Deck 21: Caring for Clients With Lower Respiratory Disorders

Question 1

The orthopedic nurse caring for a client in traction for a femur fracture knows to monitor the client for which of the following?

A) Pneumonia
B) Bed sores
C) Fat embolus
D) DVT

Answer 1

Fat embolus

Question 2

Your client has just returned from the PACU after a right lobe resection. The client has two chest tubes in place. You know that the anterior chest tube usually is placed to remove which of the following?

A) Blood
B) Pleural fluid
C) Mediasteinal fluid
D) Air

Answer 2

Air

Question 3

The local public health department is holding a flu vaccine clinic. The health department recommends flu vaccinations for healthcare workers and people at high risk for complications, or for those exposed daily to many different people. When using FluMist (live, attenuated influenza vaccine) what group is not approved?

A) Children between 6 and 12 years
B) People with hypersensitivity to milk products
C) Adolescents who regularly take aspirin
D) Adults above 70 years

Answer 3

Adolescents who regularly take aspirin

Question 4

The nurse is caring for a client who was admitted after a fall from their motorcycle. The client has a diagnosis of fractured ribs. What nursing interventions should the nurse implement for a client with fractured ribs?

A) Encourage the client to cough every 2 hours.
B) Recommend that the client expectorate.
C) Instruct the client on elastic bandage.
D) Avoid immobilizing the client.

Question 5

You are caring for a client with chronic respiratory failure. What are the signs and symptoms of chronic respiratory failure?

A) Progressive loss of lung function associated with chronic disease
B) Sudden loss of lung function associated with chronic disease
C) Progressive loss of lung function with history of normal lung function
D) Sudden loss of lung function with history of normal lung function

Question 6

The nurse is caring for a client with tuberculosis. Why should the nurse always encourage a client with tuberculosis to perform active range-of-motion (ROM) exercises three times a day?

A) For medication absorption
B) For maintaining muscle strength
C) For use as a baseline for evaluation
D) For effective pain control

Question 7

The new client on the unit was admitted with acute respiratory failure. What are the signs and symptoms of acute respiratory failure?

A) Insidious onset in client who had normal lung function
B) Sudden onset in client who had normal lung function
C) Insidious onset in client who had compromised lung function
D) Sudden onset in client who had compromised lung function

Question 8

You are preparing a client for emergency thoracic surgery. What would you document in your assessment?

A) Emergency contacts
B) IV fluids ordered
C) General statement of the client's condition
D) Detailed physical assessment

Question 9

You are a clinic nurse caring for a client with acute bronchitis. The client asks what may have caused the infection. What may induce acute bronchitis?

A) Aspiration
B) Drug ingestion
C) Chemical irritation
D) Direct lung damage

Question 10

You are caring for a client with obstructive pulmonary disease. Your nursing care includes diagnoses, outcomes, and interventions for what?

A) Pain
B) Atelectasis
C) Activity intolerance
D) Side effects of medication therapy

Question 11

The ICU nurse caring for a 2-year-old near drowning victim monitors for what possible complication?

A) Atelectasis
B) Adult respiratory distress syndrome
C) Metabolic alkalosis
D) Respiratory acidosis

Question 12

You are an ICU nurse caring for a client who was admitted with a diagnosis of smoke inhalation. You know that this client is at increased risk for which of the following?

A) Acute respiratory distress syndrome
B) Lung cancer
C) Bronchitis
D) Tracheobronchitis

Question 13

You are caring for a client with secondary pulmonary hypertension. What assessment finding would you expect?

A) Shock
B) Orthopnea
C) Lung tissue infarction
D) Restlessness

Question 14

You are caring for a client status post lung resection. When assessing your client you find that the bubbling in the water-seal chamber for the chest tubes is more than you expected. What should you check when bubbling in the water-seal chamber is excessive?

A) See if the chest tube is clogged.
B) See if the wall suction unit has malfunctioned.
C) See if a kink has developed in the tubing.
D) See if there are leaks in the system.

Question 15

The nursing instructor is talking with the junior class of nursing students about lung cancer. What would be the best rationale the instructor could give for the difficulty of early diagnosis of lung cancer?

A) Symptoms are often minimized by clients.
B) There are no early symptoms of lung cancer.
C) Symptoms often mimic other infectious diseases.
D) Symptoms often do not appear until the disease is well established.

Question 16

You are caring for a client who has just been diagnosed with lung cancer. What is a cardinal sign of lung cancer?

A) Mucopurulent sputum
B) Pain on inspiration
C) Obvious trauma
D) Shortness of breath

Question 17

You are assessing a client's potential for pulmonary emboli. What finding indicates possible deep vein thrombosis?

A) Pain in the feet
B) Inability to dorsiflex
C) Negative Homan's sign
D) Pain in the calf

Question 18

What are the conditions that make up Virchow's triad? Select all that apply.

A) Hypercoagulability
B) Disruption of the vessel lining
C) Hypocoagulability
D) Edema
E) Venostasis

Question 19

You are an occupational nurse completing routine assessments on the employees where you work. What might be revealed by a chest radiograph for a client with occupational lung diseases?

A) Fibrotic changes in lungs
B) Hemorrhage
C) Lung contusion
D) Damage to surrounding tissues

Question 20

What is the reason for chest tubes after thoracic surgery?

A) Draining secretions, air, and blood from the thoracic cavity is necessary.
B) Chest tubes allow air into the pleural space.
C) Chest tubes indicate when the lungs have re-expanded by ceasing to bubble.
D) Draining secretions and blood while allowing air to remain in the thoracic cavity is necessary.

Question 21

The nurse is assessing a client with chest tubes and notes a leak in the system. What is the nurse's first action?

A) Set up a new water-seal system.
B) Replace the chest tube.
C) Notify the physician.
D) Clamp the chest tube with hemostats.

Question 22

The nursing instructor is discussing pulmonary arterial hypertension with the nursing students. What would the instructor describe as the pathophysiology of secondary pulmonary arterial hypertension?

A) Bronchial thickening causes increased resistance and pressure in the pulmonary vascular bed.
B) Chronic lung disease causes scaring in the bronchioles raising pressure in the pulmonary vascular bed.
C) Left-sided heart failure causes increased resistance and pressure in the pulmonary vascular bed.
D) Alveolar destruction causes increased resistance and pressure in the pulmonary vascular bed.

Question 23

The clinic nurse is caring for a client who has just been diagnosed with chronic obstructive pulmonary disease (COPD). The client asks the nurse what COPD means. What would be the nurse's best response?

A) "It is an umbrella term for diseases like acute bronchitis."
B) "It means that the lungs have been damaged in such a way that there is limited airflow in and out of the lungs."
C) "It means your lungs can't expand and contract like they are supposed to which makes it hard for you to breathe."
D) "It is a term that covers so many lung diseases I can't list them all."

Question 24

You are an occupational health nurse in a large ceramic manufacturing company. How would you intervene to prevent occupational lung disease in the employees of the company?

A) Fit all employees with protective masks.
B) Insist on adequate breaks for each employee.
C) Give workshops on disease prevention.
D) Provide employees with smoking cessation materials.

Question 25

You are caring for a client who has been diagnosed with viral pneumonia. You are making a plan of care for this client. What nursing interventions would you put into the plan of care for a client with pneumonia?

A) Give antibiotics as ordered.
B) Place client on bed rest.
C) Encourage increased fluid intake.
D) Offer nutritious snacks 2 times a day.