Unit

OxygenationRespiratory

Function

FLASHCARDS

WRITE

SPELL

TEST

MATCH

GRAVITY

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to

remove

ads

Only

The

nurse

answers

the

call

light

of

a

male

patient

The

patient

is

complaining

of

an

irritating

tickling

sensation

in

the

throat

a

salty

taste

and

a

burning

sensation

in

the

chest

Upon

further

assessment

the

nurse

notes

a

tissue

with

bright

red

frothy

blood

at

the

bedside

The

nurse

can

assume

the

source

of

the

blood

is

likely

from

which

of

the

following

A

The

rectum

B

The

stomach

C

The

lungs

D

The

nose

CLICK

THE

CARD

TO

FLIP

IT

C

The

lungs

Blood

from

the

lung

is

usually

bright

red

frothy

and

mixed

with

sputum

Initial

symptoms

include

a

tickling

sensation

in

the

throat

a

salty

taste

a

burning

or

bubbling

sensation

in

the

chest

and

perhaps

chest

pain

in

which

case

the

patient

tends

to

splint

the

bleeding

side

CLICK

THE

ARROWS

BELOW

TO

ADVANCE

Terms

in

this

set

The

nurse

answers

the

call

light

of

a

male

patient

The

patient

is

complaining

of

an

irritating

tickling

sensation

in

the

throat

a

salty

taste

and

a

burning

sensation

in

the

chest

Upon

further

assessment

the

nurse

notes

a

tissue

with

bright

red

frothy

blood

at

the

bedside

The

nurse

can

assume

the

source

of

the

blood

is

likely

from

which

of

the

following

A

The

rectum

B

The

stomach

C

The

lungs

D

The

nose

C

The

lungs

Blood

from

the

lung

is

usually

bright

red

frothy

and

mixed

with

sputum

Initial

symptoms

include

a

tickling

sensation

in

the

throat

a

salty

taste

a

burning

or

bubbling

sensation

in

the

chest

and

perhaps

chest

pain

in

which

case

the

patient

tends

to

splint

the

bleeding

side

A

nurse

enters

a

clients

room

and

observes

a

container

with

sputum

Upon

questioning

about

the

specimen

which

of

the

following

items

of

information

from

the

client

would

necessitate

the

nurse

to

obtain

a

new

specimen

A

The

lid

is

secured

with

tape

B

The

container

used

is

sterile

C

The

specimen

is

from

a

deep

cough

D

I

coughed

that

up

about

hours

ago

SUBMIT

ANSWER

D

I

coughed

that

up

about

hours

ago

A

sputum

specimen

is

obtained

for

analysis

to

identify

pathogenic

organisms

Expectoration

is

the

usual

method

for

collecting

a

sputum

specimen

After

a

few

deep

breaths

the

client

coughs

using

the

diaphragm

and

expectorates

into

a

sterile

container

The

specimen

is

delivered

to

the

laboratory

within

hours

Allowing

the

specimen

to

stand

for

several

hours

in

a

warm

room

results

in

overgrowth

of

organisms

and

may

make

it

difficult

to

identify

the

organisms

A

client

arrives

at

the

physicians

office

stating

dyspnea

a

productive

cough

for

thick

green

sputum

respirations

of

breathsminute

and

a

temperature

of

F

The

nurse

auscultates

the

lung

fields

which

reveal

poor

air

exchange

in

the

right

middle

lobe

The

nurse

suspects

a

right

middle

lobe

pneumonia

To

be

consistent

with

this

anticipated

diagnosis

which

sound

heard

over

the

chest

wall

when

percussing

is

anticipated

A

Hyperresonant

B

Tympanic

C

Resonant

D

Dull

D

Dull

A

dull

percussed

sound

heard

over

the

chest

wall

is

indicative

of

little

or

no

air

movement

in

that

area

of

the

lung

Lung

consolidation

such

as

in

pneumonia

or

fluid

accumulation

produces

the

dull

sound

A

tympanic

sound

is

a

highpitched

sound

commonly

heard

over

the

stomach

or

bowel

A

resonant

sound

is

noted

over

normal

lung

tissue

A

hyper

resonant

sound

is

an

abnormal

lower

pitched

sound

that

occurs

when

free

air

exists

in

disease

processes

such

as

pneumothorax

The

nurse

is

caring

for

a

client

with

a

decrease

in

airway

diameter

causing

airway

resistance

The

client

experiences

coughing

and

mucus

production

Upon

lung

assessment

which

adventitious

breath

sounds

are

anticipated

A

Rhonchi

B

Wheezes

C

Rubs

D

Crackles

B

Wheezes

A

decrease

in

airway

diameter

such

as

in

asthma

produces

breath

sounds

of

wheezes

Wheezes

are

a

whistling

type

of

sound

relating

to

the

narrowing

on

the

airway

A

wheeze

can

have

a

highpitched

or

lowpitched

quality

A

client

arrives

at

the

physicians

office

stating

days

of

febrile

illness

dyspnea

and

cough

Upon

assisting

the

client

into

a

gown

the

nurse

notes

that

the

clients

sternum

is

depressed

especially

on

inspiration

Crackles

are

noted

in

the

bases

of

the

lung

fields

Based

on

inspection

which

will

the

nurse

document

A

The

client

has

chronic

respiratory

disease

B

The

client

has

pneumonia

in

the

bases

C

The

client

has

a

funnel

chest

D

The

client

needs

a

cough

suppressant

B

The

client

has

a

funnel

chest

The

question

asks

for

a

documentation

based

on

inspection

A

funnel

chest

known

as

pectus

excavatum

has

the

sternum

depressed

from

the

second

intercostal

space

and

it

is

more

pronounced

on

inspiration

The

nurse

would

not

diagnose

chronic

respiratory

disease

or

pneumonia

The

client

would

also

not

prescribe

a

cough

suppressant

The

nurse

enters

the

room

of

a

client

who

is

being

monitored

with

pulse

oximetry

Which

of

the

following

factors

may

alter

the

oximetry

results

A

Placement

of

the

probe

on

an

earlobe

B

Diagnosis

of

peripheral

vascular

disease

C

Reduced

lighting

in

the

room

D

Increased

temperature

of

the

room

B

Diagnosis

of

peripheral

vascular

disease

Pulse

oximetry

is

a

noninvasive

method

of

monitoring

oxygen

saturation

of

hemoglobin

A

probe

is

placed

on

the

fingertip

forehead

earlobe

or

bridge

of

nose

Inaccuracy

of

results

may

be

from

anemia

bright

lights

shivering

nail

polish

or

peripheral

vascular

disease

Which

ventilationperfusion

ratio

is

exhibited

by

a

pulmonary

emboli

A

Normal

ratio

of

perfusion

to

ventilation

B

Low

ventilationperfusion

ratio

C

Silent

unit

D

Dead

space

D

Dead

space

When

ventilation

exceeds

perfusion

a

dead

space

exists

An

example

of

a

dead

space

is

pulmonary

emboli

A

low

ventilationperfusion

ratio

exists

in

pneumonia

or

with

a

mucus

plug

A

silent

unit

occurs

in

pneumothorax

or

ARDS

A

client

with

chronic

bronchitis

is

admitted

to

the

health

facility

Auscultation

of

the

lungs

reveals

lowpitched

rumbling

sounds

Which

of

the

following

describes

these

sounds

A

Rhonchi

B

Bronchial

C

Crackles

D

Pleural

friction

rub

A

Rhonchi

Rhonchi

are

deep

lowpitched

rumbling

sounds

heard

usually

on

expiration

The

etiology

of

rhonchi

is

associated

with

chronic

bronchitis

A

client

has

a

nursing

diagnosis

of

ineffective

airway

clearance

as

a

result

of

excessive

secretions

An

appropriate

outcome

for

this

client

would

be

which

of

the

following

A

Client

reports

no

chest

pain

B

Respiratory

rate

is

to

breaths

per

minute

C

Lungs

are

clear

on

auscultation

D

Client

can

perform

incentive

spirometry

C

Lungs

are

clear

on

auscultation

Assessment

of

lung

sounds

includes

auscultation

for

airflow

through

the

bronchial

tree

The

nurse

evaluates

for

fluid

or

solid

obstruction

in

the

lung

When

airflow

is

decreased

as

with

fluid

or

secretions

adventitious

sounds

may

be

auscultated

Often

crackles

are

heard

with

fluid

in

the

airways

A

client

has

a

history

of

chronic

obstructive

pulmonary

disease

COPD

Following

a

coughing

episode

the

client

reports

sudden

and

unrelieved

shortness

of

breath

Which

of

the

following

is

the

most

important

for

the

nurse

to

assess

A

Skin

color

B

Heart

rate

C

Respiratory

rate

D

Lung

sounds

D

Lung

sounds

A

client

with

COPD

is

at

risk

for

developing

pneumothorax

The

description

given

is

consistent

with

possible

pneumothorax

Though

the

nurse

will

assess

all

the

data

auscultating

the

lung

sounds

will

provide

the

nurse

with

the

information

if

the

client

has

a

pneumothorax

Which

of

the

following

is

true

about

both

lung

transplant

and

bullectomy

A

Both

are

aimed

at

curing

COPD

B

Both

are

aimed

at

treating

endstage

emphysema

C

Both

are

used

to

treat

patients

with

bullous

emphysema

D

Both

are

aimed

at

improving

the

overall

quality

of

life

of

a

patient

with

COPD

D

Both

are

aimed

at

improving

the

overall

quality

of

life

of

a

patient

with

COPD

The

treatments

for

COPD

are

aimed

more

at

treating

the

symptoms

and

preventing

complications

thereby

improving

the

overall

quality

of

life

of

a

patient

with

COPD

In

fact

there

is

no

cure

for

COPD

Lung

transplant

is

aimed

at

treating

endstage

emphysema

and

bullectomy

is

used

to

treat

patients

with

bullous

emphysema

A

patient

with

bronchiectasis

is

admitted

to

the

nursing

unit

The

primary

focus

of

nursing

care

for

this

patient

includes

which

of

the

following

A

Implementing

measures

to

clear

pulmonary

secretions

B

Instructing

the

patient

on

the

signs

of

respiratory

infection

C

Providing

the

patient

with

a

lowcalorie

highfiber

diet

D

Teaching

the

family

how

to

perform

postural

drainage

A

Implementing

measures

to

clear

pulmonary

secretions

Nursing

management

focuses

on

alleviating

symptoms

and

helping

patients

clear

pulmonary

secretions

Although

teaching

the

family

how

to

perform

postural

drainage

and

instructing

the

patient

on

the

signs

of

respiratory

infection

are

important

they

are

not

the

nurses

primary

focus

The

presence

of

a

large

amount

of

mucus

may

decrease

the

patients

appetite

and

result

in

an

inadequate

dietary

intake

therefore

the

patients

nutritional

status

is

assessed

and

strategies

are

implemented

to

ensure

an

adequate

diet

Which

of

the

following

is

a

common

irritant

that

acts

as

a

trigger

of

asthma

A

Molds

B

Peanuts

C

Esophageal

Reflux

D

Aspirin

C

Esophageal

Reflux

Esophageal

reflux

viral

respiratory

infections

cigarette

smoke

and

exercise

are

all

irritants

that

can

trigger

asthma

Peanuts

aspirin

sensitivity

and

molds

are

antigens

A

male

patient

newly

diagnosed

with

COPD

tells

the

nurse

I

cant

believe

I

have

COPD

I

only

had

a

cough

are

there

other

symptoms

I

should

know

about

Which

of

the

following

is

the

nurses

best

response

A

As

your

COPD

worsens

you

will

develop

frequent

respiratory

infections

B

Other

symptoms

you

may

develop

are

shortness

of

breath

on

exertion

and

sputum

production

C

There

are

no

other

symptoms

however

your

cough

may

get

worse

as

the

disease

progresses

D

You

can

also

expect

to

experience

a

progressive

weight

gain

B

Other

symptoms

you

may

develop

are

shortness

of

breath

on

exertion

and

sputum

production

COPD

is

characterized

by

three

primary

symptoms

cough

sputum

production

and

dyspnea

on

exertion

Patients

with

COPD

are

at

risk

for

respiratory

insufficiency

and

respiratory

infections

which

in

turn

increase

the

risk

of

acute

and

chronic

respiratory

failure

Weight

loss

is

common

with

COPD

The

nurse

is

assigned

the

care

of

a

female

patient

diagnosed

with

cystic

fibrosis

CF

Which

of

the

following

nursing

interventions

will

be

included

in

the

patients

plan

of

care

A

Discussing

palliative

care

and

endoflife

issues

with

the

patient

B

Performing

chest

physiotherapy

as

ordered

C

Restricting

oral

intake

to

mLday

D

Providing

the

patient

with

a

low

sodium

diet

B

Performing

chest

physiotherapy

as

ordered

Nursing

care

includes

helping

patients

manage

pulmonary

symptoms

and

prevent

complications

Specific

measures

include

strategies

that

promote

removal

of

pulmonary

secretions

chest

physiotherapy

and

breathing

exercises

In

addition

the

nurse

emphasizes

the

importance

of

an

adequate

fluid

and

dietary

intake

to

promote

removal

of

secretions

and

to

ensure

an

adequate

nutritional

status

The

patient

with

CF

also

experiences

increased

salt

content

in

sweat

gland

secretions

thus

it

is

important

to

ensure

the

patient

consumes

a

diet

that

is

adequate

in

sodium

As

the

disease

progresses

the

patient

will

develop

increasing

hypoxemia

In

this

situation

preferences

for

endoflife

care

should

be

The

nurse

is

caring

for

a

patient

with

COPD

The

patient

is

receiving

oxygen

therapy

via

nasal

cannula

The

nurse

understands

that

the

goal

of

oxygen

therapy

is

to

maintain

the

patients

level

at

or

above

what

percent

A

B

C

D

D

The

goal

of

supplemental

oxygen

therapy

is

to

increase

the

baseline

resting

partial

arterial

pressure

of

oxygen

to

at

least

mm

Hg

at

sea

level

and

arterial

oxygen

saturation

to

at

least

To

help

prevent

infections

in

clients

with

COPD

the

nurse

should

recommend

vaccinations

against

two

bacterial

organisms

Which

of

the

following

are

the

two

vaccinations

A

Haemophilus

influenza

and

Gardasil

B

Streptococcus

pneumonia

and

Haemophilus

influenza

C

Streptococcus

pneumonia

and

varicella

D

Haemophilus

influenza

and

varicella

B

Streptococcus

Pneumonia

and

Haemophilus

influenza

Clients

with

COPD

are

more

susceptible

to

respiratory

infections

so

they

should

be

encouraged

to

receive

the

influenza

and

pneumococcal

vaccines

Clients

with

COPD

arent

at

high

risk

for

varicella

or

hepatitis

B

The

HPV

vaccine

is

to

guard

against

cervical

cancer

and

is

recommended

only

for

females

ages

to

years

A

client

has

intermittent

asthma

attacks

Which

of

the

following

therapies

does

the

nurse

teach

the

client

to

use

at

home

when

experiencing

an

asthma

attack

A

Inhaled

cromolyn

sodium

Intal

B

Oral

theophylline

TheoDur

C

Oxygen

therapy

D

Inhaled

albuterol

Ventolin

D

Inhaled

albuterol

Ventolin

For

intermittent

asthma

the

preferred

treatment

is

with

an

inhaled

shortacting

The

other

treatments

are

for

persistent

asthma

Which

of

the

following

would

not

be

considered

a

primary

symptom

of

COPD

A

Dyspnea

on

exertion

B

Sputum

production

C

Weight

gain

D

Cough

C

Weight

gain

COPD

is

characterized

by

three

primary

symptoms

cough

sputum

production

and

dyspnea

on

exertion

Weight

loss

is

common

with

COPD

A

nursing

student

just

learned

that

the

primary

presenting

symptom

of

emphysema

is

dyspnea

During

the

clinical

rotation

that

same

week

the

student

is

assigned

to

a

patient

diagnosed

with

emphysema

In

prioritizing

the

care

for

the

shift

the

student

would

choose

which

of

the

following

interventions

first

A

Refer

to

respiratory

therapy

if

labored

breathing

persists

B

Educate

regarding

smoking

cessation

C

Monitor

vital

signs

every

hours

including

respiratory

rate

and

characteristics

D

Apply

oxygen

therapy

as

ordered

C

Monitor

vital

signs

every

hours

including

respiratory

rate

and

characteristics

Dyspnea

may

be

severe

and

often

interferes

with

the

patients

activities

It

is

usually

progressive

worse

with

exercise

and

persistent

As

COPD

progresses

dyspnea

may

occur

at

rest

All

the

other

interventions

are

correct

yet

require

an

assessment

prior

to

their

implementation

A

commonly

prescribed

methylxanthine

used

as

a

bronchodilator

is

which

of

the

following

A

Levalbuterol

B

Albuterol

C

Terbutaline

D

Theophylline

D

Theophylline

Theophylline

is

an

example

of

a

methylxanthine

All

the

others

are

examples

of

inhaled

shortacting

agonists

Cystic

fibrosis

CF

is

diagnosed

by

clinical

signs

and

symptoms

in

addition

to

which

one

of

the

following

tests

A

Lumbar

puncture

B

Arterial

blood

gases

ABGs

C

Pulmonary

function

studies

D

Sweat

chloride

concentration

D

Sweat

chloride

concentration

Diagnosis

of

CF

is

based

on

an

elevated

sweat

chloride

concentration

together

with

clinical

signs

and

symptoms

consistent

with

the

disease

Which

of

the

following

exposures

accounts

for

the

majority

of

cases

with

regard

to

risk

factors

for

chronic

obstructive

pulmonary

disease

COPD

A

Passive

smoking

B

Exposure

to

tobacco

smoke

C

Occupational

exposure

D

Ambient

air

pollution

B

Exposure

to

tobacco

smoke

Exposure

to

tobacco

smoke

accounts

for

an

estimated

to

of

COPD

cases

Occupational

exposure

passive

smoking

and

ambient

air

pollution

are

risk

factors

but

do

not

account

for

the

majority

A

client

is

being

seen

in

the

emergency

department

for

exacerbation

of

chronic

obstructive

pulmonary

disease

COPD

The

first

action

of

the

nurse

is

to

administer

which

of

the

following

prescribed

treatments

A

Vancomycin

gram

intravenously

over

hour

B

Ipratropium

bromide

Alupent

by

metereddose

inhaler

C

Oxygen

through

nasal

cannula

at

Lminute

D

Intravenous

methylprednisolone

SoluMedrol

mg

C

Oxygen

through

nasal

cannula

at

Lminute

All

options

listed

are

treatments

that

may

be

used

for

a

client

with

an

exacerbation

of

COPD

The

first

line

of

treatment

is

oxygen

therapy

A

client

with

chronic

obstructive

pulmonary

disease

COPD

expresses

a

desire

to

quit

smoking

The

first

appropriate

response

from

the

nurse

is

A

Have

you

tried

to

quit

smoking

before

B

Nicotine

patches

would

be

appropriate

for

you

C

I

can

refer

you

to

the

American

Lung

Association

D

Many

options

are

available

for

you

A

Have

you

tried

to

quit

smoking

before

All

the

options

are

appropriate

statements

however

the

nurse

needs

to

assess

the

clients

statement

further

Assessment

data

include

information

about

previous

attempts

to

quit

smoking

A

client

newly

diagnosed

with

emphysema

asks

the

nurse

to

explain

all

about

the

disease

The

nurse

would

include

the

following

response

when

defining

emphysema

A

An

abnormal

distention

of

the

air

spaces

with

destruction

of

the

alveolar

walls

B

Decreased

sputum

production

with

dilation

of

bronchioles

C

Increased

oxygen

diffusion

with

inflammation

of

the

bronchioles

D

Inflammation

of

the

bronchioles

with

a

normal

distention

of

the

air

spaces

A

An

abnormal

distention

of

the

air

spaces

with

destruction

of

the

alveolar

walls

Emphysema

is

a

pathologic

term

that

describes

an

abnormal

distention

of

the

air

spaces

beyond

the

terminal

bronchioles

and

destruction

of

the

walls

of

the

alveoli

This

causes

a

decrease

in

oxygen

diffusion

and

an

increase

in

sputum

production

Emphysema

is

described

by

which

of

the

following

statements

A

A

disease

that

results

in

a

common

clinical

outcome

of

reversible

airflow

obstruction

B

Chronic

dilatation

of

a

bronchus

or

bronchi

C

Presence

of

cough

and

sputum

production

for

at

least

a

combined

total

of

to

months

in

each

of

two

consecutive

years

D

A

disease

of

the

airways

characterized

by

destruction

of

the

walls

of

overdistended

alveoli

D

A

disease

of

the

airways

characterized

by

destruction

of

the

walls

of

overdistended

alveoli

Emphysema

is

a

category

of

COPD

Asthma

has

a

clinical

outcome

of

airflow

obstruction

Bronchitis

includes

the

presence

of

cough

and

sputum

production

for

at

least

a

combined

total

of

to

months

in

each

of

two

consecutive

years

Bronchiectasis

is

a

condition

of

chronic

dilatation

of

a

bronchus

or

bronchi

A

client

is

at

risk

for

emphysema

When

reviewing

information

about

the

condition

with

the

client

which

would

the

nurse

emphasize

as

the

most

important

environmental

risk

factor

for

emphysema

A

Cigarette

smoking

B

Air

pollution

C

Allergens

D

Infectious

agents

A

Cigarette

smoking

The

most

important

risk

factor

for

COPD

is

cigarette

smoking

Nutrition

exercise

and

exposure

to

dust

and

pollen

are

not

risk

factors

for

COPD

Which

of

the

following

is

accurate

regarding

status

asthmaticus

A

A

severe

asthma

episode

that

is

refractory

to

initial

therapy

B

Usually

occurs

with

warning

C

Usually

does

not

progress

to

severe

obstruction

D

Patients

have

a

productive

cough

A

A

severe

asthma

episode

that

is

refractory

to

initial

therapy

Status

asthmaticus

is

a

severe

asthma

episode

that

is

refractory

to

initial

therapy

It

is

a

medical

emergency

Patients

report

rapid

progressive

chest

tightness

wheezing

dry

cough

and

shortness

of

breath

It

may

occur

with

little

or

no

warning

Which

of

the

following

are

risk

factors

for

the

development

of

chronic

obstructive

pulmonary

disease

COPD

Select

all

that

apply

A

Secondhand

smoke

B

Air

pollution

C

Infection

D

Occupational

dust

E

Tobacco

smoke

All

of

them

Risk

factors

for

chronic

obstructive

pulmonary

disease

are

tobacco

smoke

environmental

tobacco

smoke

occupational

dust

and

chemicals

indoor

and

outdoor

air

pollution

and

infection

The

nurse

is

reviewing

metereddose

inhaler

MDI

instructions

with

a

patient

Which

of

the

following

patient

statements

indicates

the

need

for

further

instruction

A

I

cant

use

a

spacer

or

holding

chamber

with

the

MDI

B

I

will

shake

the

MDI

container

before

I

use

it

C

I

will

take

a

slow

deep

breath

in

after

pushing

down

on

the

MDI

D

Because

I

am

prescribed

a

corticosteroidcontaining

MDI

I

will

rinse

my

mouth

with

water

after

use

A

I

cant

use

a

spacer

or

holding

chamber

with

the

MDI

The

patient

can

use

a

spacer

or

a

holding

chamber

to

facilitate

the

ease

of

medication

administration

The

remaining

patient

statements

are

accurate

and

indicate

the

patient

understands

how

to

use

the

MDI

correctly

Which

of

the

following

is

the

strongest

predisposing

factor

for

asthma

A

Allergy

B

Air

pollution

C

Male

gender

D

Congenital

malformations

A

Allergy

After

reviewing

the

pharmacological

treatment

for

pulmonary

diseases

the

nursing

student

knows

that

bronchodilators

relieve

bronchospasm

in

three

ways

Choose

the

correct

three

of

the

following

options

A

Decrease

alveolar

ventilation

B

Alter

smooth

muscle

tone

C

Reduce

airway

obstruction

D

Increase

oxygen

distribution

B

C

and

D

Bronchodilators

relieve

bronchospasm

by

altering

smooth

muscle

tone

and

reduce

airway

obstruction

by

allowing

increased

oxygen

distribution

throughout

the

lungs

and

improving

alveolar

ventilation

A

client

is

being

admitted

to

an

acute

healthcare

facility

with

an

exacerbation

of

chronic

obstructive

pulmonary

disease

COPD

The

client

had

been

taking

an

antibiotic

at

home

with

poor

relief

of

symptoms

and

has

recently

decided

to

stop

smoking

The

nurse

is

reviewing

athome

medications

with

the

client

The

nurse

is

placing

this

information

on

the

Medication

Reconciliation

Record

Which

of

the

following

is

incomplete

information

A

SalmeterolFluticasone

Seretide

MDI

daily

at

B

Prednisone

mg

oral

daily

at

C

Azithromycin

Zithromax

mg

oral

daily

for

days

at

on

day

D

Nicotine

patch

Nicoderm

mg

patch

daily

at

A

SalmeterolFluticasone

Seretide

MDI

daily

at

When

providing

information

about

medications

the

nurse

needs

to

include

right

drug

right

dose

right

route

right

frequency

and

right

time

Salmeterolfluticasone

does

not

include

how

many

puffs

the

client

is

to

take

Asthma

is

cause

by

which

type

of

response

A

IgAmediated

B

IgEmediated

C

IgMmediated

D

IgDmediated

B

IgEmediated

Atopy

the

genetic

predisposition

for

the

development

of

an

IgEmediated

response

to

allergens

is

the

most

common

identifiable

predisposing

factor

for

asthma

Chronic

exposure

to

airway

allergens

may

sensitize

IgE

antibodies

and

the

cells

of

the

airway

Following

are

statements

regarding

medications

taken

by

a

patient

diagnosed

with

COPD

Choose

which

statements

correctly

match

the

drug

name

to

the

drug

category

Select

all

that

apply

A

Albuterol

is

a

bronchodilator

B

Decadron

is

an

antibiotic

C

Ciprofloxacin

is

an

antibiotic

D

Bactrim

is

a

bronchodilator

E

Prednisone

is

a

corticosteroid

A

C

and

E

Theophylline

albuterol

and

atropine

are

bronchodilators

Dexamethasone

Decadron

and

prednisone

are

corticosteroids

Amoxicillin

ciprofloxacin

and

cotrimoxazole

Bactrim

are

antibiotics

These

are

all

drugs

that

could

be

prescribed

to

a

patient

with

COPD

When

performing

endotracheal

suctioning

the

nurse

applies

suctioning

while

withdrawing

and

gently

rotating

the

catheter

degrees

for

which

of

the

following

time

periods

A

to

seconds

B

to

seconds

C

to

seconds

D

to

seconds

A

to

seconds

In

general

the

nurse

should

apply

suction

no

longer

than

seconds

because

hypoxia

and

dysrhythmias

may

develop

leading

to

cardiac

arrest

Applying

suction

for

to

seconds

is

hazardous

and

may

result

in

the

patients

developing

hypoxia

which

can

lead

to

dysrhythmias

and

ultimately

cardiac

arrest

Applying

suction

for

to

seconds

is

hazardous

and

may

result

in

the

patients

developing

hypoxia

which

can

lead

to

dysrhythmias

and

ultimately

cardiac

arrest

Applying

suction

for

to

seconds

would

provide

too

little

time

for

effective

suctioning

of

secretions

The

nurse

is

teaching

the

client

in

respiratory

distress

ways

to

prolong

exhalation

to

improve

respiratory

status

The

nurse

tells

the

client

to

A

Sit

in

an

upright

position

only

B

Purse

the

lips

when

exhaling

air

from

the

lungs

C

Hold

the

breath

for

seconds

and

then

exhale

D

Initially

inhale

through

the

mouth

B

Purse

the

lips

when

exhaling

air

from

the

lungs

To

prolong

exhalation

the

client

may

perform

breathing

while

sitting

in

a

chair

or

walking

The

client

is

to

inhale

through

the

nose

and

then

exhale

against

pursed

lips

There

is

no

holding

the

breath

The

nurse

is

assisting

a

physician

with

an

endotracheal

intubation

for

a

client

in

respiratory

failure

It

is

most

important

for

the

nurse

to

assess

for

A

A

scheduled

time

for

deflation

of

the

tracheal

cuff

B

Tracheal

cuff

pressure

set

at

mm

Hg

C

Cool

air

humidified

through

the

tube

D

Symmetry

of

the

clients

chest

expansion

D

Symmetry

of

the

clients

chest

expansion

Immediately

after

intubation

the

nurse

should

check

for

symmetry

of

chest

expansion

This

is

one

finding

that

indicates

successful

endotracheal

placement

The

tracheal

cuff

pressure

is

set

between

and

mm

Hg

Routine

deflation

of

the

tracheal

cuff

is

not

recommended

because

the

client

could

then

aspirate

secretions

during

the

period

of

deflation

Warm

high

humidified

air

is

administered

through

the

endotracheal

tube

Which

ventilator

mode

provides

full

ventilatory

support

by

delivering

a

present

tidal

volume

and

respiratory

rate

A

SIMV

SynchronizedIntermittentMechanicalVentilation

B

Pressure

support

C

Assistcontrol

D

IMV

IntermittentMandatoryVentilation

C

Assistcontrol

Assistcontrol

ventilation

provides

full

ventilator

support

by

delivering

a

preset

tidal

volume

and

respiratory

rate

Intermittent

mandatory

ventilation

IMV

provides

a

combination

of

mechanically

assisted

breaths

and

spontaneous

breaths

SIMV

delivers

a

preset

tidal

volume

and

number

of

breaths

per

minute

Between

ventilatordelivered

breaths

the

patient

can

breathe

spontaneously

with

no

assistance

from

the

ventilator

for

those

extra

breaths

The

nurse

is

caring

for

a

patient

following

a

wedge

resection

While

the

nurse

is

assessing

the

patients

chest

tube

drainage

system

constant

bubbling

is

noted

in

the

water

seal

chamber

This

finding

indicates

which

of

the

following

problems

A

Tidaling

B

Air

leak

C

Tension

pneumothorax

D

Increased

drainage

B

Air

leak

The

nurse

needs

to

observe

for

air

leaks

in

the

drainage

system

they

are

indicated

by

constant

bubbling

in

the

water

seal

chamber

or

by

the

air

leak

indicator

in

dry

systems

with

a

oneway

valve

Tidaling

is

fluctuation

of

the

water

level

in

the

water

seal

that

shows

effective

connection

between

the

pleural

cavity

and

the

drainage

chamber

and

indicates

that

the

drainage

system

remains

patent

A

client

who

is

undergoing

thoracic

surgery

has

a

nursing

diagnosis

of

Impaired

gas

exchange

related

to

lung

impairment

and

surgery

on

the

nursing

care

plan

Which

of

the

following

nursing

interventions

would

be

appropriately

aligned

with

this

nursing

diagnosis

Select

all

that

apply

A

Maintain

an

open

airway

B

Monitor

pulmonary

status

as

directed

and

needed

C

Encourage

deep

breathing

exercises

D

Regularly

assess

the

clients

vital

signs

every

to

hours

E

Monitor

and

record

hourly

intake

and

output

B

C

and

D

Interventions

to

improve

the

clients

gas

exchange

include

monitoring

pulmonary

status

as

directed

and

needed

assessing

vital

signs

every

to

hours

and

encouraging

deep

breathing

exercises

Maintaining

an

open

airway

is

appropriate

for

improving

the

clients

airway

clearance

Monitoring

and

recording

hourly

intake

and

output

are

essential

interventions

for

ensuring

appropriate

fluid

balance

The

nurse

is

caring

for

a

patient

being

weaned

from

the

mechanical

ventilator

Which

of

the

following

patient

findings

would

require

the

termination

of

the

weaning

process

A

Vital

capacity

of

mLkg

B

Blood

pressure

increase

of

mm

Hg

from

baseline

C

Heart

rate

less

than

bpm

D

greater

than

mm

Hg

with

a

less

than

B

Blood

pressure

increase

of

mm

Hg

from

baseline

In

collaboration

with

the

primary

provider

the

nurse

would

terminate

the

weaning

process

if

adverse

reactions

occur

including

a

heart

rate

increase

of

beatsmin

systolic

BP

increase

of

mm

Hg

a

decrease

in

oxygen

saturation

to

less

than

respiratory

rate

less

than

or

greater

than

breathsmin

ventricular

dysrhythmias

fatigue

panic

cyanosis

erratic

or

labored

breathing

and

paradoxical

chest

movement

A

vital

capacity

of

to

mLkg

maximum

inspiratory

pressure

MIP

at

least

cm

tidal

volume

to

mLkg

minute

ventilation

Lmin

and

rapidshallow

breathing

index

below

breathsminL

greater

The

nurse

is

caring

for

a

patient

following

a

thoracotomy

Which

of

the

following

findings

requires

immediate

intervention

by

the

nurse

A

Pain

of

on

a

to

pain

scale

B

Moderate

amounts

of

colorless

sputum

C

Chest

tube

drainage

of

mLhr

D

Heart

rate

bpm

C

Chest

tube

drainage

of

mLhr

The

nurse

should

monitor

and

document

the

amount

and

character

of

drainage

every

hours

The

nurse

will

notify

the

primary

provider

if

drainage

is

mLhr

or

greater

The

other

findings

are

normal

following

a

thoracotomy

no

intervention

is

required

A

client

is

postoperative

and

prescribed

an

incentive

spirometer

IS

The

nurse

instructs

the

client

to

A

Expect

coughing

when

using

the

spirometer

properly

B

Maintain

a

supine

position

to

use

the

spirometer

C

Use

the

spirometer

twice

every

hour

D

Inhale

and

exhale

rapidly

with

the

spirometer

A

Expect

coughing

when

using

the

spirometer

properly

When

using

an

incentive

spirometer

the

client

should

be

sitting

or

in

the

semiFowlers

position

The

client

is

to

inhale

hold

the

breath

for

about

seconds

and

then

exhale

slowly

Coughing

occurs

with

the

use

of

the

incentive

spirometer

and

is

encouraged

The

client

should

use

the

spirometer

times

every

hour

while

awake

Which

of

the

following

ranges

of

water

pressure

identifies

the

amount

of

pressure

within

the

endotracheal

tube

cuff

that

is

believed

to

prevent

both

injury

and

aspiration

A

to

mm

Hg

B

to

mm

Hg

C

to

mm

Hg

D

to

mm

Hg

B

to

mm

Hg

Usually

the

pressure

is

maintained

at

less

than

cm

water

pressure

to

prevent

injury

and

at

more

than

cm

water

pressure

to

prevent

aspiration

A

measure

of

to

mm

Hg

of

water

pressure

would

indicate

that

the

cuff

is

underinflated

A

measure

of

to

mm

Hg

of

water

pressure

would

indicate

that

the

cuff

is

overinflated

A

measure

of

to

mm

Hg

of

water

pressure

would

indicate

that

the

cuff

is

underinflated

A

client

is

recovering

from

thoracic

surgery

needed

to

perform

a

right

lower

lobectomy

Which

of

the

following

is

the

most

likely

postoperative

nursing

intervention

A

Make

sure

that

a

thoracotomy

tube

is

linked

to

open

chest

drainage

B

Restrict

intravenous

fluids

for

at

least

hours

C

Encourage

coughing

to

mobilize

secretions

D

Assist

with

positioning

the

client

on

the

right

side

C

Encourage

coughing

to

mobilize

secretions

The

client

is

encouraged

to

cough

frequently

to

mobilize

secretions

The

client

will

be

placed

in

the

semiFowlers

position

Thoracotomy

tubes

are

always

attached

to

closed

sealed

drainage

to

reexpand

lung

tissue

and

prevent

pneumothorax

Restricting

IV

fluids

in

a

client

who

is

NPO

while

recovering

from

surgery

would

lead

to

dehydration

A

client

is

prescribed

postural

drainage

because

secretions

are

accumulating

in

the

upper

lobes

of

the

lungs

The

nurse

instructs

the

client

to

A

Take

prescribed

albuterol

Ventolin

before

performing

postural

drainage

B

Lay

in

bed

with

the

head

on

a

pillow

C

Perform

drainage

hour

after

meals

D

Hold

each

position

for

minutes

A

Take

prescribed

albuterol

Ventolin

before

performing

postural

drainage

When

a

client

is

to

perform

postural

drainage

the

nurse

should

instruct

the

client

to

use

the

prescribed

bronchodilator

eg

albuterol

first

This

will

open

airways

and

promote

drainage

The

client

is

to

perform

postural

drainage

before

meals

not

after

This

will

aid

in

preventing

nausea

vomiting

and

aspiration

For

secretions

accumulated

in

the

upper

lobes

the

client

will

sit

up

or

even

lean

forward

while

sitting

Head

on

a

pillow

is

not

a

sufficient

increase

in

height

The

client

is

also

to

lay

in

each

position

for

to

minutes

Which

type

of

oxygen

therapy

includes

the

administration

of

oxygen

at

pressure

greater

than

atmosphere

A

Hyperbaric

B

Transtracheal

C

Lowflow

systems

D

Highflow

systems

A

Hyperbaric

Hyperbaric

oxygen

therapy

is

the

administration

of

oxygen

at

pressures

greater

than

atmosphere

As

a

result

the

amount

of

oxygen

dissolved

in

plasma

is

increased

which

increases

oxygen

levels

in

the

tissues

Lowflow

systems

contribute

partially

to

the

inspired

gas

the

patient

breathes

which

means

that

the

patient

breathes

some

room

air

along

with

the

oxygen

Highflow

systems

are

indicated

for

patients

who

require

a

constant

and

precise

amount

of

oxygen

During

transtracheal

oxygenation

patients

achieve

adequate

oxygenation

at

lower

rates

making

this

method

less

expensive

and

more

efficient

The

nurse

is

assisting

a

client

with

postural

drainage

Which

of

the

following

demonstrates

correct

implementation

of

this

technique

A

Use

aerosol

sprays

to

deodorize

the

clients

environment

after

postural

drainage

B

Administer

bronchodilators

and

mucolytic

agents

following

the

sequence

C

Perform

this

measure

with

the

client

once

a

day

D

Instruct

the

client

to

remain

in

each

position

of

the

postural

drainage

sequence

for

to

minutes

D

Instruct

the

client

to

remain

in

each

position

of

the

postural

drainage

sequence

for

to

minutes

Postural

drainage

is

usually

performed

times

daily

before

meals

to

prevent

nausea

vomiting

and

aspiration

and

at

bedtime

Prescribed

bronchodilators

water

or

saline

may

be

nebulized

and

inhaled

before

postural

drainage

to

dilate

the

bronchioles

reduce

bronchospasm

decrease

the

thickness

of

mucus

and

sputum

and

combat

edema

of

the

bronchial

walls

The

nurse

instructs

the

client

to

remain

in

each

position

for

to

minutes

and

to

breathe

in

slowly

through

the

nose

and

out

slowly

through

pursed

lips

to

help

keep

the

airways

open

so

that

secretions

can

drain

while

in

each

position

If

the

sputum

is

Which

of

the

following

is

the

most

reliable

and

accurate

method

for

delivering

precise

concentrations

of

oxygen

through

noninvasive

means

A

Partialrebreathing

mask

B

Venturi

mask

C

Nasal

cannula

D

Tpiece

B

Venturi

mask

The

Venturi

mask

is

the

most

reliable

and

accurate

method

for

delivering

a

precise

concentration

of

oxygen

through

noninvasive

means

The

mask

is

constructed

in

a

way

that

allows

a

constant

flow

of

room

air

blended

with

a

fixed

flow

of

oxygen

Nasal

cannula

Tpiece

and

partialrebreathing

masks

are

not

the

most

reliable

and

accurate

methods

of

oxygen

administration

The

nurse

is

preparing

to

perform

chest

physiotherapy

CPT

on

a

patient

Which

of

the

following

patient

statements

would

indicate

the

procedure

is

contraindicated

A

I

just

changed

into

my

running

suit

we

can

do

my

CPT

now

B

I

have

been

coughing

all

morning

and

am

barely

bringing

anything

up

C

I

just

finished

eating

my

lunch

Im

ready

for

my

CPT

now

D

I

received

my

pain

medication

minutes

ago

lets

do

my

CPT

now

C

I

just

finished

eating

my

lunch

Im

ready

for

my

CPT

now

When

performing

CPT

the

nurse

ensures

that

the

patient

is

comfortable

is

not

wearing

restrictive

clothing

and

has

not

just

eaten

The

nurse

gives

medication

for

pain

as

prescribed

before

percussion

and

vibration

and

splints

any

incision

and

provides

pillows

for

support

as

needed

A

goal

of

CPT

is

for

the

patient

to

be

able

to

mobilize

secretions

the

patient

who

is

having

an

unproductive

cough

is

a

candidate

for

CPT

Arterial

blood

gases

should

be

obtained

at

which

timeframe

following

the

initiation

of

continuous

mechanical

ventilation

A

minutes

B

minutes

C

minutes

D

minutes

D

minutes

ABGs

should

be

obtained

to

measure

carbon

dioxide

partial

pressure

PaCO

pH

and

PaO

after

minutes

of

continuous

mechanical

ventilation

The

nurse

is

assigned

the

care

of

a

patient

with

a

chest

tube

The

nurse

should

ensure

that

which

of

the

following

items

is

kept

at

the

patients

bedside

A

An

Ambu

bag

B

A

set

of

hemostats

C

An

incentive

spirometer

D

A

bottle

of

sterile

water

D

A

bottle

of

sterile

water

It

is

essential

that

the

nurse

ensure

that

a

bottle

of

sterile

water

is

readily

available

at

the

patients

bedside

If

the

chest

tube

and

drainage

system

become

disconnected

air

can

enter

the

pleural

space

producing

a

pneumothorax

To

prevent

the

development

of

a

pneumothorax

a

temporary

water

seal

can

be

established

by

immersing

the

chest

tubes

open

end

in

a

bottle

of

sterile

water

There

is

no

need

to

have

an

Ambu

bag

incentive

spirometer

or

a

set

of

hemostats

at

the

bedside

The

nurse

has

instructed

a

patient

on

how

to

perform

pursedlip

breathing

The

nurse

recognizes

the

purpose

of

this

type

of

breathing

is

to

accomplish

which

of

the

following

A

Promote

a

more

efficient

and

controlled

ventilation

and

to

decrease

the

work

of

breathing

B

Promote

the

patients

ability

to

intake

oxygen

C

Promote

the

strengthening

of

the

patients

diaphragm

D

Improve

oxygen

transport

induce

a

slow

deep

breathing

pattern

and

assist

the

patient

to

control

breathing

D

Improve

oxygen

transport

induce

a

slow

deep

breathing

pattern

and

assist

the

patient

to

control

breathing

Pursedlip

breathing

which

improves

oxygen

transport

helps

induce

a

slow

deep

breathing

pattern

and

assists

the

patient

to

control

breathing

even

during

periods

of

stress

This

type

of

breathing

helps

prevent

airway

collapse

secondary

to

loss

of

lung

elasticity

in

emphysema

The

nurse

is

preparing

to

assist

the

health

care

provider

with

the

removal

of

a

patients

chest

tube

Which

of

the

following

instructions

will

the

nurse

correctly

give

the

patient

A

During

the

removal

of

the

chest

tube

do

not

move

because

it

will

make

the

removal

more

painful

B

When

the

tube

is

being

removed

take

a

deep

breath

exhale

and

bear

down

C

While

the

chest

tube

is

being

removed

raise

your

arms

above

your

head

D

Exhale

forcefully

while

the

chest

tube

is

being

removed

B

When

the

tube

is

being

removed

take

a

deep

breath

exhale

and

bear

down

When

assisting

in

the

chest

tubes

removal

instruct

the

patient

to

perform

a

gentle

Valsalva

maneuver

or

to

breathe

quietly

The

chest

tube

is

then

clamped

and

quickly

removed

Simultaneously

a

small

bandage

is

applied

and

made

airtight

with

petrolatum

gauze

covered

by

a

gauze

pad

and

thoroughly

covered

and

sealed

with

nonporous

tape

The

other

options

are

incorrect

instructions

for

the

patient

A

client

with

a

respiratory

condition

is

receiving

oxygen

therapy

While

assessing

the

clients

the

nurse

knows

that

the

therapy

has

been

effective

based

on

which

of

the

following

readings

A

mm

Hg

B

mm

Hg

C

mm

Hg

D

mm

Hg

B

mm

Hg

In

general

clients

with

respiratory

conditions

are

given

oxygen

therapy

only

to

increase

the

arterial

oxygen

pressure

back

to

the

clients

normal

baseline

which

may

vary

from

to

mm

Hg

Which

ventilator

mode

provides

a

combination

of

mechanically

assisted

breaths

and

spontaneous

breaths

A

SIMV

B

Pressure

support

C

Assistcontrol

D

IMV

IntermittentMandatoryVentilation

D

IMV

Intermittent

mandatory

ventilation

IMV

provides

a

combination

of

mechanically

assisted

breaths

and

spontaneous

breaths

Assistcontrol

ventilation

provides

full

ventilator

support

by

delivering

a

preset

tidal

volume

and

respiratory

rate

SIMV

delivers

a

preset

tidal

volume

and

number

of

breaths

per

minute

Between

ventilatordelivered

breaths

the

patient

can

breathe

spontaneously

with

no

assistance

from

the

ventilator

for

those

extra

breaths

Pressure

support

ventilation

assists

SIMV

by

applying

a

pressure

plateau

to

the

airway

throughout

the

patienttriggered

inspiration

to

decrease

resistance

within

the

tracheal

tube

and

ventilator

tubing

O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O 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