Chapter 30 Lower Resp

Question 1

1. What clinical manifestations should the nurse expect when assessing a client with pneumococcal pneumonia?
   a. Fever, chills, and a productive cough with purulent sputum
   b. Nonproductive cough and night sweats that are usually self-limiting
   c. Gradual onset of nasal stuffiness, sore throat, and purulent productive cough
   d. Abrupt onset of fever, nonproductive cough, and formation of lung abscesses

Answer 1

A

Question 2

2. A client with pneumonia has the nursing diagnosis of ineffective airway clearance related to excessive mucus and retained secretions. What would be an appropriate nursing intervention?
   a. Promote fluid hydration, as appropriate, to help liquefy secretions.
   b. Provide analgesics as ordered to promote client comfort.
   c. Administer oxygen as prescribed to maintain optimal oxygen levels.
   d. Teach the client how to cough effectively to bring secretions to the mouth.

Answer 2

A

Question 3

3. A client with tuberculosis (TB) has a history of nonadherence to the medication regimen. What is the most common cause of this behaviour in clients with TB?
   a. Fatigue and lack of energy to manage self-care
   b. Lack of knowledge about how the disease is transmitted
   c. Lack of social support systems for the client and family
   d. Feelings of shame and the response to the social stigma associated with TB

Answer 3

D

Question 4

4. A client has been receiving high-dose corticosteroids and broad-spectrum antibiotics for treatment of serious trauma and infection. Which of the following infections is the client most susceptible to?
   a. Aspergillosis
   b. Candidiasis
   c. Coccidioidomycosis
   d. Histoplasmosis

Answer 4

B

Question 5

5. Which of the following statements best describes the treatment of lung abscess?
   a. It is best treated with surgical excision and drainage.
   b. Antibiotics for a prolonged period is the treatment of choice.
   c. Abscesses are difficult to treat and usually result in pulmonary fibrosis.
   d. Penicillin can effectively eradicate anaerobic organisms.

Answer 5

B

Question 6

6. What is a common complication of many types of environmental lung diseases?
   a. Benign tumour growth
   b. Diffuse airway obstruction
   c. Liquefactive necrosis
   d. Pulmonary fibrosis

Answer 6

D

Question 7

7. What type of lung cancer is generally associated with the best prognosis because it is potentially surgically resectable?
   a. Adenocarcinoma
   b. Small cell carcinoma
   c. Squamous cell carcinoma
   d. Undifferentiated large cell carcinoma

Answer 7

C

Question 8

8. How does the nurse identify in a client a flail chest caused by trauma?
   a. Multiple rib fractures are determined by radiographic study.
   b. Tracheal deviation to the unaffected side is present.
   c. Paradoxical chest movement occurs during respiration.
   d. Decreased movement of the involved chest wall is apparent.

Answer 8

C

Question 9

9. The nurse notes tidalling of the water level in the tube submerged in the water-seal chamber in a client with closed chest tube drainage. What should the nurse do?
   a. Continue to monitor this normal finding.
   b. Check all connections for a leak in the system.
   c. Lower the drainage collector further from the chest.
   d. Clamp the tubing at progressively more distal points from the client until the tidalling stops.

Answer 9

A

Question 10

10. Which nursing measure should be instituted after a pneumonectomy?
    a. Monitor chest tube drainage and functioning.
    b. Position the client on the operative side or the back.
    c. Perform range-of-motion exercises on the affected upper extremity.
    d. Auscultate frequently for lung sounds on the affected side.

Answer 10

B

Question 11

11. What is the cause of respiratory problems in clients with Guillain-Barré syndrome?
    a. Central nervous system depression
    b. Deformed chest-wall muscles
    c. Paralysis of the diaphragm secondary to trauma
    d. Interruption of nerve transmission to respiratory muscles

Answer 11

D

Question 12

12. A client with chronic obstructive pulmonary disease asks why the heart is affected by the respiratory disease. Which of the following statements regarding cor pulmonale is the basis for the nurse’s response to the client?
    a. Pulmonary congestion secondary to left ventricular failure
    b. Excess serous fluid collection in the alveoli caused by retained respiratory secretions
    c. Right ventricular hypertrophy secondary to increased pulmonary vascular resistance
    d. Right ventricular failure secondary to compression of the heart by hyperinflated lungs

Answer 12

C

Question 13

13. Which statement(s) describe(s) the management of a client following lung transplantation? (Select all that apply)
    a. High doses of oxygen are administered around the clock.
    b. The use of a home spirometer will help to monitor lung function.
    c. Immuno-suppressant therapy usually involves a three drug regimen.
    d. Most clients experience an acute rejection episode in the first 2 days.
    e. The lung is biopsied using a transtracheal method if rejection is suspected.

Answer 13

B C E