Ch.25, 26, 27, & 28 Lewis Respiratory test questions and answers.

To promote the release of surfactant, the nurse encourages the patient to a. take deep breaths b. cough five times per hour to prevent alveolar collapse c. decrease fluid intake to reduce fluid accumulation in the alveoli d. sit with head of bed elevated to promote air movement through the pores of Kohn a. take deep breaths A patient with a respiratory condition asks, "How does air get into my lungs?" The nurse bases her answer on knowledge that air moves into the lungs because of a. increased CO2 and decreased O2 in the blood b. contraction of the accessory muscles c. stimulation of the respiratory muscles by the chemoreceptors d. decrease in intrathoracic pressure relative to pressure at the airway d. decrease in intrathoracic pressure relative to pressure at the airway The nurse can best determine adequate arterial oxygenation of the blood by assessing a. heart rate b. hemoglobin level c. arterial oxygen partial pressure d. arterial carbon dioxide partial pressure c. arterial oxygen partial pressure When teaching a patient about the most important respiratory defense mechanism distal to the respiratory bronchioles, which topic would the nurse discuss a. alveolar macrophages b. impaction of particles c. reflex bronchoconstriction d. mucociliary clearance mechanism a. alveolar macrophages A student nurse asks the RN what can be measured by ABG. The RN tells the student that the ABG can measure: select all that apply a. acid-base balance b. oxygenation status c. acidity of blood d. bicarbonate in arterial blood e. overall balance of electrolytes in arterial blood a. acid-base balance b. oxygenation status c. acidity of blood d. bicarbonate in arterial blood To detect early s/s of inadequate oxygenation, the nurse would examine the patient for: a. dyspnea and hypotension b. apprehension and restlessness c. cyanosis and cool, clammy skin d. increased urine output and diaphoresis b. apprehension and restlessness During the respiratory assessment of an older adult, the nurse would expect to find: Select all that apply a. a vigorous reflex cough b. increased chest expansion c. increased residual volume d. diminished lung sounds at base of lungs e. increased anteroposterior chest diameter c. increased residual volume d. diminished lung sounds at base of lungs e. increased anteroposterior chest diameter When assessing activity-exercise patterns related to respiratory health, the nurse inquires about a. dyspnea during rest or exercise b. recent weight loss or weight gain c. ability to sleep through the entire night d. willingness to wear O2 equipment in public a. dyspnea during rest or exercise When auscultating the chest of an older patient in respiratory distress, it is best to a. begin listening at the apices b. begin listening at the lung bases c. begin listening on the anterior chest d. ask the patient to breath through the nose with the mouth closed b. begin listening at the lung bases Which assessment finding of the respiratory system does the nurse interpret as abnormal? a. inspiratory chest expansion of 1 inch b. symmetric chest expansion and contraction c. resonance over the lung bases d. bronchial breath sounds in the lower lung fields d. bronchial breath sounds in the lower lung fields The nurse is preparing the patient for a diagnostic procedure to remove pleural fluid for analysis. The nurse would prepare the patient for what test? a. thoracentesis b. bronchoscopy c. pulmonary angiography d. sputum culture and sensitivity a. thoracentesis When assessing a patient's sleep-rest pattern related to respiratory health, what should the nurse ask the patient (select all that apply.)? Select all that apply. Do you awaken abruptly during the night? Do you sleep more than 8 hours per night? Do you need to sleep with the head elevated? Do you often need to urinate during the night? Do you toss and turn when trying to fall asleep? Do you awaken abruptly during the night? Do you need to sleep with the head elevated? Do you toss and turn when trying to fall asleep? The nurse is obtaining a focused respiratory assessment of a 44-yr-old female patient who is in severe respiratory distress 2 days after abdominal surgery. What is most important for the nurse to assess? Auscultation of bilateral breath sounds Percussion of anterior and posterior chest wall Palpation of the chest bilaterally for tactile fremitus Inspection for anterior and posterior chest expansion Auscultation of bilateral breath sounds The nurse, when auscultating the lower lungs of the patient, hears these breath sounds. How should the nurse document these sounds? Stridor Vesicular Coarse crackles Bronchovesicular Coarse crackles A frail 82-yr-old female patient develops sudden shortness of breath while sitting in a chair. What location on the chest should the nurse begin auscultation of the lung fields? Bases of the posterior chest area Apices of the posterior lung fields Anterior chest area above the breasts Midaxillary on the left side of the chest Bases of the posterior chest area The patient is hospitalized with pneumonia. Which diagnostic test should be used to measure the efficiency of gas exchange in the lung and tissue oxygenation? Thoracentesis Bronchoscopy Arterial blood gases Pulmonary function tests Arterial blood gases The nurse is interpreting a tuberculin skin test (TST) for a 58-yr-old female patient with end-stage renal disease secondary to diabetes mellitus. Which finding would indicate a positive reaction? Acid-fast bacilli cultured at the injection site 15-mm area of redness at the TST injection site 11-mm area of induration at the TST injection site Wheal formed immediately after intradermal injection 11-mm area of induration at the TST injection site The nurse is caring for a patient who had abdominal surgery yesterday. Today the patient's lung sounds in the lower lobes are diminished. The nurse knows this could be related to the occurrence of pain. atelectasis. pneumonia. pleural effusion. atelectasis. The nurse is caring for a patient with chronic obstructive pulmonary disorder (COPD) and pneumonia who has an order for arterial blood gases to be drawn. What is the minimum length of time the nurse should plan to hold pressure on the puncture site? 2 minutes 5 minutes 10 minutes 15 minutes 5 minutes The patient's arterial blood gas results show the PaO2 at 65 mmHg and SaO2 at 80%. What early manifestations should the nurse expect to observe in this patient? Restlessness, tachypnea, tachycardia, and diaphoresis Unexplained confusion, dyspnea at rest, hypotension, and diaphoresis Combativeness, retractions with breathing, cyanosis, and decreased output Coma, accessory muscle use, cool and clammy skin, and unexplained fatigue Restlessness, tachypnea, tachycardia, and diaphoresis A patient with recurrent shortness of breath has just had a bronchoscopy. What is a priority nursing action immediately after the procedure? Monitor the patient for laryngeal edema. Assess the patient's level of consciousness. Monitor and manage the patient's level of pain. Assess the patient's heart rate and blood pressure. Monitor the patient for laryngeal edema. The patient with Parkinson's disease has a pulse oximetry reading of 72%, but he is not displaying any other signs of decreased oxygenation. What is most likely contributing to his low SpO2 level? Artifact Anemia Dark skin color Thick acrylic nails Artifact Motion is the most likely cause of the low SpO2 for this patient with Parkinson's disease After swallowing, a 73-yr-old patient is coughing and has a wet voice. What changes of aging could be contributing to this abnormal finding? Decreased response to hypercapnia Decreased number of functional alveoli Increased calcification of costal cartilage Decreased respiratory defense mechanisms Decreased respiratory defense mechanisms A 67-yr-old male patient had a right total knee replacement 2 days ago. Upon auscultation of the patient's posterior chest, the nurse detects discontinuous, high-pitched breath sounds just before the end of inspiration in the lower portion of both lungs. Which statement most appropriately reflects how the nurse should document the breath sounds? "Bibasilar wheezes present on inspiration." "Diminished breath sounds in the bases of both lungs." "Fine crackles posterior right and left lower lung fields." "Expiratory wheezing scattered throughout the lung fields." "Fine crackles posterior right and left lower lung fields." In assessment of the patient with acute respiratory distress, what should the nurse expect to observe (select all that apply.)? Cyanosis Tripod position Kussmaul respirations Accessory muscle use Increased AP diameter Tripod position Accessory muscle use Which patient is exhibiting an early clinical manifestation of hypoxemia? A 48-yr-old patient who is intoxicated and acutely disoriented to time and place A 67-yr-old patient who has dyspnea while resting in the bed or in a reclining chair A 72-yr-old patient who has four new premature ventricular contractions per minute A 94-yr-old patient who has renal insufficiency, anemia, and decreased urine output A 72-yr-old patient who has four new premature ventricular contractions per minute When the patient is experiencing metabolic acidosis secondary to type 1 diabetes mellitus, what physiologic response should the nurse expect to assess in the patient? Vomiting Increased urination Decreased heart rate Increased respiratory rate Increased respiratory rate After assisting at the bedside with a thoracentesis, the nurse should continue to assess the patient for signs and symptoms of what? Bronchospasm Pneumothorax Pulmonary edema Respiratory acidosis Pneumothorax The patient is calling the clinic with a cough. What assessment should be made first before the nurse advises the patient? Frequency, family history, hematemesis Weight loss, activity tolerance, orthopnea Cough sound, sputum production, pattern Smoking status, medications, residence location Cough sound, sputum production, pattern What should the nurse inspect when assessing a patient with shortness of breath for evidence of long-standing hypoxemia? Fingernails Chest excursion Spinal curvatures Respiratory pattern Fingernails During the assessment in the emergency department, the nurse is palpating the patient's chest. Which finding is a medical emergency? Increased tactile fremitus Diminished chest movement Tracheal deviation to the left Decreased anteroposterior (AP) diameter Tracheal deviation to the left A patient with a recent history of a dry cough has had a chest x-ray that revealed the presence of nodules. In an effort to determine whether the nodules are malignant or benign, what is the primary care provider likely to order? Thoracentesis Pulmonary angiogram CT scan of the patient's chest Positron emission tomography (PET) Positron emission tomography (PET) A patient was seen in the clinic for an episode of epistaxis, which was controlled by placement of anterior nasal packing. During discharge teaching, the nurse instructs the patient to a. use aspirin for pain relief b. remove the packaging later that day c. skip the next dose of antihypertensive medication d. avoid vigorous nose blowing and strenuous activity d. avoid vigorous nose blowing and strenuous activity