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32 (2) > Respiratory > Flashcards

Respiratory Flashcards

1
Q

A nurse is admitting a client who has active tuberculosis to a room on a medical-surgical unit. Which of the following room assignments should the nurse make for the client?

A. A room with air exhaust directly to the outdoor environment
B. A room with another nonsurgical client
C. A room in the ICU
D. A room that is within view of the nurses’ station

A

A. A room with air exhaust directly to the outdoor environment

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2
Q

A nurse is caring for a client who has emphysema. Which of the following findings should the nurse expect to assess in this client?
(Select all that apply.)

A. Dyspnea 
B. Bradycardia 
C. Barrel chest
D. Clubbing of the fingers 
E. Deep respirations
A

A. Dyspnea
C. Barrel chest
D. Clubbing of the fingers

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3
Q

A nurse is caring for a client who has chronic obstructive pulmonary disease (COPD). The client tells the nurse, “I can feel the congestion in my lungs, and I certainly cough a lot, but I can’t seem to bring anything up.” Which of the following actions should the nurse take to help this client with tenacious bronchial secretions?

A. Maintaining a semi-Fowler’s position as often as possible
B. Administering oxygen via nasal cannula at 2 L/min
C. Helping the client select a low-salt diet
D. Encouraging the client to drink 2 to 3 L of water daily

A

D. Encouraging the client to drink 2 to 3 L of water daily

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4
Q

A nurse is observing the closed chest drainage system of a client who is 24 hr post thoracotomy. The nurse notes slow, steady bubbling in the suction control chamber. Which of the following actions should the nurse take?

A. Check the tubing connections for leaks.
B. Check the suction control outlet on the wall.
C. Clamp the chest tube.
D. Continue to monitor the client’s respiratory status.

A

D. Continue to monitor the client’s respiratory status.

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5
Q

A nurse is caring for a client who is in the immediate postoperative period following a partial laryngectomy. Which of the following parameters should the nurse assess first?

A. Pain severity
B. Wound drainage
C. Tissue integrity
D. Airway patency

A

D. Airway patency

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6
Q

A nurse is caring for a client with a tracheostomy. The client’s partner has been taught to perform suctioning. Which of the following actions by the partner should indicate to the nurse a readiness for the client’s discharge?

A. Attending a class given about tracheostomy care
B. Verbalizing all steps in the procedure
C. Performing the procedure independently
D. Asking appropriate questions about suctioning

A

C. Performing the procedure independently

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7
Q

A nurse is teaching a client who is obese and has obstructive sleep apnea how to decrease the number of nightly apneic episodes. Which of the following client statements indicates an understanding of the teaching?

A. “It might help if I tried sleeping only on my back.”
B. “I’ll sleep better if I take a sleeping pill at night.”
C. “I’ll get a humidifier to run at my bedside at night.”
D. “If I could lose about 50 pounds, I might stop having so many apneic episodes.”

A

D. “If I could lose about 50 pounds, I might stop having so many apneic episodes.”

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8
Q

A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs? pH 7.22 PaCO2 68 mm Hg Base excess -2 PaO2 78 mm Hg Saturation 80% Bicarbonate 26 mEq/L

A. Respiratory acidosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis

A

A. Respiratory acidosis

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9
Q

A nurse is caring for four hospitalized clients. Which of the following clients should the nurse identify as being at risk for fluid volume deficit?

A. The client who has been NPO since midnight for endoscopy.
B. The client who has left-sided heart failure and has a brain natriuretic peptide (BNP) level of 600 pg/mL.
C. The client who has end-stage renal failure and is scheduled for dialysis today.
D. The client who has gastroenteritis and is febrile.

A

C. The client who has end-stage renal failure and is scheduled for dialysis today.

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10
Q

A nurse is developing a plan of care for a client who is postoperative. Which of the following interventions should the nurse include in the plan to prevent pulmonary complications?

A. Perform range-of-motion exercises
B. Place suction equipment at the bedside
C. Encourage the use of an incentive spirometer
D. Administer an expectorant

A

C. Encourage the use of an incentive spirometer

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11
Q

A nurse is caring for a client following a total laryngectomy. Which of the following is the priority observation in the client’s care?

A. Patency of the intravenous line.
B. Level of pain.
C. Integrity of the dressing.
D. Need for suctioning.

A

D. Need for suctioning.

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12
Q

A nurse is caring for a group of clients in an infectious disease unit. The nurse should wear an OSHA-approved N95 respirator mask when caring for a client with which of the following infectious diseases?

A. Pertussis
B. Mycoplasma pneumonia
C. Tuberculosis
D. Respiratory syncytial virus

A

C. Tuberculosis

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13
Q

A nurse is caring for a client who just had a flexible bronchoscopy. Which of the following nursing actions is appropriate?

A. Withhold food and liquids until the client’s gag reflex returns.
B. Irrigate the client’s throat every 4 hr.
C. Have the client refrain from talking for 24 hr.
D. Suction the client’s oropharynx frequently.

A

A. Withhold food and liquids until the client’s gag reflex returns.

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14
Q

A nurse is monitoring a client following a thoracentesis. The nurse should identify which of the following manifestations as a complication and contact the provider immediately?

A. Serosanguineous drainage from the puncture site
B. Discomfort at the puncture site
C. Increased heart rate
D. Decreased temperature

A

C. Increased heart rate

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15
Q 
A nurse is caring for a client whose arterial blood gas results show a pH of 7.3 and a PaCO2 of 50 mm Hg. The nurse should identify that the client is experiencing which of the following acid-base imbalances? 
A. Metabolic acidosis 
B. Metabolic alkalosis 
C. Respiratory acidosis 
D. Respiratory alkalosis
A

C. Respiratory acidosis

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16
Q

A nurse on a medical-surgical unit is performing an admission assessment of a client who has COPD with emphysema. The client reports that he has a frequent productive cough and is short of breath. The nurse should anticipate which of the following assessment findings for this client?

A. Respiratory alkalosis
B. Increased anteroposterior diameter of the chest
C. Oxygen saturation level 96%
D. Petechiae on chest

A

A. Respiratory alkalosis

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17
Q

A nurse in a provider’s office is assessing a client. The nurse should identify that which of the following findings are manifestations of pulmonary tuberculosis? (Select all that apply)

A. Night sweats
B. Low-grade fever
C. Weight gain
D. Flushed cheeks
E. Blood in the sputum
A

A. Night sweats
B. Low-grade fever
E. Blood in the sputum

18
Q 
A nurse is assessing a client who has pulmonary tuberculosis. Which of the following findings should the nurse expect? 
A. Lethargy 
B. High-grade fever 
C. Weight gain
D. Dry cough
A

A. Lethargy

19
Q

A nurse is assessing a client immediately after the provider removed the client’s endotracheal tube. Which of the following findings should the nurse report to the provider?

A. Stridor
B. Copious oral secretions
C. Hoarseness
D. Sore throat

A

A. Stridor

20
Q

A nurse is auscultating the lungs of a client who has pleurisy. Which of the following adventitious breath sounds should the nurse expect to hear?

A. Loud, scratchy sounds
B. Squeaky, musical sounds
C. Popping sounds
D. Snoring sounds

A

B. Squeaky, musical sounds

21
Q

A nurse is reviewing the arterial blood gas values for a client. The pH is 7.32, PaCO2 48 mm Hg and the HCO3 is 23 mEq/L. The nurse should recognize that these findings indicate of which of the following acid base balances?

A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis

A

A. Respiratory acidosis

22
Q

A nurse is monitoring an older adult client immediately following a bronchoscopy. The nurse’s priority is to monitor the client for which of the following?

A. Observing for confusion
B. Auscultating breath sounds
C. Confirming the gag reflex
D. Measuring blood pressure

A

C. Confirming the gag reflex

23
Q 
A nurse in the emergency department is assessing an older adult client who has community- acquired pneumonia. Which of the following findings should the nurse expect? 
A. Unequal pupils 
B. Hypertension 
C. Tympany upon chest percussion 
D. Confusion
A

D. Confusion

24
Q 
A nurse is assessing a client who has chronic bronchitis. Which of the following percussion sounds should the nurse expect? 
A. Dullness 
B. Resonance 
C. Tympany 
D. Flatness
A

A. Dullness

25
Q

A nurse in a provider’s office is assessing an older adult client whose son reports that the client has been sick with a respiratory illness for the past 6 days. Which of the following assessment findings is a manifestation of pneumonia in the older adult client?

A. Bradycardia
B. Night sweats
C. Confusion
D. Narrowed pulse pressure

A

C. Confusion

26
Q 
A nurse is teaching a client who has tuberculosis and is to start combination drug therapy. Which of the following medications should the nurse plan to administer? (Select all that apply.) 
A. Rifampin
B. Isoniazid
C. Acyclovir
D. Pyrazinamide 
E. Montelukast
A

A. Rifampin
B. Isoniazid
D. Pyrazinamide

27
Q

A nurse is performing pulmonary hygiene for a client who has pneumonia and positions the client on his left side in Trendelenburg position. From which of the following lung segments should the nurse expect secretions to be mobilized with the client in this position?

A. Lateral segment of the left lower lobe
B. Lateral segment of the right lower lobe
C. Posterior segment of the right middle lobe
D. Posterior segment of the right lower lobe

A

A. Lateral segment of the left lower lobe

28
Q

A nurse is teaching a client who has tuberculosis and is to start medication therapy with isoniazid, rifampin and pyrazinamide. Which of the following instructions should the nurse include?

A. “Take isoniazid with an antacid.”
B. “Provide a sputum specimen every 2 weeks to the clinic for testing.”
C. “Expect your sputum cultures to be negative after 6 months of therapy.”
D. “Drink at least 8 ounces of water when you take the pyrazinamide tablet.”

A

D. “Drink at least 8 ounces of water when you take the pyrazinamide tablet.”

29
Q 
A nurse is preparing a client for discharge following a bronchoscopy. Which of the following is the nurse's monitoring priority?
A. Palpating peripheral pulses
B. Auscultating heart sounds
C. Confirming the gag reflex
D. Measuring blood pressure
A

C. Confirming the gag reflex

30
Q

A nurse is planning to prioritize client care after receiving report and rounded on assigned patients. Which of the following client’s is a high priority for the nurse to see first?
A. a client who is ambulatory and going for an x-ray at 10am
B. a client who is to be discharged at 11am
C. a client who received pain medication 30 min ago
D. a client who is SOB

A

D. a client who is SOB

31
Q 
A nurse is caring for a client who develops a pulmonary embolism. Which of the following interventions should the nurse implement first?
A. give morphine IV
B. administer oxygen therapy
C. start an iv infusion of LR
D. initiate cardiac monitoring
A

B. administer oxygen therapy

32
Q 
A nurse is caring for a client who develops a pulmonary embolism. Which of the following interventions should the nurse implement first?
A. give morphine IV
B. administer oxygen therapy
C. start an iv infusion of LR
D. initiate cardiac monitoring
A

B. administer oxygen therapy

33
Q

A nurse is preparing an adolescent client who has pneumonia for percussion, vibration, and postural drainage. Prior to the procedure which of the following nursing actions should the nurse complete first?
A. auscultate lung fields
B. assess pulse and respirations
C. assess characteristics of her sputum
D. instruct to slowly exhale with pursed lips

A

A. auscultate lung fields

34
Q

A nurse is caring for a client who has sustained life-threatening injuries due to a motor-vehicle accident. Identify the sequence the nurse should take in treating the client.
A. Control bleeding
B. Treat shock
C. Check breathing
D. Use head-tilt method if airway is obstructed

A

C. Check breathing
D. Use head-tilt method if airway is obstructed
A. Control bleeding
B. Treat shock

35
Q 
A nurse is assessing a client who has a long history of smoking and is suspected of having laryngeal cancer. The nurse should anticipate that the client will report that her earliest manifestation was
A. dysphagia
B. hoarseness
C. dyspnea
D. weight loss
A

B. hoarseness

36
Q

A nurse is caring for a client who has active pulmonary TB and a new prescription for IV rifampin. The nurse should instruct the client that they should expect to experience which of the following manifestations while taking this medication?

  • Constipation
  • Black-colored stools
  • Staining of teeth
  • Red-colored urine
A
  • Red-colored urine
37
Q

A nurse in a provider’s office is assessing a client. The nurse should identify that which of the following findings are manifestations of pulmonary TB? SATA

  • Night sweats
  • Low-grade fever
  • Weight gain
  • Flushed cheeks
  • Blood in the sputum
A
  • Night sweats
  • Low-grade fever
  • Blood in the sputum

Night sweats, low-grade fever, weight loss, and blood-streaked sputum are manifestations of TB. Flushed cheeks are a manifestation of pneumonia, not TB.

38
Q

A nurse is caring for a client who requires isolation for active TB. Which of the following precautions should the nurse include when creating a sign to post outside of the client’s room? SATA

  • Mask
  • “Close Door” sign
  • Gown
  • Biohazard
  • Handwashing
A
  • Mask
  • “Close Door” sign
  • Biohazard
  • Handwashing

Clients who have active pulmonary TB require airborne precautions.

39
Q

A nurse is auscultating the breath sounds of a client who has asthma. When the client exhales, the nurse hears continuous high-pitched squeaking sounds. The nurse should document this as which of the following adventitious breath sounds?

  • Crackles
  • Rhonci
  • Stridor
  • Wheezes
A
  • Wheezes
40
Q

A client who has emphysema has dyspnea with minimal exertion. The nurse should monitor this client for which of the following complications?

A. Resp. acidosis
B. Resp. Alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis

A

A. The client probably has hypoxemia and tries to increase his RR in an attempt to take in more O2. However, the client probably begins to exhale before he can fully exhale, causing in alveolar hypoventilation. CO2 builds up and the client develops chronic respiratory acidosis.

41
Q

A nurse is assessing a client who has COPD. The nurse should expect the client’s chest to be which of the following shapes.?

A. Pigeon
B. Funnel
C. Kyphotic
D. Barrel

A

D. Barrel shaped is due to the chronically use of the accessory muscles to assist with respiratory effort. The chest eventually develops in an anterior posterior diameter.

32 (2) (13 decks)

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