Question 1

Which of the following information should the nurse include in the teaching plan for a client who is receiving rifampin for treatment of tuberculosis?

Accepted Answer

A) "Your urine, sweat, and tears will be orange coloured." 
B) "Read a newspaper daily to check for changes in vision." 
C) "Take vitamin B6 daily to prevent peripheral nerve damage." 
D) "Call the health care provider if you notice any hearing loss."

Question 2

The nurse is caring for clients with active tuberculosis (TB) who misuse alcohol and/or are homeless. Which of the following interventions by the nurse will be most effective in ensuring adherence with the treatment regimen?

Accepted Answer

A) Educating the client about the long-term impact of TB on health 
B) Giving the client written instructions about how to take the medications 
C) Teaching the client about the high risk for infecting others unless treatment is followed 
D) Arranging for a daily noontime meal at a community centre and giving the medication then

Question 3

Which of the following actions by the occupational health nurse at a manufacturing plant where there is potential exposure to inhaled dust is most helpful in reducing incidence of lung disease?

Accepted Answer

A) Teach about symptoms of lung disease. 
B) Treat workers who inhale dust particles. 
C) Monitor workers for shortness of breath. 
D) Require the use of protective equipment.

Question 4

The nurse is caring for a client who has a steering wheel injury as a result of an automobile accident. Which of the following findings should be of most concern to the nurse during the initial assessment?

Accepted Answer

A) Paradoxical chest movement 
B) The complaint of chest wall pain 
C) A heart rate of 110 beats/minute 
D) A large bruised area on the chest

Question 5

The nurse is caring for a client with pneumonia who has symptoms of a sharp pain "whenever I take a deep breath." Which of the following actions should the nurse take next?

Accepted Answer

A) Listen to the client's lungs. 
B) Administer the PRN morphine. 
C) Have the client cough forcefully. 
D) Notify the client's health care provider.

Question 6

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

Accepted Answer

A) A 77-year-old client with tuberculosis (T
B)  who has four antitubercular medications due in 15 minutes 
B) A 23-year-old client with cystic fibrosis who has pulmonary function testing scheduled 
C) A 46-year-old client who has a deep vein thrombosis and is complaining of sudden onset shortness of breath. 
D) A 35-year-old client who was admitted the previous day with pneumonia and has a temperature of 37.9°C (100.2°F)

Question 7

The nurse is caring for a client with a pleural effusion who is scheduled for a thoracentesis. Which of the following actions should the nurse implement prior to the procedure?

Accepted Answer

A) Start a peripheral intravenous line to administer the necessary sedative drugs. 
B) Position the client sitting upright on the edge of the bed and leaning forward. 
C) Remove the water pitcher and remind the client not to eat or drink anything for 6 hours. 
D) Instruct the client about the importance of incentive spirometer use after the procedure.

Question 8

The health care provider writes a prescription for bacteriological testing for a client who has a positive tuberculosis skin test. Which of the following actions should 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 client for 3 days. 
D) Instruct the client to expectorate three specimens as soon as possible.

Question 9

The nurse is caring for a client with primary pulmonary hypertension (PPH) who is receiving nifedipine. Which of the following findings indicate that the treatment is effective?

Accepted Answer

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

Question 10

The nurse notes new onset confusion in an older-adult client in a long-term care facility. The client is normally alert and oriented. In which order should the nurse take the following actions?

Accepted Answer

A) Obtain the oxygen saturation. 
B) Check the client's pulse rate. 
C) Document the change in status. 
D) Notify the health care provider.

Question 11

The nurse is caring for a client with primary pulmonary hypertension (PPH) who has been taking a calcium channel blocker with no effect. Which of the following medications should the nurse expect that the client will receive next?

Accepted Answer

A) Nifedipine 
B) Diltiazem 
C) Iloprost 
D) Bosentan

Question 12

A staff nurse has a tuberculosis (TB) skin test of 16-mm induration. A chest radiograph is negative, and the nurse has no symptoms of TB. Which of the following information should the occupational health nurse provide to the staff nurse?

Accepted Answer

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

Question 13

Which of the following information about a client who has a recent history of

Accepted Answer

A) Chest x-ray shows no upper lobe infiltrates. 
B) TB medications have been taken for 6 months. 
C) Mantoux testing shows an induration of 10 mm. 
D) Three sputum smears for acid-fast bacilli are negative.

Question 14

To determine the effectiveness of prescribed therapies for a client with cor pulmonale and right-sided heart failure, which of the following assessments should the nurse make?

Accepted Answer

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

Question 15

The nurse is caring for a client with stage I non-small cell lung cancer who is scheduled for a lobectomy. The client tells the nurse, "I would rather have radiation than surgery." Which of the following responses by the nurse is best?

Accepted Answer

A) "Are you afraid that the surgery will be very painful?" 
B) "Did you have bad experiences with previous surgeries?" 
C) "Surgery is the treatment of choice for stage I lung cancer." 
D) "Tell me what you know about the various treatments available."

Question 16

The health care provider inserts a chest tube in a client with a hemo-pneumothorax. When monitoring the client after the chest tube placement, which of the following findings is of greatest concern?

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 17

The nurse observes an unregulated care provider doing all the following activities when caring for a client with a pulmonary embolism. Which of the following actions should cause the nurse to intervene with the client's care?

Accepted Answer

A) Lowers the head of the client's bed to 10 degrees. 
B) Splints the client's chest during coughing. 
C) Helps the client to ambulate to the bathroom. 
D) Assists the client to a bedside chair for meals.

Question 18

The nurse is caring for a client who has just had a thoracentesis. Which of the following information 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

Which of the following information obtained by the nurse about a client who has human immunodeficiency virus (HIV) and active tuberculosis (TB) disease is most important to communicate to the health care provider?

Accepted Answer

A) The Mantoux test had an induration of only 8 mm. 
B) The chest x-ray showed infiltrates in the upper lobes. 
C) The client is being treated with antiretrovirals for HIV infection. 
D) The client has a cough that is productive of blood-tinged mucus.

Question 20

The nurse is providing teaching to a client with pneumonia. Which of the following client statements indicate a good understanding of the discharge instructions given by the nurse?

Accepted Answer

A) "I will call the doctor if I still feel tired after a week." 
B) "I will need to use home oxygen therapy for 3 months." 
C) "I will continue to do the deep-breathing and coughing exercises at home." 
D) "I will schedule two appointments for the pneumonia and influenza vaccines."

Exam 30: Nursing Management Lower Respiratory Problems