Test 2 review

Which statement by the parent of a child using an albuterol inhaler leads the nurse to believe that further education is needed on how to administer the medication?

"I should administer two quick puffs of the albuterol inhaler using a spacer."

Which statement indicates the parent needs further teaching on how to prevent his other children from contracting respiratory syncytial virus (RSV)? 1. "I should make sure that both my children receive palivizumab (Synagis) injections for the remainder of this year." 2. "I should be sure to keep my infected child away from his brother until he has recovered." 3. "I should insist that all people who come in contact with my children thoroughly wash their hands before playing with them." 4. "I should insist that anyone with a respiratory illness avoid contact with my children until well."

"I should make sure that both my children receive palivizumab (Synagis)

48. The nurse is discharging a client newly diagnosed with restrictive airway disease (asthma). Which statement indicates the client understands the discharge instructions? 1. "I will call 911 if my medications don't control an attack." 2. "I should wash my bedding in warm water." 3. "I can still eat at the Chinese restaurant when I want." 4. "If I get a headache, I should take a nonsteroidal anti-inflammatory drug."

"I will call 911 if my medications don't control an attack."

What is the most important piece of information that the nurse must ask the parent of a child in status asthmaticus?

"When was your child's last dose of medication?"

19. The nurse is caring for the client diagnosed with pneumonia. Which information should the nurse include in the teaching plan? Select all that apply. 1. Place the client on oxygen delivered by nasal cannula. 2. Plan for periods of rest during activities of daily living. 3. Place the client on a fluid restriction of 1,000 mL/day. 4. Restrict the client's smoking to two (2) to three (3) cigarettes per day. 5. Monitor the client's pulse oximetry readings every four (4) hours.

1, 2, 5

35. Which statement made by the client indicates the nurse's discharge teaching is effective for the client diagnosed with COPD? 1. "I need to get an influenza vaccine each year, even when there is a shortage." 2. "I need to get a vaccine for pneumonia each year with my influenza shot." 3. "If I reduce my cigarettes to six (6) a day, I won't have difficulty breathing." 4. "I need to restrict my drinking liquids to keep from having so much phlegm."

1. "I need to get an influenza vaccine each year, even when there is a shortage."

5-10 year respiratory rate

15-25

Age group for the flu nasal spray

2-49

infant respiratory rate

20-40

A 7-month-old has a low-grade fever, nasal congestion, and a mild cough. What should the nursing care management of this child include? 1. Maintaining strict bedrest. 2. Avoiding contact with family members. 3. Instilling saline nose drops and bulb suctioning. 4. Keeping the head of the bed flat.

3, 5

newborn respiratory rate

30-60

PaCO2 should be within

35-45

How old do you have to be to get the flu shot?

6 months

PaO2 should be within (PULSE OX)

80-100

Who is at the highest priority to receive the flu vaccine? 1. A healthy 8-month-old who attends day care. 2. A 3-year-old who is undergoing chemotherapy. 3. A healthy 7-year-old who attends public school. 4. An 18-year-old who is living in a college dormitory.

A healthy 8 month old attending day care

Which laboratory result will provide the most important information regarding the respiratory status of a child with an acute asthma exacerbation?

ABG

Which should the nurse administer to provide quick relief to a child with asthma who is coughing, wheezing, and having difficulty catching her breath?

Albuterol

14. The nurse is planning the care of a client diagnosed with pneumonia and writes a problem of "impaired gas exchange." Which is an expected outcome for this problem? 1. Performs chest physiotherapy three (3) times a day. 2. Able to complete activities of daily living. 3. Ambulates in the hall several times during each shift. 4. Alert and oriented to person, place, time, and events.

Alert and oriented to person, place, time, and events.

31. Which client problems are appropriate for the nurse to include in the plan of care for the client diagnosed with COPD? Select all that apply. 1. Impaired gas exchange. 2. Inability to tolerate temperature extremes. 3. Activity intolerance. 4. Inability to cope with changes in roles. 5. Alteration in nutrition.

All answers are correct

Tamiflu (oseltamivir)

Antiviral against influenza adverse effect: seizures

26. The client diagnosed with an exacerbation of COPD is in respiratory distress. Which intervention should the nurse implement first? 1. Assist the client into a sitting position at 90 degrees. 2. Administer oxygen at six (6) LPM via nasal cannula. 3. Monitor vital signs with the client sitting upright. 4. Notify the health-care provider about the client's status.

Assist the client into a sitting position at 90 degrees.

34. Which clinical manifestation should the nurse expect to assess in the client recently diagnosed with COPD? 1. Clubbing of the client's fingers. 2. Infrequent respiratory infections. 3. Chronic sputum production. 4. Nonproductive hacking cough.

Chronic sputum production

13. The nurse is assessing a 79-year-old client diagnosed with pneumonia. Which signs and symptoms should the nurse expect to assess in the client? 1. Confusion and lethargy. 2. High fever and chills. 3. Frothy sputum and edema. 4. Bradypnea and jugular vein distention.

Confusion and lethargy

37. The nurse is completing the admission assessment on a 13-year-old client diagnosed with an acute exacerbation of asthma. Which signs and symptoms would the nurse expect to find? 1. Fever and crepitus. 2. Rales and hives. 3. Dyspnea and wheezing. 4. Normal chest shape and eupnea.

Dyspnea and wheezing.

Which should the nurse instruct children to do to stop the spread of influenza in the classroom?

Encourage hand hygiene

Which physical findings would be of most concern in an infant with respiratory distress? 1. Tachypnea. 2. Mild retractions. 3. Wheezing. 4. Grunting.

Grunting

Which position would be most comfortable for a child with left-sided pneumonia? 1. Trendelenburg. 2. Left side. 3. Right side. 4. Supine.

Left side

How will a child with respiratory distress and stridor who is diagnosed with RSV be treated? 1. Intravenous antibiotics. 2. Intravenous steroids. 3. Nebulized racemic epinephrine. 4. Alternating doses of acetaminophen (Tylenol) and ibuprofen (Motrin).

Nebulized racemic epinephrine

39. The case manager is arranging a care planning meeting regarding the care of a 65-year-old client diagnosed with adult-onset asthma. Which health-care disciplines should participate in the meeting? Select all that apply. 1. Nursing. 2. Pharmacy. 3. Social work. 4. Occupational therapy. 5. Speech therapy.

Nursing. 2. Pharmacy. 3. Social work.

16. The client diagnosed with a community-acquired pneumonia is being admitted to the medical unit. Which nursing intervention has the highest priority? 1. Administer the ordered oral antibiotic STAT. 2. Order the meal tray to be delivered as soon as possible. 3. Obtain a sputum specimen for culture and sensitivity. 4. Have the unlicensed assistive personnel weigh the client.

Obtain a sputum specimen for culture and sensitivity.

27. The nurse is assessing the client diagnosed with COPD. Which data require immediate intervention by the nurse? 1. Large amounts of thick white sputum. 2. Oxygen flowmeter set on eight (8) liters. 3. Use of accessory muscles during inspiration. 4. Presence of a barrel chest and dyspnea.

Oxygen flowmeter set on eight (8) liters.

33. The nurse observes the unlicensed assistive personnel (UAP) removing the nasal cannula from the client diagnosed with COPD while ambulating the client to the bathroom. Which action should the nurse implement? 1. Praise the UAP since this prevents the client from tripping on the oxygen tubing. 2. Place the oxygen back on the client while sitting in the bathroom and say nothing. 3. Explain to the UAP in front of the client oxygen must be left in place at all times. 4. Discuss the UAP's action with the charge nurse so appropriate action can be taken.

Place the oxygen back on the client while sitting in the bathroom and say nothing.

24. The client is admitted to a medical unit with a diagnosis of pneumonia. Which signs and symptoms should the nurse assess in the client? 1. Pleuritic chest discomfort and anxiety. 2. Asymmetrical chest expansion and pallor. 3. Leukopenia and CRT <three (3) seconds. 4. Substernal chest pain and diaphoresis.

Pleuritic chest discomfort and anxiety.

42. The client diagnosed with asthma is admitted to the emergency department with difficulty breathing and a blue color around the mouth. Which diagnostic test will be ordered to determine the status of the client? 1. Complete blood count. 2. Pulmonary function test. 3. Allergy skin testing. 4. Drug cortisol level.

Pulmonary function test.

Synagis (palivizumab)

RSV-specific monoclonal antibody Given to preemies under 29 weeks gestation adverse effect- anaphylaxis

47. The nurse is discussing the care of a child diagnosed with asthma with the parent. Which referral is important to include in the teaching? 1. Referral to a dietitian. 2. Referral for allergy testing. 3. Referral to the developmental psychologist. 4. Referral to a home health nurse.

Referral for allergy testing.

38. The nurse is planning the care of a client diagnosed with asthma and has written a problem of "anxiety." Which nursing intervention should be implemented? 1. Remain with the client. 2. Notify the health-care provider. 3. Administer an anxiolytic medication. 4. Encourage the client to drink fluids.

Remain with the client.

21. The day shift charge nurse on a medical unit is making rounds after report. Which client should be seen first? 1. The 65-year-old client diagnosed with tuberculosis who has a sputum specimen to be sent to the lab. 2. The 76-year-old client diagnosed with aspiration pneumonia who has a clogged feeding tube. 3. The 45-year-old client diagnosed with pneumonia who has a pulse oximetry reading of 92%. 4. The 39-year-old client diagnosed with bronchitis who has an arterial oxygenation level of 89%.

The 45-year-old client diagnosed with pneumonia who has a pulse oximetry reading of 92%.

36. Which referral is most appropriate for a client diagnosed with end-stage COPD? 1. The Asthma Foundation of America. 2. The American Cancer Society. 3. The American Lung Association. 4. The American Heart Association.

The American Lung Association.

9. The client diagnosed with influenza A is being discharged from the emergency department with a prescription for antibiotics. Which statement by the client indicates an understanding of this prescription? 1. "These pills will make me feel better fast and I can return to work." 2. "The antibiotics will help prevent me from developing a bacterial pneumonia." 3. "If I had gotten this prescription sooner, I could have prevented this illness." 4. "I need to take these pills until I feel better; then I can stop taking the rest."

The antibiotics will help prevent me from developing a bacterial pneumonia.

28. The nurse is caring for the client diagnosed with COPD. Which outcome requires a revision in the plan of care? 1. The client has no signs of respiratory distress. 2. The client shows an improved respiratory pattern. 3. The client demonstrates intolerance to activity. 4. The client participates in establishing goals

The client demonstrates intolerance to activity.

32. Which outcome is appropriate for the client problem "ineffective gas exchange" for the client recently diagnosed with COPD? 1. The client demonstrates the correct way to pursed-lip breathe. 2. The client lists three (3) signs/symptoms to report to the HCP. 3. The client will drink at least 2,500 mL of water daily. 4. The client will be able to ambulate 100 feet with dyspnea.

The client demonstrates the correct way to pursed-lip breathe.

29. The nurse is caring for the client diagnosed with end-stage COPD. Which data warrant immediate intervention by the nurse? 1. The client's pulse oximeter reading is 92%. 2. The client's arterial blood gas level is 74. 3. The client has SOB when walking to the bathroom. 4. The client's sputum is rusty colored.

The client's sputum is rusty colored.

Which is the nurse's best response to parents who ask what impact asthma will have on the child's future in sports?

The earlier a child is diagnosed with asthma, the more significant the symptoms

A child with severe cerebral palsy is admitted to the hospital with aspiration pneumonia. What is the most beneficial educational information that the nurse can provide to the parents? 1. The signs and symptoms of aspiration pneumonia. 2. The treatment plan for aspiration pneumonia. 3. The risks associated with recurrent aspiration pneumonia. 4. The prevention of aspiration pneumonia.

The prevention of aspiration pneumonia

41. Which statement indicates to the nurse the client diagnosed with asthma understands the teaching regarding mast cell stabilizer medications? 1. "I should take two (2) puffs when I begin to have an asthma attack." 2. "I must taper off the medications and not stop taking them abruptly." 3. "These drugs will be most effective if taken at bedtime." 4. "These drugs are not good at the time of an attack."

These drugs are not good at the time of an attack.

20. The nurse is feeding a client diagnosed with aspiration pneumonia who becomes dyspneic, begins to cough, and is turning blue. Which nursing intervention should the nurse implement first? 1. Suction the client's nares. 2. Turn the client to the side. 3. Place the client in Trendelenburg position. 4. Notify the health-care provider.

Turn the client to the side.

The parent of a child with influenza asks the nurse when the child is most infectious. Which is the nurse's best response? 1. "Twenty-four hours before and after the onset of symptoms." 2. "Twenty-four hours after the onset of symptoms." 3. "One week after the onset of symptoms." 4. "One week before the onset of symptoms."

Twenty-four hours before and after the onset of symptoms

40. The client is diagnosed with mild intermittent asthma. Which medication should the nurse discuss with the client? 1. Daily inhaled corticosteroids. 2. Use of a "rescue inhaler." 3. Use of systemic steroids. 4. Leukotriene agonists.

Use of a "rescue inhaler."

25. The nurse is assessing the client with COPD. Which health promotion information is most important for the nurse to obtain? 1. Number of years the client has smoked. 2. Risk factors for complications. 3. Ability to administer inhaled medication. 4. Willingness to modify lifestyle.

Willingness to modify lifestyle.

Pneumococcal vaccine

age 65 plus, is a 2 shot series

When a infant is diagnosed with RSV and shows nasal flaring, what does that indicate?

air hunger

What to do if xray shows consolidation in upper lungs

chest percussion, fluids

Which kind of precautions are a patient who is diagnosed with influenza or RSV put on?

droplet

Treatment for influenza

flu shot, tamiflu during onset of symptoms

fingernail clubbing in COPD patient suggests:

hypoxia

When should you collect a sputum culture

in the morning before patient eats or drinks

With infections, why is it important to do daily weighs?

insensible loss

Patients with COPD should avoid

lung irritants, extreme temps and dry climates

Are antibiotics used to treat RSV?

no

Is it better for consolidation to be upper or lower lungs?

upper, easier to excrete