Respiratory Take Home Review Questions

during/on inspiration

During a physical assessment, the nurse listens for adventitious lung sounds. Crackles are classified as fine, medium, or coarse, and are heard

sonorous wheezes

The nurse is performing auscultation of breath sounds on a respiratory patient. The sounds heard on inspiration and expiration are loud, low, coarse sounds. These are identified as

increase intake to 1000 ml daily to liquefy secretions

The appropriate outcome statement for a patient with a nursing diagnosis of Ineffective airway clearance r/t thick secretions would be that the patient will

toward the face

In order to assure optimum reception from a stethoscope, the nurse will place the earpieces pointing

internal respiration

Nurse explains that the exchange of carbon dioxide and oxygen that takes place at the alveolar level is termed

medulla oblongata

The nurse is alarmed when a patient with a severe head injury of the occipital lobe has a respiratory rate of 10, as she is aware that this may indicate an injury to the

dyspnea.

The nurse describes the respiration of a patient who is demonstrating pursed-lip breathing, flared nostrils, and retractions as

which antibiotics stop bacterial growth.

When a patient complains that he is not yet on an antibiotic, the nurse explains that the physician is waiting on the results of the culture and sensitivity because this test determines

nosocomial infection

nurse is distressed when a patient admitted with a diagnosis of pneumonia develops a UTI because the nurse recognizes the UTI as a

early morning

Because the nurse is aware that a sputum specimen must come from deep in the bronchial tree, she will attempt to collect the specimen

tracheal suctioning

Because some patients are unable to obtain a sputum specimen by coughing and expectorating, the nurse may collect the specimen by

the gag reflex has returned

Following a bronchoscopy, in order to protect the patient from aspiration, the nurse will prevent the patient from eating or drinking for 2 hours until

Blood level of Carbon dioxide

Which of the following is the most important chemical regulator of respiration?

Expiratory reserve

air that is expired beyond tidal volume in a forceful exhalation

Medulla

nurse is providing care for a patient who suffered an ischemic stroke and now requires respiratory support with mechanical ventilation. The nurse recognizes that the stroke most likely occurred in which part of the brain?

Observe the patient throughout two to three respirations.

nurse is providing care for a patient who complains of difficulty breathing. Which of the following assessments will best help the nurse determine the severity of the patient's dyspnea?

Alveoli

Gas exchange occurs in what structure

Tachypnea

respiratory rate of 36 breaths per minute in an adult

The use of accessory muscles to aid breathing

While providing care for a patient with asthma, the nurse notes the patient's shoulders are rising with each breath. The nurse recognizes this action most likely represents which of the following?

Assess the patient's rate and character of respirations

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

Coarse crackles

A patient with pulmonary edema has moist, bubbling lung sounds. What is the best way to describe this finding?

Wheezes

nurse is providing care for a patient diagnosed with asthma. Which of the following adventitious sounds is anticipated?

Hold pressure on the puncture site for 5 minutes.

A laboratory technician has just completed drawing arterial blood gases from a patient. What action should the nurse take first?

Notify physician

A patient's arterial blood gas analysis shows a PaCO2 of 68 mm Hg. What action should the nurse take first?

Raise the head of the patient's bed

A patient's oxygen saturation is 89%. Which of the following actions has the highest priority?

Breathe using your abdominal muscles, and blow out slowly through pursed lips.

Which of the following instructions is appropriate when teaching a dyspneic patient how to breathe effectively?

Right side-lying

A patient with cancer in the left lung is acutely short of breath. Which position should the nurse suggest the patient assume?

The patient demonstrates the correct procedure for administering the NMT.

A patient is being taught to administer nebulized mist treatments (NMTs) at home. Which outcome best helps the nurse know that the patient is able to administer the treatments?

Encourage the patient to cough and deep breathe

After providing chest physiotherapy, the nurse notes the patient has loose secretions and a slight rattle with expiration. Which of the following actions should the nurse take first?

The patient states that the dyspnea has lessened.

A patient has a thoracentesis for dyspnea caused by a pleural effusion. The physician obtains 1,000 mL of fluid. Which of the following indicates that the thoracentesis has been effective?

Examine the entire system and tubing for air leaks.

A patient with a chest drainage system is admitted to the respiratory unit. The nurse notes vigorous bubbling in the water seal chamber of the system. Which of the following actions by the nurse is correct?

No action is necessary; this is an expected finding.

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. How should the nurse respond?

15 seconds

A patient with a tracheostomy requires suctioning. How many seconds can the nurse suction safely with each pass of the catheter?

Check the patient

The nurse hears a ventilator alarm from the hallway. Which of the following actions should the nurse take first?

The physician will place a small tube through your nose or mouth and into the bronchi to look at your airways.

A patient's chest x-ray shows a suspicious area, and the physician plans a bronchoscopy. Which of the following explanations of a bronchoscopy should the nurse provide to the patient?

Prevent unseen blood from being swallowed or aspirated

The nurse instructs a patient with a nosebleed to sit up and lean slightly forward, recognizing that this position will most likely achieve which of the following objectives?

Ibuprofen (Motrin)

A patient comes into the emergency department with epistaxis. The physician orders that all home medications be continued. Which medication should the nurse question?

The patient swallows frequently.

A patient returns to the observation area after outpatient submucous resection for a deviated septum. Which of the following observations would most concern the nurse?

Inflammation of the mucous membranes lining the sinus cavities

Which of the following best describes sinusitis?

Rest and a room humidifier

In addition to antibiotics ordered by the physician, which of the following measures can the nurse recommend for a patient with a sinus infection?

Do not use the spray for more than 3 days, or rebound congestion may occur.

A patient has a prescription for an adrenergic nasal spray to relieve nasal congestion. Which of the following instructions should the nurse provide?

Antibiotics help prevent complications like rheumatic fever.

A patient with strep throat asks the nurse why he has to take antibiotics. Which of the following statements would the nurse include in the teaching?

Suction

What emergency equipment should the nurse have available at the bedside for a patient who has just had a tonsillectomy?

A hoarse voice

The nurse prepares to admit a patient who is being evaluated for suspected cancer of the larynx. Which of the following assessment findings does the nurse anticipate?

Maintain a patent airway.

Which action by the nurse is most important after laryngectomy surgery?

Narcotics can depress the respiratory rate and cough reflex.

While caring for a patient with a new laryngectomy, the nurse is asked by the family why the patient cannot be given higher doses of narcotics. Which of the following responses by the nurse is best?

Patient will maintain a clear airway.

The nurse develops a nursing diagnosis of risk for ineffective airway clearance related to excessive secretions. Which of the following goals is most appropriate?

Provide oxygen 2 L per nasal cannula

A nurse is providing care for a patient admitted with a temperature of 101.3�F, pulse 98 beats per minute, 34 respirations per minute, and blood pressure 106/54 mm Hg. The patient reports chills, nausea, vomiting, diarrhea, and weakness for the past 2 day

Ineffective Airway Clearance

A patient is admitted to a respiratory unit with a diagnosis of left lower lobe pneumonia. The nursing assessment reveals the patient to be febrile and experiencing a weak, congested-sounding cough. The patient has moist crackles throughout the lung field

White blood cell (WBC) count, arterial blood gases (ABGs)

Which of the following laboratory tests would best help the nurse to monitor the condition of a patient with pneumonia?

Smoking and exposure to radon gas

Which of the following factors place a patient at risk for lung cancer?

Radiation in lung cancer is most often used to increase comfort, not cure disease.

A patient with lung cancer who is scheduled to begin a course of radiation therapy asks the nurse, "How will they know if I'm cured?" The nurse's best response is based on which of the following understandings?

Thoracentesis

A patient diagnosed with a pleural effusion is very dyspneic. Which of the following procedures should the nurse anticipate assisting with?

Symptoms are caused by inflammation in the lining of your airways.

The nurse is providing discharge teaching for a patient with newly diagnosed asthma. Which of the following should be included in the discharge teaching?

Albuterol (Proventil)

A summer camp worker reports to the camp nurse with complaints of shortness of breath and audible wheezing. Which of the following inhaled medications would the nurse provide?

Air gets trapped when damage to the air sacs makes it hard for air to move in and out.

While reinforcing discharge teaching for a patient with emphysema, which of the following patient statements would indicate that teaching was effective?

To reduce airway inflammation

Corticosteroids such as methylprednisolone (Solu-Medrol) are used in the patient with chronic obstructive pulmonary disease for which of the following purposes?

Encourage use of pursed-lip breathing.

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

IV morphine

Which of the following medications can help reduce acute dyspnea in a patient with end-stage chronic obstructive pulmonary disease?

Notify the RN; this is abnormally high

A patient's arterial blood gas analysis shows a PaCO2 of 62 mm Hg. Which of the following actions is best?

Bedrest

A patient with cystic fibrosis has ineffective airway clearance. What intervention would worsen this problem?

Encourage fluids; suction prn as ordered.

A patient has difficulty raising pulmonary secretions, and the nurse writes a nursing diagnosis of "Ineffective Airway Clearance related to weak cough and fatigue." What would best help the patient maintain a clear airway?

Induration

A nurse performs purified protein derivative and Candida skin tests on a patient suspected of tuberculosis. After 48 hours, what finding at the injection sites should the nurse document as a positive result?

The patient with acquired immunodeficiency syndrome

Which of the following patients is most at risk for tuberculosis (TB)?

Isoniazid and rifampin

Which drugs are commonly prescribed to treat tuberculosis (TB)?

I will probably need to be on antibiotic therapy for 6 months to 2 years.

The nurse teaches a patient with tuberculosis (TB) about drug therapy. Which of the following statements by the patient indicate that the teaching has been effective?

A patient with a deep vein thrombosis in the leg

Which of the following patients should the nurse monitor most closely for symptoms of a pulmonary embolism (PE)?

Yell for help and start oxygen.

The nurse answers a call light and finds the patient gasping for breath and looking very anxious. Based on the patient's history, the nurse believes the patient may be experiencing a pulmonary embolism (PE). Which of the following actions should the nurse

When tidaling stops and lung sounds are equal on both sides, the tube can be removed.

A patient with a pneumothorax has a chest drainage system. The family asks when the chest tube will be removed. Which of the following responses, by the nurse, is best?

Respiratory acidosis

A patient with respiratory failure would have which of the following acid-base abnormalities?

Blood pressure 110/76 mm Hg

An LPN is collecting data on a patient who had thoracic surgery this morning. Vital signs earlier following surgery were as follows: blood pressure 156/94 mm Hg, pulse 100 beats/min, respirations 14/min, and temperature 97.4�F (approximately 36.3�C). Whic

Pneumonia

What is the most common cause of death from infection?

Bronchopneumonia

Which type of pneumonia occurs most often as a nosocomial infection in hospitalized patients, very young patients, and elderly patients?

Confusion

An older adult patient who reports difficulty breathing and a productive cough and has a low-grade fever is admitted to the hospital for diagnosis and treatment. Intervention for which of the following new-onset symptoms should take priority?

pulmonary arteries and pulmonary veins.

The circulation of the lungs is through the

have a pad and pencil or magic slate available.

A 52-year-old patient has had a laryngectomy in treatment of cancer of the larynx. A nursing diagnosis for the patient with a laryngectomy would be Impaired verbal communication related to removal of the larynx. The correct nursing intervention would be

rest 30 minutes before eating.

A 68-year-old male patient has chronic obstructive pulmonary disease (COPD). He has a markedly increased need for protein and calories to maintain an adequate nutritional status. To help him get the nutrition he needs, the nurse would encourage him to...

empyema.

An 83-year-old patient is admitted with a temperature of 102� F (38.8� C), chest pain, and fatigue. The chest radiograph reveals an accumulation of fluid in the pleural space, which the physician attempts to remove by performing a thoracentesis. The exuda

persistent hoarseness.

The patient has been admitted for possible carcinoma of the larynx. The first sign or symptom that may be present in carcinoma of the larynx is often...

use pulse oximetry

A patient, age 22, is admitted with acute asthma. It is important to monitor his oxygen saturation levels. The quickest way to assess his saturation of oxygen is to...

aspiration pneumonia.

A patient, age 54, is on postoperative day 2 after undergoing an open cholecystectomy. Immediately after the surgery, she vomited and may have aspirated some emesis. The nurse is concerned that the patient will develop pneumonia. In planning for her care,

-Eupnea
-Clear to auscultation

The nurse is caring for an individual whose respiratory rate of 14 is even and easy; breath sounds are normal. Which of the following terms would be included in a narrative note? (Select all that apply.)..

-Weakened cough due to atrophied respiratory muscles
-Increased risk of respiratory infection due to decreased ciliary activity
-Decreased gas exchange due to decreased number of alveoli

LPN is providing care for an 88-year-old patient. Which of the following age-related assessment findings would the nurse expect? (Select all that apply.)..

-Rest
-Fluids
-Decongestants

A patient sees a physician for symptoms of a cold (viral rhinitis). Which of the following treatments would the nurse expect? (Select all that apply.)..

-Influenza vaccination
-Avoiding crowds during flu season
-Good hand washing
-Avoiding sharing of eating or drinking utensils

A nurse is teaching a patient how to avoid contracting influenza and secondary bacterial infection. Which measures should be included in the instruction? (Select all that apply.)

-Use a cool mist humidifier to prevent nasal drying.
-Drink plenty of fluids unless otherwise ordered.
-Keep head elevated when sleeping, either using two pillows or sleeping in a recliner chair.

Which of the following should be included in the nurse's instructions for a patient being released after nasal surgery? (Select all that apply.)..

-D-dimer
-Spiral computed tomography (CT) scan
-Angiogram
-Ventilation-perfusion lung scan

Which of the following tests/procedures are used to diagnose a pulmonary embolism (PE)? (Select all that apply.)

-Administer guaifenesin (Mucinex) every 4 to 6 hours prn as ordered.
-Assess respiratory rate and pattern every 4 hours and prn.

A nurse is providing care for a patient with Ineffective Airway Clearance. Which of the following are appropriate interventions to address this problem? (Select all that apply.)..

25

For a patient recovering from a tonsillectomy, the physician has ordered an IV normal saline solution at 100 mL per hour. The IV tubing has a drop factor of 15. The nurse should infuse the IV at ____________________ drops per minute