Question 1

A nurse assesses a client who is prescribed fluticasone (Flovent)and notes oral lesions.Which action should the nurse take?

Accepted Answer

A)  Encourage oral rinsing after fluticasone administration. 
B)  Obtain an oral specimen for culture and sensitivity. 
C)  Start the client on a broad-spectrum antibiotic. 
D)  Document the finding as a known side effect. 
A)  Encourage oral rinsing after fluticasone administration. 
B)  Obtain an oral specimen for culture and sensitivity. 
C)  Start the client on a broad-spectrum antibiotic. 
D)  Document the finding as a known side effect. A

Question 2

The nurse is caring for a client with lung cancer who states,"I don't want any pain medication because I am afraid I'll become addicted." How should the nurse respond?

Accepted Answer

A)  "I will ask the provider to change your medication to a drug that is less potent." 
B)  "Would you like me to use music therapy to distract you from your pain?" 
C)  "It is unlikely you will become addicted when taking medicine for pain." 
D)  "Would you like me to give you acetaminophen (Tylenol) instead?" 
A)  "I will ask the provider to change your medication to a drug that is less potent." 
B)  "Would you like me to use music therapy to distract you from your pain?" 
C)  "It is unlikely you will become addicted when taking medicine for pain." 
D)  "Would you like me to give you acetaminophen (Tylenol) instead?" C

Question 3

A nurse assesses several clients who have a history of asthma.Which client should the nurse assess first?

Accepted Answer

A)  A 66-year-old client with a barrel chest and clubbed fingernails 
B)  A 48-year-old client with an oxygen saturation level of 92% at rest 
C)  A 35-year-old client who has a longer expiratory phase than inspiratory phase 
D)  A 27-year-old client with a heart rate of 120 beats/min 
A)  A 66-year-old client with a barrel chest and clubbed fingernails 
B)  A 48-year-old client with an oxygen saturation level of 92% at rest 
C)  A 35-year-old client who has a longer expiratory phase than inspiratory phase 
D)  A 27-year-old client with a heart rate of 120 beats/min D

Question 4

A nurse cares for a client who tests positive for alpha1-antitrypsin (AAT)deficiency.The client asks,"What does this mean?" How should the nurse respond?

Accepted Answer

A)  "Your children will be at high risk for the development of chronic obstructive pulmonary disease." 
B)  "I will contact a genetic counselor to discuss your condition." 
C)  "Your risk for chronic obstructive pulmonary disease is higher, especially if you smoke." 
D)  "This is a recessive gene and should have no impact on your health." 
A)  "Your children will be at high risk for the development of chronic obstructive pulmonary disease." 
B)  "I will contact a genetic counselor to discuss your condition." 
C)  "Your risk for chronic obstructive pulmonary disease is higher, especially if you smoke." 
D)  "This is a recessive gene and should have no impact on your health."

Question 5

A nurse is teaching a client who has cystic fibrosis (CF).Which statement should the nurse include in this client's teaching?

Accepted Answer

A)  "Take an antibiotic each day." 
B)  "Contact your provider to obtain genetic screening." 
C)  "Eat a well-balanced, nutritious diet." 
D)  "Plan to exercise for 30 minutes every day." 
A)  "Take an antibiotic each day." 
B)  "Contact your provider to obtain genetic screening." 
C)  "Eat a well-balanced, nutritious diet." 
D)  "Plan to exercise for 30 minutes every day."

Question 6

After teaching a client how to perform diaphragmatic breathing,the nurse assesses the client's understanding.Which action demonstrates that the client correctly understands the teaching?

Accepted Answer

A)  The client lays on his or her side with his or her knees bent. 
B)  The client places his or her hands on his or her abdomen. 
C)  The client lays in a prone position with his or her legs straight. 
D)  The client places his or her hands above his or her head. 
A)  The client lays on his or her side with his or her knees bent. 
B)  The client places his or her hands on his or her abdomen. 
C)  The client lays in a prone position with his or her legs straight. 
D)  The client places his or her hands above his or her head.

Question 7

A nurse assesses a client who has a mediastinal chest tube.Which symptoms require the nurse's immediate intervention? (Select all that apply.)

Accepted Answer

A)  Production of pink sputum 
B)  Tracheal deviation 
C)  Pain at insertion site 
D)  Sudden onset of shortness of breath 
E)  Drainage greater than 70 mL/hr
F) Disconnection at Y site 
A)  Production of pink sputum 
B)  Tracheal deviation 
C)  Pain at insertion site 
D)  Sudden onset of shortness of breath 
E)  Drainage greater than 70 mL/hr
F) Disconnection at Y site

Question 8

A nurse cares for a client with chronic obstructive pulmonary disease (COPD)who appears thin and disheveled.Which question should the nurse ask first?

Accepted Answer

A)  "Do you have a strong support system?" 
B)  "What do you understand about your disease?" 
C)  "Do you experience shortness of breath with basic activities?" 
D)  "What medications are you prescribed to take each day?" 
A)  "Do you have a strong support system?" 
B)  "What do you understand about your disease?" 
C)  "Do you experience shortness of breath with basic activities?" 
D)  "What medications are you prescribed to take each day?"

Question 9

The nurse is teaching a client with chronic obstructive pulmonary disease who has been prescribed continuous oxygen therapy at home.Which statement indicates the client correctly understands the teaching?

Accepted Answer

A)  "I plan to wear my oxygen when I exercise and feel short of breath." 
B)  "I will use my portable oxygen when grilling burgers in the backyard." 
C)  "I plan to use cotton balls to cushion the oxygen tubing on my ears." 
D)  "I will only smoke while I am wearing my oxygen via nasal cannula." 
A)  "I plan to wear my oxygen when I exercise and feel short of breath." 
B)  "I will use my portable oxygen when grilling burgers in the backyard." 
C)  "I plan to use cotton balls to cushion the oxygen tubing on my ears." 
D)  "I will only smoke while I am wearing my oxygen via nasal cannula."

Question 10

While assessing a client who is 12 hours postoperative after a thoracotomy for lung cancer,a nurse notices that the lower chest tube is dislodged.Which action should the nurse take first?

Accepted Answer

A)  Assess for drainage from the site. 
B)  Cover the insertion site with sterile gauze. 
C)  Contact the provider and obtain a suture kit. 
D)  Reinsert the tube using sterile technique. 
A)  Assess for drainage from the site. 
B)  Cover the insertion site with sterile gauze. 
C)  Contact the provider and obtain a suture kit. 
D)  Reinsert the tube using sterile technique.

Question 11

A nurse teaches a client who has chronic obstructive pulmonary disease.Which statements related to nutrition should the nurse include in this client's teaching? (Select all that apply.)

Accepted Answer

A)  "Avoid drinking fluids just before and during meals." 
B)  "Rest before meals if you have dyspnea." 
C)  "Have about six small meals a day." 
D)  "Eat high-fiber foods to promote gastric emptying." 
E)  "Increase carbohydrate intake for energy." 
A)  "Avoid drinking fluids just before and during meals." 
B)  "Rest before meals if you have dyspnea." 
C)  "Have about six small meals a day." 
D)  "Eat high-fiber foods to promote gastric emptying." 
E)  "Increase carbohydrate intake for energy."

Question 12

A nurse assesses a client who has a chest tube.For which manifestations should the nurse immediately intervene? (Select all that apply.)

Accepted Answer

A)  Production of pink sputum 
B)  Tracheal deviation 
C)  Sudden onset of shortness of breath 
D)  Pain at insertion site 
E)  Drainage of 75 mL/hr 
A)  Production of pink sputum 
B)  Tracheal deviation 
C)  Sudden onset of shortness of breath 
D)  Pain at insertion site 
E)  Drainage of 75 mL/hr

Question 13

A nurse cares for a client who is infected with Burkholderia cepacia.Which action should the nurse take first when admitting this client to a pulmonary care unit?

Accepted Answer

A)  Instruct the client to wash his or her hands after contact with other people. 
B)  Implement Droplet Precautions and don a surgical mask. 
C)  Keep the client isolated from other clients with cystic fibrosis. 
D)  Obtain blood, sputum, and urine culture specimens. 
A)  Instruct the client to wash his or her hands after contact with other people. 
B)  Implement Droplet Precautions and don a surgical mask. 
C)  Keep the client isolated from other clients with cystic fibrosis. 
D)  Obtain blood, sputum, and urine culture specimens.

Question 14

A nurse cares for a client with arthritis who reports frequent asthma attacks.Which action should the nurse take first?

Accepted Answer

A)  Review the client's pulmonary function test results. 
B)  Ask about medications the client is currently taking. 
C)  Assess how frequently the client uses a bronchodilator. 
D)  Consult the provider and request arterial blood gases. 
A)  Review the client's pulmonary function test results. 
B)  Ask about medications the client is currently taking. 
C)  Assess how frequently the client uses a bronchodilator. 
D)  Consult the provider and request arterial blood gases.

Question 15

A nurse cares for a client with a 40-year smoking history who is experiencing distended neck veins and dependent edema.Which physiologic process should the nurse correlate with this client's history and clinical manifestations?

Accepted Answer

A)  Increased pulmonary pressure creating a higher workload on the right side of the heart 
B)  Exposure to irritants resulting in increased inflammation of the bronchi and bronchioles 
C)  Increased number and size of mucus glands producing large amounts of thick mucus 
D)  Left ventricular hypertrophy creating a decrease in cardiac output 
A)  Increased pulmonary pressure creating a higher workload on the right side of the heart 
B)  Exposure to irritants resulting in increased inflammation of the bronchi and bronchioles 
C)  Increased number and size of mucus glands producing large amounts of thick mucus 
D)  Left ventricular hypertrophy creating a decrease in cardiac output

Question 16

A nurse plans care for a client who has chronic obstructive pulmonary disease and thick,tenacious secretions.Which interventions should the nurse include in this client's plan of care? (Select all that apply.)

Accepted Answer

A)  Ask the client to drink 2 liters of fluids daily. 
B)  Add humidity to the prescribed oxygen. 
C)  Suction the client every 2 to 3 hours. 
D)  Use a vibrating positive expiratory pressure device. 
E)  Encourage diaphragmatic breathing. 
A)  Ask the client to drink 2 liters of fluids daily. 
B)  Add humidity to the prescribed oxygen. 
C)  Suction the client every 2 to 3 hours. 
D)  Use a vibrating positive expiratory pressure device. 
E)  Encourage diaphragmatic breathing.

Question 17

A nurse cares for a female client who has a family history of cystic fibrosis.The client asks,"Will my children have cystic fibrosis?" How should the nurse respond?

Accepted Answer

A)  "Since many of your family members are carriers, your children will also be carriers of the gene." 
B)  "Cystic fibrosis is an autosomal recessive disorder.If you are a carrier, your children will have the disorder." 
C)  "Since you have a family history of cystic fibrosis, I would encourage you and your partner to be tested." 
D)  "Cystic fibrosis is caused by a protein that controls the movement of chloride.Adjusting your diet will decrease the spread of this disorder." 
A)  "Since many of your family members are carriers, your children will also be carriers of the gene." 
B)  "Cystic fibrosis is an autosomal recessive disorder.If you are a carrier, your children will have the disorder." 
C)  "Since you have a family history of cystic fibrosis, I would encourage you and your partner to be tested." 
D)  "Cystic fibrosis is caused by a protein that controls the movement of chloride.Adjusting your diet will decrease the spread of this disorder."

Question 18

A nurse cares for a client who has a chest tube.When would this client be at highest risk for developing a pneumothorax?

Accepted Answer

A)  When the insertion site becomes red and warm to the touch 
B)  When the tube drainage decreases and becomes sanguineous 
C)  When the client experiences pain at the insertion site 
D)  When the tube becomes disconnected from the drainage system 
A)  When the insertion site becomes red and warm to the touch 
B)  When the tube drainage decreases and becomes sanguineous 
C)  When the client experiences pain at the insertion site 
D)  When the tube becomes disconnected from the drainage system

Question 19

A nurse cares for a client who has developed esophagitis after undergoing radiation therapy for lung cancer.Which diet selection should the nurse provide for this client?

Accepted Answer

A)  Spaghetti with meat sauce, ice cream 
B)  Chicken soup, grilled cheese sandwich 
C)  Omelet, soft whole wheat bread 
D)  Pasta salad, custard, orange juice 
A)  Spaghetti with meat sauce, ice cream 
B)  Chicken soup, grilled cheese sandwich 
C)  Omelet, soft whole wheat bread 
D)  Pasta salad, custard, orange juice

Question 20

A pulmonary nurse cares for clients who have chronic obstructive pulmonary disease (COPD).Which client should the nurse assess first?

Accepted Answer

A)  A 46-year-old with a 30-pack-year history of smoking 
B)  A 52-year-old in a tripod position using accessory muscles to breathe 
C)  A 68-year-old who has dependent edema and clubbed fingers 
D)  A 74-year-old with a chronic cough and thick, tenacious secretions 
A)  A 46-year-old with a 30-pack-year history of smoking 
B)  A 52-year-old in a tripod position using accessory muscles to breathe 
C)  A 68-year-old who has dependent edema and clubbed fingers 
D)  A 74-year-old with a chronic cough and thick, tenacious secretions

Exam 30: Care of Patients with Noninfectious Lower Respiratory Problems

A nurse assesses a client who is prescribed fluticasone (Flovent)and notes oral lesions.Which action should the nurse take?

The nurse is caring for a client with lung cancer who states,"I don't want any pain medication because I am afraid I'll become addicted." How should the nurse respond?

A nurse assesses several clients who have a history of asthma.Which client should the nurse assess first?

A nurse cares for a client who tests positive for alpha1-antitrypsin (AAT)deficiency.The client asks,"What does this mean?" How should the nurse respond?

A nurse is teaching a client who has cystic fibrosis (CF).Which statement should the nurse include in this client's teaching?

After teaching a client how to perform diaphragmatic breathing,the nurse assesses the client's understanding.Which action demonstrates that the client correctly understands the teaching?

A nurse assesses a client who has a mediastinal chest tube.Which symptoms require the nurse's immediate intervention? (Select all that apply.)

A nurse cares for a client with chronic obstructive pulmonary disease (COPD)who appears thin and disheveled.Which question should the nurse ask first?

The nurse is teaching a client with chronic obstructive pulmonary disease who has been prescribed continuous oxygen therapy at home.Which statement indicates the client correctly understands the teaching?

While assessing a client who is 12 hours postoperative after a thoracotomy for lung cancer,a nurse notices that the lower chest tube is dislodged.Which action should the nurse take first?

A nurse teaches a client who has chronic obstructive pulmonary disease.Which statements related to nutrition should the nurse include in this client's teaching? (Select all that apply.)

A nurse assesses a client who has a chest tube.For which manifestations should the nurse immediately intervene? (Select all that apply.)

A nurse cares for a client who is infected with Burkholderia cepacia.Which action should the nurse take first when admitting this client to a pulmonary care unit?

A nurse cares for a client with arthritis who reports frequent asthma attacks.Which action should the nurse take first?

A nurse cares for a client with a 40-year smoking history who is experiencing distended neck veins and dependent edema.Which physiologic process should the nurse correlate with this client's history and clinical manifestations?

A nurse plans care for a client who has chronic obstructive pulmonary disease and thick,tenacious secretions.Which interventions should the nurse include in this client's plan of care? (Select all that apply.)

A nurse cares for a female client who has a family history of cystic fibrosis.The client asks,"Will my children have cystic fibrosis?" How should the nurse respond?

A nurse cares for a client who has a chest tube.When would this client be at highest risk for developing a pneumothorax?

A nurse cares for a client who has developed esophagitis after undergoing radiation therapy for lung cancer.Which diet selection should the nurse provide for this client?

A pulmonary nurse cares for clients who have chronic obstructive pulmonary disease (COPD).Which client should the nurse assess first?

Introduction to Medical Surgical Nursing Practice

Common Health Problems of Older Adults

Assessment and Care of Patients with Pain

Genetic and Genomic Concepts for Medical Surgical Nursing

Evidence Based Practice in Medical Surgical Nursing

Rehabilitation Concepts for Chronic and Disabling Health Problems

End of Life Care

Concepts of Emergency and Trauma Nursing

Care of Patients with Common Environmental Emergencies

Concepts of Emergency and Disaster Preparedness

Assessment and Care of Patients with Fluid and Electrolyte Imbalances

Assessment and Care of Patients with Acid-Base Imbalances

Infusion Therapy

Care of Preoperative Patients

Care of Intraoperative Patients

Care of Postoperative Patients

Inflammation and Immunity

Care of Patients with Arthritis and Other Connective Tissue Diseases

Care of Patients with HIV Disease and Other Immune Deficiencies

Care of Patients with Immune Function Excess: Hypersensitivity (Allergy)and Autoimmunity

Cancer Development

Care of Patients with Cancer

Care of Patients with Infection

Assessment of the Skin, Hair, and Nails

Care of Patients with Skin Problems

Care of Patients with Burns

Assessment of the Respiratory System

Care of Patients Requiring Oxygen Therapy or Tracheostomy

Care of Patients with Noninfectious Upper Respiratory Problems

Care of Patients with Infectious Respiratory Problems

Care of Critically Ill Patients with Respiratory Problems

Assessment of the Cardiovascular System

Care of Patients with Dysrhythmias

Care of Patients with Cardiac Problems

Care of Patients with Vascular Problems

Care of Patients with Shock

Care of Patients with Acute Coronary Syndromes

Assessment of the Hematologic System

Care of Patients with Hematologic Problems

Assessment of the Nervous System

Care of Patients with Problems of the Central Nervous System: The Brain

Care of Patients with Problems of the Central Nervous System: The Spinal Cord

Care of Patients with Problems of the Peripheral Nervous System

Care of Critically Ill Patients with Neurologic Problems

Assessment of the Eye and Vision

Care of Patients with Eye and Vision Problems

Assessment and Care of Patients with Ear and Hearing Problems

Assessment of the Musculoskeletal System

Care of Patients with Musculoskeletal Problems

Care of Patients with Musculoskeletal Trauma

Assessment of the Gastrointestinal System

Care of Patients with Oral Cavity Problems

Care of Patients with Esophageal Problems

Care of Patients with Stomach Disorders

Care of Patients with Noninflammatory Intestinal Disorders

Care of Patients with Inflammatory Intestinal Disorders

Care of Patients with Liver Problems

Care of Patients with Problems of the Biliary System and Pancreas

Care of Patients with Malnutrition: Undernutrition and Obesity

A nurse cares for a client who tests positive for alpha₁-antitrypsin (AAT)deficiency.The client asks,"What does this mean?" How should the nurse respond?