Deck 15: Care of Patients With Disorders of the Lower Respiratory System

Question 1

The nurse differentiates viral from bacterial pneumonia in that viral pneumonia causes:

A)elevation in white count.
B)consolidation of lung tissue.
C)interstitial inflammation.
D)copious exudate.

Answer 1

interstitial inflammation.

Question 2

When the nurse assesses that the level of drainage has not increased over the last 3 hours on a first-day postoperative thoracotomy patient,the nurse should initially:

A)inform the charge nurse.
B)rearrange tubing to correct dependent loops.
C)splint the patient with a pillow and coach to cough.
D)gently massage the tube toward the collection bottle.

Answer 2

rearrange tubing to correct dependent loops.

Question 3

The nurse providing patient education states that influenza is spread by: (Select all that apply.)

A)direct contact.
B)indirect contact.
C)vector.
D)blood-borne method.
E)droplets.

Answer 3

direct contact.
indirect contact.
droplets.

Question 4

When caring for a patient who is on a closed-chest drainage system with chest tubes,the nurse can confirm that the system is intact and working when:

A)the water level in the water-seal chamber fluctuates.
B)the level of fluid in the collection chamber rises.
C)there are constant bubbles in the water-seal chamber.
D)the suction has been attached.

Question 5

The nurse explains that a serious complication of a patient's chronic obstructive pulmonary disease (COPD)is cor pulmonale,which is exhibited by:

A)distended neck veins.
B)weight loss.
C)confusion and disorientation.
D)excessive coughing.

Question 6

The patient with acute bronchitis asks if antibiotics will be ordered for the condition.The best response by the nurse would be:

A)"Yes. Antibiotics are the best treatment option."
B)"No. Antibiotics will not help a viral condition."
C)"Antibiotics will be given if the sputum culture indicates your bronchitis is caused by bacteria."
D)"I don't think so because antibiotics will inhibit the inflammatory response of your body to the invasion of this infection."

Question 7

The nurse is assessing the patient with influenza and notes general malaise and aching muscles,which have continued for 2 weeks.The nurse is aware that the patient may have developed which complication of influenza?

A)Bronchitis
B)Bacterial pneumonia
C)Urinary infection
D)Encephalitis

Question 8

The 30-year-old American Indian female who is taking Rifater,a drug containing rifampin,isoniazid,and pyrazinamide,complains that she is tired of taking medicine and having to spit in a bottle all the time.She asks,"When can I stop all this and get on with my life?" The nurse's best response is that she will no longer be considered contagious when:

A)the sputum culture comes back negative.
B)the medication has been taken for 9 months.
C)three consecutive sputum cultures are negative.
D)the tuberculin skin test (TST) is no longer positive.

Question 9

The nurse reading a tuberculin skin test (TST)on a new employee who lives in the Midwest,is 20 years old,and has no known history of contact with any persons with tuberculosis (TB)will record it as positive if the area around the injection site has an area of swelling of _____ mm _____ hours after the injection.

A)15; 48
B)10; 72
C)5; 48
D)0 to 5; 72

Question 10

A patient who has had a left pneumonectomy to remove a lung cancer is returned to the unit from surgery.The nurse should position the patient in a _____ position.

A)high Fowler's
B)semi-Fowler's
C)right side-lying
D)left side-lying

Question 11

The nurse schedules the postural drainage treatments to be done before breakfast because:

A)fluids that have accumulated overnight can be expelled.
B)bronchial openings are still more fully open after a night's rest.
C)appetite will be stimulated for a meal after fluid is expelled.
D)the empty stomach reduces gagging.

Question 12

When caring for a patient with AIDS,the nurse is aware that this patient is most at risk for developing which type of pneumonia?

A)Hypostatic
B)Streptococcus pneumoniae
C)Atypical
D)Pneumocystis jiroveci

Question 13

The patient with asthma is prescribed a leukotriene modifier drug,montelukast (Singulair).The nurse points out that the major advantage of this drug is it:

A)has no GI side effects.
B)provides bronchodilation and anti-inflammatory effects.
C)controls acute asthma episodes.
D)can be substituted for all other asthma remedies.

Question 14

The patient with chronic airflow limitation (CAL)changed to the use of a simple face mask from a nasal cannula delivery system.The nasal equipment oxygen was set at 3 L/min.The nurse instructs the patient that,with the change in delivery systems,the oxygen should be _____ L/min.

A)decreased to 2
B)decreased to 1
C)increased to 4
D)increased to 6

Question 15

The 75-year-old resident in the nursing home who cares for 40 birds in an aviary complains of shortness of breath and fatigue and a dry cough.Based on this information,the nurse suspects the resident may be suffering from:

A)coccidioidomycosis.
B)histoplasmosis.
C)tuberculosis.
D)atypical pneumonia.

Question 16

The 79-year-old patient with bacterial pneumonia becomes increasingly restless and confused.Temperature is 100° F and pulse,blood pressure,and respirations are elevated since the last assessment 6 hours ago.The initial intervention by the nurse should be to:

A)take the patient off oral fluids.
B)assess oxygen saturation.
C)give the ordered mild sedative.
D)administer an NSAID for discomfort.

Question 17

The nurse is teaching an asthma patient proper use of the peak flowmeter.The nurse determines further teaching is needed when observing which action by the patient?

A)Repeating the procedure for a total of three readings
B)Breathing in deeply through the mouthpiece
C)Standing while performing the test
D)Recording the highest reading on the peak flow sheet

Question 18

The 75-year-old patient asks the nurse if the Pneumovax immunization he took when he was 65 is still protecting him.The nurse's most helpful reply is:

A)"Yes. Pneumovax protects you for your lifetime."
B)"No. The immunity afforded you by Pneumovax lasts only 2 years."
C)"Yes, but it loses strength and may not protect you from all 23 pneumococcal organisms anymore."
D)"No. A second dose is needed 6 years after the first for full immunity."

Question 19

The nurse explains that treatment with amantadine (Symmetrel)will:

A)prevent viral pneumonia if taken regularly.
B)stop viral spread of avian flu if taken at the first signs and symptoms of disease.
C)lessen the severity of type A flu symptoms if taken within 48 hours of exposure.
D)reduce irritation of bronchitis if taken weekly.

Question 20

The patient with sleep apnea is fitted with a continuous positive airway pressure (CPAP)mask and asks the nurse how this device will help.The nurse correctly responds with which statement?

A)"The device delivers constant positive pressure to keep your airway open."
B)"The device will require you to be intubated to open your airway."
C)"The device delivers oxygen only when you are apneic."
D)"The device delivers negative pressure to stimulate your respirations."

Question 21

Matching
Place the events of an asthma attack in proper sequence.

Step: 4

A)Mast cell-mediated inflammatory response in bronchi
B)Mucus production
C)Plugging of small airways
D)Contact with precipitator
E)Mucosal edema

Question 22

Matching
Place the events of an asthma attack in proper sequence.

Step: 5

A)Mast cell-mediated inflammatory response in bronchi
B)Mucus production
C)Plugging of small airways
D)Contact with precipitator
E)Mucosal edema

Question 23

The home health nurse recommends to the 60-year-old patient with emphysema who is anorexic to enhance her nutrition by the practices of: (Select all that apply.)

A)resting before eating.
B)avoiding gas-producing food.
C)eating four to six small meals rather than three large ones.
D)lying down after eating.
E)taking small bites and chewing slowly.

Question 24

The nurse explains to the patient on a mechanical ventilator that it is set on assist-control mode,which means that the machine will: (Select all that apply.)

A)deliver a set tidal volume.
B)deliver a set number of breaths if the patient's rate falls.
C)automatically cuts off if the patient is breathing independently.
D)deliver more oxygen at the end of an inspiration.
E)help to correct respiratory acidosis.

Question 25

Matching
Place the events of an asthma attack in proper sequence.

Step: 2

A)Mast cell-mediated inflammatory response in bronchi
B)Mucus production
C)Plugging of small airways
D)Contact with precipitator
E)Mucosal edema

Question 26

Matching
Place the events of an asthma attack in proper sequence.

Step: 1

A)Mast cell-mediated inflammatory response in bronchi
B)Mucus production
C)Plugging of small airways
D)Contact with precipitator
E)Mucosal edema

Question 27

The home health nurse making an initial call on a newly diagnosed tuberculosis patient who lives at home with his wife and child would give special instruction for infection control to: (Select all that apply.)

A)place contaminated tissues in sealable plastic bag.
B)take prescribed drug exactly as directed.
C)take airborne precautions.
D)wash hands frequently.
E)wear mask when in crowds.

Question 28

The nurse is working with a pulmonary specialist and is aware that the physician will most likely recommend that a full-year preventative protocol of isoniazid (INH)be given to people who: (Select all that apply.)

A)are living with a person newly diagnosed as having tuberculosis.
B)have had a positive tuberculin skin test but negative chest films.
C)have had a positive tuberculin skin test and are on steroids.
D)have had a positive tuberculin skin test and have diabetes.
E)have had a positive tuberculin skin test and have had a gastrectomy.
F) None of the above

Question 29

Matching
Place the events of an asthma attack in proper sequence.

Step: 3

A)Mast cell-mediated inflammatory response in bronchi
B)Mucus production
C)Plugging of small airways
D)Contact with precipitator
E)Mucosal edema

Question 30

The signs the nurse would expect to see in a patient with advanced emphysema are: (Select all that apply.)

A)productive cough.
B)dyspnea.
C)barrel chest.
D)wheezing.
E)cyanotic skin tone.

Question 31

The nurse is preparing a presentation highlighting the benefits of annual influenza vaccination.The nurse correctly targets which groups? (Select all that apply.)

A)The parents of children 3 to 6 months of age
B)Diabetics who are over 50 years old
C)Pregnant women
D)Home health aides
E)CNAs who work in long-term care facilities