Test 2 Questions

How much fluid is typically present between the pleurae, which surround the lungs, to prevent friction rub?

20-25

A client who has started therapy for drug-resistant tuberculosis demonstrates understanding of tuberculosis transmission when he says:

"I'll stop being contagious when I have a negative acid-fast bacilli test."

A client is being evaluated for possible lung cancer. Which client statement most likely indicates lung cancer?

"My cough has changed from a dry cough to one with lots of sputum production."

Arterial blood gases should be obtained how often after initiating continuous mechanical ventilation?

20 min

A client has a tracheostomy but doesn't require continuous mechanical ventilation. When weaning the client from the tracheostomy tube, the nurse initially should plug the opening in the tube for:

5 to 20 min

A client comes to the health clinic after a positive skin test for tuberculosis. What additional diagnostic tests should the nurse begin teaching the client? Select all that apply.

A chest radiograph Complete history and physical examination Drug susceptibility testing

The nursing instructor is discussing pulmonary arterial hypertension with the nursing students. What would the instructor describe as the pathophysiology of secondary pulmonary arterial hypertension?

Alveolar destruction causes increased resistance and pressure in the pulmonary vascular bed.

The nurse is mentoring a new graduate nurse. Today, the two of you are caring for a client with a new tracheostomy. The new graduate nurse asks what the complications of tracheostomy are. What would the nurse respond? Select all that apply.

Aspiration Infection Injury to the laryngeal nerve

A physician determines that a client has been exposed to someone with tuberculosis. The nurse expects the physician to order which treatment?

Daily doses of isoniazid, 300 mg for 6 months to 1 year

Which is an age-related change associated with the respiratory system?

Decreased size of the airway

A nurse is caring for a client who has a tracheostomy and temperature of 103° F (39.4° C). Which intervention will most likely lower the client's arterial blood oxygen saturation?

ET suctioning

The Family Nurse Practitioner is performing a physical examination of a client. The Nurse Practitioner examines the client's anterior, posterior, and lateral chest walls. What is the Nurse Practitioner assessing?

Evidence of muscle weakness

During a routine visit to the pulmonologist, a client is told to undergo a mediastinoscopy. After the physician leaves the room, the nurse enters and is asked about this procedure. How should the nurse respond?

Exploration and biopsy of the lymph nodes that drain the lungs

A new nurse auscultates adventitious breath sounds but is not sure what to document and confers with an experienced nurse. This experienced nurse documents a pleural friction rub. Which of the following did the experienced nurse do during her assessment to identify the rub?

Instructed the client to hold the breath

During a pulmonary assessment, the nurse observes the chest for configuration. She identifies the findings as normal. Which of the following would be consistent with normal assessment?

Lateral diameter greater than anteroposterior diameter

The nurse is caring for a client in the immediate post-thoracentesis period. In which position is the client placed?

Lying on the unaffected side

A nurse assesses a client with pneumonia. Which assessments are diagnostic for pneumonia? Select all that apply.

Presence of crackles Egophony Whispered pectoriloquy Percussion dullness

You are caring for a client with chronic respiratory failure. What are the signs and symptoms of chronic respiratory failure?

Progressive loss of lung function associated with chronic disease

A client undergoes a tracheostomy after many failed attempts at weaning him from a mechanical ventilator. Two days after tracheostomy, while the client is being weaned, the nurse detects a mild air leak in the tracheostomy tube cuff. What should the nurse do first?

Suction the client, withdraw residual air from the cuff, and reinflate it.

In relation to the structure of the larynx, which describes the cricoid cartilage?

The only complete cartilaginous ring in the larynx

A nurse is aware that the diagnostic feature of ARDS is sudden:

Unresponsive arterial hypoxemia.

The nurse is caring for a client who has recurrent sinusitis. Which consideration could the nurse suggest to best decrease the frequency of infections?

administer an OTC decongestant

A nurse is performing a respiratory assessment on a client with pneumonia. She asks the client to say "ninety-nine" several times. Through her stethoscope, she hears the words clearly over his left lower lobe. What term should the nurse use to document this finding?

bronchophony

When a client has undergone a laryngectomy and there is evidence of wound breakdown, the nurse monitors the client very carefully because of the high risk for

carotid artery hemorrhage

A nurse should include what instruction for the client during postural drainage?

change positions frequently and cough up secretions

You are a clinic nurse caring for a client with acute tracheobronchitis. The client asks what may have caused the infection. Which of the following responses from the nurse would be most accurate?

chemical irritation

A client who is diagnosed with chronic respiratory failure will have which symptom?

dyspnea

A young adult client has had a tonsillectomy and is in the immediate postoperative period. To make the client comfortable, the nurse intervenes by

patient prone with head turned to the side

What does a positive Mantoux test indicate?

production of an immune response

A nurse is caring for a client who has frequent upper respiratory infections. Which structure is most helpful in protecting against infection?

tonsils

The nurse documents breath sounds that are soft, with inspiratory sounds longer than expiratory and found over the periphery of the lungs. Which of the following will the nurse chart?

vesicular

What is the purpose of the vascular and ciliated mucous lining of the nasal cavities?

warm and humidify inspired air

The nurse is caring for a client with suspected lung cancer. Which imaging study is more accurate than computed tomography in detecting malignancies?

PET

Class 1 with regard to TB indicates

exposure and no evidence of infection

s part of a primary cancer prevention program, an oncology nurse answers questions from the public at a health fair. When someone asks about laryngeal cancer, the nurse should explain that:

laryngeal cancer is one of the most preventable kinds of cancer

Which oxygen administration device has the advantage of providing a high oxygen concentration?

nonrebreather

he clinical finding of pink, frothy sputum may be an indication of which condition?

pulmonary edema

A patient diagnosed 2 weeks ago with acute pharyngitis comes to the clinic stating that the sore throat got better for a couple of days and is now back along with an earache. What complications should the nurse be aware of related to acute pharyngitis? (Select all that apply.)

Mastoiditis Otitis media Peritonsillar abscess

A client with lung cancer develops pleural effusion. During chest auscultation, which breath sound should the nurse expect to hear?

decreased breath sounds

During a preadmission assessment, for what diagnosis would the nurse expect to find decreased tactile fremitus and hyperresonant percussion sounds?

emphysema

The nurse is educating a patient with COPD about the technique for performing pursed-lip breathing. What does the nurse inform the patient is the importance of using this technique?

it prolongs expiration

A client has suspected fluid accumulation in the pleural space of the lungs and is scheduled for a thoracentesis. The nurse will implement which of the following for this procedure? Select all that apply.

Educate the client about the need to cleanse the thoracic area. Apply pressure to the puncture site after the procedure. Complete a respiratory assessment after the procedure.

The nurse is educating a patient diagnosed with acute bacterial rhinosinusitis about interventions that may assist with symptom control. What should the nurse include in this information? (Select all that apply.)

Ensure an adequate fluid intake. Increase the humidity in the home. Apply local heat to promote drainage.

Which of the following is an age-related change associated with the lung?

Increased thickness of the alveolar membranes

The nurse is planning for the care of a client with acute tracheobronchitis. What nursing interventions should be included in the plan of care? Select all that apply.

Increasing fluid intake to remove secretions Encouraging the client to rest Using cool-vapor therapy to relieve laryngeal and tracheal irritation

During a preadmission assessment, the nurse finds increased tactile fremitus. She knows this sign is consistent with which of the following diagnoses?

PNA

A client diagnosed with tuberculosis (TB) is taking medication for the treatment of TB. The nurse should instruct the client that he or she will be safe from infecting others approximately how long after initiation of the medication therapy?

Two to 3 weeks after initiation of bacteriocidal drugs

High or increased compliance occurs in which disease process?

emphysema

A client is recovering from thoracic surgery needed to perform a right lower lobectomy. Which of the following is the most likely postoperative nursing intervention?

encourage coughing to mobilize secretions

A client with suspected severe acute respiratory syndrome (SARS) comes to the emergency department. Which physician order should the nurse implement first?

institute isolation precautions

Which type of lung cancer is characterized as fast growing and tends to arise peripherally?

large cell carcinoma

The nurse is caring for a client in the immediate post-thoracentesis period. In which position is the client placed?

lying on unaffected side

A black client with asthma seeks emergency care for acute respiratory distress. Because of this client's dark skin, the nurse should assess for cyanosis by inspecting the:

mucous membranes

In general, chest drainage tubes are not used for a patient undergoing

pneumonectomy

The nurse is caring for a client who is scheduled for a lobectomy. Following the procedure, the nurse will plan care based on the client

returning to the unit with 2 chest tubes

The nursing instructor is talking with the junior class of nursing students about lung cancer. What would be the best rationale the instructor could give for the difficulty of early diagnosis of lung cancer?

s/s do not appear until cancer is well established

Which diagnostic test is used to confirm the diagnosis of maxillary and frontal sinusitis?

sinus aspirtes

The nurse is caring for a client with an endotracheal tube. Which client data does the nurse interpret as a life-threatening situation?

sudden restlessness

The nurse is admitting a client who just had a bronchoscopy. Which assessment should be the nurse's priority?

swallow reflex

The amount of air inspired and expired with each breath is called:

tidal volume

A client with severe shortness of breath comes to the emergency department. He tells the emergency department staff that he recently traveled to China for business. Based on his travel history and presentation, the staff suspects severe acute respiratory syndrome (SARS). Which isolation precautions should the staff institute?

airborne and contact

What is the most commonly prescribed treatment for the common cold?

antihistamine

The nurse knows that a sputum culture is necessary to identify the causative organism for acute tracheobronchitis. What causative fungal organism would the nurse suspect?

aspergillus

hich is a potential complication of a low pressure in the endotracheal tube cuff?

aspiration PNA

The nurse is caring for a client reporting chest discomfort. The client's diagnosis at admission is left lower lobe pneumonia. Which strategy will the nurse instruct the client to use to help alleviate the discomfort?

assume a left lying position

The nurse assessed a 28-year-old woman who was experiencing dyspnea severe enough to make her seek medical attention. The history revealed no prior cardiac problems and the presence of symptoms for 6 months' duration. On assessment, the nurse noted the presence of both inspiratory and expiratory wheezing. Based on this data, which of the following diagnoses is likely?

asthma

The nurse auscultates crackles in a patient with a respiratory disorder. With what disorder would crackles be commonly heard?

collapsed alveolil

Which term refers to lung tissue that has become more solid in nature as a result of a collapse of alveoli or an infectious process?

consolodation

A client with supraglottic cancer undergoes a partial laryngectomy. Postoperatively, a cuffed tracheostomy tube is in place. When removing secretions that pool above the cuff, the nurse should instruct the client to:

cough as the cuff is being deflated