Deck 14: Care of Patients with Disorders of the Lower Respiratory System

Question 1

The nurse is assessing a patient with chronic obstructive pulmonary disease (COPD).Which assessment finding indicates a potential complication and requires the nurse's immediate attention?

A) Distended neck veins
B) Left lower quadrant tenderness
C) Urinary output of 40 mL/hr
D) Excessive coughing

Answer 1

Distended neck veins

Question 2

The patient with acute bronchitis asks if antibiotics will be ordered for the condition.Which response is best for the nurse to make?

A) "Antibiotics are the best treatment option."
B) "Antibiotics will not help a viral condition."
C) "Antibiotics will be given if the sputum culture indicates your bronchitis is caused by bacteria."
D) "Antibiotics will inhibit the inflammatory response of your body to the invasion of this infection."

Answer 2

"Antibiotics will be given if the sputum culture indicates your bronchitis is caused by bacteria."

Question 3

The patient with asthma is prescribed a leukotriene modifier drug,montelukast (Singulair).Which statement describes an advantage of this medication?

A) Limited gastrointestinal (GI) side effects
B) Bronchodilation and anti-inflammatory effects
C) Stringent control of acute episodes of asthma
D) Ability to replace all other asthma remedies

Answer 3

Bronchodilation and anti-inflammatory effects

Question 4

The 75-year-old patient asks the nurse if the Pneumovax immunization he took when he was 65 is still protecting him.Which reply is most accurate?

A) "Pneumovax protects you for your lifetime."
B) "Immunity afforded you by Pneumovax lasts only 2 years."
C) "Pneumovax protection varies according to your risk factors and living situation."
D) "After 6 years, you need a repeat dose of Pneumovax for full immunity."

Question 5

The nurse is caring for a 30-year-old American Indian female who is taking Rifater,a drug containing rifampin,isoniazid,and pyrazinamide.The patient asks how long she will have to take the medication.Which response explains when the patient may discontinue the medication?

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

Question 6

The 79-year-old patient with bacterial pneumonia becomes increasingly restless,confused,and agitated.The patient's temperature is 100° F,and his pulse,blood pressure,and respirations are elevated since the last assessment 6 hours ago.What action should the nurse take first?

A) Auscultate the patient's lungs.
B) Assess the patient's oxygen saturation.
C) Administer the mild sedative as ordered.
D) Administer an ordered analgesic for discomfort.

Question 7

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 people with tuberculosis (TB).The nurse should interpret the reading as positive if the area around the injection site has an induration of how many millimeters?

A) 0 mm
B) 5 mm
C) 10 mm
D) 15 mm

Question 8

After using a nasal cannula delivery system at 3 L/min,a patient with chronic airflow limitation (CAL)changes to a simple face mask.The nasal equipment oxygen was set at 3 L/min.How should the nurse adjust the oxygen flow for the new delivery system?

A) Decrease it to 2 L.
B) Keep it the same.
C) Increase it to 4 L.
D) Increase it to 6 L.

Question 9

The 75-year-old patient presents to the emergency department with shortness of breath,fatigue,and a dry cough.When information leads the nurse to suspect that this patient should undergo workup for histoplasmosis?

A) The patient reports drinking pond water.
B) The patient lives on a farm and raises chickens.
C) The patient recently went hunting in a wooded area.
D) The patient owns a landscaping company.

Question 10

The nurse is educating a patient who requires daily postural drainage treatments.Which statement indicates that the patient understands when and why treatments will be scheduled?

A) "I will have treatments first thing in the morning to get rid of fluids that have built up over night."
B) "I will have my treatments after an hour after breakfast to make sure that I am fully alert."
C) "I will have treatments after lunch to prevent an unsafe drop in my blood sugar."
D) "I will have treatments right before bed to ensure that I breathe more easily at night."

Question 11

Through which method(s)can influenza spread?

A) Direct contact
B) Indirect contact
C) Vector
D) Blood-borne method
E) Droplets

Question 12

The nurse is caring for a patient with suspected bacterial pneumonia.Which finding supports the potential diagnosis?

A) Elevated white blood cell (WBC) count
B) Consolidation of lung tissue
C) Interstitial inflammation
D) Copious exudate

Question 13

What is the purpose of treatment with amantadine (Symmetrel)?

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

Question 14

The nurse is caring for a patient with a closed-chest drainage system with chest tubes.Which observation confirms that the system is intact and working?

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 15

The nurse is caring for a first-day postoperative thoracotomy patient.The nurse assesses that the level of drainage has not increased over the last 3 hours.After assessing the patient's respiratory status,what should the nurse do next?

A) Raise the system above the patient's heart.
B) Check the tubing for kinks.
C) Reposition the patient.
D) Notify the physician.

Question 16

The patient with sleep apnea is fitted with a continuous positive airway pressure (CPAP)mask and asks the nurse how this device will help.How should the nurse respond?

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 17

The nurse is caring for a patient immediately postoperative after a left pneumonectomy.How should the nurse position the patient?

A) In high Fowler position
B) In semi-Fowler position
C) In a right side-lying position
D) In a left side-lying position

Question 18

The nurse is assessing the patient with influenza.The patient reports having general malaise and aching muscles over the past 2 weeks.The nurse suspects that the patient may have developed which complication of influenza?

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

Question 19

When caring for a patient with acquired immune deficiency syndrome (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 20

The nurse is educating an asthma patient about proper use of the peak flowmeter.The nurse determines that the patient needs further teaching when observing which action?

A) The patient repeats the procedure and obtains three readings.
B) The patient breathes deeply through the mouthpiece.
C) The patient stands while performing the test.
D) The patient reports the highest reading on the peak flow sheet.

Question 21

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 22

The nurse is preparing a presentation that highlights the benefits of annual influenza vaccination.The nurse correctly targets which groups?

A) 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.

Question 23

The nurse is caring for a patient on a mechanical ventilator that it is set on assist-control mode.Which statement(s)accurately describe this function?

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

Question 24

The nurse is performing an occupational history as part of the respiratory assessment.Which occupation(s)place the patient at increased risk for an occupational lung disorder?

A) A firefighter
B) A cotton gin worker
C) A construction contractor
D) A bartender
E) A landscaper

Question 25

The home health nurse is making an initial call on a newly diagnosed tuberculosis (TB)patient.The patient lives with his wife and child.Which infection control instructions should the nurse include in the teaching plan?

A) Place contaminated tissues in sealable plastic bag.
B) Take medications exactly as directed.
C) Implement airborne precautions.
D) Wash hands frequently.
E) Wear a mask when in crowds.

Question 26

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 27

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 28

The home health nurse is educating a 60-year-old patient with emphysema with a nutritional deficit.Which instructions should the nurse include in the teaching plan to address this problem?

A) Rest before eating.
B) Avoiding gas-producing foods.
C) Eat four to six small meals instead of three large meals.
D) Lie down after eating.
E) Take small bites and chew slowly.

Question 29

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 30

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 31

The nurse is caring for a patient with advanced emphysema.Which signs are manifestations of this disorder?

A) Productive cough
B) Dyspnea
C) Barrel chest
D) Wheezing
E) Cyanotic skin tone