chapter 49

Question 1

Which action is the purpose of the cilia?
a. Warm and moisturize inhaled air.
b. Sweep debris toward nasal cavity.
c. Stimulate cough reflex.
d. Produce mucus.

Answer 1

b. Sweep debris toward nasal cavity.

Question 2

Which event happens when there is a decrease in the oxygen level in the blood?
a. Pituitary stimulates the respiratory system to increase respiratory rate.
b. The alveoli diffuse more oxygen into the blood.
c. Chemoreceptors in the carotid body and aortic body stimulate the respiratory centers to modify respiratory rates.
d. The parietal pleura increases the negative pressure.

Answer 2

c. Chemoreceptors in the carotid body and aortic body stimulate the respiratory centers to modify respiratory rates.

Question 3

A problem for the patient with a new laryngectomy would be feelings of isolation due to
being unable to communicate verbally. Which nursing intervention is appropriate?
a. Complete care quickly.
b. Provide a pad and pencil or magic slate.
c. Refrain from conversations with the patient to reduce stress level.
d. Offer books or jigsaw puzzles for entertainment.

Answer 3

b. Provide a pad and pencil or magic slate.

Question 4

A patient comes to the health nurse at the workplace with epistaxis. The patient reports
frequent nosebleeds that have usually been controlled without intervention. Which
assessmentwould be the most helpful after the nurse has stopped the bleeding?
a. Obtain a blood pressure.
b. Record the approximate amount of blood lost.
c. Inquire about a headache.
d. Record the last episode of epistaxis.

Answer 4

a. Obtain a blood pressure.

Question 5

The nurse assessing an 11 year old who is having an asthma attack expects to hear which
adventitious sounds
a. Friction rub.
b. Expiratory wheezes
c. Crackles.
d. Absent breath sounds .

Answer 5

b. Expiratory wheezes

Question 6

How will the kidneys respond in respiratory acidosis?
a. Retain bicarbonate to increase the pH.
b. Excrete more urine to reduce potassium.
c. Concentrate the urine to conserve circulating fluid in the bloodstream.
d. Lower the pH by excretion of bicarbonate.

Answer 6

a. Retain bicarbonate to increase the pH.

Question 7

An 83-year-old patient is admitted with a temperature of 102°F (38.8°C), chest pain, and
fatigue. Which term describes the infected fluid that the health care provider removes from
the pleural cavity?
a. Emboli
b. Emphysema
c. Sputum
d. Empyema

Answer 7

d. Empyema

Question 8

Which instruction by the nurse is inappropriate for teaching the proper technique for
collection of a sputum specimen?
a. Bring the sputum up from the lungs.
b. Rinse mouth with water before expectorating in specimen cup.
c. Collect specimens after meals.
d. Send specimen to the lab without delay.

Answer 8

c. Collect specimens after meals.

Question 9

When assessing the SaO2 with a pulse oximeter, the nurse will place the oximeter on a
finger with which consideration?
a. on the same side as the blood pressure cuff.
b. while exercising the arm to stimulate circulation.
c. that is a normal temperature.
d. on the same side as an arterial catheter.

Answer 9

c. that is a normal temperature.

Question 10

A patient, age 69, has emphysema. On assessment, the nurse notes the presence of a “barrel
chest.” Which pathology causes this to occur?
a. An increase in the lateromedial area from hypertrophy of mucous glands in the
bronchi
b. An increased anteroposterior diameter caused by overinflation of the alveoli
c. A decrease in anteroposterior diameter caused by chronic dilation of the bronchi
d. A widening of the sternocostal area secondary to chronic constriction of smooth
muscles in the airways leading to bronchospasms

Answer 10

b. An increased anteroposterior diameter caused by overinflation of the alveoli

Question 11

A patient, age 22, is admitted with acute asthma. The patient shows a pulse oximetry level
of SaO2 of 82%. How should the nurse interpret this?
a. Only 82% of the red blood cells are able to use oxygen.
b. There is only 82% of oxygen bound to the hemoglobin compared with the amount
available.
c. Eighteen percent of oxygen is not dissolved in the blood.
d. The muscular respiratory effort is only 18% effective.

Answer 11

b. There is only 82% of oxygen bound to the hemoglobin compared with the amount
available.

Question 12

Which nursing intervention is for a patient, age 40, who is diagnosed with active
tuberculosis?
a. Place the patient in drainage and secretion precautions.
b. Place the patient in acid-fast bacillus (AFB) Isolation Precautions.
c. Maintain the patient in enteric isolation.
d. Place the patient in any Isolation Precautions.

Answer 12

b. Place the patient in acid-fast bacillus (AFB) Isolation Precautions.

Question 13

How should the newly diagnosed patient who has been prescribed isoniazid (INH) for the
treatment of active tuberculosis (TB) be advised?
a. Report redness and swelling of extremities.
b. Be aware that the therapy is long term.
c. Monitor renal function every several months.
d. Rise slowly to avoid dizziness.

Answer 13

b. Be aware that the therapy is long term.

Question 14

The patient has advanced emphysema and reports experiencing dyspnea and fatigue. Which
nursing intervention would be appropriate for the patient who is having difficulty with
activity tolerance?
a. Direct patient in vigorous independent ROM.
b. Allow to exercise until respirations are over 20 breaths/min over baseline.
c. Plan care to provide optimum rest.
d. Provide frequent cool showers.

Answer 14

c. Plan care to provide optimum rest.

Question 15

A patient is on postoperative day 2 after undergoing a total hip replacement. The patient
suddenly complains of chest pain and is coughing up blood-tinged sputum. Which action
should be the nurse’s initial intervention?
a. Report signs to the charge nurse.
b. Elevate head of bed and administer oxygen.
c. Prevent patient from excessive coughing.
d. Increase IV flow rate.

Answer 15

b. Elevate head of bed and administer oxygen.

Question 16

Activities, such as walking, will have which benefit for the patient with emphysema?
a. Repair dilated alveoli.
b. Increase capacity to use oxygen.
c. Lessen the oxygen needs.
d. Lessen metabolic oxygen needs.

Answer 16

b. Increase capacity to use oxygen.

Question 17

The patient with long-term emphysema is admitted with a secondary diagnosis of cor
pulmonale. Which symptoms will the patient likely exhibit?
a. Edema of the lower extremities and extended neck veins due to hypertension of the
pulmonary circulation.
b. A dry hacking cough and chest pain due to constriction of the pulmonary vein.
c. Hypertension and a headache related to pulmonary hypertension.
d. Unlabored respiration and cyanosis around the mouth.

Answer 17

a. Edema of the lower extremities and extended neck veins due to hypertension of the
pulmonary circulation.

Question 18

Which feature is a major advantage of video-assisted thoracoscopic surgery (VATS)?
a. The surgeon can record entire surgical procedure on a video.
b. The surgeon can remove tumors of the lung through a small keyhole incision.
c. The surgeon can x-ray and excise tumor in the same procedure.
d. The surgeon can avoid the use of a closed chest drainage system after surgery.

Answer 18

b. The surgeon can remove tumors of the lung through a small keyhole incision.

Question 19

In which manner would the nurse examining a patient with pleurisy document a low-pitched
grating lung sound?
a. Sonorous wheeze
b. Friction rub
c. Coarse crackles
d. Crackles

Answer 19

b. Friction rub

Question 20

In which way is inspiratory capacity defined?
a. The amount of air in the lung after a maximal inhalation
b. The amount of air moved with each normal inhalation and expiration
In which way is inspiratory capacity defined?
c. The amount of air that can be inhaled in one breath from the resting expiratory level
d. The amount of air that can be forcefully exhaled after maximum inhalation

Answer 20

c. The amount of air that can be inhaled in one breath from the resting expiratory level

Question 21

The older adult patient with long-term emphysema reports experiencing a sharp pleuritic pain after a severe period of coughing. The patient’s heart rate and respiratory rate have
increased. Auscultation reveals no breath sounds on the left side. These are signs and symptoms of which condition?
a. Pulmonary embolus
b. Spontaneous pneumothorax
c. Early signs of unilateral pneumonia
d. An attack of asthma

Answer 21

b. Spontaneous pneumothorax

Question 22

Which important precaution should the nurse include when instructing a patient with
emphysema on the use of home oxygen?
a. Use oxygen only when extremely short of breath.
b. Keep the home oxygen regulator set on 6 L.
c. Use home oxygen at night while sleeping.
d. Limit to 1 to 2 L oxygen flow.

Answer 22

d. Limit to 1 to 2 L oxygen flow.

Question 23

The patient who had a bronchoscopy 1 hour ago asks when eating will be possible. . Which
response would be most helpful?
a. In 24 hours, but must take cold liquids for the rest of the day
b. If there is no blood in his sputum
c. In 8 hours after a period of nothing by mouth
d. When the gag reflex returns

Answer 23

d. When the gag reflex returns

Question 24

The nurse caring for a patient who has a closed chest drainage system notes that there is
fluctuation (tidaling) in the water seal chamber. Which action is appropriate based on this
assessment?
a. Document the tidaling.
b. Elevate the head of the bed and notify charge nurse of malfunction of drainage
system.
c. Add more sterile water to the water seal chamber.
d. Turn patient to the affected side.

Answer 24

a. Document the tidaling.

Question 25

In which way does pursed lip breathing assist patients with asthma during an attack?
a. It distracts the patient with breathing technique to reduce anxiety.
b. It gets rid of CO2 faster.
c. It decreases breathing efforts .
d. It increases PACO2.

Answer 25

c. It decreases breathing efforts .

Question 26

In which way do leukotriene modifiers reduce the symptoms of asthma?
a. By drying up mucus
b. By causing bronchodilation and anti-inflammation effects
c. By suppressing cough
d. By liquefying mucus

Answer 26

b. By causing bronchodilation and anti-inflammation effects

Question 27

In which way should a patient be positioned after a thoracentesis is completed and the
dressing applied?
a. High Fowler
b. Semi-Fowler
c. Side lying on unaffected side
d. Prone

Answer 27

c. Side lying on unaffected side

Question 28

Which intervention should the nurse use to keep the chest tubes from becoming occluded?
a. Irrigate tubes as needed.
b. Prevent the patient from lying on it.
c. Loop the tube over the bed rail.
d. “Milk” the tube frequently.

Answer 28

b. Prevent the patient from lying on it.

Question 29

Which patient assessment indicates the most severe respiratory distress?
a. Nasal flaring, symmetrical chest wall expansion, SaO2 88%
b. Abdominal breathing, SaO2 97%
c. Substernal retraction, SaO2 84%
d. Substernal retraction, SaO2 90%

Answer 29

c. Substernal retraction, SaO2 84%

Question 30

In which part of the pharynx is the superior portion of the pharynx located?
a. Nasopharynx
b. Posteriopharynx
c. Oropharynx
d. Laryngopharynx

Answer 30

a. Nasopharynx

Question 31

Exposure to an asthma trigger can cause which aspect of asthma to occur next?
a. Inflammatory process in the mast cells of the lungs
b. Increase in edema and mucus production in the bronchioles
c. Release of histamine
d. Narrowing of the airways

Answer 31

a. Inflammatory process in the mast cells of the lungs

Question 32

The ? are the structures of the lung in which gas exchange occurs.

Answer 32

alveoli

Question 33

The are the structures of the lung in which gas exchange occurs ?

Answer 33

glottis