1. Dr. Jones prescribes albuterol sulfate (Proventil) for a patient with newly diagnose asthma. When teaching the patient about this drug, the nurse should explain that it may cause:
a. Nasal congestion
2. Miriam, a college student with acute rhinitis sees the campus nurse because of excessive nasal drainage. The nurse asks the patient about the color of the drainage. In a acute rhinitis, nasal drainage normally is:
3. A male adult patient hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis?
a. Nausea or vomiting
b. Abdominal pain or diarrhea
c. Hallucinations or tinnitus
d. Lightheadedness or paresthesia
4. Before administering ephedrine, Nurse Tony assesses the patient’s history. Because of ephedrine’s central nervous system (CNS) effects, it is not recommended for:
a. Patients with an acute asthma attack
b. Patients with narcolepsy
c. Patients under age 6
d. Elderly patients
5. A female patient suffers adult respiratory distress syndrome as a consequence of shock. The patient’s condition deteriorates rapidly, and endotracheal intubation and mechanical ventilation are initiated. When the high pressure alarm on the mechanical ventilator, alarm sounds, the nurse starts to check for the cause. Which condition triggers the high pressure alarm?
a. Kinking of the ventilator tubing
b. A disconnected ventilator tube
c. An endotracheal cuff leak
d. A change in the oxygen concentration without resetting the oxygen level alarm
6. A male adult patient on mechanical ventilation is receiving pancuronium bromide (Pavulon), 0.01 mg/kg I.V. as needed. Which assessment finding indicates that the patient needs another pancuronium dose?
a. Leg movement
b. Finger movement
c. Lip movement
d. Fighting the ventilator
7. On auscultation, which finding suggests a right pneumothorax?
a. Bilateral inspiratory and expiratory crackles
b. Absence of breaths sound in the right thorax
c. Inspiratory wheezes in the right thorax
d. Bilateral pleural friction rub.
8. Rhea, confused and short breath, is brought to the emergency department by a family member. The medical history reveals chronic bronchitis and hypertension. To learn more about the current respiratory problem, the doctor orders a chest x-ray and arterial blood gas (ABG) analysis. When reviewing the ABG report, the nurses sees many abbreviations. What does a lowercase “a” in ABG value present?
a. Acid-base balance
b. Arterial Blood
c. Arterial oxygen saturation
9. A male patient is admitted to the health care facility for treatment of chronic obstructive pulmonary disease. Which nursing diagnosis is most important for this patient?
a. Activity intolerance related to fatigue
b. Anxiety related to actual threat to health status
c. Risk for infection related to retained secretions
d. Impaired gas exchange related to airflow obstruction
10. Nurse Ruth assessing a patient for tracheal displacement should know that the trachea will deviate toward the:
a. Contralateral side in a simple pneumothorax
b. Affected side in a hemothorax
c. Affected side in a tension pneumothorax
d. Contralateral side in hemothorax
11. After undergoing a left pneumonectomy, a female patient has a chest tube in place for drainage. When caring for this patient, the nurse must:
a. Monitor fluctuations in the water-seal chamber
b. Clamp the chest tube once every shift
c. Encourage coughing and deep breathing
d. Milk the chest tube every 2 hours
12. When caring for a male patient who has just had a total laryngectomy, the nurse should plan to:
a. Encourage oral feeding as soon as possible
b. Develop an alternative communication method
c. Keep the tracheostomy cuff fully inflated
d. Keep the patient flat in bed
13. A male patient has a sucking stab wound to the chest. Which action should the nurse take first?
a. Drawing blood for a hematocrit and hemoglobin level
b. Applying a dressing over the wound and taping it on three sides
c. Preparing a chest tube insertion tray
d. Preparing to start an I.V. line
14. For a patient with advance chronic obstructive pulmonary disease (COPD), which nursing action best promotes adequate gas exchange?
a. Encouraging the patient to drink three glasses of fluid daily
b. Keeping the patient in semi-fowler’s position
c. Using a high-flow venture mask to deliver oxygen as prescribe
d. Administering a sedative, as prescribe
15. A male patient’s X-ray result reveals bilateral white-outs, indicating adult respiratory distress syndrome (ARDS). This syndrome results from:
a. Cardiogenic pulmonary edema
b. Respiratory alkalosis
c. Increased pulmonary capillary permeability
d. Renal failure
16. For a female patient with chronic obstructive pulmonary disease, which nursing intervention would help maintain a patent airway?
a. Restricting fluid intake to 1,000 ml per day
b. Enforcing absolute bed rest
c. Teaching the patient how to perform controlled coughing
d. Administering prescribe sedatives regularly and in large amounts
17. Nurse Lei caring for a client with a pneumothorax and who has had a chest tube inserted notes continues gentle bubbling in the suction control chamber. What action is appropriate?
a. Do nothing, because this is an expected finding
b. Immediately clamp the chest tube and notify the physician
c. Check for an air leak because the bubbling should be intermittent
d. Increase the suction pressure so that the bubbling becomes vigorous
18. Nurse Maureen has assisted a physician with the insertion of a chest tube. The nurse monitors the client and notes fluctuation of the fluid level in the water seal chamber after the tube is inserted. Based on this assessment, which action would be appropriate?
a. Inform the physician
b. Continue to monitor the client
c. Reinforce the occlusive dressing
d. Encourage the client to deep-breathe
19. Nurse Ryan caring for a client with a chest tube turns the client to the side, and the chest tube accidentally disconnects. The initial nursing action is to:
a. Call the physician
b. Place the tube in bottle of sterile water
c. Immediately replace the chest tube system
d. Place a sterile dressing over the disconnection site
20. A nurse is assisting a physician with the removal of a chest tube. The nurse should instruct the client to:
a. Exhale slowly
b. Stay very still
c. Inhale and exhale quickly
d. Perform the Valsalva maneuver
21. While changing the tapes on a tracheostomy tube, the male client coughs and tube is dislodged. The initial nursing action is to:
a. Call the physician to reinsert the tube
b. Grasp the retention sutures to spread the opening
c. Call the respiratory therapy department to reinsert the tracheotomy
d. Cover the tracheostomy site with a sterile dressing to prevent infection
22. Nurse Oliver is caring for a client immediately after removal of the endotracheal tube. The nurse reports which of the following signs immediately if experienced by the client?
b. Occasional pink-tinged sputum
c. A few basilar lung crackles on the right
d. Respiratory rate 24 breaths/min
23. An emergency room nurse is assessing a male client who has sustained a blunt injury to the chest wall. Which of these signs would indicate the presence of a pneumothorax in this client?
a. A low respiratory rate
b. Diminished breath sounds
c. The presence of a barrel chest
d. A sucking sound at the site of injury
24. Nurse Reese is caring for a client hospitalized with acute exacerbation of chronic obstructive pulmonary disease. Which of the following would the nurse expect to note on assessment of this client?
b. A hyperinflated chest noted on the chest x-ray
c. Increased oxygen saturation with exercise
d. A widened diaphragm noted on the chest x-ray
25. An oxygen delivery system is prescribed for a male client with chronic obstructive pulmonary disease to deliver a precise oxygen concentration. Which of the following types of oxygen delivery systems would the nurse anticipate to be prescribed?
a. Face tent
b. Venturi mask
c. Aerosol mask
d. Tracheostomy collar
26. Blessy, a community health nurse is conducting an educational session with community members regarding tuberculosis. The nurse tells the group that one of the first symptoms associated with tuberculosis is:
b. Chest pain
c. A bloody, productive cough
d. A cough with the expectoration of mucoid sputum
27. A nurse performs an admission assessment on a female client with a diagnosis of tuberculosis. The nurse reviews the result of which diagnosis test that will confirm this diagnosis?
b. Sputum culture
c. Chest x-ray
d. Tuberculin skin test
28. A nurse is caring for a male client with emphysema who is receiving oxygen. The nurse assesses the oxygen flow rate to ensure that it does not exceed:
a. 1 L/min
b. 2 L/min
c. 6 L/min
d. 10 L/min
29. A nurse instructs a female client to use the pursed-lip method of breathing and the client asks the nurse about the purpose of this type of breathing. The nurse responds, knowing that the primary purpose of pursed-lip breathing is to:
a. Promote oxygen intake
b. Strengthen the diaphragm
c. Strengthen the intercostal muscles
d. Promote carbon dioxide elimination
30. A nurse is caring for a male client with acute respiratory distress syndrome. Which of the following would the nurse expect to note in the client?
b. Low arterial PaO2
c. Elevated arterial PaO2
d. Decreased respiratory rate