Unit 16 - Respiratory Disorders Questions

What is the nurse's best response when a client with emphysema asks how removing part of the lungs through lung volume reduction surgery will improve breathing? a. "By removing only the over-inflated parts of the lungs, the air you breathe in will be going only to the lung areas that work best" b. "This surgery is preventive, because the parts of the lungs being removed are those having the highest probability for developing cancer" c. "Breathing will be improved because diseased lung parts are removed and replaced with healthy parts" d. "This surgery makes room for the new lungs when a lung transplant is available"

a. "By removing only the over-inflated parts of the lungs, the air you breathe in will be going only to the lung areas that work best"

What is the nurse's best response to a client with obstructive sleep apnea (OSA) who asks, "Why does it feel like I wake up every 5 minutes?" a. "Carbon dioxide builds up while you are not breathing, which stimulates your body to wake up and breathe" b. "Excessive sleeping during the day interferes with deeper sleep at night" c. "Your tongue may be blocking your throat, and you wake up because you are choking" d. "You really aren't waking up that often. If just feels that way"

a. "Carbon dioxide builds up while you are not breathing, which stimulates your body to wake up and breathe"

A nurse observes that a patient's anteroposterior (AP) chest diameter is the same as the lateral chest diameter. Which question would the nurse ask the patient in response to this finding? a. "Do you have any chronic breathing problems?" b. "How often do you perform aerobic exercise?" c. "Are you taking any medications or herbal supplements?" d. "What is your occupation and what are your hobbies?"

a. "Do you have any chronic breathing problems?"

Which client statements about using an aerosol inhaler for asthma management indicate to the nurse that he has correct understanding of this drug delivery system? (Select all that apply) a. "I will hold my breath for at least 10 seconds after inhaling the drug" b. "When I suspect the canister is close to empty, I will shake it to check how much is left" c. "If I use a spacer, I don't have to wait a minute between the two puffs" d. "If the spacer makes a whistling sound, I am breathing in too rapidly" e. "Rinsing my mouth after using the inhaler and then swallowing the rinse ensures I will get all of the drug"

a. "I will hold my breath for at least 10 seconds after inhaling the drug" d. "If the spacer makes a whistling sound, I am breathing in too rapidly"

A nurse cares for a female patient who has a family history of cystic fibrosis. The patient asks, "Will my children have cystic fibrosis?" How would the nurse respond? a. "Since many of your family members are carriers, your children will also be carriers of the gene" b. "Since you have a family history of cystic fibrosis, I would encourage you and your partner to be tested" c. "Cystic fibrosis is an autosomal recessive disorder. If you are a carrier, your children will have the disorder" d. "Cystic fibrosis is caused by a protein that controls the movement of chloride. Adjusting your diet will decrease the spread of this disorder"

a. "Since many of your family members are carriers, your children will also be carriers of the gene" Cystic fibrosis is an autosomal recessive disorder in which both gene alleles must be mutated for the disorder to be expressed. The nurse would encourage both the client and partner to be tested for the abnormal gene.

A nursing student caring for a patient removes the patient's oxygen as prescribed. The patient is now breathing what percentage of oxygen in the room air? a. 21% b. 31% c. 28% d. 14%

a. 21%

The nurse has just received report on a group of clients. Which client is the nurse's first priority? a. A 45-year-old with a peritonsilar abscess who can no longer swallow b. A 65-year-old with rhinosinusitis and a fever of 102 oF (38.9 oC) c. A 25-year-old who had endoscopic sinus surgery 8 hours ago d. A 55-year-old with tuberculosis who is standard first-line therapy

a. A 45-year-old with a peritonsilar abscess who can no longer swallow

Which client will the nurse recognize as being at risk for bacterial sinusitis? a. A 45-year-old with multiple dental caries and infected gums b. A 25-year-old with seasonal pollen allergies c. A 65-year-old who has a poor gag reflex after a stroke d. A 35-year-old with a 20-pack-year smoking history who now vapes

a. A 45-year-old with multiple dental caries and infected gums

A nurse assesses patients on the medical-surgical unit. Which patient is at greatest risk for development of obstructive sleep apnea? a. A 55-year-old woman who is 50 lbs (23 kg) overweight b. A 42-year-old man with gastroesophageal reflux disease c. A 26-year-old woman who is 8 months pregnant d. A 73-year-old man with type 2 diabetes mellitus

a. A 55-year-old woman who is 50 lbs (23 kg) overweight The client at highest risk would be the one who is extremely overweight.

Which client will the nurse consider to be a poor candidate for continuous positive airway pressure (CPAP) management for obstructive sleep apnea? a. A 65-year-old with chronic confusion b. A 45-year-old with septal deviation who is a mouth breather c. A 75-year-old who lives alone d. A 55-year-old with an unusually large uvula

a. A 65-year-old with chronic confusion

A nurse is assessing a patient who has suffered a nasal fracture. Which assessment would the nurse perform first? a. Airway patency b. Vital signs c. Facial pain d. Bone displacement

a. Airway patency A patent airway is the priority. The nurse first would make sure that the airway is patent before any of the other interventions.

Which changes in arterial blood gas (ABG) values will the nurse expect in a client with long-term chronic obstructive pulmonary disease (COPD)? a. Decreased pH, Decreased PaO2, Increased PaCO2, Increased Bicarbonate level b. Increased pH, Increased PaO2, Increased PaCO2, Increased Bicarbonate level c. Increased pH, Increased PaO2, Increased PaCO2, Decreased Bicarbonate level d. Decreased pH, Decreased PaO2, Decreased PaCO2, Decreased Bicarbonate level

a. Decreased pH, Decreased PaO2, Increased PaCO2, Increased Bicarbonate level

Which action will the nurse teach a client with chronic bronchitis to use to mobilize secretions? a. Drinking at least 2 L of fluid daily b. Avoiding triggers that cause coughing c. Elevating the head of the bed 45 degrees d. Assuming the tripod position as often as possible

a. Drinking at least 2 L of fluid daily

Which action will the nurse take to ensure that a client who requires drug therapy for multi-drug resistant tuberculosis and also is addicted to heroin adheres to the treatment regimen? a. Arranging for a health care worker to directly observe the client take the drugs b. Giving the client written instructions about how and when to take the drugs c. Instructing the client about the consequences of not taking the drugs d. having the client repeat the drug names and side effects

a. Arranging for a health care worker to directly observe the client take the drugs

Which assessment findings in a client with asthma indicate to the nurse that the client's asthma condition is deteriorating and progressing toward respiratory failure? a. Audible wheezing with use of accessory muscles on inhalation b. Crackles, rhonchi, and productive cough with yellow sputum c. Tachypnea, thick and tenacious sputum, and hemoptysis d. Respiratory alkalosis; slow, shallow respiratory rate

a. Audible wheezing with use of accessory muscles on inhalation

Which statements regarding noninvasive positive-pressure ventilation (NPPV) are true? (Select all that apply) a. Can only be used safely by alert clients b. Risk for ventilator-associated pneumonia is reduced by still present c. An endotracheal tube is required for oxygen therapy d. Masks must have a tight seal for effective ventilation e. The system operates with either room air or oxygen f. Vomiting with potential aspiration can occur

a. Can only be used safely by alert clients d. Masks must have a tight seal for effective ventilation e. The system operates with either room air or oxygen f. Vomiting with potential aspiration can occur

Development of which symptoms indicates to the nurse that a 48-year-old client with seasonal influenza may actually have COVID-19? a. Chest tightness and SpO2 of 86% b. Productive cough and yellow-colored sputum c. Anorexia and weight loss d. Intermittent fever and sweating

a. Chest tightness and SpO2 of 86%

Which personal factors or health problems will the nurse suspect as possible causes of a client's diagnosis of cancer of the sinuses? a. Chronic exposure to wood dust and cigarette smoking b. Yearly colds leading to development of sinus infections c. Heavy sun exposure and use of antihistamine nasal spray d. Swimming in the ocean and heating the home with forced-air furnace

a. Chronic exposure to wood dust and cigarette smoking

Which condition indicates to the nurse that the treatment plan for a client with streptococcal pneumonia is effective? a. Client has been afebrile for 48 hours b. Oxygen saturation ranges between 90% and 92% on room air c. White blood cell count is 16,000 cells/mm3 d. Bronchial breath sounds present in lung periphery

a. Client has been afebrile for 48 hours

Which factors or conditions will the nurse identify as increasing the risk for clients to develop aspiration pneumonia? (Select all that apply) a. Continuous nasogastric (NG) tube feedings b. Bronchoscopy procedure c. Decreased level of consciousness d. Magnetic resonance imaging (MRI) procedure e. Stroke f. Chest tube

a. Continuous nasogastric (NG) tube feedings b. Bronchoscopy procedure c. Decreased level of consciousness e. Stroke

Which oxygen delivery device will the nurse consider best to meet the needs to apply for a newly admitted client who requires high-flow oxygen therapy after suffering facial burns and smoke inhalation? a. Face tent b. Nasal cannula c. Venturi mask d. Nonrebreather mask

a. Face tent

Which associated health problems will the nurse expect a client with long-term obstructive sleep apnea (OSA) to have? a. Hypertension and weight gain b. Cancer and autoimmune disorders c. Hypotension and chronic hypoglycemia d. Asthma and chronic obstructive pulmonary disease

a. Hypertension and weight gain

Which features will the nurse expect to be present in a client who has long-term chronic obstructive pulmonary disease (COPD)? (Select all that apply) a. Increased anteroposterior chest diameter from air-trapping b. Respiratory acidosis with a low pH c. Poor gas exchange from decreased alveolar surface area d. Increased eosinophil count e. Hypercapnia from retained PaCO2 f. Arterial blood gas value with increased PaO2 level

a. Increased anteroposterior chest diameter from air-trapping b. Respiratory acidosis with a low pH c. Poor gas exchange from decreased alveolar surface area e. Hypercapnia from retained PaCO2

What is the nurse's best first action when a client receiving continuous oxygen therapy by nasal cannula for an acute respiratory problem is becoming increasingly confused? a. Increasing the oxygen flow rate b. Documenting the observation as the only action c. Notifying the primary health care provider immediately d. Repositioning the client from a high-Fowler to a low-Fowler position

a. Increasing the oxygen flow rate

The charge nurse on a medical unit is preparing to admit several "patients" who have possible pandemic flu during a preparedness drill. What action by the nurse is best? a. Inquire as to recent travel outside the United States b. Do not allow pregnant caregivers to care for these "patients" c. Place the "patients" on enhanced droplet precautions d. Admit the "patients" on contact precautions

a. Inquire as to recent travel outside the United States Preventing the spread of pandemic flu is equally important as caring for the clients who have it. Preventing the spread of disease is vital. The nurse would ask the "patients" about recent overseas travel to assess the risk of a pandemic flu. Patients with possible pandemic flu need to be in Contact and Airborne Precautions the infectious organism is identified and routes of transmission known. There is no specific danger to pregnant caregivers. Droplet Precautions are not appropriate.

Which action will the nurse teach an older client with a respiratory problem to make as an accommodation to promote adequate gas exchange? a. Notify your primary health care provider at the first sign of respiratory infection b. If you must walk any distance in cool weather move quickly to keep warm c. Replace at least one meal each day with a high-calorie liquid food supplement d. Avoid any nonessential activity or exercise

a. Notify your primary health care provider at the first sign of respiratory infection

Which of the following is not a possible complication or hazard of home oxygen therapy? a. Oxygen-induced hyperventilation b. Dried mucous membranes c. Absorptive atelectasis d. Toxicity e. Combustion

a. Oxygen-induced hyperventilation

Which changes in a client receiving oxygen therapy at 60% for more than 24 hours alert the nurse to the possibility of oxygen toxicity? a. Decreased PaCO2 b. Client report of increased dyspnea c. Production of thick, white, frothy sputum d. Client demand to remove the mask

b. Client report of increased dyspnea

A nurse is providing pneumonia vaccinations in a community setting. Due to limited finances, the event organizers must limit giving the vaccination to priority groups. What patients would be considered a priority when administering the pneumonia vaccination? (Select all that apply) a. Patient with well-controlled diabetes b. Patient who is taking medication for hypertension c. 22-year-old patient with asthma d. A healthy 18-year-old patient who had a cholecystectomy last year e. Healthy 72-year-old patient

a. Patient with well-controlled diabetes b. Patient who is taking medication for hypertension c. 22-year-old patient with asthma e. Healthy 72-year-old patient Clients over 65 years of age and any client (no matter what age) with a chronic health condition would be considered a priority for a pneumonia vaccination.

Which client conditions will the nurse recognize as most likely to cause a "right shift" of the oxyhemoglobin dissociation curve? (Select all that apply) a. Reduced blood and tissue levels of oxygen b. Alkalosis c. Increased metabolic demands d. Reduced blood and tissue levels of diphosphoglycerate (DPG) e. Increased body temperature f. Reduced blood and tissue pH

a. Reduced blood and tissue levels of oxygen c. Increased metabolic demands e. Increased body temperature f. Reduced blood and tissue pH The oxyhemoglobin dissociation curve is shifted to the right when conditions are present that increase overall oxygen needs. This right shift makes it easier for oxygen to dissociate from the hemoglobin molecule. Such conditions are those associated with higher metabolism and oxygen need. These include increased body temperature, increased metabolic demand, hypoxia, and acidosis (low pH with higher concentration of hydrogen ions). Reduced DPG and alkalosis (few hydrogen ions) are associated with increased oxygen need and a left shift in the oxyhemoglobin dissociation curve.

Which action is most important for the nurse to take when a client with chronic obstructive pulmonary disease (COPD) who is taking a cholinergic antagonist now reports nausea, blurred vision, headache, and inability to sleep? a. Reporting the symptoms to the primary health care provider immediately b. Asking the client to explain the exact techniques he or she uses when taking the drug c. Requesting an order to draw blood to determine the drug level d. Reminding the client that these side effects are normal and not to worry

a. Reporting the symptoms to the primary health care provider immediately

Which complication will the nurse assess for first in any client with cystic fibrosis (CF)? a. Respiratory infection b. Pneumothorax c. Weight loss d. Osteoporosis

a. Respiratory infection

Which change in the condition of a client with chronic obstructive pulmonary disease (COPD) who is receiving supplemental oxygen indicates to the nurse that an increase in the fraction of inspired oxygen (FiO2) may need to be increased? a. Restlessness has increased over the past hour b. Client reports increased mouth dryness c. Heart rate has decreased from 90 to 82 beats/min d. Blood pressure has changed from 106/80 to 110/70

a. Restlessness has increased over the past hour

Which is the priority action for the nurse to take first after applying oxygen when caring for an older client admitted with symptoms of possible seasonal influenza accompanied by vomiting and high fever? a. Starting an IV line to begin hydration therapy b. Administering IM influenza vaccination c. Asking the client when symptoms began d. Placing the client in a negative air pressure room

a. Starting an IV line to begin hydration therapy

Which action is most important for the nurse to take when preparing a client with cystic fibrosis (CF) for a lung transplantation procedure? a. Teaching the client how to perform pulmonary muscle strengthening exercises b. Collaborating with the registered dietitian nutritionist to provide high-calorie, high-protein meals c. Reminding the client to continue taking prescribed vitamin supplementation d. Using aseptic technique when assisting the client to perform pulmonary hygiene

a. Teaching the client how to perform pulmonary muscle strengthening exercises

After teaching a patient how to perform diaphragmatic breathing, the nurse assesses the patient's understanding. Which action demonstrates that the patient correctly understands the teaching? a. The patient places his or her hands on his or her abdomen b. The patient lays in a prone position with his or her legs straight c. The patient places his or her hands above his or her head d. The patient lays on his or her side with his or her knees bent

a. The patient places his or her hands on his or her abdomen To perform diaphragmatic breathing correctly, the client would place his or her hands on the abdomen to create resistance.

Which adults will the nurse identify as having a higher risk for active tuberculosis? (Select all that apply.) a. Those who were treated previously for active tuberculosis b. Kidney transplant recipients c. Homeless adults d. Those who have received bacille Calmette-Guérin (BCG) vaccine e. Those in the local prison f. Recent immigrants to the United States

a. Those who were treated previously for active tuberculosis b. Kidney transplant recipients c. Homeless adults e. Those in the local prison f. Recent immigrants to the United States

Which complication does the nurse suspect when a client with severe chronic obstructive pulmonary disease (COPD) has new-onset increased fatigue, dependent edema, neck vein distention, and oral cyanosis? a. Lung cancer b. Cor pulmonale c. Pneumonia d. Asthma

b. Cor pulmonale

Which questions are most relevant for the nurse to ask a client when assessing for risk factors and indications for head and neck cancer? (Select all that apply) a. "When was the last time you saw your dentist?" b. "Do you have recurrent laryngitis or frequent episodes of sore throat?" c. "Have you had frequent episodes of acute or chronic visual problems?" d. "How many packs per day do you smoke and for how many years?" e. "Have you had a problem wiht sores in your mouth?" f. "How many servings per day of alcohol do you typically drink?"

b. "Do you have recurrent laryngitis or frequent episodes of sore throat?" d. "How many packs per day do you smoke and for how many years?" e. "Have you had a problem with sores in your mouth?" f. "How many servings per day of alcohol do you typically drink?"

A nurse collaborates with a respiratory therapist to complete pulmonary function tests (PFTs) for a patient. Which statements would the nurse include in communications with the respiratory therapist prior to the tests? (Select all that apply) a. "The patient is ready to go down to radiology for this examination." b. "I held the patient's morning bronchodilator medication." c. "Physical therapy worked with the patient yesterday" d. "I advised the patient not to smoke for 6 hours prior to the test." e. "The patient is alert and can follow your commands."

b. "I held the patient's morning bronchodilator medication." d. "I advised the patient not to smoke for 6 hours prior to the test." e. "The patient is alert and can follow your commands." To ensure the PFTs are accurate, the therapist needs to know that no bronchodilators have been administered in the past 4 to 6 hours, the client did not smoke within 6 to 8 hours prior to the test, and the client can follow basic commands, including different breathing maneuvers. The respiratory therapist can perform PFTs at the bedside.

A nurse has educated a patient on isoniazid (INH). What statement by the patient indicates that teaching has been effective? a. "I need to take extra vitamin C while on INH" b. "I will take this medication on an empty stomach and I understand it may turn my urine reddish-orange" c. "I should take this medicine with milk or juice" d. "My contact lenses will be permanently stained"

b. "I will take this medication on an empty stomach and I understand it may turn my urine reddish-orange"

A nurse teaches a patient to use a room humidifier after a laryngectomy. Which statement would the nurse include in this patient's teaching? a. "Keep the humidifier filled with water at all times" b. "Make sure you clean the humidifier to prevent infection" c. "Use the humidifier when you sleep, even during daytime naps" d. "Add peppermint oil to the humidifier to relax the airway"

b?

A nurse assesses several patients who have a history of asthma. Which patient would the nurse assess first? a. A 48-year-old patient with an oxygen saturation level of 94% at rest b. A 27-year-old patient with a heart rate of 128 beats/min c. A 66-year-old patient with a barrel chest and clubbed fingernails d. A 35-year-old patient who has a longer expiratory phase than inspiratory phase

b. A 27-year-old patient with a heart rate of 128 beats/min Tachycardia can indicate hypoxemia as the body tries to circulate the oxygen that is available. A barrel chest is not an emergency finding. Likewise, a pulse oximetry level of 92% is not considered an acute finding. The expiratory phase is expected to be longer than the inspiratory phase in someone with airflow limitation.

Which problem does the nurse suspect when a client who has been receiving 50% oxygen by Venturi mask for 2 days now has crackles and decreased breath sounds on auscultation? a. New-onset asthma b. Absorptive atelectasis c. Bronchiolar infection d. Stasis pneumonia

b. Absorptive atelectasis

Which action will the nurse take first when caring for a client with pneumonia who has ineffective airway clearance related to fatigue, chest pain, excessive secretions, and muscle weakness? a. Administer oxygen to prevent hypoxemia and atelectasis b. Administer the prescribed bronchodilator therapy to decrease bronchospasms c. Encourage oral fluids to greater than 3,000 mL/day to ensure adequate hydration d. Maintain semi-Fowler position to facilitate breathing and prevent further fatigue

b. Administer the prescribed bronchodilator therapy to decrease bronchospasms

Which action will the nurse take first when a client with obstructive sleep apnea (OSA) who has been using continuous positive airway pressure (CPAP) with a facemask, returns to the outpatient clinic after 2 weeks with a report of ongoing daytime sleepiness? a. Reminding the client that sleep is important and to go ahead and take daytime naps b. Asking the client whether the mask fits tightly over the mouth and nose c. Encouraging the client to consider using over-the-counter sleep aids for deeper sleeping at night d. Suggesting that a nasal mask be used instead of a nose and mouth facemask

b. Asking the client whether the mask fits tightly over the mouth and nose

Which nursing action will the nurse take to prevent harm from disruption of oxygen therapy for the client receiving low-flow oxygen by simple facemask? a. Keeping a small cylinder of oxygen at client's bedside stand for emergency use in case the central oxygen delivery system fails b. Changing to a nasal cannula during meals c. Sealing the edges of the mask to the client's skin with a water-soluble lubricant d. Ensuring the flaps are closed over the exhalation ports

b. Changing to a nasal cannula during meals

For which problem does the nurse assess the client who cannot breathe through the nose because of a severe septal deviation? a. Difficulty swallowing b. Dry respiratory tract membranes c. Development of nasal polyps d. Frequent episodes of tonsillitis

b. Dry respiratory tract membranes When inspired air passes through the nose, it is filtered, warmed, and humidified. When a person is unable to breathe through the nose because of an anatomical obstruction, he or she is at risk for excessive drying of the respiratory mucous membranes. This anatomical problem does not influence the development of tonsillitis or difficulty swallowing. Nasal polyps can contribute to nasal obstruction but is not caused by a septal deviation.

Which laboratory finding does the nurse expect in a client who has metastatic lung cancer and new-onset back pain? a. Hypernatremia b. Hypercalcemia c. Hyperglycemia d. Hyperkalemia

b. Hypercalcemia

What is the nurse's first priority action to prevent harm when an 82-year-old client with pneumonia has become increasingly confused with an SpO2 change from 91% 1 hour ago to 88% now, and a respiratory rate that has increased from 26 to 32 breaths/min? a. Increasing the flow rate of the IV piggy-back antibiotic b. Increasing the oxygen flow rate by 2 L and reassessing in 5 minutes c. Assisting the client to a more upright position d. Reporting the change in status to the client's primary health care provider

b. Increasing the oxygen flow rate by 2 L and reassessing in 5 minutes

A nurse is caring for a patient using oxygen while in the hospital. What assessment finding indicates that outcomes for patient safety with oxygen therapy are being met? a. The patient understanding the need for oxygen b. Intact skin behind the ears c. Unchanged weight for the past 3 days d. 100% of meals being eaten by the patient

b. Intact skin behind the ears

Which sign or symptom will the nurse report immediately to the pulmonary health care provider to prevent harm for a client who had a percutaneous lung biopsy 2 hours ago? a. Bruising at the puncture site b. Lateral displacement of the trachea c. Oxygen saturation of 97% d. Pink-tinged sputum

b. Lateral displacement of the trachea The trachea should always be midline. Lateral displacement after a percutaneous lung biopsy is associated with complications, especially pneumothorax, which requires immediate intervention.

For which situation will the nurse take immediate action to prevent harm for a client with pneumonia who is receiving 100% oxygen via a nonrebreather mask? a. Sputum is now rust-colored b. Oxygen reservoir deflates during inspiration c. Crackles are present in the lung bases d. Skin is pink and flushed

b. Oxygen reservoir deflates during inspiration

Which problem experienced by a man with late-stage lung cancer is the priority for immediate action by the nurse? a. Anorexia and weight loss b. Pain rating of 9 on a 0-10 scale c. Constipation for 2 days d. Extreme fatigue

b. Pain rating of 9 on a 0-10 scale

How will the nurse categorize the level of asthma control for a client who reports usually waking at night with wheezing once weekly and needing to use the prescribed reliever inhaler to stop the episode? a. Minimally controlled b. Partly controlled c. Controlled d. Uncontrolled

b. Partly controlled

A nurse assesses a patient after an open lung biopsy. Which assessment finding is matched with the correct intervention? a. Patient states that he is dizzy - Nurse applies oxygen and pulse oximetry b. Patient has reduced breath sounds - Nurse calls physician immediately c. Patient's respiratory rate is 18 breaths/min - Nurse decreases oxygen flow rate d. Patient's heart rate is 55 beats/min - Nurse withholds pain medication

b. Patient has reduced breath sounds - Nurse calls physician immediately A potentially serious complication after biopsy is pneumothorax, which is indicated by decreased or absent breath sounds. The physician needs to be notified immediately.

Which complication of seasonal influenza will the nurse suspect in a 78-year-old client whose temperature remains elevated and now has new-onset confusion? a. Tuberculosis b. Pneumonia c. Emphysemia d. Heart failure

b. Pneumonia

The nurse reads the following ABGs and knows the patient is in which condition? pH = 7.32 PaCO2 = 62 mmHg PaO2 = 66 mmHg HCO3- = 28 mEq/L a. Respiratory Acidosis, not compensated b. Respiratory Acidosis, partially compensated c. Respiratory Acidosis, fully compensated d. Metabolic Acidosis, partially compensated

b. Respiratory Acidosis, partially compensated

For which symptoms would a nurse assess a client who worries a thoracentesis earlier today may have caused a pneumothorax? (Select all that apply) a. Slowing heart rate b. Sensation of air hunger c. Pain at the insertion site d. Cyanosis of oral mucous membranes e. Wheezing on inhalation and exhalation f. Tracheal deviation

b. Sensation of air hunger d. Cyanosis of oral mucous membranes f. Tracheal deviation Signs and symptoms of a pneumothorax include sensation of air hunger, tracheal deviation, and cyanosis. Other symptoms include pain on the affected side (not at the insertion site), rapid heart rate, rapid, shallow respirations, prominence of the affected side that does not move in and out with respiratory effort, and new onset of "nagging" cough. Wheezing is a bronchial and bronchiolar problem. It is not produced as a result of a pneumothorax.

Why will the nurse administer vitamin supplements to a client who has cystic fibrosis (CF)? a. Clients are too fatigued to ingest sufficient vitamins and nutrients b. Steatorrhea causes a deficiency of fat-soluble vitamins c. Increased blood levels of vitamins enhance chloride transport activity d. High doses of vitamins can slow the progression of the disease

b. Steatorrhea causes a deficiency of fat-soluble vitamins

Which action to prevent harm has the highest priority for the nurse to include when teaching a client with tuberculosis about the prescribed first-line drug therapy regimen? a. Be sure to drink at least 2 L of fluids daily b. Take these drugs daily exactly as prescribed c. Expect a change in urine color d. Use sunscreen and wear protective clothing when you are out-of-doors

b. Take these drugs daily exactly as prescribed

What is the most important personal infection control measure that the nurse will take when suctioning a client with COVID-19 or any other pandemic influenza? a. Performing oral care before, as well as after, suctioning the oropharynx b. Wearing a disposable particulate mask N95 respirator with face shield or goggles c. Washing hands and donning gloves prior to the procedure d. Keeping the door to the client room closed

b. Wearing a disposable particulate mask N95 respirator with face shield or goggles

A nurse is caring for a patient who has sleep apnea and is prescribed modafinil (Provigil). The patient asks, "How will this medication help me?" How would the nurse respond? a. "This analgesic will increase comfort while you sleep" b. "This medication will promote daytime wakefulness" c. "This medication will treat your sleep apnea" d. "This sedative will help you sleep at night"

b?

A patient admitted for pneumonia has been tachypneic for several days. When the nurse starts an IV to give fluids, the patient questions this action, saying "I have been drinking tons of water. How am I dehydrated?" What response by the nurse is best? a. "Why do you think you are so dehydrated" b. "This is really just to administer your antibiotics" c. "Breathing so quickly can be dehydrating" d. "Everyone with pneumonia is dehydrated"

c. "Breathing so quickly can be dehydrating" Tachypnea and mouth breathing, both seen in pneumonia, increase insensible water loss and can lead to a degree of dehydration. The other options do not give the client useful information.

What is the nurse's best next question after observing that a 60-year-old client's anteroposterior (AP) chest diameter is the same as the lateral chest diameter? a. "What are your hobbies?" b. No questions are needed regarding this normal finding c. "Do you have any chronic breathing problems?" d. "How often do you perform aerobic exercise?"

c. "Do you have any chronic breathing problems?" The normal chest has a lateral diameter that is twice as large as the AP diameter. When the AP diameter approaches or exceeds the lateral diameter, the client is said to have a "barrel" chest. Most commonly, a barrel chest occurs as a result of a long-term chronic airflow limitation problem such as chronic pulmonary disease or severe chronic asthma. It can also be seen in people who have lived at high altitudes for many years.

Which statement made by a client prescribed a reliever drug inhaler for asthma indicates to the nurse correct understanding of this therapy? a. "If I forget a dose, I will use the inhaler as soon as I remember it" b. "At night, I will be sure to store the inhaler in a cool, dry place" c. "I will keep this inhaler with me at all times" d. "Reliever drugs are needed to prevent asthma attacks"

c. "I will keep this inhaler with me at all times"

After teaching a patient who is prescribed a long-acting beta2 agonist medication, a nurse assesses the patient's understanding. Which statement indicates that the patient comprehends the teaching? a. "I will take this medication when I start to experience an asthma attack" b. "I will be weaned off this medication when I no longer need it" c. "I will take this medication every morning to help prevent an acute attack" d. "I will carry this medication with me at all times in case I need it"

c. "I will take this medication every morning to help prevent an acute attack"

A nurse teaches a patient who is prescribed nicotine replacement therapy. Which statement would the nurse include in this patient's teaching? a. "Make a list of reasons why smoking is a bad habit" b. "Rise slowly when getting out of bed in the morning" c. "Smoking while taking this medication will increase your risk of a stroke" d. "Stopping this medication suddenly increases your risk for a heart attack"

c. "Smoking while taking this medication will increase your risk of a stroke"

A nurse in a family practice clinic is preparing discharge instructions for a patient reporting facial pain that is worse when bending over, tenderness across the cheeks, and postnasal discharge. What instruction will be most helpful? a. "Limit fluids to dry out your sinuses." b. "Ice packs may help with the facial pain." c. "Try warm, moist heat packs on your face." d. "We will schedule you for a computed tomography scan this week."

c. "Try warm, moist heat packs on your face." This client has rhinosinusitis. Comfort measures for this condition include humidification, hot packs, nasal saline irrigations, sleeping with the head elevated, increased fluids, and avoiding cigarette smoke.

How will the nurse document the pack-year smoking history for a client who reports smoking 3 packs of cigarettes per day for 25 years and then smoking 2 packs per day for the past 20 years? a. 45-pack-year b. 90-pack-year c. 115-pack-year d. 80-pack-year

c. 115-pack-year Smoking history is documented in pack-years (number of packs per day smoked multiplied by the number of years the client has smoked). 3 packs/day x 25 years = 75 pack-years, plus 2 packs/day x 20 years = 40 pack-years. 75 + 40 = 115 pack-years

Which assessment finding in a client who has had a lobectomy and placement of a chest tube 8 hours ago requires immediate follow-up by the nurse? a. Report of pain at the chest tube insertion site b. 3-cm area of red drainage on the incisional dressing c. 200 mL red drainage from chest tube over 2 hours d. Client sleepy but able to be aroused

c. 200 mL red drainage from chest tube over 2 hours

The nurse is caring for a client who underwent a bronchoscopy performed under moderate sedation an hour ago. Which action will the nurse delegate to an assistive personnel (AP) at this time? a. Determine level of consciousness b. Offer clear liquids to moisten mucous membranes c. Auscultate breath sounds d. Assist with urinal or bedpan use for elimination

d. Assist with urinal or bedpan use for elimination Assisting with elimination is a skill that can safely be performed by assistive personnel (AP) for a stable client.

The nurse has just received report on a group of clients. Which client is the nurse's first priority? a. A 62-year-old with chronic obstructive pulmonary disease (COPD) being discharged with an oxygen saturation of 90% b. A 42-year-old with lung cancer who needs an IV antibiotic administered before going to surgery c. A 22-year-old with cystic fibrosis (CF) who has an elevated temperature and a respiratory rate of 38 breaths/min d. A 52-year-old with end-stage pulmonary fibrosis and an oxygen saturation of 89%

c. A 22-year-old with cystic fibrosis (CF) who has an elevated temperature and a respiratory rate of 38 breaths/min

The nurse has just received report on a group of clients. Which client is the nurse's first priority? a. A 40-year-old admitted 3 hours ago for a scheduled thoracentesis in 30 minutes b. A 55-year-old with bronchogenic lung cancer who returned from bronchoscopy 4 hours ago c. A 30-year-old with acute asthma who has an oxygen saturation of 89% by pulse oximetry d. A 68-year-old with pleural effusion who has decreased breath sounds at the right base

c. A 30-year-old with acute asthma who has an oxygen saturation of 89% by pulse oximetry The client in need of the most immediate assessment is the one with acute asthma with an oxygen saturation of 89% by pulse oximetry. An oxygen saturation level less than 91% indicates hypoxemia and instability requiring immediate assessment and intervention to improve blood and tissue oxygenation.

Which client will the nurse consider to be at greatest risk for an airway obstruction? a. A 25-year-old with a sinus infection b. A 65-year-old who has chronic mouth dryness and many dental caries c. A 35-year-old with a traumatic brain injury d. A 55-year-old who wears upper and lower dentures

c. A 35-year-old with a traumatic brain injury

Which symptom will the nurse expect as typical in an 82-year-old client with pneumonia? a. High fever b. Profound bradycardia c. Acute confusion d. Coughing spasms

c. Acute confusion

What is the nurse's interpretation of a 50-year-old client's respiratory assessment findings when hearing bronchial breath sounds over the left lower lobe and noting decreased fremitus and dullness to percussion in the same area? a. Obstruction of the larger airways b. Normal physical exam for a 50-year-old c. An area of increased density d. Subcutaneous emphysema

c. An area of increased density Peripheral bronchial breath sounds are abnormal and can indicate atelectasis, tumor, or pneumonia. Decreased fremitus and dullness to percussion may indicate pleural effusion, which is more dense than air.

Which action has the highest priority for the nurse caring for a client with facial trauma who has new-onset restlessness? a. Preparing the next dose of prescribed pain medication b. Providing ventilation with a manual resuscitation bag c. Applying oxygen d. Assessing for bleeding on the drip moustache dressing

c. Applying oxygen

A nurse cares for a patient with arthritis who reports frequent asthma attacks. What action would the nurse take first? a. Assess how frequently the patient uses a bronchodilator b. Review the patient's pulmonary function test results c. Ask about medications the patient is currently taking d. Consult the provider and request arterial blood gasses

c. Ask about medications the patient is currently taking Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can trigger asthma in some people. This results from increased production of leukotriene when aspirin or NSAIDs suppress other inflammatory pathways and is a high priority given the client's history.

A nurse cares for a patient who had a bronchoscopy 2 hours ago. The patient asks for a drink of water. What action would the nurse take next? a. Provide the patient with ice chips instead of a drink of water b. Call the physician and request a prescription for food and water c. Assess the patient's gag reflex before giving any food or water d. Let the patient have a small sip to see whether he or she can swallow

c. Assess the patient's gag reflex before giving any food or water

What is the priority assessment the nurse will make for a client with a posterior nosebleed who has posterior packing and is receiving oxygen therapy, antibiotics, and opioid analgesics? a. Determining the degree of mouth dryness b. Examining the skin around the nares for breakdown c. Checking gag and cough reflexes d. Asking about pain relief

c. Checking gag and cough reflexes

A patient is wearing a venturi mask to deliver oxygen and the dinner tray has arrived. What action by the nurse is best? a. Turn the oxygen off while the patient eats the meal and then restart it b. Assess the patient's oxygen saturation and, if normal, turn off the oxygen c. Determine if the patient can switch to a nasal cannula during the meal d. Have the patient lift the mask off the face when taking bites of food

c. Determine if the patient can switch to a nasal cannula during the meal Oxygen is a drug that needs to be delivered constantly. The nurse should determine if the provider has approved switching to a nasal cannula during meals. If not, the nurse should consult with the provider about this issue. The oxygen should not be turned off. Lifting the mask to eat will alter the FiO2 delivered.

Which precaution to prevent harm is most important for the nurse to teach a client who is newly prescribed nicotine replacement therapy (NRT)? a. Immediately report any change in thought process or suicide ideation because this drug can alter behavior b. Avoid crowds and people who are ill because your immunity is reduced while on this drug c. Do not smoke cigarettes or use nicotine in any form while on this drug because the risk for heart attack or stroke is increased d. Be sure to remain in an upright position for an hour after taking the drug to avoid esophageal reflux and ulceration

c. Do not smoke cigarettes or use nicotine in any form while on this drug because the risk for heart attack or stroke is increased NRT contains nicotine and cannot be used when smoking or with nicotine use in any other form because this will greatly increase circulating nicotine levels and the risk for stroke or heart attack.

Which teaching point is most important for the nurse to emphasize for a client who is scheduled to undergo pulmonary function testing (PFT)? a. Avoid strenuous physical activity for 24 hours before the procedure b. Use your bronchodilating inhaler right before arriving for the procedure c. Do not smoke for 6 hours before the test d. Eat only clear liquids for 12 hours before the procedure

c. Do not smoke for 6 hours before the test The essential teaching point for a client being prepared for a PFT is to make sure that the client does not smoke for 6 hours before the test. Smoking can alter parts of the PFT (diffusing capacity [DLCO]), yielding inaccurate results.

Which order or prescription will the nurse perform first for a client admitted with pneumonia who is febrile and also agitated as a result of alcohol intoxication? a. Assessing the need for an immediate dose of lorazepam b. Requesting a referral to a social worker for alcohol counseling c. Drawing blood for aerobic and anaerobic blood cultures d. Administering intravenous antibiotics

c. Drawing blood for aerobic and anaerobic blood cultures

A home health nurse is visiting a new patient who uses oxygen in the home. Which factor helps the nurse determine the patient is in need of more education on using the oxygen safely? a. The patient does not allow smoking in the house b. Flammable liquids are stored in the detached garage c. Electrical cords are not in good working order d. Household light bulbs are the fluorescent type

c. Electrical cords are not in good working order

What action does the nurse take first when a client who has a "do not resuscitate" (DNR) order and a nonrebreather oxygen mask, has labored breathing? a. Only provide comfort to the client b. Notify the chaplain and the family member of record c. Ensure that the tubing is patent and that oxygen flow is high d. Initiate the Rapid Response Team (RRT)

c. Ensure that the tubing is patent and that oxygen flow is high

Which assessment finding in an older client with pneumonia will the nurse report immediately to the primary health care provider? a. Productive cough and normal temperature b. Flushed cheeks and increased respiratory rate c. Hypotension and rapid, weak pulse d. SpO2 of 86% and confusion

c. Hypotension and rapid, weak pulse

When performing an assessment on an older client, which finding is most important for the nurse to assess further? a. Soft speaking voice b. Slight kyphoscoliosis c. Inability to state name and date of birth d. Need to rest after activity

c. Inability to state name and date of birth The nurse would further assess the client who is unable to state name and date of birth. The older client has a higher risk for hypoxemia than a younger client, and often becomes confused during acute respiratory conditions.

A nurse cares for a patient with a 40-year smoking history who is experiencing distended neck veins and dependent edema. Which physiologic process would the nurse correlate with this patient's history and clinical manifestations? a. Increased number and size of mucous glands producing large amounts of thick mucus b. Exposure to irritants resulting in increased inflammation of the bronchi and bronchioles c. Increased pulmonary pressure creating a higher workload on the right side of the heart d. Left ventricular hypertrophy creating a decrease in cardiac output

c. Increased pulmonary pressure creating a higher workload on the right side of the heart

Which action is most important for a nurse to take to prevent complications for a client with a history of chronic obstructive pulmonary disease (COPD) is admitted for a surgical procedure that is unrelated to the respiratory system? a. Assessing the client's respiratory system every 8 hours b. Instructing the client to use a tissue when coughing or sneezing c. Monitoring for signs and symptoms of pneumonia d. Ensuring the client remains in bed for a full 24 hours after surgery

c. Monitoring for signs and symptoms of pneumonia

Which drug will the nurse expect to teach about to a client who has been exposed to inhalation anthrax but does not have symptoms? a. Vancomycin b. Oseltamivir c. Rifampin d. Ciprofloxacin

d. Ciprofloxacin

Which behavior indicates to the nurse that a client preparing for discharge after surgery understands how to perform self-care to prevent harm from aspiration? a. Eats small frequent meals that include a variety of textures and nutrients b. Uses a straw when drinking liquid nutrition supplements c. Positions self upright before eating or drinking anything d. Chooses thin liquids that cause coughing but knows to take small sips

c. Positions self upright before eating or drinking anything

How will the nurse expect a client's age-related decreased skeletal muscle strength to affect gas exchange? a. Reduced gas exchange as a result of decreased alveolar surface b. Reduced gas exchange as a result of longer relaxation of bronchiolar smooth muscles c. Reduced gas exchange as a result of decreased changes in pressures of the chest cavity d. Reduced gas exchange as a result of failure of pulmonary circulation to fully perfuse lung tissue

c. Reduced gas exchange as a result of decreased changes in pressures of the chest cavity Breathing occurs through changes in the size of and pressure within the chest cavity. Contraction and relaxation of chest muscles (and the diaphragm) cause changes in the size and pressure of the chest cavity. When skeletal muscle strength is decreased in these muscles, pressure changes are decreased and less air moves in and out of the lungs. This reduced airflow limits gas exchange at the alveolar-capillary membrane. The alveolar surface itself is not decreased by weaker skeletal muscles, nor does this cause any relaxation of bronchiolar smooth muscle. Weaker skeletal muscles do not directly affect pulmonary circulation.

Which assessment finding is most important for the nurse caring for a client with laryngeal trauma to report immediately to health care provider to prevent harm? a. Productive cough b. Aphonia c. Stridor d. Hoarseness

c. Stridor

A nurse assesses a patient who has facial trauma. Which assessment findings require immediate intervention? a. Nasal stuffiness b. Eye pain c. Stridor d. Edema of the cheek

c. Stridor Stridor is a sign of airway obstruction and requires immediate intervention.

Which action is most appropriate for the nurse to take first when the water seal chamber of the chest drainage device in a client who had a lobectomy has small bubbles when the client coughs? a. Add adidtional sterile water to the water seal chamber b. Checking the tubing for blood clots c. Briefly increasing the amount of suction d. Documenting the finding in the medical record

d. Documenting the finding in the medical record

For which side effects of radiation therapy will the nurse prepare the client who has stage II lung cancer? (Select all that apply) a. Scalp alopecia b. Increased risk for infection c. Increased bruising d. Dry, peeling skin on the chest e. Difficulty swallowing f. Fatigue

d. Dry, peeling skin on the chest e. Difficulty swallowing f. Fatigue

A patient is receiving oxygen at 6 L per nasal cannula. The oxygen saturation level drops below the acceptable range and the patient becomes symptomatic. The nurse needs to do which of the following? a. Apply water-soluble ointment to nares and lips b. Add a humidifier to lessen the affects of dry mucous membranes c. Replace the nasal cannula with a simple mask and titrate oxygen up d. Periodically turn the oxygen down or off

c?

What is the nurse's best response to a client who smokes and is being discharged home on oxygen states, "My lungs are already damaged, so I'm not going to quit smoking?" a. "Tell me more about why you think quitting won't help you" b. "For safety, lower your oxygen flow rate when you smoke" c. "The progression to damage to your lungs can be slowed if you stop smoking now" d. "For now, let's discuss why smoking around oxygen is dangerous"

d. "For now, let's discuss why smoking around oxygen is dangerous"

The nurse has just received report on a group of clients. Which client is the nurse's first priority? a. A 50-year-old who is 1 day postoperative for abdominal surgery and is receiving 2 L oxygen by nasal cannula b. A 55-year-old who was admitted yesterday with pneumonia and is receiving antibiotics and oxygen through a nasal cannula c. A 45-year-old who is being discharged with a new prescription for home oxygen therapy by nasal cannula d. A 60-year-old admitted 2 hours ago who has a 90-pack-year smoking history and is receiving 50% oxygen by Venturi mask

d. A 60-year-old admitted 2 hours ago who has a 90-pack-year smoking history and is receiving 50% oxygen by Venturi mask

The emergency department (ED) manager is reviewing patient charts to determine how well the staff performs when treating patients with community-acquired pneumonia. What outcome demonstrates that goals for this patient type have been met? a. Chest x-ray obtained within 30 minutes b. Blood cultures obtained within 20 minutes c. Pulse oximetry obtained on all patients d. Antibiotics started before admission

d. Antibiotics started before admission Goals for treatment of community-acquired pneumonia include initiating antibiotics prior to inpatient admission or within 6 hours of presentation to the ED. Timely collection of blood cultures, chest x-rays, and pulse ox are important as well but do not coincide with establish goals.

What is the most relevant technique for the nurse to use when assessing a client for dyspnea? a. Checking oxygen saturation by pulse oximetry b. Observing the client's rate, depth, and ease of inhalation and exhalation c. Comparing previous respiratory assessment information with current data d. Asking the client about whether any breathlessness is present

d. Asking the client about whether any breathlessness is present Dyspnea, difficulty in breathing or breathlessness, is a subjective perception and varies among clients. Thus, only the client can rate his or her level of dyspnea.

A patient has been diagnosed with tuberculosis (TB). What action by the nurse takes highest priority? a. Encouraging the patient to eat a well-balanced diet b. Teaching the patient ways to balance rest with activity c. Informing the patient about follow-up sputum cultures d. Educating the patient on adherence to the treatment regimen

d. Educating the patient on adherence to the treatment regimen The treatment regimen for TB often ranges from 26 weeks, but can be up to 2 years, making adherence problematic for many people. The nurse would stress the absolute importance of following the treatment plan for the entire duration of prescribed therapy.

How will the nurse document the client's respiratory assessment findings on auscultation that are heard as popping, discontinuous, high-pitched sounds at the end of exhalation? a. Coarse crackles b. Rhonchi c. Wheezes d. Fine crackles

d. Fine crackles Fine crackles are heard as popping, discontinuous sounds that are high-pitched heard at the end of inhalation. Squeaky, musical continuous sounds heard when the client inhales and exhales are abnormal (adventitious) and described as wheezes. Coarse crackles are a rattling sound. Rhonchi are heard as low-pitched continuous snoring sounds.

A nurse evaluates the following arterial blood gas and vital sign results for a patient with chronic obstructive pulmonary disease (COPD): pH = 7.32 PaCO2 = 62 mmHg PaO2 = 66 mmHg HCO3- = 28 mEq/L Heart Rate = 110 beats/min Respiratory Rate = 12 breaths/min Blood pressure = 145/65 mmHg Oxygen saturation = 76% What action would the nurse take first? a. Document the findings as normal for a patient with COPD b. Teach the patient diaphragmatic breathing techniques c. Administer a short-acting beta2 agonist inhaler d. Initiate oxygenation therapy to increase saturation to 92%

d. Initiate oxygenation therapy to increase saturation to 92% Oxygen would be administered to a client who is hypoxic even if the client has COPD and is a carbon dioxide retainer. The other interventions do not address the client's hypoxia, which is the major issue. There is no indication the client needs an inhaler. Diaphragmatic breathing techniques would not be taught to a client in distress. These findings are not normal for all clients with COPD.

A nurse obtains the health history of a patient who is recently diagnosed with lung cancer and identifies that the patient has a 60-pack-year smoking history. Which action is most important for the nurse to take when interviewing this patient? a. Encourage the patient to be completely honest about both tobacco and marijuana use b. Tell the patient that he needs to quit smoking to stop further cancer development c. Avoid giving the patient false hope regarding cancer treatment and prognosis d. Maintain a nonjudgmental attitude to avoid causing the patient to feel guilty

d. Maintain a nonjudgmental attitude to avoid causing the patient to feel guilty

Which blood gas value indicates to the nurse that a client is experiencing hypercarbia? a. Bicarbonate = 20 mEq/L b. pH = 7.33 c. PaO2 = 80 mmHg d. PaCO2 = 60 mmHg

d. PaCO2 = 60 mmHg

What is the priority action for the nurse to take when a client comes to the emergency department with extremely labored breathing and a history of asthma that is unresponsive to prescribed inhalers? a. Establishing IV access to give emergency medications b. Asking the client how long he or she has had asthma and what triggered this attack c. Preparing the client for intubation d. Placing the client in a high-Fowler position, and starting oxygen

d. Placing the client in a high-Fowler position, and starting oxygen

What is the nurse's best first action on finding the client's oxygen saturation by pulse oximetry on the finger is 84%? a. Apply supplemental oxygen by mask or nasal cannula b. Notify the Rapid Response Team immediately c. Assess the client's cognitive function d. Recheck the value on the forehead

d. Recheck the value on the forehead Although a true low oxygen saturation is an emergency, there are many causes of a low reading using pulse oximetry. The value should be verified immediately before any interventions are implemented.

Which point is most important to prevent harm for the nurse to teach a client with chronic obstructive pulmonary disease (COPD) who is being discharged on home oxygen therapy? a. Correct performance when setting up the oxygen delivery system b. Understanding the signs and symptoms of hypoxemia c. Demonstrating how to use a pulse oximetry device d. Removing combustion hazards present in the home

d. Removing combustion hazards present in the home

Which outcome indicates to the nurse that oxygen therapy for the client with chronic obstructive pulmonary disease (COPD) who has hypoxemia and hypercarbia is effective? a. PCO2 is within normal range b. Finger clubbing is resolved c. Client reports decreased distress d. SpO2 is between 88% and 90%

d. SpO2 is between 88% and 90%

Which teaching point is most important for the patient with a peritonsillar abscess? a. Gargle with warm salt water b. Wash hands frequently c. Let us know if you want liquid medications d. Take all antibiotics as directed

d. Take all antibiotics as directed Any client on antibiotics must be instructed to complete the entire course of antibiotics. Not completing them can lead to complications or drug-resistant strains of bacteria. The other instructions are appropriate, just not the most important.

Which primary health care provider's instruction will the nurse question for a client being discharged with nasal packing in place after a posterior nosebleed? a. Sleep in a recliner or with the head in an elevated position. b. Go to the nearest emergency room if bleeding recurs. c. Use a home humidifier for at least 5 days. d. Take ibuprofen 800 mg every 8 hours as needed for pain.

d. Take ibuprofen 800 mg every 8 hours as needed for pain.

Which type of ADL assistance will the nurse plan for a client with long-standing pulmonary problems who has Class IV dyspnea? a. Dyspnea is minimal and no assistance is required. b. The client is severely dyspneic at rest and cannot participate in any self-care. c. The client may complete ADLs without assistance but requires rest periods during performance. d. The client is severely dyspneic with activity and requires assistance for bathing and dressing.

d. The client is severely dyspneic with activity and requires assistance for bathing and dressing. Class IV dyspnea occurs during usual activities, such as showering and dressing, and requires assistance from others. Dyspnea is usually not present at rest, but is with minimal exertion.

Which action is most important to teach a client living with progressing idiopathic pulmonary fibrosis? a. Maintaining an oral fluid intake of at least 2 L daily b. Taking oral temperature daily c. Using oxygen by nasal cannula whenever dyspnea is present d. Using energy conservation measures

d. Using energy conservation measures

A nurse is caring for a patient who is scheduled to undergo a thoracentesis. Which intervention would the nurse complete prior to the procedure? a. Measure oxygen saturation before and after a 12-minute walk b. Explain the procedure in detail to the patient and the family c. Verify that the patient understands all possible complications d. Validate that informed consent has been given by the patient

d. Validate that informed consent has been given by the patient A thoracentesis is an invasive procedure with many potentially serious complications.

A nurse assesses a patient who is 6 hours post-surgery for a nasal fracture and has nasal packing in place. The nurse would take all of the following actions, except: a. Assess for signs of bleeding b. Ask the patient to open his or her mouth c. Observe for clear drainage d. Watch the patient for frequent swallowing e. Administer a nasal steroid to decrease edema

e. Administer a nasal steroid to decrease edema A nasal steroid would increase the risk for infection. The nurse should observe for clear drainage because of the risk for cerebrospinal fluid leakage. The nurse should assess for signs of bleeding by asking the client to open his or her mouth and observing the back of the throat for bleeding. The nurse should also note whether the client is swallowing frequently because this could indicate postnasal bleeding.