RESPIRATORY CONCEPT

Total points33/49
 
QUIZ 1
 
A client admitted to the hospital with chest pain and shortness of breath.Arterial blood
gases were: ph 7.52,pco2 27,Hco3 22.These values indicates:
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respiratory alkalosis
 
respiratory acidosis
metabolic alkalosis
metabolic acidosis
 
The client is scheduled for brochoscopy. Which of the following is not necessary to be
done by the nurse when preparing the client for the procedure?
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Secure written consent
Ask for allergy to seafoods or iodine
Maintain NPO for 6-8 hours
Instruct client to remove dentures or bridges
 
The client had been diagnosed to have hydrothorax secondary to pulmonary
tuberculosis (PTB). The physician performs thoracentesis. The following are
appropriate nursing interventions except:
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Place the client in sitting position at the edge of the bed, arms supported on an overbed table,
feet on a foot stool.
Instruct the client to remain still and to hold his breath as the physician inserts the needle.
Inform the client that pressure sensation will be experienced as the needle is inserted.
Inform the client that he will need to turn towards affected side after the procedure.
 
 
The client had severe epistaxis, nasal packing has been done by the physician. Which
of the following statements would indicate to the nurse that the client has understood
the instructions provided?
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I will avoid activities that elicits valsalva maneuvers like straining at stool and vigorous coughing.
I should not shower until packing is removed.
I will avoid brushing until the nasal pack is removed.
The nasal packing will be in place for 7-10 days.
 
 
The nurse is teaching the client how to manage a nosebleed. Which of the following
instructions would be appropriate to give to the client?
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Tilt your head backward and pinch your nose.
Lie down flat and place an ice compress over the bridge of your nose.
Blow your nose gently with your neck flexed.
Sit down, lean forward and pinch the soft portion of your nose.
 
 
After tonsillectomy, which of the following findings would alert the nurse to suspect
early hemorrhage in the client?
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Frequent swallowing or drooling of bright red secretions.
 
Pulse rate of 95bpm.
Blood pressure of 110/70mmhg
Body temperature of 37.2
 
Which of the following is the priority nursing diagnosis for the client with a total
laryngectomy due to cancer?
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Deficient fluid volume related to difficulty swallowing
Feeding-self care deficit related to inability to swallow.
Impaired verbal communication related to inability to speak.
 
Powerlessness related to diagnosis of cancer.
 
The nurse is suctioning the client with tracheostomy after laryngectomy. Which of the
following is inappropriate nursing action?
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The nurse uses a sterile catheter each time the client is suctioned.
Applies suction for 5-10 seconds at a time.
Hyperoxygenate the client before and after suctioning.
Cleanses the catheter in sterile water after each use and reuse for no longer than 8 hours.
 
 
Bed rest is prescribed for the client with pneumonia during the acute phase of the
illness. Bed rest serves which of the following purposes?
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It reduces cellular demand for oxygen.
 
It decreases the episodes of coughing.
It promotes safety.
It promotes clearance of secretions.
 
A client with pneumonia is experiencing pleuritic pain. Which of the following
measures would most likely be successful in reducing his chest pain?
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Encourage the client to breath slowly.
 
Have the client practice abdominal breathing
Offer the client incentive spirometer
Teach the client to splint the rib cage when coughing.
 
What is the rationale that supports multidrug treatment for clients with tuberculosis?
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Multiple drugs potentiate the drugs actions.
Multiple drugs reduces undesirable drug side effects.
Multiple drugs allow reduced drug dosages to be given.
Multiple drugs reduce development of resistant strains of the bacteria.
 
 
A client has a positive reaction to the Mantoux Test. The nurse correctly interprets this
reaction to mean that the client:
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Has active tuberculosis
Has had exposure to MYcobacterium Tuberculosis
 
Has developed a resistance to tubercle bacilli
Has developed passive immunity to tuberculosis
 
Which of the following physical assessment finding would the nurse expect to find in a
client with COPD?
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Barrel-chest
 
Collapsed neck veins
Increased chest excursions with respiration.
Nonproductive hacking cough
 
Which of the following is the primary reason to teach pursed-lip breathing to the clients
with emphysema?
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To promote oxygen intake
To strengthen the diaphragm
 
To strengthen the intercostal muscles.
To promote carbon dioxide elimination.
 
The nurse is observing an elderly client use his metered dose inhaler(MDI) to
administer his bronchodilator medication. Which of the following client actions should
the nurse correct to improve the clients technique?
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The client shakes the inhaler immediately before use.
 
The client waits 1 minute between puffs.
The client activates the MDI on exhalation.
The client holds his breath for 10 seconds after inhalation.
 
Which of the following would be the most important nursing intervention to help
prevent lung cancer?
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Encourage cigarette smokers to have yearly chest x-ray.
Instruct people about techniques for cessation of smoking.
Recommend that people have their houses cleaned from dusts regularly.
 
Encourage people to avoid cool and damp weather.
 
A 40 year old male client returned to his room an hour ago following bronchoscopy.
He is requesting for glass of water. The nurse must first:
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Keep the client on NPO until an order is written.
 
Check the VS
Check the gag and swallowing reflex
Encourage deep breathing exercise
 
Which of the following will the nurse interpret as Positive Mantoux Test?
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redness greater than 5 mm
swelling greater than 7 mm
induration greater then 10 mm
 
exudates covering more than 12 mm
 
The nurse enters the room of a client with COPD. The clients oxygen is running at
8L/min, the nurse best initial nursing action is:
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check the doctors order
lower oxygen rate at 2L/min
 
take his VS
put the client in fowlers position
 
A 52 year old client is being discharged following laryngectomy for cancer of the
larynx.Prior to discharge, the nurse assesses the following psychomotor skills:
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administering injections,changing dressings and chest physiotherapy
taking the BP and PR,and monitoring serum glucose
suctioning and caring for tracheostomies and tracheostomy tube
 
tube feedings,taking aerosol medications and taking BP
 
A 74 year old client is diagnosed with tuberculosis.Which of the following laboratory
reports most accurately confirm the diagnosis?
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chest x-ray
 
sputum culture
cbc
mantoux test
 
A client has active TB.Which of the following clinical manifestations will be exhibit?
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chest and lower back pain
headache and fever
fever,chills,night sweats, and hemoptysis
 
fever more than 104 degree F and nausea
 
Before starting on isoniazid(INH), a client will probably have which of the following
laboratory tests?
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AST and ALT
 
BUN,serum creatinine
serum glucose level
blood uric acid level
 
The drug of choice in the treatment of histoplasmosis is:
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streptomycin
rifampicin
paraaminosalysilic acid
amphotericin B
 
 
Which of the following would be considered most normal in the water -seal chamber
within the first 24 hours postoperatively with a two- bottle water-seal drainage?
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no fluctuation in the water seal tube
intermittent, slight bubbling from the water seal-tube drainage
bright red bloody drainage
continous bubbling in the water-seal tube
 
 
Chelsea,a 19 year old client comes to the emergency department with acute
asthma .His respiratory rate is 44 breaths/min and he appears in acute respiratory
distress. Which of the following actions should be taken first?
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take a full nursing history
administer bronchodilator by nebulizer
 
provide emotional support to the client
administer oxygen at 6L/min
 
Which of the following additional assessment data should immediately be gathered to
determine the status of a client with a respiratory rate of 4 breaths/min.
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ABG and breath sounds
level of consciousness and pulse oximeter value
 
breath sounds and reflexes
heart sounds and reflexes
 
Which of the following statements best describes ARDS?
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alveoli are overdistended
alveoli are fluid filled
 
alveoli are filled with mucus secretions
alveoli have increased perfusion
 
A client with chest tube has accidentaly removed it. What should be done first?
lie the client down on the left side
lie the client down on his right side
apply an occlusive dressing over the site
 
re-insert the tube that fell out
 
Patient Jerome with emphysema is observed to have labored breathing and exhibits
slow, shallow respirations. This endagers him to develop.
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respiratory alkalosis
respiratory acidosis
 
metabolic alkalosis
metabolic acidosis
 
The most comfortable position for client with COPD is:
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semi fowlers position
sitting upright, leaning forward
 
lateral position
high fowlers position
 
The client had undergone total laryngectomy. He has permanent tracheostomy.Which
nursing action needs intervention during tracheal suctioning.
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the nurse use sterile gloves and sterile suction catheter
the nurse administers 100% oxygen before and after suctioning
 
the nurse applies suction for 30 seconds at a time
the nurse applies suction during withdrawal of the suction catheter tip
 
Which of the following breathing techniques does the nurse teach a client with
pulmonary emphysema that will assist in exhalation?
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push on abdomen during exhalation
sit in high fowlers position with legs extended
lean forward 30-40 degrees with each exhalation
 
sit up with shoulders back
 
The nurse teaches an adolescent who has has a tonsillectomy by which of the
following?
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avoid coughing and clearing the throat the first week postoperatively
 
do not eat or drink anything for the first 24 hours
if your stool is black for the first few days postop,notify the doctor
avoid cold beverages to prevent irritation of the throat
 
Caranzo is a 43 year old was admiited to the hospital after she has been hit by a
motor vehicle. The patient is a known hypertensive with maintenance medication she
has been taking for almost 2 years. She is also a known diabetic and has had history
of miscarriage. Which of the following factors places Ms.Caranzo at risk for developing
ARDS(Acute Respiratory Distress Syndrome)?
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Traumatic Injury
History of Miscarriage
Use maintenance medication for hypertension
 
History of diabetes
 
Upon assessment , Caranzo presents to you the following symptoms. Which of these
would you consider a classic finding in the patient with ARDS?
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Severe hyponatremia
Hypercapnia
Hypoxia resistant to oxygen therapy
 
a sudden hypocalcemia with tetany
 
You would suspect that Caranzo is at risk of developing pulmonary edema. Which of
the following is the best explanation to that?
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Left sided heart failure
Alveolocapillary membrane damage
 
Extravascular fluid volume excess
Pulmonary artery infarct
Option 5
 
Mis Caranzo pulse oximeter reading continously decreases and shows signs of
hypoxemia such as restlessness. You know that the physician would possible to:
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Prescribed mechanical ventilation
Prescribed low FIO2 concentration
 
Inserts a chest tube
Prescribed CPT
 
A client with emphysema is observed to have labored breathing and exhibits slow,
shallow respirations. This endagers him to develop:
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Respiratory Alkalosis
Respiratory Acidosis
 
Metabolic alkalosis
Kyphosis
 
Patient Kevin states that he has smoked a half pack of cigarettes per day for 40 years.
This should be documented as:
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10 pack years
20 pack years
30 pack years
40 pack years
 
 
Patient Angge, a 22 year old college student with history of asthma, presents to the
emergency department with difficulty of breathing. Upon auscultation what
adventitious breath sound would you expect?
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Diminished breath sounds and crackles in lung bases
Moist crackles in the lung base
Distant breath sounds and expiratory wheezes
 
Bronchial breath sounds in lung bases
 
A severe inflammatory response triggered the patients asthma attack.Which of the
following drugs would expect to give to combat the inflammatory response?
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Theophylline
 
Prednisone
Albuterol
Metoprolol
 
Kim a 45 year old obese who had pneumonectomy for lung cancer 2 days ago. Her
post operative course has been uneventful, but she refuses to get out of bed. Which of
the following intervention would help prevent the complication of immobility?
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Performing passive ROM exercises
 
Administering IV fluids at kvo
Using knee catch on bed at all times
Rubbing the patients leg frequently
 
To assess the patient for homans sign the nurse should?
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elevate the patient legs and look for discoloration in the ankle area
 
squeeze the patients calf and note for any tenderness
dorsiflex the foot with leg elevated, notify any calf pain
plantar flex the foot
 
While performing passive ROM exercises to a Charisa, she suddenly developed pain,
shortness of breath and air hunger.The nurse knows she must further assess the
patients chest pain to determine the origin.When determining whether the chest pain
is cardiac or pleuritic in nature, the nurse knows that pleuritic pain is typically?
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is described as crushing and substernal
worsens with deep inspiration
 
is relieved by nitroglycerine
is relieved when the patient leans forward
 
Another patient in the central intensive care unit is diagnosed with pulmonary
embolism. Which of the following is the most appropriate nursing diagnosis for this
patient?
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Ineffective airway clearance
Risk for Infection
Impaired gas exchange
 
Altered cardiopulmonary tissue perfusion
 
Allen is admitted to the medical surgical floor with a diagnosis of bacterial pneumonia.
The most common causative organism of bacterial pneumonia is:
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streptococcus pneumoniae
 
proteus spicies
haemophillus influenza
escherichia coli
 
The physician ordered for a sputum culture. Which of the following is correct
instruction by the nurse is collecting sputum specimen to patient?
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Tell the patient to cough deeply and expectorate in the specimen container
Place the client in the semi fowlers position and tell her to cough slowly
Place the patient in high fowlers position and tell her to expectorate saliva into the specimen
container
Tell the patient to breath deeply, cough shallowly and expectorate saliva into the container
 
 
You include in your intervention to perform CPT but isnt successful in removing Allens
secretions. Which type of drug would the nurse expect to prescribed following chest
physiotherapy?
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Anticholinergic
Mucolytic
 
Antibiotic
Diuretic
 
In planning care for Allen,which of the following is the most appropriate nursing
diagnosis?
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Fluid volume deficit
decreased cardiac output
impaired gas exchange
 
risk for infection