Deck 9: Airway and Breathing

Question 1

For optimal respiratory function after surgery, what action by the nurse is best?

A) Teach the client pulmonary hygiene measures.
B) Adequately treat the client's pain.
C) Instruct the client on the incentive spirometer.
D) Ambulate the client four times a day.

Answer 1

Adequately treat the client's pain.

Question 2

The nurse has taught a preoperative client about deep breathing plus coughing, and incentive spirometry. The client asks why both activities are needed. What response by the nurse is best?

A) "They really work best when done together."
B) "The incentive spirometer will make you cough."
C) "This is the standard for postoperative clients."
D) "You have the right to refuse doing either one."

Answer 2

"They really work best when done together."

Question 3

A client who just had abdominal surgery does not want to participate in coughing and deep breathing exercises. What response by the nurse is best?

A) Re-educate the client on how to perform coughing and deep breathing exercises.
B) Tell the client he/she can just ambulate instead of coughing and deep breathing.
C) Assess the client for pain, then explain the importance of these activities.
D) Have the client use the spirometer 5 times an hour instead of coughing and deep breathing.

Answer 3

Assess the client for pain, then explain the importance of these activities.

Question 4

The nurse needs to provide percussion and postural drainage on a client who has a tube feeding. What action by the nurse is best?

A) Turn the feeding off during the procedure.
B) Skip drainage position for anterior basal lung segments.
C) Turn the feeding off 30 minutes prior to the procedure.
D) Skip drainage position for lateral basal lung segments.

Question 5

A nurse is working with a patient getting humidified oxygen via nasal cannula. What action by the nurse is most appropriate?

A) Refills the water reservoir with cool tap water promptly when empty.
B) Adjusts the oxygen flowmeter to between 6 and 8 L/minute.
C) Checks the skin integrity behind the client's ears.
D) Holds the client's mucolytic medication while getting humidity.

Question 6

Which statement about using a simple face mask to deliver oxygen does the nurse recognize is true?

A) It can deliver the highest rates of oxygen
B) It has built-in humidification
C) The client can also inhale room air
D) It does not require high-flow oxygen

Question 7

A client with COPD needs an oxygen delivery system that is rapidly adjustable and can deliver a moderate range of oxygen. Which system does the nurse choose?

A) Venturi mask
B) Simple face mask
C) Non-rebreather mask
D) Face tent

Question 8

The nurse educating a client on the use of a CPAP to control obstructive sleep apnea is aware that which factor may reduce compliance with the device?

A) Need to wear at least 12 hours a day for effectiveness
B) May cause the client to feel claustrophobic
C) Only comes with a mask which interferes with prone sleeping
D) Must be attached to oxygen, adding to the expense

Question 9

A client on oxygen is leaving the floor for diagnostic testing. What action by the nurse is most appropriate?

A) Removes oxygen if client's oxygen saturation is >94%
B) Calls the receiving department requesting bedside testing
C) Removes the oxygen and instructs the receiving department to restart it there
D) Ensures there is more than 500 psi oxygen in the portable cylinder

Question 10

A student is caring for a client on oxygen. What action by the student demonstrates the need for further education?

A) Moistens the client's lips with a petroleum-based product
B) Places the oxygen device on the client after setting the flow rate
C) Educates the family not to smoke in the room
D) Listens for hissing at the oxygen wall outlet

Question 11

A nurse has placed a client on oxygen via a non-rebreather mask. Before leaving the room, what action by the nurse is most appropriate?

A) Ensures the flowmeter is not set above 6 L/minute
B) Determines that the reservoir bag is fully inflated
C) Double checks that all entry/exit holes on the mask are closed
D) Checks the level of water in the humidification reservoir

Question 12

The student is providing interventions to maintain an open airway in four clients during a simulation. What action by the student requires remediation by the faculty?

A) Chooses an oropharyngeal airway on an awake client
B) Suctions the client through a nasopharyngeal airway
C) Only suctions the client when needed, not on a schedule
D) Educates a client about a tracheostomy after 7 days of mechanical ventilation

Question 13

The nurse is suctioning a client who has a new tracheostomy and notes the secretions to be bloody. What action by the nurse is most appropriate?

A) Documents the findings in the client's chart
B) Applies more lubricant to the suction catheter
C) Turns the suction down to 60 mm Hg
D) Notifies the surgeon immediately

Question 14

The nurse is performing tracheostomy care. What action by the nurse is inconsistent with best practice?

A) Keeps oxygen source running close to the client's stoma
B) Scrubs the inner cannula clean with the supplied brush
C) Carefully cuts a slit in a gauze dressing to fit under the flange
D) Shakes off excess saline from inner cannula before reinserting

Question 15

The client is prescribed 36% oxygen per nasal cannula. At what flow rate does the nurse set the flowmeter?

A) 2 liters/minute
B) 3 liters/minute
C) 4 liters/minute
D) 5 liters/minute

Question 16

A student is reviewing pulmonary anatomy and physiology. What statement by the student indicates the need to study more?

A) Oxygen diffuses passively from the alveoli to the pulmonary capillaries.
B) To have adequate oxygenation, a person must have adequate hemoglobin.
C) Alveoli can collapse and recover without causing problems.
D) The byproducts of cellular respiration include carbon dioxide and water.

Question 17

Which client type is most at risk for a pulmonary problem?

A) Postoperative
B) Postpartum
C) Malnourished
D) Elderly

Question 18

Which laboratory value, if abnormal, would impact respiratory function the most?

A) White blood cell count
B) Potassium level
C) Red blood cell count
D) Oxygen saturation

Question 19

Which of the following terms are matched to their correct definition? (Select all that apply.)

A) Atelectasis: Collapsed alveoli leading to loss of lung volume
B) Consolidation: Taking many things and combining them into one
C) Expectorate: To spit out mucus and phlegm
D) Tidal volume: The amount of fluid in the water seal chamber of a chest tube
E) Vital capacity: Greatest volume of air that can be exhaled after maximal inhalation

Question 20

Which actions by the nurse will help thin secretions so they can be mobilized? (Select all that apply.)

A) Provide adequate hydration.
B) Administer humidified air or oxygen.
C) Manage the patient's pain.
D) Encourage use of the incentive spirometer.
E) Administer appropriate medications.

Question 21

A nurse who has not practiced in several years has returned to work. When suctioning a client, the nurse instills saline into the client's tracheostomy to "thin the secretions." What statements by the precepting nurse are most appropriate? (Select all that apply.)

A) "Saline in the tracheostomy does not thin the secretions."
B) "That seems to be a good idea. I will check it out."
C) "Instilling saline in the tracheostomy increases infection risk."
D) "The research shows that doesn't hurt or help the situation."
E) "Adding saline before suctioning causes pain and anxiety."

Question 22

The nurse who works with clients receiving oxygen understands which principles when working with the high-pressure cylinders? (Select all that apply.)

A) Keep cylinders stored in designated stands.
B) Turn flowmeters off when cylinder is not in use.
C) Carry the cylinder carefully to where it is needed.
D) Let the flowmeter to blow off extra oxygen after use.
E) Determine how much oxygen is left in the cylinder before use.

Question 23

A nurse is suctioning a client through a tracheostomy. Which actions by the nurse are appropriate? (Select all that apply.)

A) Gather all equipment and create a clean field to work from.
B) Use the nondominant hand to control the suction port.
C) Apply suction during insertion of the catheter.
D) Rotate the catheter during removal.
E) Assess the client's oxygenation status before and after suctioning.

Question 24

A nurse is preparing to receive a client from the Post Anesthesia Care Unit after having a tracheostomy placed. What equipment should the nurse ensure is at the bedside? (Select all that apply.)

A) Suction canister and tubing
B) New tracheostomy tube
C) Tracheostomy tube 1 size smaller
D) Obturator from the tracheostomy kit used
E) Simple face mask

Question 25

Which of the following clients does the nurse recognize as being good candidates for percussion and postural drainage? (Select all that apply.)

A) Pneumonia
B) Cystic fibrosis
C) Bronchiectasis
D) COPD
E) On mechanical ventilation

Question 26

The faculty observes a student working on pulmonary hygiene with a postoperative client. What actions by the student demonstrate good knowledge of this procedure? (Select all that apply.)

A) Has the client use the spirometer 10 times every hour while awake
B) Holds the spirometer for a client who has severe arthritis in the hands
C) Instructs the client to hold the inspiration for 3 to 5 seconds
D) Has the client do spirometry along with coughing
E) Suctions the client's oropharynx after using the spirometer