Question 1

A postoperative patient is taking shallow breaths because of fear of incisional pain.Which action should the nurse take first?

Accepted Answer

A)  Instruct the patient on the use of an incentive spirometer. 
B)  Measure peak expiratory flow rate with a peak flow meter. 
C)  Call respiratory therapy to provide a metered-dose inhaler (MDI). 
D)  Contact the physician to request nebulized mist treatments (NMTs).

Question 2

A patient is recovering after a bronchoscopy.Which action is a priority for this patient?

Accepted Answer

A)  Encourage oral fluids. 
B)  Check for swallow and gag reflexes. 
C)  Monitor the patient for return to consciousness. 
D)  Order a meal because the patient has been NPO for 8 hours.

Question 3

The nurse is examining a chest drainage system on a patient with a pneumothorax and notes the water level in the water seal chamber fluctuating with each of the patient's respirations.What should the nurse do?

Accepted Answer

A)  Clamp the tubing and call for help. 
B)  Have the patient take a deep breath. 
C)  Examine the entire system and tubing for leaks. 
D)  No action is necessary; this is an expected finding.

Question 4

A patient being mechanically ventilated is prescribed peak end-expiratory pressure (PEEP).How does this setting assist the ventilated patient?

Accepted Answer

A)  It delivers a breath only if the patient does not breathe spontaneously. 
B)  It provides positive pressure on expiration to keep small airways open. 
C)  It delivers a breath in a set pattern regardless of the patient's respiratory pattern. 
D)  It provides positive pressure on inspiration and expiration to increase oxygenation.

Question 5

The nurse is auscultating a patient's lungs but is unable to hear much air movement.What should the nurse do to most effectively hear the lung sounds?

Accepted Answer

A)  Try another stethoscope. 
B)  Have the patient rest between breaths. 
C)  Have the patient assume a side-lying position. 
D)  Ask the patient to breathe deeply through the mouth.

Question 6

A patient's chest x-ray shows a suspicious area,and the physician plans a bronchoscopy.How should the nurse describe this procedure to the patient?

Accepted Answer

A)  "You will be asked to use a mouthpiece to blow into a machine." 
B)  "You will need to drink a thick white liquid that will be opaque on the x-rays." 
C)  "A dye will be injected to help visualize the structures of the bronchioles. Do you have any allergies?" 
D)  "The physician will place a small tube through your nose or mouth and into the bronchi to look at your airways."

Question 7

The nurse is coaching a patient to empty the lungs of all air before using a metered-dose inhaler.What air that is expired beyond tidal volume in a forceful exhalation is the nurse coaching the patient to remove from the lungs?

Accepted Answer

A)  Tidal volume 
B)  Expiratory reserve 
C)  Forced vital capacity 
D)  Peak expiratory flow rate

Question 8

The nurse documents that a patient's chest is within normal limits.What does this statement mean?

Accepted Answer

A)  The chest is deeper than it is wide. 
B)  The chest is equally wide and deep. 
C)  The chest is twice as wide as it is deep. 
D)  The chest is greater than 30 inches in diameter.

Question 9

The nurse is preparing to suction a patient's tracheostomy Place in order the steps the nurse should take to complete this procedure.All options must be used.

Accepted Answer

A)  ____ Connect oxygen source to manual resuscitation bag. 
B)  ____ Connect catheter to suction tubing, and turn on suction to level specified by institution policy. 
C)  ____ Pour saline into sterile container. 
D)  ____ Suction small amount of saline into catheter. 
E)  ____ Use thumb to stop suction, and insert catheter through tracheostomy tube until patient coughs or resistance is met.
F) ____ Oxygenate patient with three ventilations using a manual resuscitation bag connected to an oxygen source.
G) ____ Slowly withdraw catheter, suctioning intermittently while rotating it.

Question 10

A patient's oxygen saturation is 89%.Which actions should the nurse take first?

Accepted Answer

A)  Raise the head of the patient's bed. 
B)  Call the respiratory therapist STAT. 
C)  Place the patient in a supine position. 
D)  No action; this is a normal oxygen saturation.

Question 11

The nurse is auscultating a patient's chest and hears an adventitious sound in the left lower lobe.What is the first step in determining whether this is an abnormality?

Accepted Answer

A)  Call another nurse to listen to the patient's lungs. 
B)  Ask the patient if this has ever occurred in the past. 
C)  Have the physician listen and verify what the nurse is hearing. 
D)  Listen to the corresponding area in the patient's right lower lobe.

Question 12

The nurse is providing care for a patient diagnosed with asthma.Which adventitious sound should the nurse expect when auscultating this patient's lung sounds?

Accepted Answer

A)  Crackles 
B)  Wheezes 
C)  Pleural friction rub 
D)  Diminished breath sounds

Question 13

The nurse is asked to assist with the intubation of a confused patient with respiratory failure.What should the nurse do first?

Accepted Answer

A)  Ask the patient to sign a consent form. 
B)  Check the patient's advance directives. 
C)  Place the patient in a supine position with neck extended. 
D)  Obtain necessary equipment according to institution policy.

Question 14

A patient enters the emergency department with a stab wound to the chest.The physician places chest tubes to drain air and blood from the patient's thoracic cavity.The nurse sets up the chest tube drainage system.Where should the nurse place the system?

Accepted Answer

A)  Below the patient's chest 
B)  At the level of the patient's heart 
C)  1 inch higher than the head of the bed 
D)  At the level of the patient's diaphragm

Question 15

A patient is having problems with oxygenation of body tissues.What is important for the nurse to consider about the transport of oxygen in the blood?

Accepted Answer

A)  It is in blood plasma as free oxygen. 
B)  It travels on red blood cell membranes. 
C)  It is bonded to hemoglobin in blood plasma. 
D)  It is bonded to hemoglobin in red blood cells.

Question 16

A patient has a thoracentesis for dyspnea caused by a pleural effusion.The physician obtains 1000 mL of fluid.Which outcome indicates that the thoracentesis has been effective?

Accepted Answer

A)  No bleeding at the site is noted. 
B)  No cancer cells are found in the fluid. 
C)  The patient states that the dyspnea has lessened. 
D)  The fluid is sent to the laboratory in a timely manner.

Question 17

A patient is making a loud crowing sound caused by an obstruction of the airways by a foreign body.How should the nurse document this patient's lung sound?

Accepted Answer

A)  Stridor 
B)  Wheeze 
C)  Crackles 
D)  Pleural friction rub

Question 18

During the admission assessment of an individual admitted to the medical respiratory unit,the nurse notes the patient has a barrel-shaped chest.Which assessment should the nurse perform next?

Accepted Answer

A)  Assess the patient's rate and character of respirations. 
B)  Ask the patient about presence of a productive cough. 
C)  Palpate the patient's thorax to determine presence of tenderness. 
D)  Obtain a blood sample for arterial blood gas (ABG) to detect respiratory acidosis.

Question 19

A patient is prescribed noninvasive positive-pressure ventilation (NIPPV).How can the nurse increase the patient's comfort when using this ventilation system?

Accepted Answer

A)  Administer opioid analgesics. 
B)  Remove the unit while the patient is sleeping. 
C)  Re-tape the tube to the opposite side of the mouth every 24 hours. 
D)  Use a skin barrier on the area where the mask comes in contact with the skin.

Question 20

A patient with pneumonia is having difficulty raising secretions for a sputum culture.Which action should the nurse take first?

Accepted Answer

A)  Administer a bronchodilator. 
B)  Suction the patient to obtain a specimen. 
C)  Encourage the patient to take deep breaths. 
D)  Obtain the specimen with a cotton-tipped swab.

Exam 29: Respiratory System Function, Assessment, and Therapeutic Measures