Nursing textbooks respiratory practice questions, set 2
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Nursing textbooks respiratory practice questionsset 2
You pick airway, oxygen, and breathing actions in the order a nurse actually moves. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the Nursing textbooks exam guide or more Nursing textbooks practice questions.
Five respiratory questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
A client admitted for the treatment of venous thromboembolism reports chest pain and dyspnea. Which of the following is the primary intervention for the nurse to implement?
A. Apply oxygen, as prescribed
B. Assess and rate the chest pain
C. Apply compression stockings
D. Prepare for ventilation-perfusion scan
Show answer and rationale
Correct answer: A — Apply oxygen, as prescribed
Based on the client's symptoms, the nurse suspects pulmonary embolism (PE). Emergency intervention is required to decrease the client's risk for death; therefore, the priority intervention is the application of oxygen. Although managing the client's pain is important this is not the priority intervention. The client may be prescribed a ventilation-perfusion scan and pulmonary angiography but these actions are not the priority interventions by the nurse. Application of compression stockings is ideal for preventing pulmonary emboli in high-risk clients but not an appropriate intervention after occurrence.
Question 2
It is cold season and the school nurse has been asked to provide an educational event for the parent teacher organization of the local elementary school. What should the nurse include in teaching about the treatment of pharyngitis?
A. Pharyngitis is more common in children whose immunizations are not up to date.
B. There are no effective, evidence-based treatments for pharyngitis.
C. Use of warm saline gargles or throat irrigations can relieve symptoms.
D. Heat may increase the spasms in pharyngeal muscles.
Show answer and rationale
Correct answer: C — Use of warm saline gargles or throat irrigations can relieve symptoms.
Depending on the severity of the pharyngitis and the degree of pain, warm saline gargles or throat irrigations are used. The benefits of this treatment depend on the degree of heat that is applied. The nurse teaches about these procedures and about the recommended temperature of the solution: high enough to be effective and as warm as the patient can tolerate, usually 105??F to 110??F (40.6??C to 43.3??C). Irrigating the throat may reduce spasm in the pharyngeal muscles and relieve soreness of the throat. You would not tell the parent teacher organization that there is no real treatment of pharyngitis.
Question 3
The nurse is caring for a patient who is hospitalized with active tuberculosis (TB) and the nurse observes a family member who is visiting the patient. Which of the following actions by the visitor should cause the nurse to intervene?
A. Washes hands before entering the patient's room
B. Hands the patient a tissue from the box at the bedside
C. Puts on a surgical face mask before visiting the patient
D. Brings food from a 'fast-food' restaurant to the patient
Show answer and rationale
Correct answer: C — Puts on a surgical face mask before visiting the patient
An N95 mask, rather than a standard surgical mask, should be used when entering the patient's room because the HEPA mask can filter out 100% of small airborne particles. Handwashing before visiting the patient is not necessary, but there is no reason for the nurse to stop the family member from doing this. Because anorexia and weight loss are frequent problems in patients with TB, bringing food from outside the hospital is appropriate. The family member should wash the hands after handling a tissue that the patient has used, but no precautions are necessary when giving the patient an unused tissue.
Question 4
A patient with newly diagnosed lung cancer tells the nurse, 'I think I am going to die pretty soon.' Which of the following responses by the nurse is best?
A. Would you like to talk to the hospital chaplain about your feelings?
B. Can you tell me what it is that makes you think you will die so soon?
C. Are you afraid that the treatment for your cancer will not be effective?
D. Do you think that taking an antidepressant medication would be helpful?
Show answer and rationale
Correct answer: B — Can you tell me what it is that makes you think you will die so soon?
The nurse's initial response should be to collect more assessment data about the patient's statement. The answer beginning 'Can you tell me what it is' is the most open-ended question and will offer the best opportunity for obtaining more data. The answer beginning, 'Are you afraid' implies that the patient thinks that the cancer will be immediately fatal, although the patient's statement may not be related to the cancer diagnosis. The remaining two answers offer interventions that may be helpful to the patient, but more assessment is needed to determine whether these interventions are appropriate.
Question 5
The nurse is providing discharge instructions to a client diagnosed with postoperative tonsillectomy and adenoidectomy. Which discharge instruction(s) would the nurse include? Select all that apply.
A. Postoperative bleeding most frequently occurs in the hours after surgery.
B. Avoid carbonated fluids
C. Gradually increase fluids then add soft foods.
D. Apply an ice collar to the neck area.
E. Gargle with warm saline water.
Show answer and rationale
Correct answer: B — Avoid carbonated fluids
A client may be at risk for postoperative bleeding for several days following the surgical procedure as the scab may be removed from the surgical site early causing the bleeding. Clients should avoid carbonated beverages and citrus fluids or foods because these agents are caustic to the suture line. The client should gradually increase fluids from thin liquids to thick liquids then soft foods through the recovery process. Applying an ice collar and gargling with saline decreases swelling and aids in preventing infection. Pain medication would be appropriate throughout the day, not just at night.
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Question 6
While assessing a patient who has pneumonia, the nurse has the patient repeat the letter E while the nurse auscultates. The nurse notes that the patients voice sounds are distorted and that the letter A is audible instead of the letter E. How should this finding be documented?
A. Bronchophony
B. Egophony
C. Whispered pectoriloquy
D. Sonorous wheezes
Correct answer:
This finding would be documented as egophony, which can be best assessed by instructing the patient to repeat the letter E. The distortion produced by consolidation transforms the sound into a clearly heard A rather than E. Bronchophony describes vocal resonance that is more intense and clearer than normal. Whispered pectoriloquy is a very subtle finding that is heard only in the presence of rather dense consolidation of the lungs. Sound is so enhanced by the consolidated tissue that even whispered words are heard. Sonorous wheezes are not defined as a voice sound, but rather as a breath sound.
The nurse is assessing a newly admitted medical patient and notes there is a depression in the lower portion of the patients sternum. This patients health record should note the presence of what chest deformity?
A. A barrel chest
B. A funnel chest
C. A pigeon chest
D. Kyphoscoliosis
Correct answer:
A funnel chest occurs when there is a depression in the lower portion of the sternum, and this may lead to compression of the heart and great vessels, resulting in murmurs. A barrel chest is characterized by an increase in the anteroposterior diameter of the thorax and is a result of overinflation of the lungs. A pigeon chest occurs as a result of displacement of the sternum and includes an increase in the anteroposterior diameter. Kyphoscoliosis, which is characterized by elevation of the scapula and a corresponding S-shaped spine, limits lung expansion within the thorax.
Which of the following nursing actions is most effective in preventing aspiration pneumonia in patients who are at risk?
A. Turn and reposition immobile patients at least every 2 hours.
B. Place patients with altered consciousness in side-lying positions.
C. Monitor for respiratory symptoms in patients who are immuno-suppressed.
D. Provide for continuous subglottic aspiration in patients receiving enteral feedings.
Correct answer:
The risk for aspiration is decreased when patients with a decreased level of consciousness are placed in a side-lying or upright position. Frequent turning prevents pooling of secretions in immobilized patients but will not decrease the risk for aspiration in patients at risk. Monitoring of parameters such as breath sounds and oxygen saturation will help detect pneumonia in immunocompromised patients, but it will not decrease the risk for aspiration. Continuous subglottic suction is recommended for intubated patients but not for all patients receiving enteral feedings.
A patient presents to the ED stating she was in a boating accident about 3 hours ago. Now the patient has complaints of headache, fatigue, and the feeling that he just cant breathe enough. The nurse notes that the patient is restless and tachycardic with an elevated blood pressure. This patient may be in the early stages of what respiratory problem?
A. Pneumoconiosis
B. Pleural effusion
C. Acute respiratory failure
D. Pneumonia
Correct answer:
Early signs of acute respiratory failure are those associated with impaired oxygenation and may include restlessness, fatigue, headache, dyspnea, air hunger, tachycardia, and increased blood pressure. As the hypoxemia progresses, more obvious signs may be present, including confusion, lethargy, tachycardia, tachypnea, central cyanosis, diaphoresis, and, finally, respiratory arrest. Pneumonia is infectious and would not result from trauma. Pneumoconiosis results from exposure to occupational toxins. A pleural effusion does not cause this constellation of symptoms.
A hospital has been the site of an increased incidence of hospital-acquired pneumonia (HAP). What is an important measure for the prevention of HAP?
A. Administration of prophylactic antibiotics
B. Administration of pneumococcal vaccine to vulnerable individuals
C. Obtaining culture and sensitivity swabs from all newly admitted patients
D. Administration of antiretroviral medications to patients over age 65
Correct answer:
Pneumococcal vaccination reduces the incidence of pneumonia, hospitalizations for cardiac conditions, and deaths in the general older adult population. A one-time vaccination of pneumococcal polysaccharide vaccine (PPSV) is recommended for all patients 65 years of age or older and those with chronic diseases. Antibiotics are not given on a preventative basis and antiretroviral medications do not affect the most common causative microorganisms. Culture and sensitivity testing by swabbing is not performed for pneumonia since the microorganisms are found in sputum.
The client diagnosed with acute respiratory distress syndrome (ARDS) presents with severe hypoxemia, despite oxygen administration via face mask. The nurse anticipates and prepares for which prescription from the health care provider (HCP)?
A. Intermittent positive pressure breathing (IPPB)
B. Increasing oxygen to 12 to 15 L flow
C. Insertion of endotracheal (ET) tube
D. Insertion of chest tube
Correct answer:
To maintain the client's airway, an ET tube or tracheostomy tube will be inserted for administration of mechanical ventilation. Mechanical ventilation uses positive end-expiratory pressure (PEEP), not IPPB. The use of IPPB is appropriate for respiratory failure, not ARDS. Because the client is not experiencing a pneumothorax based on the clinical manifestations, a chest tube is not indicated for reinflation. Increasing the oxygen flow rate via mask does not maintain patency of the airway; however, the use of mechanical ventilation is supported for this purpose.
A nurse is assigned to care for a client with bronchial irritation. The client is prescribed diphenhydramine. Before administering the drug, which of the following would the nurse do?
A. Document color and amount of any sputum present.
B. Record the previous prescriptions.
C. Take vital signs every 4 hours.
D. Assess the client's cardiovascular status.
Correct answer:
Before drug administration, the nurse should document the color and amount of any sputum present. The nurse need not record the previous prescriptions; however, the nurse should determine if any drugs the client uses would potentially interact with diphenhydramine. The nurse needs to take the client's vital signs, but not every 4 hours. The nurse needs to assess the respiratory status of the client before administering mucolytics and expectorants, but not before administering diphenhydramine HCl. Assessing the client's cardiovascular status is not necessary.
The nurse is caring for an adolescent client injured in a snowboarding accident. The client has a head injury, a fractured right rib, and various abrasions and contusions. The client has a blood pressure of 142/88 mm Hg, pulse of 102 beats/minute, and respirations of 26 breaths/minute. Which laboratory test best provides data on a potential impairment in ventilation?
A. Blood gases
B. Complete blood count
C. Blood chemistry
D. Serum alkaline phosphate
Correct answer:
Blood gases report the partial pressure of oxygen, which is dissolved in the blood. Normal readings are 80 to 100 mm Hg. By documenting oxygen levels in the blood, the nurse recognizes the current ventilation. The complete blood count provides information regarding number of blood cells, which can relate to the disease processes such as anemia and infection. The blood chemistry provides information on liver/renal function and electrolytes within the system. Serum alkaline phosphate is a laboratory test used to help detect liver disease and bone disorders.
A client arrived in the emergency department with a sharp object penetrating the diaphragm. When planning nursing care, which client need would the nurse identify as a priority?
A. Acute pain
B. Infection risk
C. Impaired gas exchange
D. Ineffective airway clearance
Correct answer:
The diaphragm separates the thoracic and abdominal cavities. On inspiration, the diaphragm contracts and moves downward, creating a partial vacuum. Without this vacuum, air is not as efficiently drawn into the thoracic cavity. Hypoxia or hypoxemia may occur from the poor availability of oxygen. Although the nursing diagnosis of acute pain is probable, gas exchange is a higher priority. Ineffective airway clearance is not the greatest concern because the problem is with ventilation. Infection risk is present but is not the highest-priority client need.
A patient has a diagnosis of multiple sclerosis. The nurse is aware that neuromuscular disorders such as multiple sclerosis may lead to a decreased vital capacity. What does vital capacity measure?
A. The volume of air inhaled and exhaled with each breath
B. The volume of air in the lungs after a maximal inspiration
C. The maximal volume of air inhaled after normal expiration
D. The maximal volume of air exhaled from the point of maximal inspiration
Correct answer:
Vital capacity is measured by having the patient take in a maximal breath and exhale fully through a spirometer. Vital lung capacity is the maximal volume of air exhaled from the point of maximal inspiration, and neuromuscular disorders such as multiple sclerosis may lead to a decreased vital capacity. Tidal volume is defined as the volume of air inhaled and exhaled with each breath. The volume of air in the lungs after a maximal inspiration is the total lung capacity. Inspiratory capacity is the maximal volume of air inhaled after normal expiration.
About these Nursing textbooks respiratory questions
Nursing textbooks respiratory practice questions, set 2 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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