Question 1

The young man who had a bronchoscopy 1 hour ago asks when he can eat. Which response would be most helpful?

Accepted Answer

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 
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

Question 2

Which patient assessment indicates the most severe respiratory distress?

Accepted Answer

A)  Nasal flaring, symmetrical chest wall expansion, SaO2 88% 
B)  Abdominal breathing, SaO2 97% 
C)  Substernal retraction, SaO2 84% 
D)  Substernal retraction, SaO2 90% 
A)  Nasal flaring, symmetrical chest wall expansion, SaO2 88% 
B)  Abdominal breathing, SaO2 97% 
C)  Substernal retraction, SaO2 84% 
D)  Substernal retraction, SaO2 90%

Question 3

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. What should be the nurse's initial intervention?

Accepted Answer

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. 
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.

Question 4

The nurse explains to the person with pneumonia in the left lung that being positioned in the "good lung down" offers the advantage of (select all that apply):

Accepted Answer

A)  PaO2 rising in the good lung. 
B)  blood flow to "bad lung" being increased. 
C)  the dependent lung being better perfused. 
D)  dyspnea disappearing. 
E)  decreased hypoxia. 
A)  PaO2 rising in the good lung. 
B)  blood flow to "bad lung" being increased. 
C)  the dependent lung being better perfused. 
D)  dyspnea disappearing. 
E)  decreased hypoxia.

Question 5

A patient, age 69, has emphysema. On assessment, the nurse notes the presence of a "barrel chest." What does this pathology result from?

Accepted Answer

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 
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

Question 6

What is true about activities such as walking for the patient with emphysema?

Accepted Answer

A)  Repair dilated alveoli 
B)  Increase capacity to use oxygen 
C)  Lessen the oxygen needs 
D)  Lessen metabolic oxygen needs 
A)  Repair dilated alveoli 
B)  Increase capacity to use oxygen 
C)  Lessen the oxygen needs 
D)  Lessen metabolic oxygen needs

Question 7

The patient with long-term emphysema is admitted with a secondary diagnosis of cor pulmonale. What should the nurse anticipate?

Accepted Answer

A)  The patient will present with edema of the lower extremities and extended neck veins due to hypertension of the pulmonary circulation. 
B)  The patient will present with a dry hacking cough and chest pain due to constriction of the pulmonary vein. 
C)  The patient will present with hypertension and a headache related to pulmonary hypertension. 
D)  The patient will present with unlabored respiration and cyanosis around the mouth. 
A)  The patient will present with edema of the lower extremities and extended neck veins due to hypertension of the pulmonary circulation. 
B)  The patient will present with a dry hacking cough and chest pain due to constriction of the pulmonary vein. 
C)  The patient will present with hypertension and a headache related to pulmonary hypertension. 
D)  The patient will present with unlabored respiration and cyanosis around the mouth.

Question 8

When assessing the SaO? with a pulse oximeter, the nurse will place the oximeter on a finger:

Accepted Answer

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. 
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.

Question 9

Which instruction by the nurse is inappropriate for teaching the proper technique for collection of a sputum specimen?

Accepted Answer

A)  Bring the sputum up from the lungs 
B)  Rinse mouth with water before expectorating in specimen cup 
C)  Collect specimens before meals 
D)  Send specimen to the lab without delay 
A)  Bring the sputum up from the lungs 
B)  Rinse mouth with water before expectorating in specimen cup 
C)  Collect specimens before meals 
D)  Send specimen to the lab without delay

Question 10

The patient has advanced emphysema and complains of dyspnea and fatigue. What would the most appropriate nursing intervention be for the nursing diagnosis of Activity intolerance related to an imbalance between the oxygen supply and demand?

Accepted Answer

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. 
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.

Question 11

How do leukotriene modifiers reduce the symptoms of asthma?

Accepted Answer

A)  By drying up mucus 
B)  By causing bronchodilation and anti-inflammation effects 
C)  By suppressing cough 
D)  By liquefying mucus 
A)  By drying up mucus 
B)  By causing bronchodilation and anti-inflammation effects 
C)  By suppressing cough 
D)  By liquefying mucus

Question 12

A nursing diagnosis for the patient with a new laryngectomy would be Social isolation related to impaired verbal communication related to removal of the larynx. What is an appropriate nursing intervention?

Accepted Answer

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 
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

Question 13

What is inspiratory capacity?

Accepted Answer

A)  The amount of air in the lung after a maximal inhalation 
B)  The amount of air moved with each normal inhalation and expiration 
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 
A)  The amount of air in the lung after a maximal inhalation 
B)  The amount of air moved with each normal inhalation and expiration 
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

Question 14

What happens when there is a decrease in the oxygen level in the blood?

Accepted Answer

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 
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

Question 15

The nurse explains that the diagnostic test that can scan the chest and the abdomen in less than 30 seconds is the _____________ _____.

Accepted Answer

spiral CT scan
helical CT scan

Question 16

How does pursed lip breathing assist patients with asthma during an attack?

Accepted Answer

A)  It distracts the patient with breathing technique to reduce anxiety. 
B)  It gets rid of CO2 faster. 
C)  It opens bronchioles by backflow air pressure. 
D)  It increases PACO2.. 
A)  It distracts the patient with breathing technique to reduce anxiety. 
B)  It gets rid of CO2 faster. 
C)  It opens bronchioles by backflow air pressure. 
D)  It increases PACO2..

Question 17

Which preoperative teaching should a nurse include for a person scheduled for a partial laryngectomy? (Select all that apply.)

Accepted Answer

A)  Tracheal suction will be frequent 
B)  The presence of a temporary tracheotomy 
C)  That isolation will be required for 24 hours 
D)  The surgery involves removal of a diseased vocal cord 
E)  Some speech will be retained
F) Starting mucolytic agents 
A)  Tracheal suction will be frequent 
B)  The presence of a temporary tracheotomy 
C)  That isolation will be required for 24 hours 
D)  The surgery involves removal of a diseased vocal cord 
E)  Some speech will be retained
F) Starting mucolytic agents

Question 18

The older adult patient with long-term emphysema complains of 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 what condition?

Accepted Answer

A)  Pulmonary embolus 
B)  Spontaneous pneumothorax 
C)  Early signs of unilateral pneumonia 
D)  An attack of asthma 
A)  Pulmonary embolus 
B)  Spontaneous pneumothorax 
C)  Early signs of unilateral pneumonia 
D)  An attack of asthma

Question 19

Which important precaution should the nurse include when instructing an emphysema patient on the use of home oxygen?

Accepted Answer

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 
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

Question 20

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

Accepted Answer

alveoli
The end structures of

Exam 48: Care of the Patient with a Respiratory Disorder

The young man who had a bronchoscopy 1 hour ago asks when he can eat. Which response would be most helpful?

Which patient assessment indicates the most severe respiratory distress?

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. What should be the nurse's initial intervention?

The nurse explains to the person with pneumonia in the left lung that being positioned in the "good lung down" offers the advantage of (select all that apply):

A patient, age 69, has emphysema. On assessment, the nurse notes the presence of a "barrel chest." What does this pathology result from?

What is true about activities such as walking for the patient with emphysema?

The patient with long-term emphysema is admitted with a secondary diagnosis of cor pulmonale. What should the nurse anticipate?

When assessing the SaO? with a pulse oximeter, the nurse will place the oximeter on a finger:

Which instruction by the nurse is inappropriate for teaching the proper technique for collection of a sputum specimen?

The patient has advanced emphysema and complains of dyspnea and fatigue. What would the most appropriate nursing intervention be for the nursing diagnosis of Activity intolerance related to an imbalance between the oxygen supply and demand?

How do leukotriene modifiers reduce the symptoms of asthma?

A nursing diagnosis for the patient with a new laryngectomy would be Social isolation related to impaired verbal communication related to removal of the larynx. What is an appropriate nursing intervention?

What is inspiratory capacity?

What happens when there is a decrease in the oxygen level in the blood?

The nurse explains that the diagnostic test that can scan the chest and the abdomen in less than 30 seconds is the _____________ _____.

How does pursed lip breathing assist patients with asthma during an attack?

Which preoperative teaching should a nurse include for a person scheduled for a partial laryngectomy? (Select all that apply.)

The older adult patient with long-term emphysema complains of 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 what condition?

Which important precaution should the nurse include when instructing an emphysema patient on the use of home oxygen?

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

Evolution of Nursing

Legal and Ethical Aspects of Nursing

Documentation

Communication

Nursing Process and Critical Thinking

Cultural and Ethnic Considerations

Asepsis and Infection Control

Body Mechanics and Patient Mobility

Hygiene and Care of the Patient’s Environment

Safety

Vital Signs

Physical Assessment

Admission, Transfer, and Discharge

Surgical Wound Care

Specimen Collection and Diagnostic Testing

Care of Patients Experiencing Urgent Alterations in Health

Complementary and Alternative Therapies

Pain Management, Comfort, Rest, and Sleep

Nutritional Concepts and Related Therapies

Fluids and Electrolytes

Mathematics and Medication Administration

Care of Patients with Alterations in Health

Life Span Development

Loss, Grief, Dying, and Death

Health Promotion and Pregnancy

Labor and Delivery

Care of the Mother and Newborn

Care of the High-Risk Mother, Newborn, and Family with Special Needs

Health Promotion for the Infant, Child, and Adolescent

Basic Pediatric Nursing Care

Care of the Child with a Physical and Mental or Cognitive Disorder

Health Promotion and Care of the Older Adult

Concepts of Mental Health

Care of the Patient with a Psychiatric Disorder

Care of the Patient with an Addictive Personality

Home Health Nursing

Long-Term Care

Rehabilitation Nursing

Hospice Care

Introduction to Anatomy and Physiology

Care of the Surgical Patient

Care of the Patient with an Integumentary Disorder

Care of the Patient with a Musculoskeletal Disorder

Care of the Patient with a Gastrointestinal Disorder

Care of the Patient with a Gallbladder, Liver, Biliary Tract, or Exocrine Pancreatic Disorder

Care of the Patient with a Blood or Lymphatic Disorder

Care of the Patient with a Cardiovascular or a Peripheral Vascular Disorder

Care of the Patient with a Urinary Disorder

Care of the Patient with an Endocrine Disorder

Care of the Patient with a Reproductive Disorder

Care of the Patient with a Sensory Disorder

Care of the Patient with a Neurologic Disorder

Care of the Patient with an Immune Disorder

Care of the Patient with HIV/AIDS

Care of the Patient with Cancer

Professional Roles and Leadership

Filters

The nurse explains that the diagnostic test that can scan the chest and the abdomen in less than 30 seconds is the _________ _.