RESPIRATORY TEST BANK EXAM
QUESTIONS AND ANSWERS
The nurse caring for a patient recently diagnosed with lung disease encourages the
patient not to smoke. What is the primary rationale behind this nursing action?
A) Smoking decreases the amount of mucus production.
B) Smoke particles compete for binding sites on hemoglobin.
C) Smoking causes atrophy of the alveoli.
D) Smoking damages the ciliary cleansing mechanism. - Answer-Ans: D
Feedback:
In addition to irritating the mucous cells of the bronchi and inhibiting the function of
alveolar
macrophage (scavenger) cells, smoking damages the ciliary cleansing mechanism of
the respiratory
tract. Smoking also increases the amount of mucus production and distends the alveoli
in the lungs. It
reduces the oxygen-carrying capacity of hemoglobin, but not by directly competing for
binding sites.
A patient has been brought to the ED by the paramedics. The patient is suspected of
having ARDS. What
intervention should the nurse first anticipate?
A) Preparing to assist with intubating the patient
B) Setting up oxygen at 5 L/minute by nasal cannula
C) Performing deep suctioning
D) Setting up a nebulizer to administer corticosteroids - Answer-Ans: A
Feedback:
A patient who has ARDS usually requires intubation and mechanical ventilation. Oxygen
by nasal
cannula would likely be insufficient. Deep suctioning and nebulizers may be indicated,
but the priority is
to secure the airway.
The nurse is caring for a patient who is scheduled for a lobectomy for a diagnosis of
lung cancer. While
assisting with a subclavian vein central line insertion, the nurse notes the clients oxygen
saturation
rapidly dropping. The patient complains of shortness of breath and becomes
tachypneic. The nurse
suspects a pneumothorax has developed. Further assessment findings supporting the
presence of a
pneumothorax include what?
A) Diminished or absent breath sounds on the affected side
B) Paradoxical chest wall movement with respirations
,C) Sudden loss of consciousness
D) Muffled heart sounds - Answer-Ans: A
Feedback:
In the case of a simple pneumothorax, auscultating the breath sounds will reveal absent
or diminished
breath sounds on the affected side. Paradoxical chest wall movements occur in flail
chest conditions. Sudden loss of consciousness does not typically occur. Muffled or
distant heart sounds occur in
pericardial tamponade.
The nurse is providing discharge teaching for a patient who developed a pulmonary
embolism after total
knee surgery. The patient has been converted from heparin to sodium warfarin
(Coumadin)
anticoagulant therapy. What should the nurse teach the client?
A) Coumadin will continue to break up the clot over a period of weeks
B) Coumadin must be taken concurrent with ASA to achieve anticoagulation.
C) Anticoagulant therapy usually lasts between 3 and 6 months.
D) He should take a vitamin supplement containing vitamin K - Answer-Ans: C
Feedback:
Anticoagulant therapy prevents further clot formation, but cannot be used to dissolve a
clot. The therapy
continues for approximately 3 to 6 months and is not combined with ASA. Vitamin K
reverses the effect
of anticoagulant therapy and normally should not be taken.
A new employee asks the occupational health nurse about measures to prevent
inhalation exposure of the
substances. Which statement by the nurse will decrease the patients exposure risk to
toxic substances?
A) Position a fan blowing on the toxic substances to prevent the substance from
becoming stagnant in
the air.
B) Wear protective attire and devices when working with a toxic substance.
C) Make sure that you keep your immunizations up to date to prevent respiratory
diseases resulting
from toxins.
D) Always wear a disposable paper face mask when you are working with inhalable
toxins. - Answer-Ans: B
When working with toxic substances, the employee must wear or use protective devices
such as face
masks, hoods, or industrial respirators. Immunizations do not confer protection from
toxins and a paper
mask is normally insufficient protection. Never position a fan directly blowing on the
toxic substance as
it will disperse the fumes throughout the area.
, A new employee asks the occupational health nurse about measures to prevent
inhalation exposure of the
substances. Which statement by the nurse will decrease the patients exposure risk to
toxic substances?
A) Position a fan blowing on the toxic substances to prevent the substance from
becoming stagnant in
the air.
B) Wear protective attire and devices when working with a toxic substance.
C) Make sure that you keep your immunizations up to date to prevent respiratory
diseases resulting
from toxins.
D) Always wear a disposable paper face mask when you are working with inhalable
toxins. - Answer-Ans: B
When working with toxic substances, the employee must wear or use protective devices
such as face
masks, hoods, or industrial respirators. Immunizations do not confer protection from
toxins and a paper
mask is normally insufficient protection. Never position a fan directly blowing on the
toxic substance as
it will disperse the fumes throughout the area.
An x-ray of a trauma patient reveals rib fractures and the patient is diagnosed with a
small flail chest
injury. Which intervention should the nurse include in the patients plan of care?
A) Suction the patients airway secretions.
B) Immobilize the ribs with an abdominal binder.
C) Prepare the patient for surgery.
D) Immediately sedate and intubate the patient. - Answer-Ans: A
Feedback:
As with rib fracture, treatment of flail chest is usually supportive. Management includes
clearing
secretions from the lungs, and controlling pain. If only a small segment of the chest is
involved, it is
important to clear the airway through positioning, coughing, deep breathing, and
suctioning. Intubation
is required for severe flail chest injuries, and surgery is required only in rare
circumstances to stabilize
the flail segment.
The nurse is caring for a patient who is receiving oxygen therapy for pneumonia. How
should the nurse
best assess whether the patient is hypoxemic?
A) Assess the patients level of consciousness (LOC).
B) Assess the patients extremities for signs of cyanosis.
C) Assess the patients oxygen saturation level.
QUESTIONS AND ANSWERS
The nurse caring for a patient recently diagnosed with lung disease encourages the
patient not to smoke. What is the primary rationale behind this nursing action?
A) Smoking decreases the amount of mucus production.
B) Smoke particles compete for binding sites on hemoglobin.
C) Smoking causes atrophy of the alveoli.
D) Smoking damages the ciliary cleansing mechanism. - Answer-Ans: D
Feedback:
In addition to irritating the mucous cells of the bronchi and inhibiting the function of
alveolar
macrophage (scavenger) cells, smoking damages the ciliary cleansing mechanism of
the respiratory
tract. Smoking also increases the amount of mucus production and distends the alveoli
in the lungs. It
reduces the oxygen-carrying capacity of hemoglobin, but not by directly competing for
binding sites.
A patient has been brought to the ED by the paramedics. The patient is suspected of
having ARDS. What
intervention should the nurse first anticipate?
A) Preparing to assist with intubating the patient
B) Setting up oxygen at 5 L/minute by nasal cannula
C) Performing deep suctioning
D) Setting up a nebulizer to administer corticosteroids - Answer-Ans: A
Feedback:
A patient who has ARDS usually requires intubation and mechanical ventilation. Oxygen
by nasal
cannula would likely be insufficient. Deep suctioning and nebulizers may be indicated,
but the priority is
to secure the airway.
The nurse is caring for a patient who is scheduled for a lobectomy for a diagnosis of
lung cancer. While
assisting with a subclavian vein central line insertion, the nurse notes the clients oxygen
saturation
rapidly dropping. The patient complains of shortness of breath and becomes
tachypneic. The nurse
suspects a pneumothorax has developed. Further assessment findings supporting the
presence of a
pneumothorax include what?
A) Diminished or absent breath sounds on the affected side
B) Paradoxical chest wall movement with respirations
,C) Sudden loss of consciousness
D) Muffled heart sounds - Answer-Ans: A
Feedback:
In the case of a simple pneumothorax, auscultating the breath sounds will reveal absent
or diminished
breath sounds on the affected side. Paradoxical chest wall movements occur in flail
chest conditions. Sudden loss of consciousness does not typically occur. Muffled or
distant heart sounds occur in
pericardial tamponade.
The nurse is providing discharge teaching for a patient who developed a pulmonary
embolism after total
knee surgery. The patient has been converted from heparin to sodium warfarin
(Coumadin)
anticoagulant therapy. What should the nurse teach the client?
A) Coumadin will continue to break up the clot over a period of weeks
B) Coumadin must be taken concurrent with ASA to achieve anticoagulation.
C) Anticoagulant therapy usually lasts between 3 and 6 months.
D) He should take a vitamin supplement containing vitamin K - Answer-Ans: C
Feedback:
Anticoagulant therapy prevents further clot formation, but cannot be used to dissolve a
clot. The therapy
continues for approximately 3 to 6 months and is not combined with ASA. Vitamin K
reverses the effect
of anticoagulant therapy and normally should not be taken.
A new employee asks the occupational health nurse about measures to prevent
inhalation exposure of the
substances. Which statement by the nurse will decrease the patients exposure risk to
toxic substances?
A) Position a fan blowing on the toxic substances to prevent the substance from
becoming stagnant in
the air.
B) Wear protective attire and devices when working with a toxic substance.
C) Make sure that you keep your immunizations up to date to prevent respiratory
diseases resulting
from toxins.
D) Always wear a disposable paper face mask when you are working with inhalable
toxins. - Answer-Ans: B
When working with toxic substances, the employee must wear or use protective devices
such as face
masks, hoods, or industrial respirators. Immunizations do not confer protection from
toxins and a paper
mask is normally insufficient protection. Never position a fan directly blowing on the
toxic substance as
it will disperse the fumes throughout the area.
, A new employee asks the occupational health nurse about measures to prevent
inhalation exposure of the
substances. Which statement by the nurse will decrease the patients exposure risk to
toxic substances?
A) Position a fan blowing on the toxic substances to prevent the substance from
becoming stagnant in
the air.
B) Wear protective attire and devices when working with a toxic substance.
C) Make sure that you keep your immunizations up to date to prevent respiratory
diseases resulting
from toxins.
D) Always wear a disposable paper face mask when you are working with inhalable
toxins. - Answer-Ans: B
When working with toxic substances, the employee must wear or use protective devices
such as face
masks, hoods, or industrial respirators. Immunizations do not confer protection from
toxins and a paper
mask is normally insufficient protection. Never position a fan directly blowing on the
toxic substance as
it will disperse the fumes throughout the area.
An x-ray of a trauma patient reveals rib fractures and the patient is diagnosed with a
small flail chest
injury. Which intervention should the nurse include in the patients plan of care?
A) Suction the patients airway secretions.
B) Immobilize the ribs with an abdominal binder.
C) Prepare the patient for surgery.
D) Immediately sedate and intubate the patient. - Answer-Ans: A
Feedback:
As with rib fracture, treatment of flail chest is usually supportive. Management includes
clearing
secretions from the lungs, and controlling pain. If only a small segment of the chest is
involved, it is
important to clear the airway through positioning, coughing, deep breathing, and
suctioning. Intubation
is required for severe flail chest injuries, and surgery is required only in rare
circumstances to stabilize
the flail segment.
The nurse is caring for a patient who is receiving oxygen therapy for pneumonia. How
should the nurse
best assess whether the patient is hypoxemic?
A) Assess the patients level of consciousness (LOC).
B) Assess the patients extremities for signs of cyanosis.
C) Assess the patients oxygen saturation level.
