Iggy Questions Cpt 29 & 30 Flashcards
Which of these clients will the charge nurse on the medical unit assign to an RN who has floated from the postanesthesia care unit (PACU)?
A) Client with allergic rhinitis scheduled for skin testing B) Client with emphysema who needs teaching about pulmonary function testing C) Client with pancreatitis who needs a preoperative chest x-ray D)Client with pleural effusion who has had 1200 mL removed by thoracentesis
D
Correct: A nurse working in the PACU would be familiar with assessing vital signs and respiratory status after procedures such as thoracentesis.
An RN and an LPN/LVN are working together to provide care for a client hospitalized with dyspnea who requires all of these nursing actions. Which of these actions is best accomplished by the RN?
A) Administer the purified protein derivative (PPD) for tuberculosis testing. B) Assess vital signs and the puncture site after thoracentesis. C) Monitor oxygen saturation using pulse oximetry every 4 hours. D) Plan client and family teaching regarding upcoming pulmonary function testing.
D
Correct: Developing the teaching plan is the most complex of the skills listed and requires RN education and licensure
A client has returned to the postanesthesia care unit (PACU) after a bronchoscopy. Which of these nursing tasks is best for the charge nurse to delegate to the experienced nursing assistant working in PACU?
A) Assess breath sounds. B) Check gag reflex. C) Determine level of consciousness. D) Monitor blood pressure and pulse.
D
Correct: A nursing assistant working in the PACU would have experience in taking client vital signs after the client has had conscious sedation or anesthesia.
The RN has received report about all of these clients. Which client needs the most immediate assessment?
A) Client with acute asthma who has an oxygen saturation of 89% by pulse oximetry B) Client admitted 3 hours ago for a scheduled thoracentesis in 30 minutes C) Client with bronchogenic lung cancer who returned from bronchoscopy 3 hours ago D) Client with pleural effusion who has decreased breath sounds at the right base
A
Correct: An oxygen saturation level less than 91% indicates hypoxemia and requires immediate assessment and intervention to improve blood and tissue oxygenation.
The home health nurse is assigned to visit all of these clients when a change in agency staffing requires that one of the clients should be rescheduled for a visit on the following day. Which of these clients would be best to reschedule?
A) Client with emphysema who has been on home oxygen for a month and has SPO2 levels of 91% to 93% B) Client with history of a cough, weight loss, and night sweats who has just had a positive Mantoux test C) Client with newly diagnosed pleural effusion who needs an admission visit and an initial intake assessment D) Client with percutaneous lung biopsy yesterday who called in to report increased dyspnea
A
This client has an appropriate Spo2 for home oxygen use.
Which of these assessment findings will be of greatest concern when the nurse is assessing a client with emphysema?
A) Barrel-shaped chest B) Bronchial breath sounds heard at the bases C) Hyperresonance to percussion of the chest D) Ribs lying horizontal
B
Correct: Bronchial breath sounds are not normally heard in the periphery and may indicate increased lung density, as in a tumor or an infective process such as pneumonia.
People involved in which occupations or activities are encouraged to wear masks and to have adequate ventilations? Select all that apply.
A) Bakers
B) Coal miners
C) Electricians
D) Furniture refinishers
E) Plumbers
F) Potters
A,B,D,F
Correct: Being exposed to flour as a baker for prolonged periods of time may cause a condition called occupational asthma.
Correct: Coal miners are at risk to develop pneumoconiosis as the result of inhalation of coal dust.
Correct: Owing to the chemicals used to refinish furniture (paint strippers, solvents), masks and adequate ventilation are essential for furniture refinishers. One of the main solvents involved will metabolize in the body to carbon monoxide and will impair the ability of the tissue to extract oxygen.
Correct: Silicosis or inhalation of silica dust is a hazard for professional and recreational potters.
Which nursing intervention is the priority in preparing the client for pulmonary function testing (PFT)?
A) Administer bronchodilator medication on call. B) Encourage clear fluid intake 12 hours before the procedure C) Ensure no smoking 6 hours before the test. D) Provide supplemental oxygen as testing begins.
C
Correct: If the client has been smoking, this may alter parts of the PFT (diffusing capacity [DlCO]), yielding inaccurate results.
The nurse is performing a client assessment for the client’s potential employer. The client reports dyspnea when climbing stairs but is not dyspneic at rest. Which dyspnea classification does the nurse assign to this client in the report to the employer?
A) Class I, can perform perform manual labor B) Class II, can perform desk job C) Class III, minimally employable D) Class IV, must remain at home
B
Correct: This client is dyspneic when climbing stairs or walking on an incline but not on level walking. Therefore, this client is employable only for a sedentary job or under special circumstances.
A client comes to the emergency department with a productive cough. Which symptom does the nurse look for that will require immediate attention?
A) Blood in the sputum B) Mucoid sputum C) Pink frothy sputum D) Yellow sputum
C
Correct: Pink frothy sputum is common with pulmonary edema and requires immediate attention and intervention to prevent the client’s condition from getting worse.
A client with asthma reports shortness of breath. What is the nurse assessing when auscultating this client’s chest?
A) Adventitious breath sounds B) Fremitus C) Oxygenation status D) Respiratory excursion
A
Correct: Adventitious sounds are additional breath sounds superimposed on normal sounds. They indicate pathologic changes in the lung.
Four clients are sent back to the emergency department from triage at the same time. Which client requires the nurse’s immediate attention?
A) Client with acute allergic reaction B) Client with dyspnea on exertion C) Client with lung cancer with cough D) Client with sinus infection with fever
A
Correct: An acute allergic reaction can lead to immediate respiratory distress. This is an emergent situation that requires the immediate attention of the nurse.
The nurse auscultates popping, discontinuous sounds over the client’s anterior chest. How does the nurse classify these sounds?
A) Crackles B) Rhonchi C) Pleural friction rub D) Wheeze
A
orrect: Crackles are described as a popping, discontinuous sound caused by air moving into previously deflated airways. The airways have been deflated due to the presence of fluids in the lungs, and crackles should be considered to be a sign of fluid overload.
In the older adult client, which respiratory change does not require further assessment by the nurse?
A) Increased anteroposterior (AP) diameter B) Increased respiratory rate C) Shortness of breath D) Sputum production
A
orrect: Increased AP diameter is normal with aging.
In assessing the client’s respiratory status, blood gas test results reveal pH of 7.50, PaO2 of 99, PaCO2 of 29, and HCOes001-1.jpg of 22. What action does the nurse need to take first?
A) Call the physician. B) Encourage the client to slow his breathing rate. C) Nothing. These results are within the normal range. D) Provide oxygen support.
B
Correct: The arterial blood gases (ABGs) indicate respiratory alkalosis, which is commonly caused by hyperventilation. Encouraging the client to slow down his breathing rate may help him return to normal breathing and may correct this abnormality.
The client returns to the medical unit after a therapeutic bronchoscopy. Which intervention does the nurse apply first?
A) Assess the puncture site for drainage. B) Implement NPO (nothing by mouth) status. C) Monitor for signs of anaphylaxis. D) Perform aggressive chest physiotherapy.
B
Correct: Until the client has a gag reflex and is fully alert, he should be maintained on NPO status to prevent aspiration.
Why are the turbinates important?
A) They decrease the weight of the skull on the neck. B) They increase the surface area of the nose for heating and filtering. C) They move inspired particles from nose to throat for removal. D)They separate two nasal passages down the middle.
B
Correct: The turbinates increase the surface area of the nose, so that more heating, filtering, and humidifying of inspired air can occur before air passes into the nasopharynx.
A client is having surgery. He asks his nurse, “When they put that tube in my throat, where does it really go?” What is the name of the opening of the vocal cords?
A) Arytenoid cartilage B) Epiglottis C) Glottis D) Palatine tonsils
C
Correct: The glottis is the opening of the vocal cords into which the endotracheal tube is passed during intubation for surgery.
Where does gas exchange occur?
A) Acinus B) Alveolus C)Bronchus D) Carina
B
Correct: The alveolus is the structural unit of the lung where gas exchange occurs.
