Question 1

A patient recovering from a lung transplant will have denervation of the lung tissue. What should the nurse include when planning this patient's care?

Accepted Answer

The answer of A patient recovering from a lung transplant...

Question 2

The nurse assists in the extubation of a patient recovering from injuries caused by a motor vehicle crash. Which observations indicate that the patient is able to independently maintain an airway?

Accepted Answer

The answer of The nurse assists in the extubation of...

Question 3

After an assessment the nurse is concerned that a patient is experiencing cor pulmonale associated with right-heart failure. What findings led the nurse to make this clinical decision?

Accepted Answer

The answer of After an assessment the nurse is concerned...

Question 4

A patient who is intubated is having difficulty being weaned from the ventilator. What actions should the nurse take to successfully wean this patient?

Accepted Answer

Weaning in the morning (A) is often preferred as the patient is typically more rested. Placing the patient in high-Fowler's position (B) helps improve lung expansion and oxygenation. Limiting activities (C) reduces oxygen demand and fatigue during the weaning process.

Question 5

The nurse instructs a patient on the use of a metered-dose inhaler for asthma medications. To demonstrate understanding of the instructions, in which order should the patient self-administer this medication?

Accepted Answer

The correct order for self-administering medication via a metered-dose inhaler is:

1. Exhale slowly and completely to ensure full inhalation of the medication.

2. Shake the canister vigorously for 3 to 5 seconds to ensure the proper mixing of the medication.

3. Press and hold the canister down while inhaling deeply and slowly for 3 to 5 seconds to release the medication.

4. Rinse the mouth to prevent any remaining medication from sticking to the mouth and throat.

5. Hold the breath for 10 seconds, release the pressure on the container, remove from the mouth, and exhale to ensure the medication has fully settled in the lungs.

Question 6

A patient being mechanically ventilated is exhibiting hypoxia, with a pulse oximeter reading of 88%. After ensuring the integrity of the ventilator tubing and assessing the patient, the nurse auscultates adventitious lung sounds. Which action should the nurse take next?

Accepted Answer

The adventitious lung sounds suggest the presence of secretions in the airways that may be causing the hypoxia. Suctioning can help remove the secretions and thus improve oxygenation. Contacting the physician may be necessary, but suctioning should be done first. Turning the patient to one side or silencing the alarm are not appropriate actions to address hypoxia and adventitious lung sounds.

Question 7

A patient is diagnosed with subacute hypersensitivity pneumonitis. What should the nurse expect to assess in this patient?

Accepted Answer

The answer of A patient is diagnosed with subacute hypersensitivity...

Question 8

The nurse is caring for a patient intubated for acute respiratory distress syndrome (ARDS). Which medications should the nurse expect to be prescribed for this patient?

Accepted Answer

The answer of The nurse is caring for a patient...

Question 9

The chest x-ray of a patient who was recently intubated shows the endotracheal tube located in the right bronchus. What does the nurse recognize related to this finding?

Accepted Answer

The endotracheal tube should be placed in the trachea, not in one of the bronchi. The nurse should recognize that the tube needs to be withdrawn slightly to ensure proper placement within the trachea.

Question 10

The nurse is caring for a patient experiencing atelectasis of the right lower lung lobe. What interventions should the nurse include in this patient's plan of care?

Accepted Answer

The answer of The nurse is caring for a patient...

Question 11

A patient being mechanically ventilated is diagnosed with barotrauma. Which assessment findings would lead the nurse to determine that the patient is experiencing subcutaneous emphysema?

Accepted Answer

Subcutaneous emphysema is characterized by swelling and a crackling sensation upon palpation due to air trapped under the skin, often seen in the neck, face, and upper chest areas.

Question 12

A patient who is intubated is exhibiting rhonchi and has a pulse oximeter of 92%, soft abdomen, heart rate of 88 bpm, and blood pressure of 98/54 mmHg. Which would be the nurse's first priority?

Accepted Answer

The patient is exhibiting rhonchi, which indicates mucus or fluid in the airways, and a low pulse oximetry reading of 92%, indicating the patient is not receiving enough oxygen. Therefore, suctioning the patient to remove secretions and increase airway clearance is the nurse's first priority to improve oxygenation. Contacting the physician may be necessary, but suctioning the patient should be done first. Increasing the oxygen may also be necessary, but it is not the priority intervention in this case. Starting dopamine is not indicated based on the patient's vital signs.

Question 13

The family of a mechanically ventilated patient receiving a chest tube asks why the tube is necessary. How should the nurse respond?

Accepted Answer

The chest tube is necessary to decompress the lung and prevent further complications. It helps to remove air or fluids from the pleural space to allow the lung to re-expand fully.

Question 14

The nurse is reviewing the results of laboratory and diagnostic tests conducted on a patient experiencing respiratory dysfunction. Which results confirm the nurse's suspicion that the patient has cystic fibrosis?

Accepted Answer

The answer of The nurse is reviewing the results of...

Question 15

The nurse is caring for a patient who is intubated and being mechanically ventilated. Which of the physician's orders should the nurse question for this patient?

Accepted Answer

Endotracheal suctioning every hour may be too frequent and increase the risk for complications such as airway trauma and hypoxemia. The nurse should question the order and collaborate with the physician to determine a more appropriate suctioning regimen.

Question 16

The nurse instructs a patient with chronic obstructive pulmonary disease (COPD) on the huff cough technique. Which observations indicate that teaching has been effective?

Accepted Answer

The answer of The nurse instructs a patient with chronic...

Question 17

A chest CT scan confirms that a patient has bronchiectasis. On which problems should the nurse focus when determining the care this patient will need?

Accepted Answer

The answer of A chest CT scan confirms that a...

Question 18

The nurse realizes that the medication tiotropium bromide (Spiriva) is contraindicated for a patient with chronic obstructive pulmonary disease (COPD). What information in the patient's medical history led to this clinical decision?

Accepted Answer

Tiotropium bromide (Spiriva) is an anticholinergic medication used in the management of COPD. It is contraindicated in patients with narrow-angle glaucoma (A) because it can increase intraocular pressure, and in patients with prostatic hypertrophy (D) because it can exacerbate urinary retention.

Question 19

A patient being mechanically ventilated has the following ventilator settings: SIMV 16, PEEP 20 cm of H₂O, FiO₂ 45%, tidal volume .450 liters. What concern should the nurse have for this patient?

Accepted Answer

The high PEEP (Positive End-Expiratory Pressure) of 20 cm H2O can increase the risk of barotrauma due to the excessive pressure applied to the lungs, potentially causing lung injury or pneumothorax.

Question 20

During an assessment the nurse suspects that a patient has chronic bronchitis. On what assessment findings is the nurse basing this clinical decision?

Accepted Answer

The answer of During an assessment the nurse suspects that...

Quiz 37: Nursing Care of Patients With Gas Exchange Disorders

A patient recovering from a lung transplant will have denervation of the lung tissue. What should the nurse include when planning this patient's care?

The nurse assists in the extubation of a patient recovering from injuries caused by a motor vehicle crash. Which observations indicate that the patient is able to independently maintain an airway?

After an assessment the nurse is concerned that a patient is experiencing cor pulmonale associated with right-heart failure. What findings led the nurse to make this clinical decision?

A patient who is intubated is having difficulty being weaned from the ventilator. What actions should the nurse take to successfully wean this patient?

The nurse instructs a patient on the use of a metered-dose inhaler for asthma medications. To demonstrate understanding of the instructions, in which order should the patient self-administer this medication?

A patient being mechanically ventilated is exhibiting hypoxia, with a pulse oximeter reading of 88%. After ensuring the integrity of the ventilator tubing and assessing the patient, the nurse auscultates adventitious lung sounds. Which action should the nurse take next?

A patient is diagnosed with subacute hypersensitivity pneumonitis. What should the nurse expect to assess in this patient?

The nurse is caring for a patient intubated for acute respiratory distress syndrome (ARDS) . Which medications should the nurse expect to be prescribed for this patient?

The chest x-ray of a patient who was recently intubated shows the endotracheal tube located in the right bronchus. What does the nurse recognize related to this finding?

The nurse is caring for a patient experiencing atelectasis of the right lower lung lobe. What interventions should the nurse include in this patient's plan of care?

A patient being mechanically ventilated is diagnosed with barotrauma. Which assessment findings would lead the nurse to determine that the patient is experiencing subcutaneous emphysema?

A patient who is intubated is exhibiting rhonchi and has a pulse oximeter of 92%, soft abdomen, heart rate of 88 bpm, and blood pressure of 98/54 mmHg. Which would be the nurse's first priority?

The family of a mechanically ventilated patient receiving a chest tube asks why the tube is necessary. How should the nurse respond?

The nurse is reviewing the results of laboratory and diagnostic tests conducted on a patient experiencing respiratory dysfunction. Which results confirm the nurse's suspicion that the patient has cystic fibrosis?

The nurse is caring for a patient who is intubated and being mechanically ventilated. Which of the physician's orders should the nurse question for this patient?

The nurse instructs a patient with chronic obstructive pulmonary disease (COPD) on the huff cough technique. Which observations indicate that teaching has been effective?

A chest CT scan confirms that a patient has bronchiectasis. On which problems should the nurse focus when determining the care this patient will need?

The nurse realizes that the medication tiotropium bromide (Spiriva) is contraindicated for a patient with chronic obstructive pulmonary disease (COPD) . What information in the patient's medical history led to this clinical decision?

A patient being mechanically ventilated has the following ventilator settings: SIMV 16, PEEP 20 cm of H₂O, FiO₂ 45%, tidal volume .450 liters. What concern should the nurse have for this patient?

During an assessment the nurse suspects that a patient has chronic bronchitis. On what assessment findings is the nurse basing this clinical decision?

Quiz 37: Nursing Care of Patients With Gas Exchange Disorders

A patient recovering from a lung transplant will have denervation of the lung tissue. What should the nurse include when planning this patient's care?

The nurse assists in the extubation of a patient recovering from injuries caused by a motor vehicle crash. Which observations indicate that the patient is able to independently maintain an airway?

After an assessment the nurse is concerned that a patient is experiencing cor pulmonale associated with right-heart failure. What findings led the nurse to make this clinical decision?

A patient who is intubated is having difficulty being weaned from the ventilator. What actions should the nurse take to successfully wean this patient?

The nurse instructs a patient on the use of a metered-dose inhaler for asthma medications. To demonstrate understanding of the instructions, in which order should the patient self-administer this medication?

A patient being mechanically ventilated is exhibiting hypoxia, with a pulse oximeter reading of 88%. After ensuring the integrity of the ventilator tubing and assessing the patient, the nurse auscultates adventitious lung sounds. Which action should the nurse take next?

A patient is diagnosed with subacute hypersensitivity pneumonitis. What should the nurse expect to assess in this patient?

The nurse is caring for a patient intubated for acute respiratory distress syndrome (ARDS) . Which medications should the nurse expect to be prescribed for this patient?

The chest x-ray of a patient who was recently intubated shows the endotracheal tube located in the right bronchus. What does the nurse recognize related to this finding?

The nurse is caring for a patient experiencing atelectasis of the right lower lung lobe. What interventions should the nurse include in this patient's plan of care?

A patient being mechanically ventilated is diagnosed with barotrauma. Which assessment findings would lead the nurse to determine that the patient is experiencing subcutaneous emphysema?

A patient who is intubated is exhibiting rhonchi and has a pulse oximeter of 92%, soft abdomen, heart rate of 88 bpm, and blood pressure of 98/54 mmHg. Which would be the nurse's first priority?

The family of a mechanically ventilated patient receiving a chest tube asks why the tube is necessary. How should the nurse respond?

The nurse is reviewing the results of laboratory and diagnostic tests conducted on a patient experiencing respiratory dysfunction. Which results confirm the nurse's suspicion that the patient has cystic fibrosis?

The nurse is caring for a patient who is intubated and being mechanically ventilated. Which of the physician's orders should the nurse question for this patient?

The nurse instructs a patient with chronic obstructive pulmonary disease (COPD) on the huff cough technique. Which observations indicate that teaching has been effective?

A chest CT scan confirms that a patient has bronchiectasis. On which problems should the nurse focus when determining the care this patient will need?

The nurse realizes that the medication tiotropium bromide (Spiriva) is contraindicated for a patient with chronic obstructive pulmonary disease (COPD) . What information in the patient's medical history led to this clinical decision?

A patient being mechanically ventilated has the following ventilator settings: SIMV 16, PEEP 20 cm of H2O, FiO2 45%, tidal volume .450 liters. What concern should the nurse have for this patient?

During an assessment the nurse suspects that a patient has chronic bronchitis. On what assessment findings is the nurse basing this clinical decision?

A patient being mechanically ventilated has the following ventilator settings: SIMV 16, PEEP 20 cm of H₂O, FiO₂ 45%, tidal volume .450 liters. What concern should the nurse have for this patient?