Deck 11: Determinants and Assessment of Pulmonary Function

Question 1

A postoperative patient's nasogastric drainage has been 500 mL in the last 8 hours.The nurse would assess this patient for findings associated with which acid-base imbalance?

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

Answer 1

Metabolic alkalosis

Question 2

The nurse is assessing an 80-year-old patient who has no underlying respiratory pathology but whose carbon dioxide level is slightly elevated.The nurse would contribute this increase to which changes associated with normal aging? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Alveolar-capillary membrane thinning
B)Increase in total lung surface area
C)Increase in size of the airways
D)Increase in air trapping
E)Overgrowth of alveoli

Answer 2

Increase in size of the airways
Increase in air trapping

Question 3

A patient with pulmonary edema has a respiratory rate of 28 per minute.The nurse plans care for this patient based on which change in the lungs?

A)Decreased work of breathing
B)Reduced muscle activity
C)Dehydration of lung tissues
D)Decreased compliance

Answer 3

Decreased compliance

Question 4

A patient's PaO₂ is 88 mm Hg while on FiO₂ of 0.50.What can the nurse conclude about this patient's intrapulmonary shunt? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)The shunt is estimated to be 176.
B)The shunt is estimated to be 568.
C)The shunt is below the minimum acceptable level.
D)This data has little use in determining oxygenation status of the patient who is retaining CO₂.
E)No determination of intrapulmonary shunt can be made from this data.

Question 5

A 40-year-old postoperative patient has a hemoglobin level of 8 g/dL and an SaO₂ of 95%.Considering all aspects,what conclusion would the nurse make about this patient's condition?

A)The patient is stable and at no special risk.
B)Oxygenation is adequate for a postoperative patient.
C)This patient has a potential risk of hypoxia.
D)The patient's SaO₂ is higher than expected for the patient's age.

Question 6

The patient has been diagnosed with early stage pneumonia.The nurse would anticipate which laboratory results?

A)Increased PaO₂ and increased PaCO₂
B)Decreased PaO₂ and normal PaCO₂
C)Normal PaO₂ and elevated PaCO₂
D)Decreased PaO₂ and increased PaCO₂

Question 7

A patient's PaO₂ level is 76 mm Hg.The nurse would be least concerned regarding this finding in which patient?

A)The patient is 83 years old.
B)The patient is recovering from anesthesia.
C)The patient is a smoker.
D)The patient is intubated.

Question 8

A patient with severe chronic respiratory illness suddenly develops a high fever.The nurse would plan care for this patient based on which understanding of the fever's impact on the oxyhemoglobin dissociation curve? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)The curve will shift to the right.
B)Additional oxygen will be released to the tissues.
C)Life-threatening tissue hypoxia may occur.
D)The change will be similar to what occurs with alkalosis.
E)Hemoglobin will bind more readily to oxygen.

Question 9

The nurse is assessing a patient with an endotracheal tube and notes decreased breath sounds on the left with normal sounds on the right.Which condition may cause this? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Pressure from a right pneumothorax
B)Misplacement of the endotracheal tube
C)High pulmonary pressures
D)Partial obstruction of the endotracheal tube
E)A large infiltrate in the left lung

Question 10

The patient complains that he awakens "two or three" times every night because he is so short of breath.The nurse would ask additional assessment questions about which condition?

A)Paroxysmal nocturnal dyspnea
B)Pneumonia
C)Stroke
D)Kidney infection

Question 11

The nurse is auscultating a patient's lung fields and hears a coarse sound like bubbling water.The sounds are heard best on expiration and in the center of the patient's chest.How should the nurse document these sounds?

A)Crackles
B)Rhonchi
C)Wheeze
D)Stridor

Question 12

A patient is undergoing testing to differentiate her airway disorder as being restrictive or obstructive.The nurse would evaluate a normal result on which test to indicate a restrictive disorder is present?

A)Vital capacity
B)Tidal volume
C)Minute ventilation
D)Forced expiratory volume

Question 13

A nurse is participating on a committee charged with the task of choosing capnography equipment for a new emergency department (ED).The nurse should present which information regarding these choices? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Sidestream analyzers provide direct real-time measurements of ETCO₂.
B)Mainstream analyzers require the patient to be intubated.
C)Colorimetric capnography is useful for determining accurate placement of endotracheal tubes.
D)Mainstream analyzers provide continuous ETCO₂ measurements.
E)Colorimetric measurement provides a wide range of color results that are compared to a standard chart.

Question 14

A patient's arterial blood gases (ABGs)are as follows: pH 7.30,PaCO₂ 30 mm Hg,HCO₃ 14 mEq/L,and PaO₂ 50.The nurse evaluates these ABGs as representing which acid-base imbalance?

A)Uncompensated respiratory alkalosis with moderate hypoxemia
B)Compensated metabolic acidosis with severe hypoxemia
C)Partially compensated metabolic acidosis with moderate hypoxemia
D)Partially compensated respiratory alkalosis with mild hypoxemia

Question 15

The nurse is assessing the nutritional intake of a patient diagnosed with chronic carbon dioxide retention.Which patient report indicates the patient requires additional information about dietary choices?

A)"I try to eat salad with lunch every day."
B)"I drink a cup of coffee in the morning with breakfast."
C)"I usually eat a sandwich and pasta salad for lunch."
D)"I have been trying to increase the protein in my diet."

Question 16

The arterial blood gases of a patient with a large mass in the right lung show increasing hypoxemia and the patient will be intubated for placement on a mechanical ventilator.In which position should the nurse place this patient until intubation is begun?

A)Flat in bed lying on the left side
B)Flat in bed lying on the right side
C)Lying on the left side with the head of the bed elevated to 30 degrees
D)Lying on the right side with the head of the bed elevated 30 degrees

Question 17

The nurse is planning to use a respiratory spirometer to measure the amount of air that moves in and out of a patient's lungs with each normal breath.How will the nurse document the results of this test?

A)Tidal volume
B)Vital capacity
C)Forced expiratory volume
D)Minute ventilation

Question 18

A patient,diagnosed with diabetic ketoacidosis,presents with Kussmaul respirations at a rate of 28.A newly licensed nurse asks the patient to try to slow his breathing.What instruction should the preceptor provide?

A)"Keep trying to slow the patient's respirations because breathing so fast is hard on his heart."
B)"If he keeps breathing like that he will develop respiratory acidosis."
C)"Let the patient set his respiratory rate as rapid breathing helps to compensate for his acidosis."
D)"The patient is breathing deeply to help offset diabetes-induced hypoxemia."

Question 19

A nurse who is evaluating a patient's arterial blood gases (ABGs)has determined that the patient's pH is acidic.What is the next question the nurse would ask in this interpretation?

A)Is the patient symptomatic of an acidic condition?
B)Which individual ABG component matches the pH acid-base state?
C)Is the PaCO₂ within normal range?
D)Is the acidosis compensated or uncompensated?

Question 20

A patient was extubated in the postanesthesia recovery room prior to transfer to the intensive care unit (ICU).Upon admission to the ICU the patient is sedated,but will arouse when stimulated.Blood pressure is 106/68 mm/Hg,heart rate is 68 and regular,temperature is 97.8°F,and respirations are 12 bpm.The nurse would monitor this patient for which changes in arterial blood gases?

A)Increase in pH and decrease in PaCO₂
B)Increase in pH and increase in HCO₃
C)Decrease in pH and increase in PaCO₂
D)Decrease in pH and decrease in HCO₃