Question 1

The patient is admitted to the emergency department with a pneumothorax.Which of the following does the nurse anticipate the patient will be experiencing?

Accepted Answer

The patient with pneumothorax is likely to experience dyspnea (difficulty breathing) due to the collapsed lung. Eupnea refers to normal breathing and is unlikely in this scenario. Fremitus refers to the vibration felt when a patient speaks, which may be diminished in a pneumothorax but is not a common symptom. Orthopnea refers to difficulty breathing when lying flat and is not typically associated with pneumothorax.

Question 2

The nurse is reviewing the results of the patient's diagnostic testing for respiratory function.Of the following results,which finding results fall within normal limits?

Accepted Answer

A pH of 7.50 is considered alkaline and outside the normal range of 7.35-7.45. An SaO₂ of 86% is below the normal range of 95-100%. A PaO₂ of 76 mm Hg is below the normal range of 80-100 mm Hg. A PaCO₂ of 36 mm Hg falls within the normal range of 35-45 mm Hg.

Question 3

Which of the following statements is incorrect regarding the older adult patient and cardiopulmonary function?

Accepted Answer

Older adults may not complain of dyspnea, but rather express it as fatigue or weakness.

Question 4

The patient with a chronic obstructive respiratory disease is receiving oxygen via a nasal cannula.The nurse plans to include which of the following interventions in the patient's care?

Accepted Answer

Regular assessment of the nares for skin breakdown is important due to the potential irritation from the nasal cannula.

Question 5

The patient has chest tubes in place after thoracic surgery.What does the nurse need to know about working with a patient who has a chest tube?

Accepted Answer

Periodic lifting and drainage of coiled loop will help maintain pleural drainage by preventing blockages and ensuring the fluid flows freely.

Question 6

The patient has experienced a myocardial infarction,resulting in damage to the left ventricle.Which of the following does the nurse know the patient may experience as a possible complication?

Accepted Answer

Damage to the left ventricle can lead to decreased cardiac output and subsequent pulmonary congestion due to an increase in pressure in the pulmonary vasculature. Jugular neck vein distension may be present with right-sided heart failure, not left-sided. Peripheral edema and liver enlargement may be present with right-sided heart failure or liver disease, but are not necessarily associated with a myocardial infarction and damage to the left ventricle.

Question 7

Several patients are experiencing increased respiratory secretions and require intervention to assist in their removal.Chest percussion is indicated and appropriate for the patient experiencing which one of the following?

Accepted Answer

Chest percussion is recommended for patients with cystic fibrosis to assist in loosening and removing respiratory secretions. Thrombocytopenia involves low levels of platelets, and chest percussion may increase the risk of bleeding. Osteoporosis involves weakened bones, and chest percussion may increase the risk of fractures. Spinal fractures may also increase the risk of further injury with chest percussion.

Question 8

The unit manager,who is orienting the new staff nurse,evaluates which one of the following as an appropriate technique for nasotracheal suctioning?

Accepted Answer

The time taken for catheter passage to removal should be no longer than 15 seconds to prevent hypoxemia. A) Placing the patient in a supine position can increase the risk of aspiration. B) Nasotracheal suctioning requires a sterile technique to prevent infection. C) The oropharynx should be suctioned after the nasotracheal area to prevent contamination of the trachea.

Question 9

The nurse knows that a pacemaker may be required for which of the following conditions?

Accepted Answer

A pacemaker may be required for sinus bradycardia, which is a slow heart rate that can cause symptoms such as dizziness, fainting, and shortness of breath. Sinus tachycardia is a fast heart rate that may not require a pacemaker. Ventricular fibrillation is a life-threatening heart rhythm that requires immediate medical attention with interventions such as defibrillation. Heart failure is a condition where the heart is unable to pump effectively, and while some patients with heart failure may benefit from a pacemaker, it is not always required.

Question 10

At a community health fair,the nurse informs the residents that the influenza vaccine is recommended for which of the following patients?

Accepted Answer

The influenza vaccine is recommended for patients in any age group who have a chronic disease as they are at higher risk for complications from the flu. It is also recommended for other groups such as pregnant women, children, and older adults. It is not recommended for patients who are currently experiencing flulike symptoms as it is designed to prevent the flu rather than treat it. Age alone is not a determining factor for vaccine eligibility.

Question 11

It is suspected that the patient's oxygenation status is deteriorating.The nurse is aware that which abnormal assessment finding represents the most serious indication of the patient's decreased oxygenation?

Accepted Answer

Central cyanosis, which is the bluish discoloration of the skin and mucous membranes, is the most serious indication of decreased oxygenation as it is a sign of hypoxemia affecting the central circulation. Poor skin turgor, clubbing of the nails, and pursed-lip breathing are also possible signs of decreased oxygenation, but they are not as life-threatening as central cyanosis.

Question 12

On admitting a patient,the nurse finds a history of myocardial ischemia.What is the most disconcerting dysrhythmia that electrocardiography can reveal for this patient?

Accepted Answer

Ventricular tachycardia is the most disconcerting dysrhythmia for a patient with a history of myocardial ischemia, as it can quickly lead to ventricular fibrillation and sudden cardiac arrest. Sinus bradycardia and sinus dysrhythmias are relatively common and may not be a significant concern in this patient population. Atrial fibrillation can also be problematic, but it is not typically as immediately life-threatening as ventricular tachycardia.

Question 13

The patient has recently had a mitral valve replacement.To prevent excess serosanguineous fluid buildup,which of the following does the nurse anticipate will be included in care?

Accepted Answer

Chest tube placement is commonly used to prevent or manage fluid buildup after cardiac surgeries, such as mitral valve replacement, by draining excess serosanguineous fluid from the thoracic cavity.

Question 14

The nurse has reviewed information about the cardiovascular system before caring for a patient with heart disease.The nurse knows that which of the following statements is true concerning the physiology of the cardiovascular system?

Accepted Answer

The QRS interval on an electrocardiogram represents the electrical impulses passing through the ventricles. It is a measure of the depolarization of the ventricles.

Answer: None of the other choices are true.
 A) Stimulating the parasympathetic system slows down the heart rate, not increase it. B) Heart muscle disease can lead to the heart muscles becoming stiff, which can impair function. Stretching of the heart muscles is not a normal response to disease. D) When stroke volume decreases, the heart must compensate by increasing heart rate to maintain cardiac output, not decrease it.

Question 15

Acute renal failure and a resulting metabolic acidosis develop in a patient.The nurse recognizes that the respiratory system compensates through which of the following processes?

Accepted Answer

The respiratory system compensates for metabolic acidosis by hyperventilation, which decreases the serum carbon dioxide and thereby increases the pH. This helps to counterbalance the excess acid in the bloodstream by removing carbon dioxide, a weak acid that can combine with water to form carbonic acid. This compensation mechanism can be observed through arterial blood gas analysis, which typically shows a decrease in carbon dioxide levels and an increase in pH.

Question 16

The nurse is checking the patient's overall oxygenation.In assessment of the presence of central cyanosis,which of the following areas will the nurse inspect?

Accepted Answer

Central cyanosis is best assessed by inspecting the patient's tongue, as it reflects the oxygenation status of central circulation.

Question 17

A 64-year-old patient is seen in the emergency department for palpitations and mild shortness of breath.The electrocardiogram reveals a normal P wave,P-R interval,and QRS complex with a regular rhythm and a rate of 108 beats per minute.The nurse should recognize this as which type of cardiac dysrhythmia?

Accepted Answer

The ECG findings indicate sinus tachycardia, which is characterized by a normal P wave, P-R interval, and QRS complex with a regular rhythm and a heart rate over 100 beats per minute.

Question 18

The patient has pneumonia in the left lobe.The nurse should encourage him to lie in which of the following positions?

Accepted Answer

The patient should be encouraged to lie with the unaffected lung down to facilitate better ventilation and perfusion to the affected lobe. This will help improve gas exchange and reduce the workload on the affected lung.

Question 19

The nurse is working on a respiratory care unit in the hospital.On entering the room of a patient with emphysema,the nurse notes that the patient is experiencing respiratory distress.Which of the following actions should the nurse take?

Accepted Answer

Providing oxygen at 2 L per minute via nasal cannula is appropriate for a patient with emphysema experiencing respiratory distress, as it helps improve oxygenation while avoiding high oxygen levels that can suppress their respiratory drive.

Question 20

The nurse is working on a pulmonary unit at the local hospital.The nurse is alert to which of the following as being an early sign of hypoxia?

Accepted Answer

Restlessness is an early sign of hypoxia as the body is trying to compensate for lack of oxygen. Cyanosis may not be present until hypoxia becomes severe. Decreased respiratory rate and blood pressure may occur later in the progression of hypoxia.

Quiz 38: Cardiopulmonary Functioning and Oxygenation