Question 1

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 
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 2

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." 
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 3

Which action should the nurse plan to prevent aspiration in a high-risk patient?

Accepted Answer

A) Turn and reposition an immobile patient at least every 2 hours. 
B) Place a patient with altered consciousness in a side-lying position. 
C) Insert a nasogastric tube for feeding a patient with high calorie needs. 
D) Monitor respiratory symptoms in a patient who is immunosuppressed. 
A) Turn and reposition an immobile patient at least every 2 hours. 
B) Place a patient with altered consciousness in a side-lying position. 
C) Insert a nasogastric tube for feeding a patient with high calorie needs. 
D) Monitor respiratory symptoms in a patient who is immunosuppressed.

Question 4

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

Question 5

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 O2 therapy 
A) Purpose of antibiotic therapy 
B) Ways to limit oral fluid intake 
C) Appropriate use of cough suppressants 
D) Safety concerns with home O2 therapy

Question 6

A patient with a possible pulmonary embolism complains of chest pain and difficulty breathing. The nurse finds a heart rate of 142 beats/min,blood pressure of 100/60 mm Hg,and respirations of 42 breaths/min. Which action should the nurse take first?

Accepted Answer

A) Administer anticoagulant drug therapy. 
B) Notify the patient's health care provider. 
C) Prepare patient for a spiral computed tomography (CT). 
D) Elevate the head of the bed to a semi-Fowler's position. 
A) Administer anticoagulant drug therapy. 
B) Notify the patient's health care provider. 
C) Prepare patient for a spiral computed tomography (CT). 
D) Elevate the head of the bed to a semi-Fowler's position.

Question 7

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 is 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. 
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 8

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

Question 9

After 2 months of tuberculosis (TB)treatment with isoniazid,rifampin (Rifadin),pyrazinamide,and ethambutol,a patient continues to have positive sputum smears for acid-fast bacilli (AFB). Which action should the nurse take next?

Accepted Answer

A) Teach about drug-resistant TB. 
B) Schedule directly observed therapy. 
C) Ask the patient whether medications have been taken as directed. 
D) Discuss the need for an injectable antibiotic with the health care provider. 
A) Teach about drug-resistant TB. 
B) Schedule directly observed therapy. 
C) Ask the patient whether medications have been taken as directed. 
D) Discuss the need for an injectable antibiotic with the health care provider.

Question 10

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

Accepted Answer

A) The O2 saturation is 90%. 
B) The blood pressure is 98/56 mm Hg. 
C) The epoprostenol (Flolan) infusion is disconnected. 
D) The international normalized ratio (INR) is prolonged. 
A) The O2 saturation is 90%. 
B) The blood pressure is 98/56 mm Hg. 
C) The epoprostenol (Flolan) infusion is disconnected. 
D) The international normalized ratio (INR) is prolonged.

Question 11

A patient is admitted with active tuberculosis (TB). The nurse should question a health care provider's order to discontinue airborne precautions unless which assessment finding is documented?

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) Sputum smears for acid-fast bacilli are negative. 
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) Sputum smears for acid-fast bacilli are negative.

Exam 27: Lower Respiratory Problems

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

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?

Which action should the nurse plan to prevent aspiration in a high-risk patient?

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?

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

A patient with a possible pulmonary embolism complains of chest pain and difficulty breathing. The nurse finds a heart rate of 142 beats/min,blood pressure of 100/60 mm Hg,and respirations of 42 breaths/min. Which action should the nurse take first?

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 is effective?

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?

After 2 months of tuberculosis (TB)treatment with isoniazid,rifampin (Rifadin),pyrazinamide,and ethambutol,a patient continues to have positive sputum smears for acid-fast bacilli (AFB). Which action should the nurse take next?

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

A patient is admitted with active tuberculosis (TB). The nurse should question a health care provider's order to discontinue airborne precautions unless which assessment finding is documented?

Professional Nursing Practice

Health Disparities and Culturally Competent Care

Health History and Physical Examination

Patient and Caregiver Teaching

Chronic Illness and Older Adults

Stress and Stress Management

Sleep and Sleep Disorders

Pain

Palliative Care at End of Life

Substance Use Disorders

Inflammation and Wound Healing

Genetics and Genomics

Altered Immune Responses and Transplantation

Infection and Human Immunodeficiency Virus Infection

Cancer

Fluid, electrolyte, and Acid-Base Imbalances

Preoperative Care

Intraoperative Care

Postoperative Care

Assessment of Visual and Auditory Systems

Visual and Auditory Problems

Assessment of Integumentary System

Integumentary Problems

Burns

Assessment of Respiratory System

Upper Respiratory Problems

Obstructive Pulmonary Diseases

Assessment of Hematologic System

Hematologic Problems

Assessment of Cardiovascular System

Hypertension

Coronary Artery Disease and Acute Coronary Syndrome

Heart Failure

Dysrhythmias

Inflammatory and Structural Heart Disorders

Vascular Disorders

Assessment of Gastrointestinal System

Nutritional Problems

Obesity

Upper Gastrointestinal Problems

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Assessment of Urinary System

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Breast Disorders

Sexually Transmitted Infections

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Assessment of Nervous System

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Stroke

Chronic Neurologic Problems

Dementia and Delirium

Spinal Cord and Peripheral Nerve Problems

Assessment of Musculoskeletal System

Musculoskeletal Trauma and Orthopedic Surgery

Musculoskeletal Problems

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Critical Care

Shock, sepsis, and Multiple Organ Dysfunction Syndrome

Acute Respiratory Failure and Acute Respiratory Distress Syndrome

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