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

Question 1

A patient is admitted to a respiratory unit with a diagnosis of pneumonia. Assessment data reveal the patient to be febrile and experiencing a weak, congested-sounding cough, with moist crackles throughout the lung fields. Based on the data provided, the nurse will focus care on which issue?

A)Confusion from fever
B)Inadequate oxygen level
C)Difficulty with breathing
D)Inability to clear the airway

Answer 1

Inability to clear the airway

Question 2

The nurse is providing care for a patient admitted with an acute lower respiratory infection. The nurse notices that the patient is stifling the cough reflex and exhibiting shallow respirations due to pain. The nurse will focus nursing care on the prevention of which condition?

A)Atelectasis
B)Pulmonary emboli
C)Chronic airway obstruction
D)Respiratory failure

Answer 2

Atelectasis

Question 3

The licensed practical nurse/licensed vocational nurse (LPN/LVN) is reviewing laboratory results for a patient with COPD. Which action does the LPN/LVN take if the ABG analysis shows a PaCO₂ of 62 mm Hg?

A)Notify the registered nurse (RN) of the high laboratory result.
B)Have the patient breathe into a paper bag.
C)Increase the flow rate of the patient's nasal oxygen.
D)No action is necessary; this is a normal PaCO₂ level.

Answer 3

Notify the registered nurse (RN) of the high laboratory result.

Question 4

The nurse is reviewing the medications prescribed by the health care provider (HCP) for a patient with COPD. Which prescription will cause the nurse to verify the ordered medication?

A)Corticosteroid inhaler
B)Antitussive
C)Short-term antibiotic therapy
D)Theophylline bronchodilator

Question 5

The nurse is providing care for a patient with a lower respiratory tract infection who is having difficulty expectorating secretions. The patient is weak and easily fatigued. Which action by the nurse will best assist the patient in maintaining a clear airway?

A)Review effective coughing technique.
B)Plan activities with rest periods between.
C)Explain the importance of fluid intake.
D)Encourage abdominal and pursed-lip breathing.

Question 6

The nurse enters the room of a patient who is acutely short of breath. Which action should the nurse take first?

A)Assist the patient into Sims' position.
B)Encourage use of pursed-lip breathing.
C)Ask the patient what caused the dyspnea.
D)Teach the patient use of accessory muscles.

Question 7

A patient with chronic obstructive pulmonary disease (COPD) is prescribed methylprednisolone. For what reason should the nurse realize that corticosteroids are used in the treatment of this health problem?

A)To dry up respiratory secretions
B)To treat infection from secretion stasis
C)To reduce airway inflammation
D)To improve the blood capacity to carry oxygen

Question 8

The nurse is performing a follow up visit with a patient recently diagnosed with a GOLD 1 classification of COPD. Which statement by the patient indicates the most important compliance with previous patient teaching?

A)"I am attending an exercise class three times a week."
B)"I am including more fresh foods in my daily diet."
C)"I successfully completed a smoking-cessation program."
D)"I am wearing a respiratory filter when I work outside."

Question 9

A patient with TB who is in respiratory isolation must go to the x-ray department. Which action will the nurse take?

A)Place a gown and gloves on the patient.
B)Place a mask over the patient's nose and mouth.
C)Notify the x-ray department that the test must be cancelled.
D)Call the x-ray department to make sure the waiting room is empty.

Question 10

The nurse is researching the dietary recommendations by the American Lung Association for patients with lower respiratory tract disease. Which strategy is not supported by the American Lung Association?

A)Eat more food early in the day if fatigue occurs late in the day.
B)Consume a daily diet high in complex carbohydrates.
C)Consult with the HCP regarding a multivitamin.
D)Maintain a diet that is low in fats and high in carbohydrates.

Question 11

A patient with lung cancer develops pleural effusion. Which explanation by the nurse would help the patient understand this problem?

A)"Pus has developed in your alveoli that must be removed to improve your breathing."
B)"You have large amounts of fluid collecting in your airways because of your diagnosis."
C)"Fluid has collected in the space between your lungs and the sac surrounding your lungs."
D)"Fluid in your pericardial sac places pressure on your lungs, making it difficult to breathe."

Question 12

A patient who is planning to become pregnant expresses concern about the high incidence of asthma in her family. Which recommendation by the nurse is least helpful?

A)Suggest the patient undergo genetic studies and counseling.
B)Prevent exposure to environmental tobacco smoke during pregnancy.
C)During the first year of life, avoid giving a child acetaminophen.
D)Avoid broad-spectrum antibiotics during the child's first year of life.

Question 13

The nurse is providing care for a patient admitted for a lower respiratory infection. On admission, the patient's vital signs were blood pressure (BP) 140/80 mm Hg, apical pulse (AP) 112 beats/min, respirations (R) 32 breaths/min, and pain level of 8 on a scale of 0 to 10. After assisting the patient to bed and applying the prescribed oxygen, which finding helps the nurse evaluate the effectiveness of nursing care?

A)BP 130/78 mm Hg
B)AP 100 beats/min
C)R 20 breaths/min
D)Pain level of 6/10

Question 14

A patient diagnosed with a pleural effusion is experiencing severe dyspnea. With which procedure does the nurse anticipate assisting?

A)Tracheostomy
B)Thoracentesis
C)Bronchoscopy
D)Pericardiocentesis

Question 15

The nurse is caring for a patient with pneumonia. Which set of laboratory tests will be most helpful to the nurse to monitor the condition of this patient?

A)Electrolytes and serum creatinine
B)Complete blood count (CBC) and urinalysis
C)Partial thromboplastin time (PTT) and serum potassium
D)White blood cell (WBC) count and arterial blood gases (ABGs)

Question 16

The nurse is providing care for a patient diagnosed with an obstructive respiratory disorder. Which patient finding indicates that nursing interventions may be ineffective?

A)Respiratory secretions are coughed up.
B)Daily care is performed independently.
C)The patient uses oxygen only when active.
D)The patient reports a low level of anxiety.

Question 17

The nurse is reviewing data collected on a patient with a respiratory disorder. Which factors does the nurse identify as placing the patient at risk for lung cancer?

A)Smoking and exposure to radon gas
B)Living in a cold climate and having pets
C)Eating foods high in beta carotene and fiber
D)Living in crowded conditions and a lack of sunlight

Question 18

The nurse is providing care for a patient with a suspected pulmonary emboli. Which data will the nurse gather about this patient?

A)BP from both arms
B)Heart sounds and peripheral edema
C)Activity prior to manifestations
D)Side effects of medications

Question 19

A summer camp worker reports shortness of breath and audible wheezing to the camp nurse. Which inhaled medication will the nurse provide?

A)Albuterol
B)Cromolyn sodium
C)Triamcinolone
D)Nedocromil sodium

Question 20

The nurse works in a clinic and is performing tuberculosis (TB) screening with the purified protein derivative (PPD). Which option about PPD screening is correct?

A)The test is positive if reddened area occurs within 48 to 72 hours.
B)If a person is anergic, a larger area of induration will appear.
C)A positive reaction to the test indicates active disease process.
D)A reddened area without induration is considered negative.

Question 21

Some lung cancers produce __________ hormones that mimic the body's own hormones.

Question 22

The nurse auscultates the lung sounds of a patient with a pneumothorax every 4 hours. Which finding indicates to the nurse that the patient's condition is improving?

A)Patient anxiety is decreased.
B)Crackles or wheezes are heard.
C)Bilateral lung sounds are present.
D)Symmetry of the chest is noted.

Question 23

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

A)D-dimer
B)Spirometry
C)Angiogram
D)Ventilation-perfusion lung scan
E)Spiral computed tomography (CT) scan

Question 24

Management of asthma involves avoidance of triggers. Which environmental triggers will the nurse suggest the patient eliminate?

A)Carpet and drapes in the bedroom
B)Exposure to secondhand smoke
C)Pets and foods that cause symptoms
D)Cardiovascular exercise
E)Beta-blocking medications

Question 25

The nurse works on a pulmonary care unit and provides care for multiple patients with obstructive pulmonary conditions. Which specific symptoms will prompt the nurse to identify a patient's diagnosis as chronic bronchitis as opposed to other pulmonary diseases? (Select all that apply.)

A)Chronic productive cough
B)Classic barrel-shaped chest
C)Use of accessory muscles to breath
D)Condition worsening in the winter
E)Clear breath sounds with coughing

Question 26

The nurse is providing care for a patient admitted to the hospital for a respiratory disorder. The HCP is prescribing diagnostic tests to rule out bronchiectasis. Which manifestations does the nurse recognize as possible indicators for the diagnosis? (Select all that apply.)

A)Radiographic studies reveal areas of bronchial dilation.
B)Adult patient has a history of cystic fibrosis since birth.
C)Family history reveals multiple members with lung cancer.
D)The patient has recurring episodes of lower extremity edema.
E)Bronchitis occurred three times in the last three years.

Question 27

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.)

A)Extreme thirst
B)Finger clubbing
C)Body mass index 16
D)Thick sputum production
E)Complaints of frequent foul-smelling stool

Question 28

The nurse finds a patient gasping for breath and looking very anxious. Based on the patient's history, the nurse believes the patient may be experiencing a pulmonary embolism (PE). Which action should the nurse take first?

A)Contact the physician.
B)Call for help and start oxygen.
C)Check the patient's vital signs.
D)Place the patient in a left lateral position.

Question 29

The nurse works primarily with patients diagnosed with lung cancer. Which patient with lung cancer does the nurse recognize as having the best prognosis?

A)Small cell lung cancer
B)Large cell carcinoma
C)Adenocarcinoma
D)Squamous cell carcinoma

Question 30

A patient is diagnosed with respiratory failure. Which acid-base abnormality should the nurse expect the patient to demonstrate?

A)Metabolic acidosis
B)Metabolic alkalosis
C)Respiratory acidosis
D)Respiratory alkalosis