Deck 48: Care of the Patient with a Respiratory Disorder

Question 1

A patient, age 22, is admitted with acute asthma. The patient shows a pulse oximetry level of SaO? of 82%. How should the nurse interpret this?

A) Only 82% of the red blood cells are able to use oxygen.
B) There is only 82% of oxygen bound to the hemoglobin compared with the amount available.
C) Eighteen percent of oxygen is not dissolved in the blood.
D) The muscular respiratory effort is only 18% effective.

Answer 1

There is only 82% of oxygen bound to the hemoglobin compared with the amount available.

Question 2

What is the appropriate nursing intervention for a patient, age 40, who is diagnosed with active tuberculosis?

A) Place the patient in drainage and secretion precautions
B) Place the patient in acid-fast bacillus (AFB) Isolation Precautions
C) Maintain the patient in enteric isolation
D) Place the patient in any Isolation Precautions

Answer 2

Place the patient in acid-fast bacillus (AFB) Isolation Precautions

Question 3

How would the nurse examining a patient with pleurisy document a low-pitched grating lung sound?

A) Sonorous wheeze
B) Friction rub
C) Coarse crackles
D) Crackles

Answer 3

Friction rub

Question 4

What is a major advantage of video assisted thoracoscopic surgery (VATS)?

A) The surgeon can record entire surgical procedure on a video.
B) The surgeon can remove tumors of the lung through a small keyhole incision.
C) The surgeon can x-ray and excise tumor in the same procedure.
D) The surgeon can avoid the use of a closed chest drainage system after surgery.

Question 5

The patient has advanced emphysema and complains of dyspnea and fatigue. What would the most appropriate nursing intervention be for the nursing diagnosis of Activity intolerance related to an imbalance between the oxygen supply and demand?

A) Direct patient in vigorous independent ROM.
B) Allow to exercise until respirations are over 20 breaths/min over baseline.
C) Plan care to provide optimum rest.
D) Provide frequent cool showers.

Question 6

Which instruction by the nurse is inappropriate for teaching the proper technique for collection of a sputum specimen?

A) Bring the sputum up from the lungs
B) Rinse mouth with water before expectorating in specimen cup
C) Collect specimens before meals
D) Send specimen to the lab without delay

Question 7

A nursing diagnosis for the patient with a new laryngectomy would be Social isolation related to impaired verbal communication related to removal of the larynx. What is an appropriate nursing intervention?

A) Complete care quickly
B) Provide a pad and pencil or magic slate
C) Refrain from conversations with the patient to reduce stress level
D) Offer books or jigsaw puzzles for entertainment

Question 8

When assessing the SaO? with a pulse oximeter, the nurse will place the oximeter on a finger:

A) on the same side as the blood pressure cuff.
B) while exercising the arm to stimulate circulation.
C) that is a normal temperature.
D) on the same side as an arterial catheter.

Question 9

What is inspiratory capacity?

A) The amount of air in the lung after a maximal inhalation
B) The amount of air moved with each normal inhalation and expiration
C) The amount of air that can be inhaled in one breath from the resting expiratory level
D) The amount of air that can be forcefully exhaled after maximum inhalation

Question 10

What happens when there is a decrease in the oxygen level in the blood?

A) Pituitary stimulates the respiratory system to increase respiratory rate
B) The alveoli diffuse more oxygen into the blood
C) Chemoreceptors in the carotid body and aortic body stimulate the respiratory centers to modify respiratory rates
D) The parietal pleura increases the negative pressure

Question 11

A 55-year-old man comes to the health nurse at his place of work with epistaxis. He reports he has frequent nosebleeds that he can usually control himself. What would be the most helpful assessment after the nurse has stopped the bleeding?

A) Obtain a blood pressure
B) Record the approximate amount of blood lost
C) Inquire about a headache
D) Record the last episode of epistaxis

Question 12

The patient with long-term emphysema is admitted with a secondary diagnosis of cor pulmonale. What should the nurse anticipate?

A) The patient will present with edema of the lower extremities and extended neck veins due to hypertension of the pulmonary circulation.
B) The patient will present with a dry hacking cough and chest pain due to constriction of the pulmonary vein.
C) The patient will present with hypertension and a headache related to pulmonary hypertension.
D) The patient will present with unlabored respiration and cyanosis around the mouth.

Question 13

The nurse assessing an 11-year-old who is having an asthma attack expects to hear adventitious sounds of:

A) friction rub.
B) sibilant wheezes.
C) crackles.
D) sonorous wheezes.

Question 14

How will the kidneys behave in respiratory acidosis?

A) Retain bicarbonate to increase the pH
B) Excrete more urine to reduce potassium
C) Concentrate the urine to conserve circulating fluid in the blood stream
D) Lower the pH by excretion of bicarbonate

Question 15

A patient is on postoperative day 2 after undergoing a total hip replacement. The patient suddenly complains of chest pain and is coughing up blood-tinged sputum. What should be the nurse's initial intervention?

A) Report signs to the charge nurse.
B) Elevate head of bed and administer oxygen.
C) Prevent patient from excessive coughing.
D) Increase IV flow rate.

Question 16

How should the newly diagnosed patient who has been prescribed isoniazid (INH) for the treatment of active tuberculosis (TB) be advised?

A) Report redness and swelling of extremities
B) Accept that the therapy is long term
C) Monitor renal function every several months
D) Rise slowly to avoid dizziness

Question 17

An 83-year-old patient is admitted with a temperature of 102° F (38.8° C), chest pain, and fatigue. What is the infected fluid that the physician removes called?

A) Emboli
B) Emphysema
C) Sputum
D) Empyema

Question 18

A patient, age 69, has emphysema. On assessment, the nurse notes the presence of a "barrel chest." What does this pathology result from?

A) An increase in the lateromedial area from hypertrophy of mucous glands in the bronchi
B) An increased anteroposterior diameter caused by overinflation of the alveoli
C) A decrease in anteroposterior diameter caused by chronic dilation of the bronchi
D) A widening of the sternocostal area secondary to chronic constriction of smooth muscles in the airways leading to bronchospasms

Question 19

What is the purpose of the cilia?

A) Warm and moisturize inhaled air
B) Sweep debris toward nasal cavity
C) Stimulate cough reflex
D) Produce mucus

Question 20

What is true about activities such as walking for the patient with emphysema?

A) Repair dilated alveoli
B) Increase capacity to use oxygen
C) Lessen the oxygen needs
D) Lessen metabolic oxygen needs

Question 21

Which patient assessment indicates the most severe respiratory distress?

A) Nasal flaring, symmetrical chest wall expansion, SaO2 88%
B) Abdominal breathing, SaO2 97%
C) Substernal retraction, SaO2 84%
D) Substernal retraction, SaO2 90%

Question 22

The young man who had a bronchoscopy 1 hour ago asks when he can eat. Which response would be most helpful?

A) In 24 hours, but must take cold liquids for the rest of the day
B) If there is no blood in his sputum
C) In 8 hours after a period of nothing by mouth
D) When the gag reflex returns

Question 23

What should the nurse do to keep the chest tubes from becoming occluded?

A) Irrigate tubes as needed
B) Prevent dependent loops
C) Loop the tube over the bed rail
D) "Milk" the tube frequently

Question 24

How should a patient be positioned after a thoracentesis is completed and the dressing applied?

A) High Fowler
B) Semi-Fowler
C) Side lying on unaffected side
D) Prone

Question 25

How do leukotriene modifiers reduce the symptoms of asthma?

A) By drying up mucus
B) By causing bronchodilation and anti-inflammation effects
C) By suppressing cough
D) By liquefying mucus

Question 26

The nurse caring for a patient who has a closed chest drainage system notes that there is fluctuation (tidaling) in the water seal chamber. What is the most appropriate nursing action based on this assessment?

A) Document the tidaling
B) Elevate the head of the bed and notify charge nurse of malfunction of drainage system
C) Add more sterile water to the water seal chamber
D) Turn patient to the affected side

Question 27

What are age-related changes in the older adult that make them at risk for respiratory diseases? (Select all that apply.)

A) Moist mucous membranes
B) Kyphosis
C) Decrease in pulmonary blood flow
D) Stasis pooling of secretions
E) Reduced number of cilia

Question 28

The nurse explains that the opening between the vocal cords is the __________.

Question 29

The nurse explains that the diagnostic test that can scan the chest and the abdomen in less than 30 seconds is the _____________ _____.

Question 30

Which preoperative teaching should a nurse include for a person scheduled for a partial laryngectomy? (Select all that apply.)

A) Tracheal suction will be frequent
B) The presence of a temporary tracheotomy
C) That isolation will be required for 24 hours
D) The surgery involves removal of a diseased vocal cord
E) Some speech will be retained
F) Starting mucolytic agents

Question 31

The nurse prepares a patient for the procedure of a(n) __________, which will remove the fluid from around the lung to improve respiration and obtain a specimen.

Question 32

The _________ are the structures of the lung in which gas exchange occurs.

Question 33

The nurse explains to the person with pneumonia in the left lung that being positioned in the "good lung down" offers the advantage of (select all that apply):

A) PaO2 rising in the good lung.
B) blood flow to "bad lung" being increased.
C) the dependent lung being better perfused.
D) dyspnea disappearing.
E) decreased hypoxia.

Question 34

The older adult patient with long-term emphysema complains of a sharp pleuritic pain after a severe period of coughing. The patient's heart rate and respiratory rate have increased. Auscultation reveals no breath sounds on the left side. These are signs and symptoms of what condition?

A) Pulmonary embolus
B) Spontaneous pneumothorax
C) Early signs of unilateral pneumonia
D) An attack of asthma

Question 35

The nurse recognizes that the _______ reading in an arterial gas report indicates the amount of oxygen dissolved in the plasma.

Question 36

How does pursed lip breathing assist patients with asthma during an attack?

A) It distracts the patient with breathing technique to reduce anxiety.
B) It gets rid of CO2 faster.
C) It opens bronchioles by backflow air pressure.
D) It increases PACO2..

Question 37

Identify the purposes of chest drainage. (Select all that apply.)

A) Drains air, blood, and fluid from pleural space
B) Restores positive pressure in chest cavity
C) Restores negative intrapleural pressure
D) Allows lung to collapse and rest
E) Allows route for medication administration

Question 38

Which important precaution should the nurse include when instructing an emphysema patient on the use of home oxygen?

A) Use oxygen only when extremely short of breath
B) Keep the home oxygen regulator set on 6 L
C) Use home oxygen at night while sleeping
D) Limit to 1 to 2 L oxygen flow

Question 39

Which independent nursing measures are effective in aiding a patient to expectorate? (Select all that apply.)

A) Positioning in orthopneic position
B) Suctioning
C) Assisting to cough
D) Providing hydration
E) Starting IV fluids

Question 40

The nurse traces the path of unoxygenated blood through the respiratory system to the distribution of oxygenated blood to the body. Place the events of reoxygenation in order. (Separate letters by a comma and space as follows: A, B, C, D)

A) Pulmonary artery takes blood to capillary system of the alveoli
B) Blood enters the left atria via the pulmonary vein
C) Blood enter the left ventricle
D) Unoxygenated blood enters the right ventricle
E) Blood enters the aorta
F) CO₂ diffused and oxygen infused into the blood in alveoli
G) Unoxygenated blood enters the right atrium

Question 41

The nurse describes the pathophysiologic process of an asthma attack. Place the events in their proper sequence. (Separate letters by a comma and space as follows: A, B, C, D)

A) Inflammatory process in the mast cells of the lungs
B) Increase in edema and mucus production in the bronchioles
C) Release of histamine
D) Narrowing of the airways
E) Exposure to allergen