Question 1

The nurse is assisting with the development of content on lung diseases to be provided during an upcoming health fair.What should the nurse include as being the disease that one-third of the world's population is currently infected?

Accepted Answer

One-third of the world's population is currently infected with TB.A.B.C.One third of the world's population is not currently infected with AIDS or pneumonia or has cancer.

Question 2

The nurse observes a newly admitted patient in the hospital room and determines that data collection should be focused on chronic obstructive pulmonary disease.What did the nurse observe to make this decision?

Accepted Answer

In chronic obstructive pulmonary disease patients use accessory muscles to breathe and tend to assume the classic tripod position to aid breathing.A.B.C.Coughing,lying supine in bed and walking around the room do not necessarily indication that the patient has chronic obstructive pulmonary disease.

Question 3

The nurse is concerned that a patient with a chronic low oxygen saturation level should be wearing home oxygen.Which oxygenation level should be used to make this decision?

Accepted Answer

Patients with chronic oxygen saturation levels of less than or equal to 88% should be placed on home oxygen.A.B.Oxygenation levels greater than 88% do not need to be prescribed home oxygen.D.The patient may need additional intervention if the oxygen level is 72%

Question 4

A patient has a positive response to a Candida test,in addition to a positive purified protein derivative (PPD)skin test.Which interpretation of these results is correct?

Accepted Answer

The positive Candida reaction means the patient's immune system is intact and that the PPD test is reliable.A.Two negative results would indicate anergy.C.All patients react to Candida.D.Active infection is possible but must be confirmed with a culture.

Question 5

The nurse is reviewing the health statuses for assigned patients to determine the risk for pneumonia.Which type of pneumonia occurs most often as a nosocomial infection in hospitalized patients,very young patients,and older patients?

Accepted Answer

Generalized pneumonia is very serious and is called bronchopneumonia.Bronchopneumonia occurs more often as a nosocomial (hospital-acquired)infection in hospitalized patients,the very young,and the very old.B.Lobar pneumonia is localized.A.C.Fungal and viral pneumonias refer to specific causes but are not necessarily more frequent in the populations listed.

Question 6

The nurse is assisting in the planning of care for a patient with chronic obstructive pulmonary disease.What should be the goals of care for this patient? (Select all that apply.)

Accepted Answer

The goals of COPD treatment include cessation of cigarette smoking,improve activity tolerance,prevent disease progression,and prevent and treat exacerbations.D.Completing an advance directive is not a goal for treatment.

Question 7

The nurse is caring for a patient with long-standing bronchiectasis.Which manifestation should the nurse report immediately?

Accepted Answer

Distended neck veins and dependent edema are signs of cor pulmonale and should be reported immediately.A.B.D.Fever,sputum,and cough are expected in patients with bronchiectasis.

Question 8

An older adult patient who reports difficulty breathing and a productive cough and has a low-grade fever is admitted to the hospital for diagnosis and treatment.Which new-onset symptom should take priority?

Accepted Answer

New onset confusion in a patient with respiratory symptoms is a sign of impaired gas exchange.It must be corrected immediately.A.C.D.Crackles,blood-tinged sputum,and fatigue are all important but are not the first priority.

Question 9

According to Centers for Disease Control and Prevention (CDC)guidelines,which individuals should the nurse consider as being positive for the TB skin test? (Select all that apply.)

Accepted Answer

5 mm or more is positive in patients with HIV,close contacts with TB,a history of TB,or IV drug abuse and unknown HIV status.A.D.10 mm or more is positive in persons who are foreign-born,are IV drug abusers and HIV-negative,are low income,reside in residential facilities,or are children younger than age 4.E.A 15-mm result is positive in a person with no TB risk factors.

Question 10

A nurse is providing care for a patient with Ineffective Airway Clearance.Which are appropriate interventions to address this problem? (Select all that apply.)

Accepted Answer

Interventions to help with ineffective airway clearance include teaching the use of incentive spirometry,assessing respiratory rate and pattern every 4 hours and as needed,encouraging the patient to deep breathe and cough every 2 hours,and administering medication to thin secretions as prescribed.A.Daily weights may be done for other reasons but are not directly related to the problem of ineffective airway clearance.

Question 11

A patient is prescribed long-term anticoagulant therapy as treatment for pulmonary emboli.What should the nurse ensure the patient is instructed before being discharged home? (Select all that apply.)

Accepted Answer

The patient on long-term anticoagulant therapy needs to be instructed to avoid accidental injury and bleeding.The patient should be instructed to wear shoes at home,use an electric razor,and use a soft toothbrush.D.Bruising is not expected and should be reported to the health care provider.E.There is no reason to restrict the intake of citrus fruits.

Question 12

The nurse is caring for a patient with a suspected pulmonary embolism.Which diagnostic tests or procedures should the nurse expect to be prescribed for this patient? (Select all that apply.)

Accepted Answer

A spiral CT scan is a new and fast type of CT scan that is noninvasive and can diagnose PE quickly.If this is not available,a lung scan (ventilation-perfusion scan)is done to assess the extent of ventilation of lung tissue and the areas of blood perfusion.A pulmonary angiogram can outline the pulmonary vessels with a radiopaque dye injected via a cardiac catheter.D-dimer is a fibrin fragment that is found in the blood after any thrombus formation.It can be present in a number of disorders,but if it is negative,PE can be eliminated as a possible cause of the patient's symptoms.D.Bronchoscopy is not used to determine PE.B.Spirometry is not a diagnostic test.

Question 13

The nurse needs to collect a sputum specimen for culture from a patient with a chronic cough.What actions should the nurse take when collecting this specimen? (Select all that apply.)

Accepted Answer

A specimen for culture should be obtained first thing in the morning before the patient eats breakfast.C.The culture specimen should be obtained before antibiotics are started to avoid altering culture results.D.The patient does not need to drink warm water before obtaining the specimen.E.If the patient has eaten,the mouth should be rinsed with water to keep food particles out of the specimen.

Question 14

A patient is having a therapeutic thoracentesis to remove pleural fluid.What volume of pleural fluid should the nurse recognize as being abnormal?

Accepted Answer

More than 25 mL of fluid is considered abnormal.A.B.C.A normal amount of pleural fluid around each lung is 1 to 15 mL.

Question 15

A young adult is admitted with manifestations associated with cystic fibrosis.What should the nurse expect to find when collecting data from this patient? (Select all that apply.)

Accepted Answer

Symptoms of cystic fibrosis usually first appear in infancy or childhood,although a few individuals are not diagnosed until adulthood.Manifestations include finger clubbing,malnutrition,thick sputum production,and frequent foul-smelling stools.A.Extreme thirst is not a manifestation of cystic fibrosis.

Question 16

A patient is diagnosed with a pulmonary embolism.To be effective,how soon should thrombolytic agents be administered?

Accepted Answer

Thrombolytic agents such as alteplase (Activase)or reteplase (Retavase)may be used in life-threatening emergencies to dissolve the clot Thrombolytics must be administered within 4 to 6 hours of the clot's occurrence.B.C.D.Administering the medication after 6 hours would be ineffective to dissolve the clot.

Quiz 31: Nursing Care of Patients With Lower Respiratory Tract Disorders