Deck 30: Respiratory Care

Question 1

An important principle of nebulization therapy is to caution the client against

A)Coughing too much.
B)Hyperventilation.
C)Too much exertion just prior to the treatment.
D)Cleaning the equipment with soap and water.

Answer 1

Hyperventilation.

Question 2

Match the definition in column B with the type of lung volume in column A.
Column A

A)Expiratory reserve volume
B)Inspiratory reserve volume
C)Reserve volume
D)Tidal volume
Column B
1)Volume of air expelled following maximum inspiration
2)Volume of air normally inspired
3)Volume of air expelled following a resting expiration
4)Volume of air remaining in lungs at end of maximum expiration
5)Maximum volume of air inspired above tidal volume

Answer 2

A)3
B)5
C)4
D)2

Question 3

Instructions for coughing exercises include having the client _____________ deeply and to cough using _____________ and respiratory muscles.

Answer 3

Inhale,abdominal.

Question 4

The client is placed in a _____________ position when teaching deep breathing and coughing exercises.Have the client take a _____________ breath through the _____________ until the chest is expanded and abdominal muscles rise.

Question 5

An elderly client has an order for humidified oxygen at 6 litersper minute.You understand the rationale for this order is to

A)Prevent infection of the upper airways.
B)Administer oxygen to treat hypoxemia.
C)Maintain moist mucous membranes.
D)Keep the upper airways patent.

Question 6

Which of the following statements is true for the client receiving oxygen per nasal cannulae?

A)Deep breathing will increase the amount of oxygen inhaled.
B)Vaseline use is appropriate for nares care.
C)Mouth breathing will not alter oxygen percent inspired.
D)Humidification of inspired air is indicated.

Question 7

The best method to prevent hypoxia when suctioning is

A)Suction only when necessary.
B)Hyperoxygenate for 1-2 minutes before suctioning.
C)Suction for no more than 10 seconds.
D)Use only a small-sized catheter for suctioning.

Question 8

Place an X in front of the statements that are correct about tracheostomy care.

A)The outer cannula is frequently disposable and needs no cleaning._______
B)The inner cannula is cleansed with hydrogen peroxide when nondisposable cannula is used._______
C)Oropharyngeal suctioning should be done before deflating the trach cuff._______
D)The incision site should be observed and cleansed only if dried blood surrounds the site._______
E)Nonraveling dressings are used to prevent aspiration of lint._______
F)Trach ties should only be changed when assistance is available._______

Question 9

Endotracheal tube or tracheostomy tube cuffs are inflated to minimal occlusive volume.Adequate occlusion is determined using a stethoscope to

A)hear a hissing sound over the suprasternal notch on expiration.
B)hear a hissing sound over the suprasternal notch on end inspiration.
C)hear the client speak softly on exhalation.
D)infalted cuff pressure greater than client's blood pressure.

Question 10

Complete the following instructions for clients requiring diaphragmatic breathing: The client is to breathe in deeply through the _____________.The client is to exhale by _____________.To assist in exhaling effectively,instruct the client to tighten the _____________ muscles.

Question 11

The priority concern for the client with a capped tracheostomy tube is

A)Means for communication.
B)Tube cuff deflation.
C)Aspiration precautions.
D)Continuous pulse oximetry.

Question 12

A high flow rate of oxygen administered to the client with COPD may cause

A)Headache.
B)Respiratory alkalosis.
C)Oxygen dependency.
D)CO₂ retention.

Question 13

The oxygen delivery system that provides the highest concentration of oxygen is

A)Nasal prongs.
B)Mask without reservoir bag.
C)Mask with reservoir bag.
D)Venturi mask.

Question 14

Inaccurate pulse oximetry readings can be found in clients with

A)Polycythemia.
B)Recent contrast media studies.
C)High CO₂ levels.
D)Cardiac anomalies.

Question 15

Oxygen delivered through a nasal cannula can deliver no more than _____________% oxygen.

A)24
B)30
C)38
D)44

Question 16

All of the following actions are performed with tracheostomy suctioning except

A)Hyperoxygenate lungs with oxygen after suctioning.
B)Insert catheter without applying suction.
C)Instill 10 mL of normal saline into trach before suctioning.
D)Suction for 10 seconds.

Question 17

Oxygen is most accurately delivered by

A)Nasal cannula.
B)Simple mask.
C)Mask with reservoir bag.
D)Venturi mask.

Question 18

Both sensor probes must be aligned directly opposite each other when using a finger or toe site for pulse oximetry to ensure _____________.

Question 19

The most accurate statement about percussion,vibration,and drainage is

A)Percussion is done for 1 minute over each lung segment.
B)Vibration is performed on exhalation.
C)To drain lower right lobe,the client is positioned in Fowler's position.
D)Coughing and deep breathing are done at the end of the treatment.

Question 20

Negative pressure used when performing tracheostomy suction is _____________ mm Hg.

A)40-60
B)60-80
C)80-120
D)120-140

Question 21

While changing the trach ties,the client is accidentally decannulated.Your initial nursing intervention is to

A)Call the physician.
B)Place in Fowler's position.
C)Insert obturator through trach opening.
D)Suction client.

Question 22

Nursing responsibilities when assisting with endotracheal intubation include all of the following except

A)Place client in a supine position with chin flexed toward chest.
B)Tape ET tube in place after insertion.
C)Suction client before intubation.
D)Auscultate lung fields before and after intubation.

Question 23

Safety measures that are monitored for all clients requiring a closed drainage system include all of the following except

A)Keeping rubber-tipped hemostats at bedside.
B)Air vent is closed to the environment.
C)Keeping the system below chest tube insertion site.
D)Ensuring that suction control chamber water level is maintained.

Question 24

Continuous air bubbling in the water-seal bottle indicates that

A)Air is passing out of the pleural space.
B)Air is being removed from within the lung tissue.
C)Air is leaking into the drainage system.
D)Nothing is wrong;air bubbling is normal.

Question 25

Place an X in front of the true statements related to airway insertion.

A)Oropharyngeal airways are initially turned upside down for insertion._______
B)Only the tip of the nasopharyngeal airway is lubricated prior to insertion._______
C)Clients are placed in a semi-Fowler's position for endotracheal intubation._______
D)Breath sounds are assessed following endotracheal intubation._______
E)Sterile technique is used in cleaning and suctioning the new tracheostomy tube._______

Question 26

Which one of the following principles is incorrect when discussing the water-seal chest drainage system?

A)When the chest has been opened,a vacuum must be applied to reestablish positive pressure.
B)Water acts as a seal to prevent air from being drawn into the pleural space.
C)Air drawn into the chest cavity collapses the lung.
D)Water-seal mechanisms operate on a negative pressure principle.

Question 27

Chest tubes are inserted following a thoracotomy and attached to a Pleur-evac drainage system.When evaluating the effectiveness of the drainage system,you notice that fluid is fluctuating up and down in the water-seal chamber.What is your initial intervention?

A)Clamp the chest tubes closest to the client.
B)Call the physician immediately.
C)Look for leaks in the tubing.
D)Do nothing because this fluctuation is normal.

Question 28

When suctioning a client with a cuffed tracheostomy tube,which of the following nursing measures should be considered?

A)Oxygenation should be provided after the suctioning procedure only if it was prolonged.
B)The size of the suction catheter should not exceed half the diameter of the tracheostomy tube.
C)Apply suction when inserting as well as when removing the catheter.
D)Suctioning should not exceed 15 seconds at a time.
Clinical Situation: James Jackson was injured in an automobile accident.His chest hit the steering wheel and,upon admission to the ER,he was complaining of shortness of breath.A chest tube has been inserted to evacuate a hemothorax.Questions 27-30 refer to this situation.