Deck 12: Alterations in Pulmonary Function

Question 1

The nurse is caring for a patient in early acute respiratory distress syndrome (ARDS).Which finding would indicate that the disease is progressing?

A)Increased lung compliance
B)Decrease in heart rate
C)Hypoxemia refractory to oxygen therapy
D)Respiratory acidosis

Answer 1

Hypoxemia refractory to oxygen therapy

Question 2

A patient is diagnosed with cystic fibrosis.The nurse will anticipate providing care for a patient with which change in lung function?

A)Decreased total lung capacity
B)Progressive respiratory alkalosis
C)Increased PaCO₂
D)Increased forced expiratory volume (FEV)

Answer 2

Increased PaCO₂

Question 3

A patient is being admitted for treatment of pneumothorax.The nurse would anticipate providing care for a patient with which pathophysiology?

A)Prolonged expiratory time
B)Increased lung compliance
C)Reduced tidal volume
D)Hyper-inflated lungs

Answer 3

Reduced tidal volume

Question 4

The patient's Wells score indicates intermediate risk for the development of pulmonary embolism.Which nursing interventions would help reduce this risk? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Monitor daily D-dimer levels.
B)Strictly measure all intake and output.
C)Encourage ambulation.
D)Instruct the patient on use of antiembolism stockings.
E)Prevention of leg injury

Question 5

The nurse is caring for a patient with obstructive pulmonary disease who had tachycardia,tachypnea,and restlessness.The patient has become very lethargic,but has a normal respiratory rate.The nurse should evaluate this change as indicating which condition?

A)The patient is now able to rest and sleep.
B)The patient's condition has significantly deteriorated.
C)The patient's condition shows some slight improvement.
D)The patient's condition has stabilized significantly.

Question 6

An older adult presents to the emergency department in septic shock.A diagnosis of pneumonia is made,antibiotics are prescribed,and the patient will be admitted to the acute care unit.When should the nurse start the prescribed intravenous antibiotic?

A)Whenever the drug is received from the pharmacy
B)After the preliminary results of the sputum specimen are obtained
C)Within 30 minutes of the order being received
D)Within 1 hour of diagnosis

Question 7

A patient had chest tube insertion for a pneumothorax.External suction was discontinued yesterday.This morning the nurse assesses tidaling in the water-seal chamber.What nursing action is indicated?

A)Collaborate with the healthcare provider regarding need to reinstitute the external suction.
B)Check the connections between the chest tube and the drainage system.
C)No action is necessary as this is an expected occurrence.
D)Have the patient cough forcefully.

Question 8

A patient with pneumonia is restless and confused with increased blood pressure and respiratory rate.PaO₂ is less than 60 mm Hg with a normal PaCO₂.What conclusion can the nurse draw regarding this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)The patient has ventilation failure.
B)Without treatment the patient's oxygen saturation is likely to drop rapidly.
C)The patient has decreased airflow.
D)The patient is at risk for respiratory muscle fatigue.
E)Acute respiratory failure is present.

Question 9

A patient diagnosed with acute respiratory distress syndrome (ARDS)is being mechanically ventilated with 12 cm of positive end-expiratory pressure (PEEP).On assessment,the nurse notes deterioration of vital signs and absent breath sounds in the right lung field.The nurse intervenes immediately due to the presence of which most likely complication?

A)Obstructed endotracheal tube
B)Increased severity of ARDS
C)Decreased cardiac output
D)Pneumothorax

Question 10

The nurse is caring for a patient who sustained a fractured femur from a motor vehicle accident 1 day ago.The patient is anxious,restless,appears short of breath,and requests pain medication for chest discomfort.Which nursing intervention is priority?

A)Administer pain medication as ordered.
B)Increase intravenous fluids.
C)Evaluate the patient's oxygen saturation.
D)Help the patient assume a more comfortable position.

Question 11

A patient tells the nurse that when he is exposed to cigarette smoke he begins to get short of breath,starts coughing,and gets a "high-pitched noise" in his lungs when he breathes.The nurse would ask additional assessment questions about which pulmonary disorder?

A)Chronic obstructive pulmonary disorder (COPD)
B)Asthma
C)Emphysema
D)Pneumonia

Question 12

A patient recovering from thoracic surgery is demonstrating evidence of impaired oxygenation and ventilation.His breathing is shallow and his oxygen saturation is dropping.Which nursing intervention is most suited to addressing this issue?

A)Teach the patient to use the incentive spirometer every 1 to 2 hours.
B)Suction as necessary.
C)Splint the chest when coughing.
D)Encourage fluids up to 2.5 liters per day.

Question 13

A patient presents to the emergency department after falling from a ladder at home.He has multiple contusions and abrasion on his right side and is holding his right arm tightly across his chest.On inspection,the nurse notes that the patient's trachea is slight displaced toward the left.Which nursing intervention is priority?

A)Have the patient release his arm and sit up straight for reassessment.
B)Notify the emergency room physician immediately.
C)Auscultate the patient's lung fields.
D)Position the patient flat in bed without a pillow.

Question 14

A patient has inability to clear thick secretions from her airway.Which nursing interventions are appropriate to address this problem? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Encourage bedrest to conserve energy.
B)Administer pain medications as needed.
C)Position the patient on the unaffected side.
D)Encourage the patient to provide as much self-care as possible.
E)Encourage slow,deep breaths.

Question 15

The nurse working in an intensive care unit is alert to the development of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS).The nurse would monitor which patients most closely for this complication? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)A patient who sustained a severe chest contusion.
B)A patient hospitalized for treatment of drug overdose.
C)A patient who sustained severe head trauma.
D)A patient hospitalized for treatment of pneumonia.
E)A patient diagnosed with sepsis.

Question 16

The nurse is preparing to participate in evaluation of the severity of a patient's community-acquired pneumonia using the CURB-65 criteria.Which information will the nurse collect for this evaluation? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)The patient's respiratory rates for the last several hours
B)BUN results
C)The patient's history of smoking,if any
D)The patient's gender
E)The patient's age

Question 17

The emergency department has treated two patients in the last day with symptoms that may be H5N1 . It is thought that H5N1 is a nonhuman virus that has crossed species.

A)The nurse manager is updating staff on the pathophysiology of this disease.The manager would evaluate education as effective if which statement was made by a staff member?
B)H5N1 is more common in patients also infected with HIV.
C)H5N1 is typically found in swine.
D)H5N1 is related to respiratory syncytial virus (RSV),so young children will be the most likely patients.

Question 18

The nurse is caring for a patient who has recently undergone major abdominal surgery.The patient is exhibiting shallow breathing and is hesitant to cough and deep breathe.How would the nurse describe the major health concern for this patient?

A)"The patient's breathing pattern is not sufficient."
B)"The patient does not have a clear airway."
C)"If the patient continues to breathe in this manner,pneumonia is a real risk."
D)"The patient is not exchanging oxygen and carbon dioxide correctly."

Question 19

The nurse is caring for a patient with a chest tube and a three-chamber disposable drainage system.The physician orders an anteroposterior (AP)chest x-ray to be done in the x-ray department.How would the nurse transport the patient?

A)Do a portable film in the patient's room instead of in the x-ray department.
B)Clamp the chest tube after full exhalation and call the department so they can be ready when you arrive.
C)Disconnect the drainage system from the wall suction and transport.
D)Clamp the chest tube after full inspiration and call the department so they can be ready when you arrive.

Question 20

A patient has been uncooperative with pulmonary hygiene following thoracic surgery because "it hurts more than I can bear." Which intervention should the nurse employ?

A)Instruct the patient to cough 3 to 4 times with each exhalation.
B)Assist the patient to a sitting position to lean over the bedside table while coughing.
C)Provide the patient with a pillow to splint the incision while coughing.
D)Guide the patient to cough with the glottis open.