Deck 5: Respiratory

Question 1

You are caring for a patient in respiratory acidosis. Which of the following results confirms this diagnosis?

A)pH 7.50, PCO₂52 mm Hg
B)pH 7.35, PCO₂40 mm Hg
C)pH 7.25, PCO₂50 mm Hg
D)pH 5.50, PCO₂30 mm Hg

Answer 1

pH 7.25, PCO₂50 mm Hg

Question 2

You have drawn an arterial blood gas on your patient. In reviewing the results you note the following: pH 7.45, PCO₂of 30 mm Hg, and bicarbonate of 22mEq/L. What do you interpret these results to mean?

A)Metabolic acidosis, compensated
B)Metabolic alkalosis, compensated
C)Respiratory acidosis, compensated
D)Respiratory alkalosis, compensated

Answer 2

Respiratory alkalosis, compensated

Question 3

You are planning to draw an arterial blood gas from your patient, but you must perform an Allen's test first. You know that the Allen's test is used to test what?

A)Popliteal circulation
B)Ulnar circulation
C)Femoral circulation
D)Carotid circulation

Answer 3

Ulnar circulation

Question 4

You are caring for a patient who is in diabetic ketoacidosis. You observe the patient in Kussmaul respiration. What are Kussmaul respirations?

A)Abnormally deep, regular and increased respirations
B)Regular, slow respirations
C)Labored, increased respirations
D)Short periods of apnea

Question 5

You are caring for a patient with chronic obstructive pulmonary disease who has come in with respiratory distress. The patient takes theophylline (Theo-Dur). A therapeutic level is drawn on the patient. You would know the patient needs to be educated on complying with medication if the therapeutic is what?

A)10 mcg/mL
B)12 mcg/mL
C)15 mcg/mL
D)18 mcg/mL

Question 6

You have assisted the physician with insertion of a chest tube. As you monitor the fluid level in the water seal chamber you notice fluctuations in the fluid. What is the appropriate action?

A)Notify the physician.
B)Encourage the patient to deep breathe.
C)This is a normal finding.
D)Reinforce the dressing.

Question 7

You are caring for a patient with a chest tube. When you turn the patient to the side the tube comes disconnected. What action should you take next?

A)Notify the physician
B)Place the tube in a bottle of sterile water
C)Replace the chest tube
D)Put a sterile dressing over the disconnected site

Question 8

You are assisting the physician with removal of a chest tube. The nurse should instruct the patient to:

A)Remain very still.
B)Inhale and exhale quickly.
C)Exhale slowly.
D)Perform the Valsalva's maneuver.

Question 9

You are changing the tape on a tracheostomy tube when the patient coughs, and the tube becomes dislodged. The initial action of the nurse should be:

A)Cover the site with a sterile dressing.
B)Notify the physician.
C)Grasp the retention sutures and spread the opening.
D)Notify the respiratory therapist.

Question 10

You are caring for a patient who had a radical neck dissection. The endotracheal tube has just been removed. Which of the following signs would you want to report to the physician immediately?

A)Stridor
B)Occasional pink-tinged sputum
C)Respiratory rate of 24 breaths a minute
D)Basilar crackles on the right side

Question 11

You are caring for an older patient who is on complete bedrest. What interventions would you take to prevent respiratory complications?

A)Monitoring vital signs routinely
B)Decreasing oral fluid intake
C)Turning the patient every two hours
D)Instructing the patient to bear down every hour and hold their breath

Question 12

You are caring for a toddler with croup. Which of the following clinical manifestations would you not see with croup?

A)Worsening symptoms at night, that improve during the day
B)Worsening symptoms during the day that improve with sleep
C)Harsh, brassy cough
D)Inspiratory stridor and low grade fever

Question 13

If you were caring for a child who had croup that had to be in a cool mist tent, what action would you need to take if the child became frightened and began crying consistently?

A)Notify the physician and get an order for sedation.
B)Have the mother make the child stay in the tent.
C)Give the child a toy to play with in the tent.
D)Place the child in mom's lap and direct cool mist over the child's face.

Question 14

You need to read a Mantoux test on the child you are caring for. An area of induration measuring 10 mm would indicate what result?

A)Negative
B)Positive
C)Inconclusive
D)Definitive and requiring a repeat test

Question 15

You are caring for child with bronchiolitis. Which of the following would be the most appropriate method of assessing this patient for dehydration?

A)Intake and output
B)Fontanels
C)Mucous membranes
D)Weight

Question 16

You are caring for a child with epiglottitis. On assessment of the child what would indicate to you that the child is experiencing airway obstruction?

A)The child is leaning backwards and supporting himself with his hands and arms.
B)The child has a low-grade fever and complains of a sore throat.
C)The child is leaning forward with the chin thrust out.
D)The child exhibits nasal flaring and bradycardia.

Question 17

You are caring for a child with respiratory syncytial virus (RSV). You are preparing to give the child ribavirin (Virazole). Which route is most appropriate for administering this medication?

A)Subcutaneous
B)Intramuscular
C)Oxygen tent
D)Oral

Question 18

You are caring for a child with acute exacerbation of asthma. What would indicate a worsening of the condition?

A)Increased wheezing
B)Decreased wheezing
C)Warm, dry skin
D)A pulse rate of 90 beats per minute

Question 19

You are caring for a child who has HIV with a positive Mantoux test. The physician orders isoniazid (INH). You instruct the child's mother that the patient will have to take the medication for how long?

A)4 months
B)6 months
C)9 months
D)12 months

Question 20

What is the most appropriate nursing intervention if your patient's heart rate drops during suctioning?

A)Continue to suction.
B)Limit suctioning to 15 seconds.
C)Stop and reoxygenate the patient.
D)Notify the physician.

Question 21

You are caring for an unconscious patient who has had an arterial blood gas drawn. The results reveal a pH of 7.30, low bicarbonate, a normal carbon dioxide level, normal oxygen level and an elevated potassium level. What would the diagnosis be for this patient based on the laboratory results?

A)Metabolic acidosis
B)Respiratory acidosis
C)Combined respiratory and metabolic acidosis
D)Overcompensated respiratory acidosis

Question 22

What sign would indicate that a patient with a blunt injury to the chest has developed a pneumothorax?

A)A sucking sound at the site of injury
B)Diminished breath sounds
C)A low respiratory rate
D)Presence of a barrel chest

Question 23

You are assessing a patient with acute exacerbation of COPD. What would you expect to find on this assessment?

A)Increased oxygen saturation
B)Hypocapnia
C)A hyperinflated chest on x-ray film
D)A widened diaphragm on chest x-ray film

Question 24

In which position would a patient with emphysema be able to enhance the effectiveness of breathing?

A)On the side, lying in bed
B)Sitting in a recliner
C)Sitting up in bed
D)Sitting on the side of the bed and leaning on an overbed table

Question 25

Which diagnostic test would confirm a diagnosis of tuberculosis?

A)Bronchoscopy
B)Chest x-ray
C)Sputum culture
D)Tuberculin skin test

Question 26

Your patient with emphysema is receiving oxygen. What flow rate would you not want to exceed for this patient?

A)1 L/min
B)2 L/min
C)6 L/min
D)10 L/min

Question 27

You are reviewing an arterial blood gas for a patient. Which result would lead you to believe this patient has respiratory acidosis?

A)pH of 7.48
B)PCO₂of 32 mm Hg
C)pH of 7.30
D)HCO3 of 20 mEq/L

Question 28

What is the primary action of aminophylline (theophylline) when given for acute bronchitis?

A)Promote expectoration.
B)Suppress the cough.
C)Relax the smooth muscles of the bronchial airway.
D)Prevent infection.

Question 29

Which of the laboratory results would indicate that a patient's theophylline level is therapeutic?

A)5 mcg/ml
B)15 mcg/ml
C)25 mcg/ml
D)30 mcg/ml

Question 30

Which of the following would you expect to find in a patient with acute respiratory distress syndrome?

A)Decreased respiratory rate
B)Pallor
C)Low arterial PAO2
D)An elevated arterial PAO2

Question 31

Which clinical manifestation would a patient with a pulmonary embolus display?

A)Decreased respirations
B)Bradypnea
C)Dyspnea
D)Bradycardia

Question 32

What is a distinctive sign that a patient has flail chest?

A)Cyanosis
B)Hypotension
C)Dyspnea, especially on exhalation
D)Paradoxical chest movement