Question 1

After change-of-shift report,which patient should the nurse assess first?

Accepted Answer

The patient's history and symptoms suggest possible tension pneumothorax,a medical emergency.The other patients also require assessment as soon as possible,but tension pneumothorax will require immediate treatment to avoid death from inadequate cardiac output or hypoxemia.

Question 2

Which action by the nurse will be most effective in decreasing the spread of pertussis in a community setting?

Accepted Answer

The increased rate of pertussis in adults is thought to be due to decreasing immunity after childhood immunization.Immunization is the most effective method of protecting communities from infectious diseases.Hand washing should be taught,but pertussis is spread by droplets and contact with secretions.Supportive care does not shorten the course of the disease or the risk for transmission.Taking antibiotics as prescribed does assist with decreased transmission,but patients are likely to have already transmitted the disease by the time the diagnosis is made.

Question 3

The nurse provides discharge teaching for a patient who has two fractured ribs from an automobile accident.Which statement,if made by the patient,would indicate that teaching has been effective?

Accepted Answer

Prevention of the complications of atelectasis and pneumonia is a priority after rib fracture.This can be ensured by deep breathing and coughing.Use of a rib binder,shallow breathing,and taking pain medications only at night are likely to result in atelectasis.

Question 4

Which intervention will the nurse include in the plan of care for a patient who is diagnosed with a lung abscess?

Accepted Answer

Long-term antibiotic therapy is needed for effective eradication of the infecting organisms in lung abscess.Chest physiotherapy and postural drainage are not recommended for lung abscess because they may lead to spread of the infection.Foul smelling and bloody sputum are common clinical manifestations in lung abscess.Expectorants may be used because the patient is encouraged to cough.

Question 5

A patient has acute bronchitis with a nonproductive cough and wheezes.Which topic should the nurse plan to include in the teaching plan?

Accepted Answer

Cough suppressants are frequently prescribed for acute bronchitis.Because most acute bronchitis is viral in origin,antibiotics are not prescribed unless there are systemic symptoms.Fluid intake is encouraged.Home oxygen is not prescribed for acute bronchitis,although it may be used for chronic bronchitis.

Question 6

The nurse notes new onset confusion in an older patient who is normally alert and oriented.In which order should the nurse take the following actions? (Put a comma and a space between each answer choice [A,B,C,D].)

Accepted Answer

Assessment for physiologic causes of new onset confusion such as pneumonia,infection,or perfusion problems should be the first action by the nurse.Airway and oxygenation should be assessed first,then circulation.After assessing the patient,the nurse should notify the health care provider.Finally,documentation of the assessments and care should be done.

Question 7

An experienced nurse instructs a new nurse about how to care for a patient with dyspnea caused by a pulmonary fungal infection.Which action by the new nurse indicates a need for further teaching?

Accepted Answer

Fungal infections are not transmitted from person to person.Therefore no isolation procedures are necessary.The other actions by the new nurse are appropriate.

Question 8

The nurse is caring for a patient with idiopathic pulmonary arterial hypertension (IPAH)who is receiving epoprostenol (Flolan).Which assessment information requires the most immediate action by the nurse?

Accepted Answer

The half-life of this drug is 6 minutes,so the nurse will need to restart the infusion as soon as possible to prevent rapid clinical deterioration.The other data also indicate a need for ongoing monitoring or intervention,but the priority action is to reconnect the infusion.

Question 9

Which factors will the nurse consider when calculating the CURB-65 score for a patient with pneumonia (select all that apply)?

Accepted Answer

Data collected for the CURB-65 are mental status (confusion),BUN (elevated),blood pressure (decreased),respiratory rate (increased),and age (65 and older).The other information is also essential to assess,but are not used for CURB-65 scoring.

Question 10

A patient who was admitted the previous day with pneumonia complains of a sharp pain of 7 (based on 0 to 10 scale)"whenever I take a deep breath." Which action will the nurse take next?

Accepted Answer

The patient's statement indicates that pleurisy or a pleural effusion may have developed and the nurse will need to listen for a pleural friction rub and/or decreased breath sounds.Assessment should occur before administration of pain medications.The patient is unlikely to be able to cough forcefully until pain medication has been administered.The nurse will want to obtain more assessment data before calling the health care provider.

Question 11

The nurse is caring for a patient who has a right-sided chest tube after a right lower lobectomy.Which nursing action can the nurse delegate to the unlicensed assistive personnel (UAP)?

Accepted Answer

UAP education includes documentation of intake and output.The other actions are within the scope of practice and education of licensed nursing personnel.

Quiz 24: Nursing Management: Lower Respiratory Problems

After change-of-shift report,which patient should the nurse assess first?

Which action by the nurse will be most effective in decreasing the spread of pertussis in a community setting?

The nurse provides discharge teaching for a patient who has two fractured ribs from an automobile accident.Which statement,if made by the patient,would indicate that teaching has been effective?

Which intervention will the nurse include in the plan of care for a patient who is diagnosed with a lung abscess?

A patient has acute bronchitis with a nonproductive cough and wheezes.Which topic should the nurse plan to include in the teaching plan?

The nurse notes new onset confusion in an older patient who is normally alert and oriented.In which order should the nurse take the following actions? (Put a comma and a space between each answer choice [A,B,C,D].)

An experienced nurse instructs a new nurse about how to care for a patient with dyspnea caused by a pulmonary fungal infection.Which action by the new nurse indicates a need for further teaching?

The nurse is caring for a patient with idiopathic pulmonary arterial hypertension (IPAH) who is receiving epoprostenol (Flolan) .Which assessment information requires the most immediate action by the nurse?

Which factors will the nurse consider when calculating the CURB-65 score for a patient with pneumonia (select all that apply) ?

A patient who was admitted the previous day with pneumonia complains of a sharp pain of 7 (based on 0 to 10 scale) "whenever I take a deep breath." Which action will the nurse take next?

The nurse is caring for a patient who has a right-sided chest tube after a right lower lobectomy.Which nursing action can the nurse delegate to the unlicensed assistive personnel (UAP) ?