Question 1

After discharge teaching has been completed for a patient who has had a lung transplant, the nurse will evaluate that the teaching has been effective if the patient states

Accepted Answer

A)  "I will make an appointment to see the doctor every year." 
B)  "I will not turn the home oxygen up higher than 2 L/minute." 
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 2

The nurse notes that a patient has incisional pain, a poor cough effort, and scattered rhonchi after a thoracotomy. Which action should the nurse take first?

Accepted Answer

A)  Assist the patient to sit up at the bedside. 
B)  Splint the patient's chest during coughing. 
C)  Medicate the patient with the prescribed morphine. 
D)  Have the patient use the prescribed incentive spirometer.

Question 3

The health care provider inserts a chest tube in a patient with a hemopneumothorax. When monitoring the patient after the chest tube placement, the nurse will be most concerned about

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 4

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

Accepted Answer

A)  Repeat the tuberculin skin testing. 
B)  Teach about the reason for the blood tests. 
C)  Obtain consecutive sputum specimens from the patient for 3 days. 
D)  Instruct the patient to expectorate three specimens as soon as possible.

Question 5

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

Accepted Answer

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

Question 6

After the nurse has received change-of-shift report about the following four patients, which patient should be assessed first?

Accepted Answer

A)  A 77-year-old patient with tuberculosis ( TB ) who has four antitubercular medications due in 15 minutes 
B)  A 23-year-old patient with cystic fibrosis who has pulmonary function testing scheduled 
C)  A 46-year-old patient who has a deep vein thrombosis and is complaining of sudden onset shortness of breath. 
D)  A 35-year-old patient who was admitted the previous day with pneumonia and has a temperature of 100.2° F ( 37.8° C )

Question 7

To determine the effectiveness of prescribed therapies for a patient with cor pulmonale and right-sided heart failure, which assessment will the nurse make?

Accepted Answer

A)  Lung sounds 
B)  Heart sounds 
C)  Blood pressure 
D)  Peripheral edema

Question 8

Which nursing action will be most effective in preventing aspiration pneumonia in patients who are at risk?

Accepted Answer

A)  Turn and reposition immobile patients at least every 2 hours. 
B)  Place patients with altered consciousness in side-lying positions. 
C)  Monitor for respiratory symptoms in patients who are immunosuppressed. 
D)  Provide for continuous subglottic aspiration in patients receiving enteral feedings.

Question 9

A patient with bacterial pneumonia has rhonchi and thick sputum. Which action will the nurse use to promote airway clearance?

Accepted Answer

A)  Assist the patient to splint the chest when coughing. 
B)  Educate 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 10

The nurse is performing tuberculosis ( TB ) screening in a clinic that has many patients who have immigrated to the United States. Before doing a TB skin test on a patient, which question is most important for the nurse to ask?

Accepted Answer

A)  "Is there any family history of TB?" 
B)  "Have you received the bacille Calmette-Guérin ( BCG ) vaccine for TB?" 
C)  "How long have you lived in the United States?" 
D)  "Do you take any over-the-counter ( OTC ) medications?"

Question 11

A patient is admitted to the emergency department with an open stab wound to the right chest. What is the first action that the nurse should take?

Accepted Answer

A)  Position the patient so that the right chest is dependent. 
B)  Keep the head of the patient's bed at no more than 30 degrees elevation. 
C)  Tape a nonporous dressing on three sides over the chest wound. 
D)  Cover the sucking chest wound firmly with an occlusive dressing.

Question 12

After a patient with right lower-lobe pneumonia has been treated with intravenous ( IV ) antibiotics for 2 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 ( WBC ) count is 9000/µl. 
D)  Increased tactile fremitus is palpable over the right chest.

Question 13

The nurse notes new onset confusion in an 89-year-old patient in a long-term care facility. The patient is normally alert and oriented. In which order should the nurse take the following actions? Put a comma and space between each solve choice (a, b, c, d, etc.) ____________________
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...

Question 14

A patient with primary pulmonary hypertension ( PPH ) is receiving nifedipine ( Procardia ). The nurse will evaluate that the treatment is effective if

Accepted Answer

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

Question 15

A patient with a possible pulmonary embolism complains of chest pain and difficulty breathing. The nurse finds a heart rate of 142, BP reading of 100/60, and respirations of 42. The nurse's first action should be to

Accepted Answer

A)  elevate the head of the bed to 45 to 60 degrees. 
B)  administer the ordered pain medication. 
C)  notify the patient's health care provider. 
D)  offer emotional support and reassurance.

Question 16

A patient with newly diagnosed lung cancer tells the nurse, "I think I am going to die pretty soon." 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 17

When developing a teaching plan for a patient with a 42 pack-year history of cigarette smoking, it will be most important for the nurse to include information about

Accepted Answer

A)  computed tomography ( CT ) screening for lung cancer. 
B)  options for smoking cessation. 
C)  reasons for annual sputum cytology testing. 
D)  erlotinib ( Tarceva ) therapy to prevent tumor risk.

Question 18

Which assessment information obtained by the nurse when caring for a patient who has just had a thoracentesis is most important to communicate to the health care provider?

Accepted Answer

A)  BP is 150/90 mm Hg. 
B)  Oxygen saturation is 89%. 
C)  Pain level is 5/10 with a deep breath. 
D)  Respiratory rate is 24 when lying flat.

Question 19

After 2 months of tuberculosis ( TB ) treatment with a standard four-drug regimen, a patient continues to have positive sputum smears for acid-fast bacilli ( AFB ). Which action should the nurse take next?

Accepted Answer

A)  Ask the patient whether medications have been taken as directed. 
B)  Discuss the need to use some different medications to treat the TB. 
C)  Schedule the patient for directly observed therapy three times weekly. 
D)  Educate about using a 2-drug regimen for the last 4 months of treatment.

Question 20

When providing preoperative instruction for a patient scheduled for a left pneumonectomy for cancer of the lung, the nurse informs the patient that the postoperative care includes

Accepted Answer

A)  positioning on the right side. 
B)  bed rest for the first 24 hours. 
C)  frequent use of an incentive spirometer. 
D)  chest tubes to water-seal chest drainage.

Exam 28: Nursing Management: Lower Respiratory Problems