Question 1

The nursing instructor is talking with senior nursing students about diagnostic procedures used in respiratory diseases. The instructor discusses thoracentesis, defining it as a procedure performed for diagnostic purposes or to aspirate accumulated excess fluid or air from the pleural space. What would the instructor tell the students purulent fluid indicates?

Accepted Answer

Purulent fluid is a sign of infection, and may indicate the presence of bacteria in the pleural space leading to conditions such as pneumonia, tuberculosis, or empyema.

Question 2

You are performing pulmonary function studies on clients in the clinic. What position do you know a client should be in to have maximum lung capacities and volumes?

Accepted Answer

The standing position is the optimal position for measuring maximum lung capacities and volumes as it allows for maximum chest expansion and the greatest thoracic volume. Lying on the unaffected side or resting the head on a pillow can limit chest expansion, and lying flat on the back can result in decreased lung volumes due to the weight of the abdominal contents on the diaphragm.

Question 3

The nurse is caring for a client diagnosed with asthma. While performing the shift assessment, the nurse auscultates breath sounds including sibilant wheezes, which are continuous musical sounds. What characteristics describe sibilant wheezes?

Accepted Answer

Sibilant wheezes are high-pitched, musical sounds heard primarily during expiration but can also be heard during inspiration, indicating narrowed airways often seen in conditions like asthma.

Question 4

What is the difference between respiration and ventilation?

Accepted Answer

Respiration refers to the exchange of gases between the body and the environment, while ventilation specifically refers to the movement of air in and out of the respiratory tract. Respiration includes both ventilation and the exchange of gases in the lungs, as well as the transport of oxygen and carbon dioxide in the blood and cellular respiration in the cells.

Question 5

The student nurse is caring for a client who has serial sputum tests ordered. The student asks their instructor why the sputum tests have to be repeated on successive days. What would be the instructor's best response?

Accepted Answer

A negative sputum test does not always rule out the presence of a disease, and the test may need to be repeated multiple times to increase the chances of detecting the disease.

Question 6

The nurse working in the radiology clinic is assisting with a pulmonary angiography. The nurse knows that when monitoring clients after a pulmonary angiography, what should the physician be notified about?

Accepted Answer

Absent distal pulses may indicate a potential complication of the pulmonary angiography, such as arterial embolism or thrombus formation. The physician should be notified immediately to prevent further complications. Raised temperature in the affected limb, excessive capillary refill, and flushed feeling are not typically associated with pulmonary angiography and may not require immediate notification of the physician.

Question 7

Perfusion refers to blood supply to the lungs, through which the lungs receive nutrients and oxygen. What are the two methods of perfusion?

Accepted Answer

The two methods of perfusion are the bronchial and pulmonary circulation. The bronchial circulation supplies oxygenated blood to the lung tissue itself, while the pulmonary circulation is responsible for gas exchange within the alveoli.

Question 8

What happens to the diaphragm during inspiration?

Accepted Answer

During inspiration, the diaphragm contracts and flattens, which increases the volume of the thoracic cavity and decreases the pressure inside the lungs. This allows air to flow into the lungs.

Question 9

Your client is scheduled for a bronchoscopy to visualize the larynx, trachea, and bronchi. What precautions would you recommend to the client before the procedure?

Accepted Answer

Abstaining from food for at least 6 hours before the procedure is recommended to reduce the risk of aspiration during the bronchoscopy. Sedatives or narcotics might be used for sedation during the procedure under controlled conditions, and atropine might be used to dry secretions and improve visibility. Practicing holding the breath is not typically advised as the procedure involves the insertion of a bronchoscope through the mouth or nose, and the patient's breathing might be assisted or controlled during the procedure.

Question 10

The nurse is preparing a client for a diagnostic procedure. What should the nurse remember when providing information and appropriate explanations about diagnostic procedures to clients?

Accepted Answer

Clients may experience decreased energy levels as a result of the procedure, and the nurse should provide appropriate education and support regarding this potential outcome. However, explanations should not be overly detailed and should be repeated as necessary to ensure understanding. Activity levels may also need to be modified before and after the procedure, depending on the specific diagnostic testing being performed.

Question 11

The nurse is caring for a client in sickle cell crisis. The plan of care for this client includes giving oxygen by nasal canula. What is the rationale behind this nursing action?

Accepted Answer

In sickle cell crisis, the sickled red blood cells have damaged oxyhemoglobin, making it difficult for adequate oxygen to reach the cells. Providing oxygen through a nasal cannula can help to increase the amount of oxygen in the blood, which can improve tissue perfusion and alleviate some of the symptoms of the crisis.

Question 12

An 18-month-old child is brought to the Emergency Department by their parents who explain that their child swallowed a watch battery. Radiologic studies show that the battery is in the lungs. Which area of lung is the battery most likely to be in?

Accepted Answer

The right upper lung is the most common location for foreign bodies in the lungs, as it is the most dependent portion of the lung when a child is in the upright position.

Question 13

The Family Nurse Practitioner is performing a physical examination of a client. The Nurse Practitioner examines the client's anterior, posterior, and lateral chest walls. What is the Nurse Practitioner assessing?

Accepted Answer

The Nurse Practitioner is assessing for evidence of muscle weakness by examining the anterior, posterior, and lateral chest walls, which can indicate respiratory muscle strength and function.

Question 14

What determines the amount of CO₂ in the blood for the lungs to excrete?

Accepted Answer

The amount of hydrogen ions in the blood influences the pH level, which in turn affects the conversion of bicarbonate and carbonic acid, ultimately determining the amount of CO2 to be excreted by the lungs.

Question 15

Your client has just had an invasive procedure to assess the respiratory system. What do you know should be assessed on this client?

Accepted Answer

Respiratory distress should be assessed in a client who has just had an invasive procedure to assess the respiratory system, as it can indicate complications such as pneumothorax, bleeding, or infection.

Question 16

You are caring for a client who is in respiratory distress. The physician orders arterial blood gases (ABGs) to determine various factors related to blood oxygenation. What site can ABG's be obtained from?

Accepted Answer

ABGs are obtained by puncturing an artery, usually the radial artery, to obtain a sample of arterial blood. It is not obtained from the trachea, bronchi, pleural surfaces, or arm veins.

Question 17

The nursing instructor is teaching a pre-nursing pathophysiology class. The class is covering the respiratory system. The instructor explains that the respiratory system is comprised of both the upper and lower respiratory system. The nose is part of the upper respiratory system. The instructor continues to explain that the nasal cavities have a vascular and ciliated mucous lining. What is the purpose of the vascular and ciliated mucous lining of the nasal cavities?

Accepted Answer

The vascular and ciliated mucous lining of the nasal cavities serves to warm and humidify the air that is breathed in (inspired air), making it easier for the lungs to process. This lining helps in adjusting the temperature and moisture level of the air entering the respiratory system to match the body's internal environment.

Question 18

A student nurse is caring for a client who is severely anemic. The instructor asks the student how anemia affects the transport of oxygen to the cells. What would be the student's best answer?

Accepted Answer

Anemia is characterized by a decreased number of red blood cells, which reduces the amount of hemoglobin available to transport oxygen to the cells. Hemoglobin is the protein in red blood cells that binds to oxygen and transports it to the cells. Without enough hemoglobin, cells are denied adequate oxygen. Choices A and B are inaccurate. While oxygen can temporarily dissolve in plasma, it is not a primary source of oxygen transport to the cells. White blood cells do not transport oxygen. Choice C is partially correct but does not fully address the role of hemoglobin in oxygen transport.

Question 19

You are a nurse in the radiology unit of your hospital. You are caring for a client who is scheduled for a lung scan. You know that lung scans need the use of radioisotopes and a scanning machine. Before the perfusion scan, what must the client be assessed for?

Accepted Answer

The client must be assessed for an iodine allergy because many radioisotopes used in lung scans contain iodine. An iodine allergy can cause an allergic reaction or anaphylaxis if not identified beforehand. Bleeding, dysrhythmias, and inflammation are not directly related to the use of radioisotopes in lung scans.

Question 20

The instructor in the anatomy and physiology class is talking about alveolar respiration. What would the instructor tell the class is the main purpose of alveolar respiration?

Accepted Answer

Alveolar respiration is the exchange of gases between the lungs and the bloodstream. The main purpose of alveolar respiration is to determine the amount of CO₂ in the body.

Quiz 19: Introduction to the Respiratory System