatment. The other actions are appropriate also but are not the priority.​

A nurse is caring for a patient with a history of chronic obstructive pulmonary disease (COPD). The nurse understands that the shift to the right on the oxyhemoglobin dissociation curve can result in which of the following physiological effects?​ A) Increased oxygen affinity for hemoglobin ​ B) Enhanced oxygen delivery to tissues ​ C) Decreased oxygen release to tissues ​ D) Improved lung compliance​ ​

B) A shift to the right on the oxyhemoglobin dissociation curve indicates a decreased affinity of hemoglobin for oxygen, which results in increased oxygen release to the tissues. In conditions such as COPD, increased levels of carbon dioxide (hypercapnia) and decreased pH (acidosis) can cause this rightward shift, making it more difficult for hemoglobin to release oxygen to the tissues.​

A nurse is caring for a postoperative patient who has been immobile for an extended period. The nurse understands that this patient is at risk for developing atelectasis. Which of the following best describes the primary pathological process that occurs in atelectasis?​ A) Accumulation of fluid in the alveoli ​ B) Collapse of alveoli and reduced lung volume ​ C) Inflammation of the bronchial tubes ​ D) Enlargement of the airway passages​

B) Atelectasis is characterized by the collapse of alveoli, leading to reduced lung volume and impaired gas exchange. It often occurs when there is insufficient ventilation or when there is an obstruction that prevents the full inflation of the alveoli.​

A nurse is caring for a patient with COPD. Which of the following physiological changes contributes to the development of the "barrel chest" appearance often seen in patients with advanced COPD?​ A) Increased lung elasticity ​ B) Hyperinflation of the alveoli ​ C) Reduced residual volume ​ D) Normal diaphragmatic function

B) In advanced COPD, hyperinflation of the alveoli occurs due to air trapping, which leads to the development of a "barrel chest" appearance. This hyperinflation is a result of increased residual volume and functional residual capacity, making the chest appear more rounded.​ Option A is not correct because COPD is associated with decreased lung elasticity, not increased. Option C is incorrect because reduced residual volume is not typically seen in COPD. Option D is incorrect because in advanced COPD, diaphragmatic function may be compromised due to the chronic overuse of accessory muscles for breathing.​

A nurse is caring for a patient with a spontaneous pneumothorax. Which of the following pathophysiological mechanisms underlies the development of a spontaneous pneumothorax?​ A) Accumulation of pus within the pleural cavity​ B) Rupture of small air sacs (blebs) on the lung surface ​ C) Blockage of a pulmonary artery by a blood clot ​ D) Compression of the trachea by a mediastinal mass​ ​

B) Spontaneous pneumothorax is often caused by the rupture of small air sacs (blebs or bullae) on the lung surface. These air sacs are thin-walled and can rupture spontaneously or due to increased pressure, leading to the escape of air into the pleural cavity and the development of a pneumothorax.​

The nurse is preparing to give a bed bath to an immobilized client with tuberculosis. The nurse should wear which item when performing this care?​ A. Surgical mask and gloves​ B. Particulate respirator, gown, protective eyewear, and gloves​ C. Particulate respirator and protective eyewear​ D. Surgical mask, gown, and protective eyewear

B. Particulate respirator, gown, protective eyewear, and gloves​​Rationale: The nurse who is in contact with a client with tuberculosis should wear an individually fitted particulate respirator. The nurse also would wear gloves as per standard precautions. The nurse wears a gown when the possibility exists that the clothing could become contaminated, such as when giving a bed bath.

A client seeks medical attention for a new onset of fatigue and changes in coordination. Which additional assessment finding indicates to the nurse that the client is demonstrating signs of low oxygenation? Select all that apply. A. Drowsiness B. Shortness of breath C. Agitation D. Impaired thought process E. Cough

B. Shortness of breath C. Agitation D. Impaired thought process A change in the client's respiratory rate or pattern may be one of the earliest indicators of the need for oxygen therapy. These changes may result from hypoxemia or hypoxia. Severe hypoxia can be life threatening. The signs and symptoms signaling the need for supplemental oxygen may depend on how suddenly this need develops. The client has new onset of symptoms so the low oxygenation will be associated with acute hypoxia. With acute hypoxia, changes occur in the central nervous system because the neurologic centers are very sensitive to oxygen deprivation. Acute hypoxia that is newly presenting may manifest in signs such as shortness of breath, impaired thought process, and agitation. With long-standing or chronic hypoxia that is not manifesting as a new onset of symptoms, the client may demonstrate apathy, drowsiness, and delayed reaction time. The client may also demonstrate symptoms similar to alcohol intoxication such as impaired judgment. The presence of cough is not a manifestation of acute or chronic hypoxia.

A nurse is teaching a client about the use of beclomethasone to treat asthma. The nurse should explain that the drug has which of the following therapeutic effects? Thin mucus Relaxes bronchial smooth muscle decreases inflammation increases cough threshold

Beclomethasone, an intranasal glucocorticoid, treats asthma by reducing inflammation.

Which of the following conditions is characterized by a restrictive lung pathology that leads to reduced lung compliance and impaired ventilation?​ A) Asthma ​ B) Pneumonia ​ C) Pulmonary fibrosis ​ D) Chronic bronchitis

C) Pulmonary fibrosis is a condition characterized by the formation of scar tissue in the lung parenchyma. This scar tissue reduces lung compliance, making the lungs less elastic and more difficult to expand. As a result, patients with pulmonary fibrosis experience impaired ventilation and reduced lung function.

A nurse is caring for a patient recently diagnosed with sarcoidosis. Which of the following statements best describes the primary pathological feature of sarcoidosis?​ A) Sarcoidosis is characterized by the formation of fibrous tissue in the lung parenchyma. ​ B) Sarcoidosis is primarily a bacterial infection affecting the lungs and lymph nodes. ​ C) Sarcoidosis is characterized by the presence of non-caseating granulomas in affected tissues. ​ D) Sarcoidosis is caused by the destruction of alveoli and bronchiole walls.​ .​

C) Sarcoidosis is an inflammatory condition characterized by the formation of non-caseating granulomas, primarily in the lungs and lymph nodes but potentially affecting other organs as well. These granulomas are collections of immune cells and macrophages, and they do not contain the necrotic (caseating) material seen in tuberculosis granulomas. The exact cause of sarcoidosis is unknown.​

A nurse should recognize that using pseudoephedrine to treat allergic rhinitis required cautious use with clients who have which condition? Peptic ulcer disease A seizure disorder Anemia Coronary artery disease

Coronary artery disease Because pseudoephedrine, an oral sympathomimetic, can cause systemic vasoconstriction, it requires cautious use with clients who have severe hypertension or coronary artery disease.

A nurse is caring for a patient with a suspected Pulmonary Embolism (PE). Which of the following physiological changes is the primary pathological feature of a PE?​ A) Accumulation of fluid in the alveoli ​ B) Constriction of the bronchial tubes ​ C) Thickening of the pleural membranes​ D) Obstruction of pulmonary blood vessels ​

D) The primary pathological feature of a Pulmonary Embolism (PE) is the obstruction of pulmonary blood vessels by a blood clot or embolus. This obstruction disrupts normal blood flow to the lungs, leading to impaired oxygenation and potentially life-threatening consequences.​

The community health nurse is conducting an educational session with community members regarding the symptoms associated with tuberculosis. Which is one of the first manifestations associated with tuberculosis?​​ a. Dyspnea​ b. Chest pain​ c. A bloody, productive cough​ d. A cough with the expectoration of mucoid sputum

D. A cough with the expectoration of mucoid sputum​​Rationale: One of the first pulmonary manifestations of tuberculosis is a slight cough with the expectoration of mucoid sputum. Options 1, 2, and 3 are late manifestations and signify cavitation and extensive lung involvement.​ ​

A client's spouse states that she is worried about her husband because he appears to be breathing "really hard." The nurse performs a respiratory assessment. What findings would indicate a need for further interventions? SATA A. BP 122/82, HR 102, R 24, noted barrel chest, temperature 98.4 °F (36.9 °C) B. Pale, paper-thin skin, O2 at 2L/min via nasal cannula C. Client states, "It always seems like I just can't catch my breath." D. BP 122/80, HR 116, R 24, pale and clammy skin, temp 101.3 °F (38.5 °C)

P 122/80, HR 116, R 24, pale and clammy skin, temp 101.3 °F (38.5 °C) Bronchopulmonary infections must be controlled to diminish inflammatory edema and to permit recovery of normal ciliary action. Minor respiratory infections of no consequence to people with normal lungs can be life-threatening to people with COPD. The breathing pattern of most people with COPD is shallow, rapid, and inefficient; the more severe the disease, the more inefficient the breathing pattern. Any factor that interferes with normal breathing quite naturally induces anxiety, depression, and changes in behavior.

A nurse is teaching a client about the use of an expectorant to treat a cough. The nurse should include that an expectorant has which of the following therapeutic effects? Suppresses the cough stimulus Reduces surface tension Reduces inflammation Dries mucous membranes

Reduces surface tension Expectorants act by reducing the surface tension and viscosity of respiratory secretions. This results in thinning thick mucus, making it easier to cough out of the lungs and drain out of the nose and sinuses.

A client has a nursing diagnosis of ineffective airway clearance related to excessive mucus production. The best short-term goal is for the client to A. Increase fluid intake. B. Assume an upright position to facilitate drainage. C. Report decreased congestion. D. Use a room vaporizer to loosen secretions.

Report decreased congestion. A report from the client of decreased congestion indicates improvement of the problem. The other options are actually interventions or actions that the client can undertake to achieve a long-term goal of a patent airway.

A nurse is caring for a client who is taking codeine. The nurse should identify that which of the following assessments is priority to make? Blood pressure Apical heart rate Respirations Level of consciousness

Respiratory Rate The greatest risk to clients who are taking codeine, an opioid agonist, is severe respiratory depression. Therefore, the respiratory rate is the priority assessment.

A client has been classified as status asthmaticus. The nurse understands that this client will likely initially exhibit symptoms of: A. Metabolic alkalosis B. Respiratory alkalosis C. Respiratory acidosis D. Metabolic acidosis

Respiratory alkalosis There is a reduced PaCO2 and initial respiratory alkalosis, with a decreased PaCO2 and an increased pH. As status asthmaticus worsens, the PaCO2 increases and the pH decreases, reflecting respiratory acidosis.

A nurse is assisting a provider who is performing a thoracentesis at the bedside of a client. Which of the actions should the nurse take? Wear goggles and a mask during the procedure. Cleanse the procedure area with an antiseptic solution. Instruct the client to take deep breaths during the procedure. Position the client laterally on the affected side before the procedure. Apply pressure to the site after the procedure.

Wear goggles and a mask during the procedure. Cleanse the procedure area with an antiseptic solution. Apply pressure to the site after the procedure.(decrease risk of bleeding)