Respiratory - Term 3
A nurse is reviewing the history and physicals of several clients from the clinic who are taking rifampin for the treatment of tuberculosis. Which client presets a specific concern for the nurse?
26-year-old taking oral contraceptives
A client with tuberculosis asks the nurse how long chemotherapy will be continued. What is the nurse's most accurate reply?
6 to 12 months
A physician orders guaifenesin 300 mg four times a day. The dosage strength is 200 milligrams/5 milliliters. To ensure the patient's safety, how many milliliters should the nurse administer for each dose? Record your answer using one decimal place. ____ mL
7.5 mL
Acetaminophen (Tylenol) 15 mg/kg is prescribed for a preschooler who weights 44 lb. Each 5 mL of solution contains 160 mg. How many milliliters of acetaminophen should the nurse administer? Record your answer rounding to one decimal place. ____ mL
9.4 mL
A client complains of left-sided chest pain after playing racquetball. The client is hospitalized and diagnosed with left pneumothorax. When assessing the client's left chest area, what does the nurse expect to identify?
Absence of breath sounds on auscultation
On the first postoperative day following a thyroidectomy, a client tolerates full-fluid diet. This is changed to a soft diet on the second postoperative day. The client reports having a sore throat when swallowing. What should the nurse do first?
Adminsister analgesics as prescribed before meals
A nurse auscultates a client's lungs and hears a fine crackling sound in the left lower lung during respiration. The nurse charts, "crackles and ronchi in the left lower lung." What does this documentation represent?
An inaccurate interpretation
A client's chest tube has accidentally dislodged. What is the nursing action of highest priority?
Apply a petroleum gauze dressing over the site
When suctioning a client with a tracheostomy, what is an important safety measure for the nurse?
Apply suction only as the catheter is being withdrawn
A client is admitted to the hospital with pancytopenia as a result of chemotherapy. What should the nurse plan to teach this client in an effort to minimize the risk of complications as a result of pancytopenia?
Avoid traumatic injuries and exposure to infection
After thoracic surgery a client has a chest tube connected to a water-seal drainage system that is attached to suction. When excessive bubbling is observed in the water-seal chamber, what should the nurse do?
Check the system for air leaks
The laboratory data of four clients are shown below. Which client may have respiratory alkalosis? Client A - pH: 7.48 Partial pressure (PaC02) of carbon dioxide: 32 mm Hg Client B - pH: 7.32 Partial pressure (PaC02) of carbon dioxide: 48 mm Hg Client C - pH: 7.30 Partial pressure (PaC02) of carbon dioxide: 35 mm Hg Client D - pH: 7.46 Partial pressure (PaC02) of carbon dioxide: 46 mm Hg
Client A - pH 7.48 Partial pressure (PaC02) of carbon dioxide: 32 mm Hg
The nurse provides discharge teaching to a client with tuberculosis. Which treatment measure does the nurse reinforce as the highest priority?
Consistently taking prescribed medication
A nurse is providing immediate postoperative care to a client who had a lung resection for a malignancy. The client has a closed chest tube drainage system connected to suction. Which assessment finding requires additional evaluation by the nurse?
Constant bubbling in the water seal chamber
The chemotherapy protocol prescribed for a client with tuberculosis includes vitamin B6 and isoniazid. What does the nurse identify as the reason for prescribing vitamin B6?
Counteract the peripheral neuritis that isoniazid may cause
While walking in a hallway, a client with a chest tube becomes confused and pulls the chest tube out. What is the nurse's immediate action?
Cover the opening with the cleanest material available
A client with emphysema is admitted to the hospital with pneumonia. On the third hospital day, the client complains of a sharp pain on the right side of the chest. The nurse suspects a pneumothorax. What breath sound is most likely to be present when the nurse assesses the client's right side?
Decreased sounds
A nurse is developing a plan of care for a client that had a chest tube removed. What should the plan include in order to promote respiratory exchange?
Deep breathing and coughing every hour
What is the priority goal for a client with asthma who is being discharged from the hospital with prescriptions for inhaled brochodilators?
Demonstrates use of a metered-dose inhaler
A client who recently returned from another country exhibits signs and symptoms suspicious of severe acute respiratory syndrome (SARS). Which clinical manifestations support this diagnosis? Select all that apply.
Dry cough Shortness of breath Fever greater than 100.4°F
Which central nervous system manifestation observed in a client with a respiratory disorder indicates inadequate oxygenation?
Early unexplained restlessness
The nurse is caring for a client with tuberculosis. Which suggestions from the nurse will be beneficial for the client? Select all that apply.
"Avoid exposure to any inhalation irritants" "Eat foods that are rich in protein as well as vitamins C and B" "Cover the mouth and nose with a tissue when coughing or sneezing"
A client is being treated for Influenza A (H1N1). The nurse has provided instructions to the client about how to decrease the risk of transmission to others. Which patient statement indicates a need for further instruction/clarification?
"I should obtain a pneumococcal vaccination each year"
After assessing a client who is addicted to drugs, the nurse suspects that the client is at an increased risk for sinusitis and rhinitis. Which statement of the client's may have led the nurse to suspect this risk?
"I snort the powder form of cocaine"
An infant who was in a motor vehicle collision has undergone open repair of a fractured sternum and now has a chest tube. What should the nurse explain to the infant's parents about the chest tube?
"The tube has been placed to drain the air that entered the chest cavity during surgery"
Before signing a consent form for a total laryngectomy, a client asks, "Because part of my throat will be taken out and I will breathe through a hole in my neck, will I be able to talk like I did before I had the surgery?" Which is the nurse's best response?
"You seem very concerned. Tell me what you know about your surgery."
A healthcare provider prescribes an initial loading dose of oral digoxin for a school-aged child. The medication is supplied as an elixir, 50 mcg/mL. How many milliliters of solution will the nurse administer? Record your answer using one decimal place. ____ mL
1.5 mL
After a laryngectomy is scheduled, what is the most important factor for the nurse to include in the preoperative teaching plan?
Establishing a means for communicating postoperatively
The nurse develops a plan of care related to a coughing and deep breathing regimen for a client who has had a pneumonectomy. The plan should include that, postoperatively, the client should cough and deep breathe how often?
Every hour for the first 24 hours and then every 2 hours
A primary health care provider prescribes airborne precautions for a client with tuberculosis. After being taught about the details of airborne precautions, the client is seen walking down the hall to get a glass of juice from the kitchen. What is the most effective nursing intervention?
Explore what the precautions mean to the client
Which manifestations indicate the prodromal stage in a client with inhalation anthrax? Select all that apply.
Fatigue Mild chest pain Dry harsh cough
A client is admitted to the hospital with a diagnosis of laryngeal cancer. What is a common early sign of laryngeal cancer for which the nurse should assess this client?
Hoarseness
While documenting client records, the nurse finds that an incorrect dose of drug was administered to a client. Which document should be filed in response to this action?
Incident report
The nurse provides instructions to a client who will be using an incentive spirometer postoperatively. During the client's return demonstration, the nurse concludes that the teaching has been effective when the client does what?
Inhales deeply through the mouthpiece, holds the breath for four seconds, and then exhales
A nurse is assisting the primary healthcare provider in examining a client. The primary healthcare provider confirms that the client has obstructive sleep apnea. Which physical symptoms does the nurse expect the client to report? Select all that apply.
Insomnia Morning Headaches Frequent awakening at night
A parent of three young children has contracted tuberculosis. Which does the nurse expect the healthcare provider to prescribe for members of the family who have a positive reaction to the tuberculin skin test and are candidates for treatment?
Isoniazid
Several days after a client had a total laryngectomy, the health care provider prescribes a progressive diet as tolerated. What should the nurse do?
Keep suction apparatus readily available in case excessive respiratory secretions occur
During a client's immediate postoperative period after a laryngectomy, what is a nursing priority?
Keep the trachea free of secretions
A client who had surgery for a laryngectomy is returned to the surgical unit from the postanesthesia care unit. Which position is most appropriate for the nurse to place the client at this time?
Lateral with the head slightly elevated and flexed
A client with human immunodeficiency virus (HIV) infections is diagnosed with tuberculosis. Before starting antitubercular pharmacotherapy, what essential test results should the nurse review?
Liver function studies
A nurse is caring for a client with severe dyspnea who is receiving oxygen via a Venturi mask. What should the nurse do when caring for this client?
Monitor oxygen saturation levels when eating
A nurse is caring for a client with a pneumothorax who has a chest tube attached to a closed drainage system. If the chest tube and closed chest drainage system are effective, which type of pressure will be reestablished?
Negative pressure in the pleural space
A client is admitted to the hospital for a surgical resection of the lower left lobe of the lung. After surgery the client has a chest tube to a closed-chest drainage system. What should the nurse do to determine if the chest tube is patent?
Observe for fluctuations of the fluid in the water-seal chamber
The client has just had a chest tube inserted. How should the nurse monitor for the complication of subcutaneous emphysema?
Palpate around the tube insertion sites for crepitus
A client develops subcutaneous emphysema after a chest injury with suspected pneumothorax. What assessment by the nurse is the best method for detecting this complication?
Palpating the neck or face
A client develops a nosebleed (epistaxis) and seeks treatment at a first-aid station. How can the nurse help control the bleeding?
Pinching the nostrils together
A client being treated for Influenza A (H1N1) is scheduled for a computed tomography (CT) scan. To ensure client and visitor safety during transport, the nurse should take which precaution?
Place a surgical mask on the client
What action should the nurse take when using pulse oximetry to determine a toddler's oxygen saturation?
Placing the sensor probe on the finger
Which technique is not used to manage mild sleep apnea?
Polysomnography
Which test is used to diagnose sleep apnea?
Polysomnography
A client with laryngeal cancer has a partial laryngectomy and tracheostomy. What should the nurse do to best facilitate communication postoperatively?
Provide a means for the client to write
After reviewing a client's medical records, a nurse suspects that the client has sleep apnea. Which medical diagnosis is related to sleep apnea?
Pulmonary Edema
A client with a history of heart failure is experiencing dyspnea with a respiratory rate of 32. Crackles are noted bilaterally. The client is in Sims position, receiving oxygen at 2 L/min via nasal cannula. Which action should the nurse take first?
Raise the client to high-Fowler position
A client has a closed chest drainage system in place. What should the nurse do to determine the amount of chest tube drainage?
Refer to the date and time markings on the outside of the collection chamber
A client with a spontaneous pneumothorax asks, "Why did they put this tube into my chest?" The nurse explains that the purpose of the chest tube is to do what?
Remove air from the pleural space
A client arrives for a vaccination at an influenza prevention clinic. A nursing assessment identifies a current febrile illness with a cough. The nurse should do what?
Reschedule administration of the vaccine for the next month
An emergency tracheotomy has been performed on a 6-year-old child with acute epiglottitis, and the child, and the child is receiving humidified air through a tracheotomy collar. What early clinical manifestations of hypoxia should alert the nurse to suction the tracheotomy?
Restlessness and increase in pulse
A nurse is caring for a client with a pneumothorax and chest tube. To evaluate the effectiveness of a chest tube, the nurse assesses for which finding?
Return of breath sounds
A client has a chest tube inserted to treat a right hemopneumothorax. In which position should the nurse place the client to facilitate chest drainage?
Right side-lying
Which nursing action would be appropriate for treating a client with respiratory alkalosis caused by hyperventilation secondary to anxiety? Select all that apply.
Sedating the client Helping the client breathe into a paper bag Instructing the client to breathe slowly to retain and accumulate carbon dioxide in the body
When providing discharge teaching for a young female client who had a pneumothorax, it is important the nurse include the signs and symptoms of a recurring pneumothorax. What is the most important symptom that the nurse should teach the client to report to the healthcare provider?
Severe shortness of breath
When performing nasotracheal suctioning, the nurse notices that the client has a blood pressure of 90/70 and a heart rate of 50 beats per minute. What is the priority nursing intervention in this situation?
Stopping the suctioning procedure immediately
What should the nurse include in the plan of care for a client who just had a total laryngectomy?
Suctioning the tracheostomy tube whenever necessary
A nurse is caring for a client with advanced stage oral cancer who has just undergone surgery. The healthcare provider prescribes a combination of chemotherapy and radiation therapy. What does the nurse understand to be the reason behind this intervention?
To make the client more comfortable
Following assessment, a nurse documents auscultation of coarse ronchi in the anterior upper lung fields bilaterally that clears with coughing. What would be the cause of these sounds?
Turbulence due to muscular spasm and fluid or mucus in the larger airways
A client with laryngeal cancer is receiving chemotherapy. Which laboratory report is most important for the nurse to monitor when considering the effects of chemotherapy?
White blood cell count
