Deck 28: Respiratory Care

Question 1

Which type of airway would not be used on a conscious patient?

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

Answer 1

Oropharyngeal airway

Question 2

An instructor explains that the alveoli are air sacs encircled by tiny capillaries and that oxygen moves via diffusion from an area of higher concentration to an area of lower concentration. A student identifies this process as

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

Answer 2

External respiration.

Question 3

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.

Answer 3

The diaphragm contracts.

Question 4

A student nurse is providing care for a patient who becomes short of breath while ambulating to the bathroom. The best way for the student to document this finding is to write:

A) "Patient cyanotic with ambulation."
B) "Dyspnea noted after walking 15 feet."
C) "Patient complains that he can't catch his breath."
D) "Hypoxemia present after walking to the bathroom."

Question 5

A nurse enters a room and notes that a patient has a very productive cough. The nurse would be most concerned about a life-threatening situation if the sputum looks

A) Greenish yellow.
B) Frothy and pink-tinged.
C) Thick and white.
D) Rusty in color.

Question 6

A student nurse is observing care given to a patient who had cardiothoracic surgery and who now has two chest tubes in the left chest connected by Y tubing. One of the patient's family members asks why the lower chest tube has a great deal of drainage while the upper chest tube has minimal drainage. The best response by the student nurse is:

A) "The upper chest tube is being used to drain air from the chest while the lower one drains blood and fluid."
B) "The upper chest tube is there in case the fluid accumulates near the level of the heart."
C) "The lower chest tube serves as the first drainage system, and if it fills up, the upper tube will begin to drain."
D) "How much drainage is seen in each tube really depends on the type of surgery done. Sometimes the upper one drains more than it does for this case."

Question 7

A nurse notes a new order for sputum specimen for culture to be collected on a 91-year-old. The patient has a weak cough. The best action by the nurse is to

A) Place a clean cup at the patient's bedside and instruct him or her to spit into it whenever he or she is able.
B) Contact respiratory therapy to induce sputum collection.
C) Explain the order to the patient and plan sputum collection for the following morning.
D) Encourage the patient to limit fluid intake so that sputum can be more readily collected.

Question 8

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

A) 7.28
B) 7.34
C) 7.43
D) 7.47

Question 9

While preparing to feed a patient with a tracheostomy tube connected to mechanical ventilation, a nurse notes that the cuff is deflated. Which of the following actions should the nurse take first?

A) No action is required.
B) The nurse should check the most recent ABG (arterial blood gas) results.
C) The nurse should inflate the cuff.
D) The nurse should listen to breath sounds.

Question 10

A nurse is reinforcing instructions to use the incentive spirometer. Further teaching is necessary if the patient states:

A) "I was able to get the ball up to the marked level today."
B) "I blew into that thing 10 times a little while ago."
C) "I've been using the incentive spirometer every hour."
D) "I feel so tired when I finish using the incentive spirometer."

Question 11

A nurse is caring for a patient with a tracheostomy collar who has a weak cough and has rattling sounds in her throat. The best action by the nurse is to

A) Reduce the humidity of the oxygen.
B) Replace the obturator.
C) Remove the outer cannula.
D) Suction the patient.

Question 12

A nurse is caring for a number of patients on a medical unit. The patient of the highest priority is

A) A 22-year-old with pneumonia who is restless and confused.
B) A 41-year-old with a chest tube who has noted tidaling.
C) A 58-year-old with chronic obstructive pulmonary disease with a nonproductive cough.
D) A 72-year-old with pneumonia who has rusty-colored sputum.

Question 13

While observing a student nurse perform open tracheostomy suctioning, a nurse recognizes that further instruction is required if

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

Question 14

A nurse is caring for a patient with a chest tube who has notable crepitus at the chest tube site, extending across the chest about 3 inches. The best statement the nurse can make is:

A) "Don't worry. That happens with a lot of chest tubes. We'll simply mark this and keep an eye on it."
B) "That is a local swelling caused by the trauma of having the tube placed. It will go down a few days after the tube comes out."
C) "There are some new, small pockets of air under your skin that I'd like to have the doctor examine."
D) "You may be developing an infection. I'd like to check your temperature and change the chest tube dressing so that I can see the site."

Question 15

A nurse is caring for a patient with a pneumothorax and a newly placed right-sided anterior chest tube connected to dry suction. The nurse notes bubbles in the middle chamber. What should the nurse should conclude?

A) This is expected with a pneumothorax and will not be seen once the pneumothorax has resolved.
B) This indicates an air leak; the nurse should examine and secure all connections with tape.
C) This indicates a malfunction in the suction setup; the nurse should stop the suction and notify the physician.
D) This is expected with all chest tubes and indicates that the suction is functioning properly.

Question 16

A nurse working in a pediatrician's office is preparing to do a throat culture for a 5-year-old. The child's parent asks, "Why do we have to do this?" The best statement the nurse could make to the child's parent is:

A) "It is important to identify and treat a Streptococcus infection quickly to prevent major illness."
B) "We need to test every sick child for whooping cough."
C) "Doctors have really cut down on how many antibiotics are given because the insurance companies won't pay for them."
D) "Throat cultures are primarily used to test children for the mumps."

Question 17

A nurse is caring for an African American individual with a long history of lung disease. The nurse would be most concerned if

A) The patient's respiratory rate is
B) The patient's oxygen saturation was 96%.
22)
C) The patient's skin is warm and moist.
D) The patient's mucous membranes are ashen.

Question 18

While caring for a patient with pneumonia, a nurse notes that the patient's sputum is greenish and very thick. The highest priority in the patient's plan of care is to

A) Encourage the use of the incentive spirometer.
B) Provide pain medication every 4 hours as ordered.
C) Provide a bedside commode.
D) Encourage the patient to increase oral intake.

Question 19

A nurse is caring for a patient with a high blood level of carbon dioxide. The nurse would expect which of the following responses by the body's respiratory system?

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

Question 20

A nurse enters the room of a patient who is taking a nebulizer treatment set up by the respiratory therapist. The nurse should intervene if

A) The patient 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 21

A patient is connected to a chest drainage system. When wet suction is required to gently drain the patient's pleural space, a nurse identifies that the amount of suction in the system is controlled by

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 22

A nurse is providing care for a patient after abdominal surgery. To help prevent respiratory complications, the plan of care should include which of the following?

A) Turning the patient every 4 to 6 hours
B) Encouraging the use of the incentive spirometer
C) Encouraging oral intake
D) Dressing changes every shift
E) Encouraging the patient to hold a pillow against the incision while taking deep breaths and coughing

Question 23

Which of the following should be included in the plan of care for a client with severe chronic obstructive pulmonary disease (COPD) who is being seen by home health care?

A) Obtain shower chair.
B) Teach patient to alternate activity with rest periods.
C) Provide diet high in carbohydrates.
D) Encourage small, frequent meals.
E) Assess the use of accessory muscles with respiratory effort.

Question 24

When performing a respiratory assessment, a nurse should include which of the following?

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

Question 25

A nurse notes an order for O₂ 2 L NC. Which of the following supplies should the nurse gather?

A) Bottle of saline for humidification
B) Oxygen tubing with nasal cannula
C) Flowmeter
D) Mask setup
E) Suction catheter

Question 26

A nurse is caring for a patient with chronic obstructive lung disease who is having difficulty breathing. The nurse should provide this patient with routine supplemental oxygen at

A) 2 to 3 L/min.
B) 3 to 4 L/min.
C) 4 to 5 L/min.
D) 5 to 6 L/min.

Question 27

A patient is showing changes in mental function, skin and mucous membrane color, and respiratory rate and rhythm. A nurse identifies this impaired oxygenation condition as

A) Atelectasis.
B) Hypoxia.
C) Crepitus.
D) Diffusion.

Question 28

A nurse needs to suction the mouth of a patient with a pharyngeal airway in place. To prevent damage to the catheter from the patient biting down on the tube, the nurse should choose a Yankauer suction catheter, also known as a(n) ____________________ suction tube.

Question 29

A patient with chronic obstructive pulmonary disease (COPD) requires a precise mix of room air and oxygen to equal a specific percentage of oxygen. The nurse identifies that the correct oxygen delivery device for this patient is a

A) Non-rebreathing mask.
B) Venturi mask.
C) Nasal cannula.
D) Simple face mask.

Question 30

A patient with cancerous tumors in the laryngeal area will need to be placed on longer-term ventilator support. The nurse identifies that this patient will require a(n)

A) Endotracheal tube.
B) Chest tube.
C) Oropharyngeal airway.
D) Tracheostomy.

Question 31

An instructor explains that when fresh oxygen enters the bloodstream, it is carried by the hemoglobin on the red blood cells through the arteries and arterioles to the capillaries. A student recognizes that this process that occurs between the bloodstream and the body cells is called

A) Internal respiration.
B) Diffusion.
C) External respiration.
D) Expiration.

Question 32

A patient with chronic obstructive pulmonary disease and pneumonia is suffering from ineffective airway clearance related to secretions in the airways as evidenced by ineffective cough and adventitious breath sounds. The first intervention in a nurse's care plan should be to

A) Increase the patient's supplemental oxygen to 5 L per nasal cannula.
B) Encourage the patient to increase fluid intake to help thin his or her mucus.
C) Decrease the patient's activities that require the use of accessory muscles.
D) Increase the patient's carbohydrate intake to improve his or her strength.

Question 33

A patient with chronic obstructive pulmonary disease with full mobility requires a source of oxygen that is lightweight and easy to carry with a shoulder strap. The nurse suggests

A) An oxygen concentrator.
B) An oxygen tank.
C) An oxygen E-cylinder.
D) Liquid oxygen.

Question 34

Trace the normal airway into the body by placing the following anatomical structures in sequential order (1-6). (Enter the number of each step in the proper sequence, do not use commas).
1. Alveoli
2. Pharynx
3. Left bronchus
4. Bronchiole
5. Trachea
6. Nostrils

Question 35

An instructor explains that safety precautions must be followed anytime oxygen is in use. A student shows a need for additional instruction by saying:

A) "I should eliminate the possibility of static electricity, which could spark a fire."
B) "I should avoid using petroleum-based products such as petroleum jelly on the lips of patients using supplemental oxygen."
C) "I should provide a higher liter flow of oxygen for patients with chronic lung disease."
D) "I should check the electrical devices, such as electric razors, in the room to ensure that there are no frayed wires."

Question 36

An instructor explains that when blood and drainage are present in the pleural space, they pool in the lower portion of the cavity. A student recognizes that this is called a(n) ____________________.