Deck 28: Respiratory Care

Question 1

A nurse is caring for a client with a high blood level of carbon dioxide.Which response by the body's respiratory system will the nurse expect?

A)The breathing rate increases.
B)The breathing rate slows.
C)The breathing rate will not be affected.
D)The breathing stops.

Answer 1

The breathing rate increases.

Question 2

The nurse is providing care for a client who is experiencing severely compromised respiratory function.The physician has ordered the placement of an artificial airway.The client is awake and aware.Which type of airway is least expected by the nurse for this client?

A)Tracheostomy
B)Nasal trumpet
C)Oropharyngeal airway
D)Endotracheal tube

Answer 2

Oropharyngeal airway

Question 3

The nurse notes a new order for collection of a sputum specimen for culture from an older adult client.Which is the most appropriate action by the nurse?

A)Place a clean cup at the client's bedside with instructions to spit into it when available.
B)Contact respiratory therapy to provide a treatment that will induce sputum collection.
C)Explain the order to the client and plan sputum collection for the following morning.
D)Encourage the client to increase fluid intake so that sputum can be more readily collected.

Answer 3

Explain the order to the client and plan sputum collection for the following morning.

Question 4

The nurse is caring for a client with a chest tube.Upon assessment, the nurse notes the presence of crepitus at the chest tube site, extending across the chest about three inches.Which action by the nurse is immediate?

A)Mark the area and continue to monitor.
B)Document the assessment finding.
C)Report the condition to the physician.
D)Check for other signs of infection.

Question 5

Which of the following mechanisms results in inhalation?

A)The intercostal muscles relax.
B)The ribs move inward.
C)The diaphragm contracts.
D)Pressure within the lungs raises above atmospheric pressure.

Question 6

The nurse working in a pediatrician's office is preparing to do a throat culture for a preschool-aged client being seen for a sore throat.The parent asks, "Why is this test necessary?" Which reply will the nurse make to the parent?

A)"It is important to identify and treat a Streptococcus infection quickly to prevent major illness."
B)"We are attempting to test every sick child for the possibility of whooping cough."
C)"Doctors need to cut the number of antibiotics ordered because the insurance companies won't pay for them."
D)"Throat cultures are always performed on clients with sore throats and intense coughing."

Question 7

The nurse is caring for a client with chronic obstructive pulmonary disease (COPD).The client tells the nurse they feel short of breath and are having difficulty breathing.Which supplemental oxygen is correct for this client?

A)2 L/min
B)3 L/min
C)4 L/min
D)5 L/min

Question 8

The nurse is providing care to a client who is comatose and is on ventilator support, which has been provided for two weeks.Which change does the nurse expect the client's physician to order?

A)Insertion of an endotracheal tube
B)Placement of a chest tube
C)Switch to an oropharyngeal airway
D)Performance of a tracheostomy

Question 9

A nurse is caring for a client with compromised respiratory function.The client has a productive cough, and sputum appears frothy and pink-tinged.Which conclusion by the nurse causes the greatest concern?

A)The client has pneumonia or other infection.
B)The client has life-threatening pulmonary edema.
C)The client has lung injury related to fire and smoke.
D)The client has a lung infection from a bacterial pathogen.

Question 10

The nurse enters the room of a client who is taking a nebulizer treatment set up by the respiratory therapist.Which observation by the nurse would be cause for intervening with the treatment?

A)The client is breathing in and out through the nose.
B)Mist is coming out of the end of the nebulizer hose.
C)The nebulizer is connected to compressor tubing.
D)Liquid is seen in the nebulizer cup.

Question 11

A nurse is caring for a number of clients on a medical unit.Which client will the nurse identify as the highest priority?

A)A young-adult client with pneumonia who is restless and confused
B)A middle-age client with a chest tube who has noticeable tidaling
C)An adult client with chronic obstructive pulmonary disease and a nonproductive cough
D)An older-adult client with pneumonia expectorating rust-colored sputum

Question 12

The nurse is providing discharge teaching to a client with COPD who is being discharged on supplemental oxygen for home use.Which information should the nurse exclude from the client teaching?

A)Wear natural fiber clothing in order to reduce the possibility of static electricity.
B)Avoid the use of petroleum products for grooming and skin maintenance.
C)Turn up the oxygen flow rate at night to avoid shortness of breath during sleep.
D)Have electrical items used for grooming checked to rule out shorts and sparking.

Question 13

The nurse is providing care to a client who had cardiothoracic surgery.The client now has two chest tubes in the left chest connected by Y tubing.A family member asks why the lower chest tube has a great deal of drainage while the upper chest tube has minimal drainage.Which is the correct response by the nurse?

A)"The upper chest tube is draining air from the chest while the lower one drains fluids."
B)"The upper chest tube is there in case the fluid accumulates near the level of the heart."
C)"The upper chest tube is placed to suction off fluid that is displaced with movement."
D)"The upper chest tube is placed to suction off drainage that can occur with infection."

Question 14

The nurse is providing care for a client who becomes short of breath when ambulating to the bathroom.Which documentation should the nurse enter on the client's medical record?

A)Cyanotic with ambulation
B)Dyspnea noted after walking 15 feet
C)Client states inability to walk to the bathroom
D)Hypoxemia present after walking to the bathroom

Question 15

The nurse is providing care for a client diagnosed with chronic obstructive pulmonary disease (COPD).The nurse applies knowledge of anatomy and physiology to understand the client's condition.Which physiological function does the nurse recognize as being defective in a client with COPD?

A)Internal respiration
B)External respiration
C)Inspiration
D)Excursion

Question 16

Which of the following pH values indicates the presence of alkalosis?

A)7.28
B)7.32
C)7.40
D)7.47

Question 17

The LPN/LVN is reinforcing instructions to a client for the use of an incentive spirometer.Which statement by the client will prompt the LPN/LVN to notify the RN that additional teaching is necessary?

A)"I was able to raise the ball up to the marked level today."
B)"I blow into the mouthpiece 10 times a day just as instructed."
C)"I've been using the incentive spirometer every hour."
D)"I feel so tired when I finish using the incentive spirometer."

Question 18

While caring for a client with pneumonia, the nurse notes that the client is having difficulty expectorating thick, rust-colored sputum.Which nursing intervention is the priority?

A)Encourage the use of the incentive spirometer.
B)Provide pain medication as ordered.
C)Provide a bedside commode.
D)Encourage increased fluid intake.

Question 19

A client is connected to a chest tube drainage system.The physician has prescribed suction that will gently drain the client's pleural space.The nurse is aware that which factor controls the amount of suction in the system?

A)The dial setting on the wall suction
B)The amount of water placed in chamber one
C)The negative pressure in chamber two
D)The amount of drainage in chamber three

Question 20

The RN is observing a LPN/LVN perform open tracheostomy suctioning.The RN would stop the LPN/LVN if which behavior is observed?

A)The LPN/LVN dons sterile gloves before touching the suction catheter.
B)The LPN/LVN suctions the client's mouth and then the tracheostomy with the same catheter.
C)The LPN/LVN discards the suction catheter and other supplies into the client's bedside biohazard trashcan.
D)The LPN/LVN lubricates the suction catheter with sterile normal saline.

Question 21

The home-care nurse is visiting a client diagnosed with chronic obstructive pulmonary disease (COPD).The client is routinely cared for by the client's spouse, who states, "It takes forever to do all the morning care." Which suggestion will the nurse make to the spouse?

A)Routine morning care can be skipped several times a week.
B)Inquire if the client has enough energy for morning care.
C)Perform all care at once and then let the client rest quietly.
D)Decide if some care activities can be done later in the day.

Question 22

The nurse is providing care for a client after abdominal surgery.Which interventions should the nurse include in the client's plan of care to help prevent respiratory complications? Select all that apply.

A)Schedule for the client to be turned every 4 to 6 hours.
B)Encourage the client to use the incentive spirometer.
C)Closely monitor the client's oral fluid intake every shift.
D)Assist the client to provide a sputum specimen for culture.
E)Teach the client to cough and deep breathe with a pillow splint

Question 23

Which assessment activities should the nurse include when performing a respiratory assessment on a client admitted with a diagnosis of bilateral pneumonia? Select all that apply.

A)Pulse rate
B)Use of accessory muscles
C)Skin color
D)Respiratory rate
E)Cough

Question 24

The nurse is preparing for a client with severe chronic obstructive pulmonary disease (COPD)to be discharged home.Which discharge teaching is important for the nurse to provide? Select all that apply.

A)The safety reasons why the client will need a shower chair
B)The importance for alternating activity with rest periods
C)The reason the client will need a diet high in carbohydrates
D)The rationale for the client to eat small, frequent meals
E)The symptoms that will require the client to contact the physician