Deck 43: Oxygenation and Circulation

Question 1

Which of the following breathing patterns may be the result of metabolic acidosis?

A)Cheyne-Stokes
B)Biot's
C)Cluster
D)Kussmaul's

Answer 1

Kussmaul's

Question 2

As a part of preoperative teaching,the nurse is instructing Mr.Zuk on the use of a volume-oriented incentive spirometer.Which instruction should be included in this teaching?

A)Tilt the device slightly toward yourself while using
B)Take a deep breath and cough several times before using the incentive spirometer
C)Inhale a slow,deep breath to elevate the ball in the cylinder and hold for 2 seconds
D)Blow out into the mouthpiece until the ball in the cylinder rises and hold it for 2 seconds

Answer 2

Inhale a slow,deep breath to elevate the ball in the cylinder and hold for 2 seconds

Question 3

Ms.Calloway is a student nurse who is teaching her client about the anatomy and physiology of the heart.What does she teach her client is the primary pacemaker of the heart?

A)SA node
B)AV node
C)Purkinje fibres
D)Bundle of HIS

Answer 3

SA node

Question 4

Mr.Bruce,55 years old,has chronic obstructive lung disease and has oxygen ordered at 1.5 litres per minute via nasal cannula.Mr.Bruce complains of shortness of breath.What action should be taken by the nurse?

A)Increase the oxygen to 3 litres per minute via nasal cannula
B)Lower the head of the client's bed to semi-Fowler's position
C)Have Mr.Bruce breathe through pursed lips
D)Increase oxygen to a partial non-rebreather mask

Question 5

Mrs.Katerina has an endotracheal tube in place and is on a mechanical ventilator.She is restless and is pulling at the tube.How would the nurse assess if the tube is still in place?

A)Count the client's respirations
B)Monitor an O₂ saturation
C)Auscultate for bilateral breath sounds
D)Deflate the cuff and listen for air leak

Question 6

The ties on Mr.Julian's tracheostomy are very soiled.What is the safest method for changing these ties?

A)Remove the old ties,clean the area well,and then put on new ties
B)Attach the new tape and tie with a square knot behind the client's neck
C)Use two people,one to hold the trach,the other to change the ties
D)Remove the outer cannula,replace the soiled ties,and reinsert

Question 7

Mrs.Lois has a nursing diagnosis of ineffective airway clearance related to inadequate chest expansion and poor cough effort related to pain secondary to trauma.One of her outcomes is a patent airway.How would the nurse determine whether Mrs.Lois has met this outcome?

A)Auscultate her lungs
B)Assess her oxygen saturations
C)Measure her vital capacity
D)Measure her tidal volume

Question 8

Mr.Julian is coughing up copious amounts of secretions.What actions would the nurse take to suction Mr.Julian's tracheostomy?

A)Turn the suction level up to 60 mm Hg prior to inserting the catheter
B)Increase the oxygen flow to the client by 20% prior to suctioning
C)Insert the catheter approximately 12.5 cm without applying suction
D)Hyperventilate the lungs before suctioning

Question 9

While suctioning Mr.Julian's tracheostomy,the nurse notes that Mr.Julian's heart rate has increased from 80 to 100 bpm.Based on this assessment,what action should the nurse take?

A)Immediately discontinue suctioning
B)Prepare to resuscitate the client
C)Continue to suction until the airway is clear
D)Complete the suctioning as quickly as possible

Question 10

What action should the nurse take after inserting an oropharyngeal airway in Mr.Ahmed?

A)Tape the airway in place
B)Suction the client
C)Turn the client's head to the side
D)Insert a nasal trumpet

Question 11

Mrs.Headly,who is being mechanically ventilated,has copious amounts of secretions ranging from thick and tenacious to frothy.What should the nurse do in preparation for suctioning Mrs.Headly?

A)Hyperventilate Mrs.Headly pre-suctioning
B)Increase oxygen delivery to 60-80%
C)Instill normal saline into the endotracheal tube before suctioning
D)Avoid hyperventilation before suctioning

Question 12

The nurse is preparing to assist with the removal of Mrs.Charles's chest tube.Which of the following actions following removal is appropriate considering there is no purse-string suture?

A)Apply an occlusive dressing to the site
B)Leave the site open to air so the site can heal
C)Provide suture material for the physician to use to close the site
D)Apply a non-adherent gauze dressing

Question 13

Mrs.Leonard is receiving oxygen by non-rebreather mask.Which of the following is a true statement regarding this type of oxygen delivery?

A)It is used only when humidity is necessary.
B)It delivers oxygen concentrations of 60-90%.
C)It does not interfere with eating or talking.
D)It delivers the highest concentration of oxygen next to mechanical ventilation.

Question 14

Mr.Jacks is a 23-year-old with a respiratory rate of 36 breaths per minute.What term would the nurse use to document this in the electronic health record?

A)Eupnea
B)Bradypnea
C)Tachypnea
D)Dyspnea

Question 15

Mrs.Lois has a nursing diagnosis of ineffective airway clearance related to inadequate chest expansion and poor cough effort related to pain secondary to trauma.What is an appropriate nursing order to help her achieve the outcome of a patent airway?

A)Provide uninterrupted periods of sleep
B)Teach the rationale for her clear fluid diet
C)Assess for cyanosis and clubbing of the fingers
D)Encourage and assist with frequent position changes

Question 16

Mr.Patterson is 73 years old and is being seen in the emergency room.He is having difficulty breathing,his respiratory rate is increased,and he is coughing up pinkish coloured frothy secretions.Considering his symptoms,what does this condition lead to initially?

A)Hypoxemia
B)Hypoxia
C)Apnea
D)Tachypnea

Question 17

Mr.Bruce will be going home on oxygen therapy.What statement,made by Mr.Bruce,would indicate that he needs further discharge teaching instructions?

A)"I will replace my cotton blankets with wool ones."
B)"My son will not be able to smoke when I am around."
C)"I will have my electrical appliance checked for grounding."
D)"I will buy a fire extinguisher for my bedroom."

Question 18

Ten-year-old Kyle has cystic fibrosis.What is the best time to plan his twice-daily postural drainage?

A)8 am and 11 am
B)12 pm and 6 pm
C)7 am and 8 pm
D)9 am and 9 pm

Question 19

Which diagnostic test measures the normal volume of air inspired and expired with each breath?

A)Tidal volume
B)Vital capacity
C)Total lung capacity
D)Inspiratory reserve volume

Question 20

Mr.Julian,a 60-year-old man,has a new tracheostomy.Upon arrival to the unit what is the priority nursing action?

A)Call respiratory care to attach the tracheotomy tube to the ventilator
B)Remove the tracheotomy ties and replace them with an elastic bandage
C)Remove the tracheotomy inner cannula
D)Tape the tracheotomy obturator to the head of the bed

Question 21

Priscilla is a 1-day-old infant born at 36 weeks gestation.She is in the neonatal intensive care unit for monitoring.Which of the following would be considered a normal finding?

A)Irregularly irregular heart rate of 200
B)Irregular heart rate increasing and decreasing with each breath
C)Regular heart rate of 70 to 120 beats per minute
D)Heart rate of 60 to 100 beats per minute

Question 22

Mr.Gunstensen is to have a sputum specimen collected for acid-fast bacillus.How would the nurse go about collecting this specimen?

A)Early evening weekly for 3 weeks
B)Early evening specimen daily for 3 days
C)Early morning specimen daily for 3 days
D)Immediately after a warm drink times three specimens

Question 23

Mrs.Patrick brings her husband into the clinic with respiratory difficulties.Which of the following findings indicate a partial upper airway obstruction?

A)Hyperventilation
B)Hypoventilation
C)Oxygen saturation of 92% on room air
D)Low-pitched snoring sound during inhalation

Question 24

Normal breathing is dependant on which of the following factors?

A)Positive intrapleural pressure
B)Negative intrapleural pressure
C)Absence of intrapulmonic pressure
D)Equal intrapleural and intrapulmonic pressures

Question 25

Mr.Van Denamstel is suspected of having arterial vascular disease.He is in the clinic to have an ankle-brachial index (ABI)done.What is the first information the nurse is required to collect?

A)Take blood pressure in both arms
B)Take brachial pulse and the post tibial pulse
C)Take systolic pressure using dorsalis pedis
D)Take brachial pulse and dorsalis pedis

Question 26

Mrs.Kafi has just delivered a premature infant at 33 weeks gestation.After careful examination,it is determined that his only complication is respiratory distress syndrome (RDS).What does the nurse tell Mrs.Kafi is the reason why her infant son requires mechanical ventilation?

A)His alveolar walls are too thin for adequate air exchange.
B)He cannot produce an adequate supply of a protein necessary for lung expansion.
C)He has limited blood supply to his lungs due to constricted blood vessels.
D)He has a condition known as bronchopulmonary dysplasia (BPD).

Question 27

Mr.Grant has a 20-year history of chronic obstructive lung disease.What changes in Mr.Grant may be indicative of chronic hypoxemia?

A)Bradycardia
B)Shortening of the nail beds
C)Fatigue and lethargy
D)Peripheral edema

Question 28

What is the reason why American Heart Association has advocated a C-A-B approach to cardiopulmonary resuscitation instead of the longstanding A-B-C?

A)Airway is easier to maintain open after compressions
B)Compressions are more effective without airway or respirations
C)Reduces time to first compressions
D)Allows for more accurate landmarking for compressions