Question 1

A patient with bacterial pneumonia has rhonchi and thick sputum.What is the nurse's most appropriate action to promote airway clearance?

Accepted Answer

A)  Assist the patient to splint the chest when coughing. 
B)  Teach the patient about the need for fluid restrictions. 
C)  Encourage the patient to wear the nasal oxygen cannula. 
D)  Instruct the patient on the pursed lip breathing technique.

Question 2

The nurse is caring for a patient with idiopathic pulmonary arterial hypertension (IPAH)who is receiving epoprostenol (Flolan).Which assessment information requires the most immediate action by the nurse?

Accepted Answer

A)  The oxygen saturation is 94%. 
B)  The blood pressure is 98/56 mm Hg. 
C)  The patient's central IV line is disconnected. 
D)  The international normalized ratio (INR) is prolonged.

Question 3

An older patient is receiving standard multidrug therapy for tuberculosis (TB).The nurse should notify the health care provider if the patient exhibits which finding?

Accepted Answer

A)  Yellow-tinged skin 
B)  Orange-colored sputum 
C)  Thickening of the fingernails 
D)  Difficulty hearing high-pitched voices

Question 4

The health care provider writes an order for bacteriologic testing for a patient who has a positive tuberculosis skin test.Which action should the nurse take?

Accepted Answer

A)  Teach about the reason for the blood tests. 
B)  Schedule an appointment for a chest x-ray. 
C)  Teach about the need to get sputum specimens for 2 to 3 consecutive days. 
D)  Instruct the patient to expectorate three specimens as soon as possible.

Question 5

A patient who is taking rifampin (Rifadin)for tuberculosis calls the clinic and reports having orange discolored urine and tears.Which is the best response by the nurse?

Accepted Answer

A)  Ask if the patient is experiencing shortness of breath, hives, or itching. 
B)  Ask the patient about any visual abnormalities such as red-green color discrimination. 
C)  Explain that orange discolored urine and tears are normal while taking this medication. 
D)  Advise the patient to stop the drug and report the symptoms to the health care provider.

Question 6

The nurse provides discharge teaching for a patient who has two fractured ribs from an automobile accident.Which statement,if made by the patient,would indicate that teaching has been effective?

Accepted Answer

A)  "I am going to buy a rib binder to wear during the day." 
B)  "I can take shallow breaths to prevent my chest from hurting." 
C)  "I should plan on taking the pain pills only at bedtime so I can sleep." 
D)  "I will use the incentive spirometer every hour or two during the day."

Question 7

A patient with a pleural effusion is scheduled for a thoracentesis.Which action should the nurse take to prepare the patient for the procedure?

Accepted Answer

A)  Start a peripheral IV line to administer the necessary sedative drugs. 
B)  Position the patient sitting upright on the edge of the bed and leaning forward. 
C)  Obtain a large collection device to hold 2 to 3 liters of pleural fluid at one time. 
D)  Remove the water pitcher and remind the patient not to eat or drink anything for 6 hours.

Question 8

A patient with idiopathic pulmonary arterial hypertension (IPAH)is receiving nifedipine (Procardia).Which assessment would best indicate to the nurse that the patient's condition is improving?

Accepted Answer

A)  Blood pressure (BP) is less than 140/90 mm Hg. 
B)  Patient reports decreased exertional dyspnea. 
C)  Heart rate is between 60 and 100 beats/minute. 
D)  Patient's chest x-ray indicates clear lung fields.

Question 9

A patient has acute bronchitis with a nonproductive cough and wheezes.Which topic should the nurse plan to include in the teaching plan?

Accepted Answer

A)  Purpose of antibiotic therapy 
B)  Ways to limit oral fluid intake 
C)  Appropriate use of cough suppressants 
D)  Safety concerns with home oxygen therapy

Question 10

The nurse completes discharge teaching for a patient who has had a lung transplant.The nurse evaluates that the teaching has been effective if the patient makes which statement?

Accepted Answer

A)  "I will make an appointment to see the doctor every year." 
B)  "I will stop taking the prednisone if I experience a dry cough." 
C)  "I will not worry if I feel a little short of breath with exercise." 
D)  "I will call the health care provider right away if I develop a fever."

Question 11

The nurse supervises unlicensed assistive personnel (UAP)who are providing care for a patient with right lower lobe pneumonia.The nurse should intervene if which action by UAP is observed?

Accepted Answer

A)  UAP splint the patient's chest during coughing. 
B)  UAP assist the patient to ambulate to the bathroom. 
C)  UAP help the patient to a bedside chair for meals. 
D)  UAP lower the head of the patient's bed to 15 degrees.

Question 12

The nurse monitors a patient after chest tube placement for a hemopneumothorax.The nurse is most concerned if which assessment finding is observed?

Accepted Answer

A)  A large air leak in the water-seal chamber 
B)  400 mL of blood in the collection chamber 
C)  Complaint of pain with each deep inspiration 
D)  Subcutaneous emphysema at the insertion site

Question 13

Employee health test results reveal a tuberculosis (TB)skin test of 16-mm induration and a negative chest x-ray for a staff nurse working on the pulmonary unit.The nurse has no symptoms of TB.Which information should the occupational health nurse plan to teach the staff nurse?

Accepted Answer

A)  Standard four-drug therapy for TB 
B)  Need for annual repeat TB skin testing 
C)  Use and side effects of isoniazid (INH) 
D)  Bacille Calmette-Guérin (BCG) vaccine

Question 14

The clinic nurse teaches a patient with a 42 pack-year history of cigarette smoking about lung disease.Which information will be most important for the nurse to include?

Accepted Answer

A)  Options for smoking cessation 
B)  Reasons for annual sputum cytology testing 
C)  Erlotinib (Tarceva) therapy to prevent tumor risk 
D)  Computed tomography (CT) screening for lung cancer

Question 15

A patient with right lower-lobe pneumonia has been treated with IV antibiotics for 3 days.Which assessment data obtained by the nurse indicates that the treatment has been effective?

Accepted Answer

A)  Bronchial breath sounds are heard at the right base. 
B)  The patient coughs up small amounts of green mucus. 
C)  The patient's white blood cell (WB
C)  count is 9000/µL. 
D)  Increased tactile fremitus is palpable over the right chest.

Question 16

Which action by the nurse will be most effective in decreasing the spread of pertussis in a community setting?

Accepted Answer

A)  Providing supportive care to patients diagnosed with pertussis 
B)  Teaching family members about the need for careful hand washing 
C)  Teaching patients about the need for adult pertussis immunizations 
D)  Encouraging patients to complete the prescribed course of antibiotics

Question 17

An alcoholic and homeless patient is diagnosed with active tuberculosis (TB).Which intervention by the nurse will be most effective in ensuring adherence with the treatment regimen?

Accepted Answer

A)  Arrange for a friend to administer the medication on schedule. 
B)  Give the patient written instructions about how to take the medications. 
C)  Teach the patient about the high risk for infecting others unless treatment is followed. 
D)  Arrange for a daily noon meal at a community center where the drug will be administered.

Question 18

A patient has just been admitted with probable bacterial pneumonia and sepsis.Which order should the nurse implement first?

Accepted Answer

A)  Chest x-ray via stretcher 
B)  Blood cultures from two sites 
C)  Ciprofloxacin (Cipro) 400 mg IV 
D)  Acetaminophen (Tylenol) rectal suppository

Question 19

A patient with newly diagnosed lung cancer tells the nurse,"I don't think I'm going to live to see my next birthday." Which response by the nurse is best?

Accepted Answer

A)  "Would you like to talk to the hospital chaplain about your feelings?" 
B)  "Can you tell me what it is that makes you think you will die so soon?" 
C)  "Are you afraid that the treatment for your cancer will not be effective?" 
D)  "Do you think that taking an antidepressant medication would be helpful?"

Question 20

The nurse notes new onset confusion in an older patient who is normally alert and oriented.In which order should the nurse take the following actions? (Put a comma and a space between each answer choice [A,B,C,D].)
A) Obtain the oxygen saturation.
B) Check the patient's pulse rate.
C) Document the change in status.
D) Notify the health care provider.

Accepted Answer

The answer of The nurse notes new onset confusion in...

Exam 28: Nursing Management: Lower Respiratory Problems

A patient with bacterial pneumonia has rhonchi and thick sputum.What is the nurse's most appropriate action to promote airway clearance?

The nurse is caring for a patient with idiopathic pulmonary arterial hypertension (IPAH) who is receiving epoprostenol (Flolan) .Which assessment information requires the most immediate action by the nurse?

An older patient is receiving standard multidrug therapy for tuberculosis (TB) .The nurse should notify the health care provider if the patient exhibits which finding?

The health care provider writes an order for bacteriologic testing for a patient who has a positive tuberculosis skin test.Which action should the nurse take?

A patient who is taking rifampin (Rifadin) for tuberculosis calls the clinic and reports having orange discolored urine and tears.Which is the best response by the nurse?