Question 1

The nurse is auscultating a patient's lungs but is unable to hear much air movement.What should the nurse do to most effectively hear the lung sounds?

Accepted Answer

Asking the patient to breathe deeply through the mouth can help enhance the sounds.Allow the patient to rest at intervals to prevent hyperventilation.A.If this does not work,then trying another stethoscope may be helpful.C.Sitting,not side-lying,best helps the patient to take deep breaths.B.Having the patient rest is helpful if he or she is fatigued or dyspneic but will not make breath sounds easier to hear.

Question 2

The nurse is reviewing the exchange of gases in the blood stream with a patient prescribed oxygen therapy.How should the nurse explain the transport of carbon dioxide in the blood?

Accepted Answer

Most carbon dioxide is carried in the blood in the form of bicarbonate ions in the plasma.A.C.Hydrogen ions do not transport CO₂,and it is not carried in plasma as CO₂.D.Hemoglobin carries oxygen.

Question 3

The nurse is providing care for a patient diagnosed with asthma.Which adventitious sound should the nurse expect when auscultating this patient's lung sounds?

Accepted Answer

Patients with asthma have narrowed airways that cause wheezing.A.D.Diminished breath sounds and crackles are less common with asthma.C.Friction rub is associated with pleurisy.

Question 4

The nurse is reviewing the results of a patient's pulmonary function tests.Which result describes the air remaining in lungs after normal expiration?

Accepted Answer

Functional residual capacity is the air remaining in lungs after normal expiration.C.Forced vital capacity is the maximum amount of air expired forcefully after maximum inspiration.B.Expiratory reserve is the amount of air beyond tidal volume in the most forceful exhalation.A.Tidal volume is the air inspired and expired in one breath.

Question 5

The nurse is coaching a patient to empty the lungs of all air before using a metered-dose inhaler.What air that is expired beyond tidal volume in a forceful exhalation is the nurse coaching the patient to remove from the lungs?

Accepted Answer

Expiratory reserve is the amount of air beyond tidal volume in the most forceful exhalation.C.Forced vital capacity is the maximum amount of air expired forcefully after maximum inspiration.D.Peak expiratory flow rate is the maximum flow rate of air expired during forced vital capacity.A.Tidal volume is the air inspired and expired in one breath.

Question 6

A patient has a low oxygen level.Which body structure should the nurse consider as being responsible for this low level?

Accepted Answer

Gas exchange occurs in the alveoli.A.C.D.The nasal passages,larynx,and bronchi transport air.

Question 7

The nurse is auscultating a patient's chest and hears an adventitious sound in the left lower lobe.What is the first step in determining whether this is an abnormality?

Accepted Answer

Comparing sounds on each side can help identify normal versus abnormal sounds.A.B.C.Having another nurse or physician listen or questioning the patient are good strategies,but the first step is to listen on both sides to verify differences.

Question 8

A patient with pulmonary edema has moist,bubbling lung sounds.How should the nurse describe this finding?

Accepted Answer

Moist bubbling sound heard on inspiration or expiration is described as coarse crackles.B.Fine crackles occur with heart failure or atelectasis and are finer and less bubbly.A.D.Wheezing sounds like violins,and a friction rub sounds like leather rubbing together.

Question 9

The nurse is reviewing the arterial blood gas results for a patient with a respiratory disorder.What should the nurse recognize as being the most important chemical regulator of respiration?

Accepted Answer

Carbon dioxide is usually the major regulator of respiration because even small changes in its blood level change the pH.A.Fluctuations in oxygen level have no effect on pH,and an adequate oxygen level in the blood can be maintained even if breathing ceases for a few minutes.B.Nitrogen does not control respirations.D.Hemoglobin level affects tissue oxygenation but is not the most important regulator of respiration.

Question 10

The nurse is providing care to a patient who experienced an ischemic stroke and now requires respiratory support with mechanical ventilation.The nurse realizes that the stroke most likely occurred in which part of the brain?

Accepted Answer

The respiratory centers are located in the medulla oblongata and pons.B.The cerebrum controls some motor functions,sensation,vision,and conscious thought,among other functions.C.The cerebellum controls movement.D.The hypothalamus controls a variety of functions.

Question 11

A patient is having problems with oxygenation of body tissues.What is important for the nurse to consider about the transport of oxygen in the blood?

Accepted Answer

Hemoglobin carries oxygen in the blood.B.C.Hemoglobin is in red blood cells,not on cell membranes or in plasma.A.Oxygen is not transported free in plasma.

Question 12

A nurse is providing care for a patient who complains of difficulty breathing.Which assessment will best help the nurse determine the severity of the patient's dyspnea?

Accepted Answer

Dyspnea or shortness of breath is subjective and can best be described using a 0-to-10 scale.A.B.D.Describing it,observing the patient,and respiratory rate all provide good information but do not quantify severity like a rating scale does.

Question 13

An adult patient has a respiratory rate of 36 breaths per minute.Which term should the nurse use to document this finding?

Accepted Answer

Thirty-six breaths per minute is too fast (normal 12 to 20),which describes tachypnea.B.Bradypnea is slow respirations.A.Apnea is no respirations.D.A normal adult respiratory rate is 12 to 20 breaths per minute.

Question 14

The nurse is reviewing the physiology of the respiratory system with a patient being treated for pneumonia.What structure should the nurse identify as sweeping mucus and pathogens from the nasal cavities and trachea to the pharynx?

Accepted Answer

The mucosa in the nose and trachea is ciliated epithelium; mucus with trapped dust and microorganisms is swept upward toward the pharynx and is usually swallowed.D.Simple squamous epithelium does not have cilia.B.Alveolar macrophages destroy foreign particles in the alveoli,not the trachea.C.Connective tissue does not fight pathogens.

Question 15

During the admission assessment of an individual admitted to the medical respiratory unit,the nurse notes the patient has a barrel-shaped chest.Which assessment should the nurse perform next?

Accepted Answer

A barrel-shaped chest is associated with air trapping that would be further assessed by the rate and character of the respirations.C.Chest tenderness is not associated with respiratory disease.B.D.Respiratory acidosis and cough are associated with pulmonary disease but do not cause a barreled chest and are not the priority at this time.

Question 16

A laboratory technician has just completed drawing arterial blood gases from a patient.What action should the nurse take first?

Accepted Answer

Pressure must be held for 5 minutes as the pressure in an artery can cause bleeding.A.D.There is no reason to call the physician or increase oxygen.C.Holding a fist may increase bleeding.

Question 17

A patient with pneumonia is having difficulty raising secretions for a sputum culture.Which action should the nurse take first?

Accepted Answer

Deep breathing can trigger a cough and help raise sputum.A.B.Suctioning and bronchodilators may help but are more invasive and would not be tried first.D.A cotton-tipped swab can obtain a throat culture,not a sputum specimen.

Question 18

A patient is making a loud crowing sound caused by an obstruction of the airways by a foreign body.How should the nurse document this patient's lung sound?

Accepted Answer

A loud crowing noise from airway obstruction is called stridor.B.Wheezes are from narrowed airways and are not as loud as stridor.C.Crackles are bubbling noises.D.A friction rub sounds like leather rubbing together.

Question 19

While providing care for a patient with asthma,the nurse notes the patient's shoulders are rising with each breath.What should the nurse realize this action represents?

Accepted Answer

Use of the sternocleidomastoid (accessory)muscles causes the shoulders to rise during labored inspiration.C.Fatigued muscles would contract less,not more,making the shoulders rise.A.Hyperinflation can occur with respiratory disease but does not cause shoulders to rise.D.Breathing exercises include diaphragmatic and pursed-lip breathing,not raising the shoulders.

Question 20

The nurse observes a patient who has periods of fast,deep respirations alternating with periods of apnea.What term should the nurse use to describe this pattern?

Accepted Answer

Fast deep respirations alternated with periods of apnea are Cheyne-Stokes respirations.D.Hyperventilation is deep breathing.B.A.Kussmaul's are slow and deep,and tachypnea is a rate that is too fast.

Quiz 29: Respiratory System Function, Assessment, and Therapeutic Measures