ATI Respiratory Practice Questions with Rationales

ATI Respiratory Practice Questions with Rationales 1. A nurse is caring for a school-age child who has mild persistent asthma. Which of the following is an expected finding? (Select all that apply.) a. Symptoms are continuous throughout the day. R Symptoms are continuous throughout the day is incorrect. Continual asthma symptoms throughout the day are seen with severe persistent asthma. b. Daytime symptoms occur more than twice a week. R Daytime symptoms occur more than twice a week is correct. A child with mild persistent asthma will typically have daytime symptoms more than twice a week, but not daily. c. Nighttime symptoms occur approximately twice a month. R Nighttime symptoms occur approximately twice a month is incorrect. Nighttime symptoms occurring approximately twice a month are seen with intermittent asthma. d. Minor limitations occur with normal activity. R Minor limitations occur with normal activity is correct. A child with mild persistent asthma will have some minor limitations with normal daily activities. e. Peak expiratory flow (PEF) is greater than or equal to 80% of the predicted value. R Peak expiratory flow (PEF) is greater than or equal to 80% of the predicted value is correct. A child with mild persistent asthma will have a PEF greater than or equal to 80% of the predicted value. 2. A nurse is planning care for a child with suspected epiglottitis. Which of the following is an appropriate action for the nurse to take? a. Obtain a throat culture R Obtaining a throat culture on a child with suspected epiglottitis could precipitate obstruction of the airway and should be avoided. b. Place client in an upright position R Placing the child in an upright position will assist in maintaining a patent airway and is an appropriate action for the nurse to take. c. Transfer for a throat x-ray R The airway of a child with suspected epiglottitis could become obstructed easily, therefore transferring for a throat x-ray is not an appropriate action for the nurse to take. d. Visualize the epiglottis with a tongue depressor R Visualizing the epiglottis with a tongue depressor on a child with suspected epiglottitis could precipitate obstruction of the airway and should be avoided. 3. A nurse is caring for a pre-school age child who has a epiglottitis with a barking cough. Which of the following is an appropriate nursing action? a. Encourage coughing. R Encouraging the client to cough is not an appropriate nursing and precipitates a complete obstruction. b. Attempt to obtain a throat culture. R Attempting to obtain a throat culture is not an appropriate nursing action and may precipitate a complete obstruction. c. Visualize the back of the throat. R Trying to visualize the back of the throat is not an appropriate nursing action and may precipitate a complete obstruction. d. Apply oxygen. R Applying high-flow oxygen on the client and keeping the client calm is an appropriate action by the nurse to improve oxygenation. 4. A nurse is reinforcing teaching to an assistive personnel to count respiration rate on a newborn. Which of the following statements indicate understanding of why the respiratory rate should be counted for a complete minute? a. “Newborns are abdominal breathers.” R Newborns are abdominal breathers. However, this has no impact on obtaining a respiratory rate. b. “Newborns do not expand their lungs fully with each respiration.” R The labor of breathing in a newborn will vary. However, this has no impact on obtaining a respiratory rate. c. “Activity will increase the respiration rate.” R Activity will increase the respiration rate. However, this has no impact on obtaining a respiratory rate. d. “The rate and rhythm are irregular in newborns.” R Newborns have an irregular respiratory rate and rhythm. Therefore, counting the respiratory rate for a complete minute is recommended to obtain an accurate rate. 5. A nurse is caring for a preterm newborn who is in an incubator. The nurse should make sure that the maximum oxygen concentration to deliver to this client is a. 30%. R This is a safe oxygen concentration to deliver to a preterm newborn, but not the maximum. Of course, the nurse should make sure the newborn receives the oxygen concentration the provider prescribes. b. 40%. R Oxygen concentrations higher than 40% can cause retinal damage and visual impairment. This is the maximum concentration to deliver. c. 50%. R This is an unsafe oxygen concentration to deliver to a preterm newborn. The nurse should make sure the newborn receives the oxygen concentration the provider prescribes. d. 60%. R This is an unsafe oxygen concentration to deliver to a preterm newborn. The nurse should make sure the newborn receives the oxygen concentration the provider prescribes. 6. A nurse is caring for an infant who has a tracheoesophageal fistula. Which of the following findings are associated with this diagnosis? (Select all that apply.) a. Coughing R Coughing is correct. Coughing is a finding associated with a tracheoesophageal fistula. b. Apnea R Apnea is correct. Apnea is a finding associated with a tracheoesophageal fistula. c. Sunken abdomen R Sunken abdomen is incorrect. Abdominal distension, not a sunken abdomen, is a finding associated with a tracheoesophageal fistula. d. Cyanosis R Cyanosis is correct. Cyanosis is a finding associated with a tracheoesophageal fistula. e. Frothy saliva R Frothy saliva is correct. Frothy saliva is a finding associated with a tracheoesophageal fistula. 7. A nurse is caring for a child with a suspected diagnosis of cystic fibrosis. Which of the following diagnostic tests will the nurse prepare the child for to confirm the diagnosis? a. Sweat chloride test R Clients with cystic fibrosis have an increase of sodium and chloride in both saliva and sweat. Therefore, a sweat chloride test is a definitive diagnostic test to determine the diagnosis of cystic fibrosis. b. A sputum culture R A sputum culture will determine the organism infecting the lungs. However, it is not a diagnostic test to determine the diagnosis of cystic fibrosis. c. A stool fat content analysis R A stool fat content analysis will determine the amount of fat within a stool. However, it is not a diagnostic test to determine the diagnosis of cystic fibrosis. d. Pulmonary function test R Pulmonary function tests will determine the lung capability. However, it is not a diagnostic test to determine the diagnosis of cystic fibrosis. 8. A nurse is caring for a school-age child who has environmental allergies who is scheduled to begin desensitization therapy. Which of the following statements by the client indicates the teaching has been effective? a. "I'll receive my allergy shots daily for the first two weeks." R Allergen solutions are injected weekly during the first year of therapy. b. "At each visit, I'll receive an allergy shot with a little bit less of the allergen than I received the visit before." R Each allergy shot uses an increased amount of allergen so the client can build up an immunity to the allergen. c. "To reduce my symptoms I will need allergy shots for the rest of my life." R The recommended course of desensitization therapy is usually 5 years. d. "I'll need to remain in the clinic for 30 minutes after each shot." R After the allergy shot is administered, observation for a minimum of 30 minutes is required to monitor the client for any manifestations of an anaphylactic reaction to the injection. 9. A nurse is caring for a toddler who has laryngotracheobronchitis and is placed in a cool mist tent. Which of the following findings should the nurse expect as a result of the treatment? a. Decreased stridor R Laryngotracheobronchitis, or croup, is caused by infection of the upper airway (larynx, trachea, and bronchus) and is characterized by a barking cough. Edema and obstruction in the upper airways cause the cough and stridor. The cool mist tent humidifies the inspired air, which will reduces respiratory effort and stridor. b. Improved hydration R The treatment does not affect hydration. c. Barking cough R Edema and obstruction in the upper airways cause the characteristic cough, but this is a manifestation of the infection, not a result of the treatment. d. Temperature stabilization R Reducing the child's temperature may not occur as a result of the mist tent treatment. 10. A nurse is assessing a patient admitted for an asthma exacerbation. Which breath sounds does the nurse expect to assess? a. Rubs b. Rattles c. Wheezes R Asthma causes bronchoconstriction and narrowed passageways. Wheezes are produced as air passes through narrowed passageways. Rubs are the sound created by the friction of one surface rubbing over another. Pleural friction rub is caused by inflammation of the pleural space. Rattles is the term formerly used for crackles. Crackles are the sounds made when air passes through fluid or moisture. d. Crackles