Question 1

The nurse enters the room of a patient who is acutely short of breath. Which action should the nurse take first?

Accepted Answer

A)  Assist the patient into Sims' position.
B)  Encourage use of pursed-lip breathing.
C)  Ask the patient what caused the dyspnea.
D)  Teach the patient use of accessory muscles. B

Question 2

A patient with chronic obstructive pulmonary disease (COPD) is prescribed methylprednisolone. For what reason should the nurse realize that corticosteroids are used in the treatment of this health problem?

Accepted Answer

A)  To dry up respiratory secretions
B)  To treat infection from secretion stasis
C)  To reduce airway inflammation
D)  To improve the blood capacity to carry oxygen C

Question 3

The nurse works primarily with patients diagnosed with lung cancer. Which patient with lung cancer does the nurse recognize as having the best prognosis?

Accepted Answer

A)  Small cell lung cancer
B)  Large cell carcinoma
C)  Adenocarcinoma
D)  Squamous cell carcinoma D

Question 4

The nurse auscultates the lung sounds of a patient with a pneumothorax every 4 hours. Which finding indicates to the nurse that the patient's condition is improving?

Accepted Answer

A)  Patient anxiety is decreased.
B)  Crackles or wheezes are heard.
C)  Bilateral lung sounds are present.
D)  Symmetry of the chest is noted.

Question 5

A patient diagnosed with a pleural effusion is experiencing severe dyspnea. With which procedure does the nurse anticipate assisting?

Accepted Answer

A)  Tracheostomy
B)  Thoracentesis
C)  Bronchoscopy
D)  Pericardiocentesis

Question 6

The nurse is caring for a patient with pneumonia. Which set of laboratory tests will be most helpful to the nurse to monitor the condition of this patient?

Accepted Answer

A)  Electrolytes and serum creatinine
B)  Complete blood count (CB
C)   and urinalysis
C)  Partial thromboplastin time (PTT)  and serum potassium
D)  White blood cell (WB
C)   count and arterial blood gases (ABGs)

Question 7

The nurse is reviewing data collected on a patient with a respiratory disorder. Which factors does the nurse identify as placing the patient at risk for lung cancer?

Accepted Answer

A)  Smoking and exposure to radon gas
B)  Living in a cold climate and having pets
C)  Eating foods high in beta carotene and fiber
D)  Living in crowded conditions and a lack of sunlight

Question 8

A summer camp worker reports shortness of breath and audible wheezing to the camp nurse. Which inhaled medication will the nurse provide?

Accepted Answer

A)  Albuterol
B)  Cromolyn sodium
C)  Triamcinolone
D)  Nedocromil sodium

Question 9

Management of asthma involves avoidance of triggers. Which environmental triggers will the nurse suggest the patient eliminate?

Accepted Answer

A)  Carpet and drapes in the bedroom
B)  Exposure to secondhand smoke
C)  Pets and foods that cause symptoms
D)  Cardiovascular exercise
E)  Beta-blocking medications

Question 10

A patient is admitted to a respiratory unit with a diagnosis of pneumonia. Assessment data reveal the patient to be febrile and experiencing a weak, congested-sounding cough, with moist crackles throughout the lung fields. Based on the data provided, the nurse will focus care on which issue?

Accepted Answer

A)  Confusion from fever
B)  Inadequate oxygen level
C)  Difficulty with breathing
D)  Inability to clear the airway

Question 11

A patient who is planning to become pregnant expresses concern about the high incidence of asthma in her family. Which recommendation by the nurse is least helpful?

Accepted Answer

A)  Suggest the patient undergo genetic studies and counseling.
B)  Prevent exposure to environmental tobacco smoke during pregnancy.
C)  During the first year of life, avoid giving a child acetaminophen.
D)  Avoid broad-spectrum antibiotics during the child's first year of life.

Question 12

The nurse is providing care for a patient diagnosed with an obstructive respiratory disorder. Which patient finding indicates that nursing interventions may be ineffective?

Accepted Answer

A)  Respiratory secretions are coughed up.
B)  Daily care is performed independently.
C)  The patient uses oxygen only when active.
D)  The patient reports a low level of anxiety.

Question 13

The nurse is performing a follow up visit with a patient recently diagnosed with a GOLD 1 classification of COPD. Which statement by the patient indicates the most important compliance with previous patient teaching?

Accepted Answer

A)  "I am attending an exercise class three times a week."
B)  "I am including more fresh foods in my daily diet."
C)  "I successfully completed a smoking-cessation program."
D)  "I am wearing a respiratory filter when I work outside."

Question 14

A patient with TB who is in respiratory isolation must go to the x-ray department. Which action will the nurse take?

Accepted Answer

A)  Place a gown and gloves on the patient.
B)  Place a mask over the patient's nose and mouth.
C)  Notify the x-ray department that the test must be cancelled.
D)  Call the x-ray department to make sure the waiting room is empty.

Question 15

The nurse is providing care for a patient with a suspected pulmonary emboli. Which data will the nurse gather about this patient?

Accepted Answer

A)  BP from both arms
B)  Heart sounds and peripheral edema
C)  Activity prior to manifestations
D)  Side effects of medications

Question 16

The nurse is providing care for a patient with a lower respiratory tract infection who is having difficulty expectorating secretions. The patient is weak and easily fatigued. Which action by the nurse will best assist the patient in maintaining a clear airway?

Accepted Answer

A)  Review effective coughing technique.
B)  Plan activities with rest periods between.
C)  Explain the importance of fluid intake.
D)  Encourage abdominal and pursed-lip breathing.

Question 17

The nurse is reviewing the medications prescribed by the health care provider (HCP) for a patient with COPD. Which prescription will cause the nurse to verify the ordered medication?

Accepted Answer

A)  Corticosteroid inhaler
B)  Antitussive
C)  Short-term antibiotic therapy
D)  Theophylline bronchodilator

Question 18

The nurse works in a clinic and is performing tuberculosis (TB) screening with the purified protein derivative (PPD). Which option about PPD screening is correct?

Accepted Answer

A)  The test is positive if reddened area occurs within 48 to 72 hours.
B)  If a person is anergic, a larger area of induration will appear.
C)  A positive reaction to the test indicates active disease process.
D)  A reddened area without induration is considered negative.

Question 19

A patient with lung cancer develops pleural effusion. Which explanation by the nurse would help the patient understand this problem?

Accepted Answer

A)  "Pus has developed in your alveoli that must be removed to improve your breathing."
B)  "You have large amounts of fluid collecting in your airways because of your diagnosis."
C)  "Fluid has collected in the space between your lungs and the sac surrounding your lungs."
D)  "Fluid in your pericardial sac places pressure on your lungs, making it difficult to breathe."

Question 20

The nurse works on a pulmonary care unit and provides care for multiple patients with obstructive pulmonary conditions. Which specific symptoms will prompt the nurse to identify a patient's diagnosis as chronic bronchitis as opposed to other pulmonary diseases? (Select all that apply.)

Accepted Answer

A)  Chronic productive cough
B)  Classic barrel-shaped chest
C)  Use of accessory muscles to breath
D)  Condition worsening in the winter
E)  Clear breath sounds with coughing

Exam 31: Nursing Care of Patients With Lower Respiratory Tract Disorders