NURS208 FINAL EXAM COMPLETE EXAM QUESTIONS WITH DETAILED VERIFIED ANSWERS
ALREADY GRADED A+
A nurse working in a long-term care facility is providing teaching to patients with altered
oxygenation due to conditions such as asthma and COPD. Which measures would the nurse
recommend? Select all that apply.
Refrain from exercise.
Reduce anxiety.
Eat meals 1 to 2 hours prior to breathing treatments.
Eat a high-protein/high-calorie diet.
Maintain a high-Fowler's position when possible.
Drink 2 to 3 pints of clear fluids daily. b, d, e. When caring for patients with COPD, it is
important to create an environment that is likely to reduce anxiety and ensure that they eat a
high-protein/high-calorie diet. People with dyspnea and orthopnea are most comfortable in a
high-Fowler's position because accessory muscles can easily be used to promote respiration.
Patients with COPD should pace physical activities and schedule frequent rest periods to
conserve energy. Meals should be eaten 1 to 2 hours after breathing treatments and exercises,
and drinking 2 to 3 quarts (1.9 to 2.9 L) of clear fluids daily is recommended.
A nurse is assisting a respiratory therapist with chest physiotherapy for patients with ineffective
cough. For which patient might this therapy be recommended?
A postoperative adult
An adult with COPD
A teenager with cystic fibrosis
,A child with pneumonia c. Chest physiotherapy may help loosen and mobilize secretions,
increasing mucus clearance. This is especially helpful for patients with large amounts of
secretions or an ineffective cough, such as patients with cystic fibrosis. Chest physiotherapy has
limited evidence for its effectiveness and is not recommended for use in numerous patient
populations, including children with pneumonia, adults with COPD, and postoperative adults
(Andrews et al., 2013; Lisy, 2014; Strickland et al., 2013).
A nurse is teaching a patient how to use a meter-dosed inhaler for her asthma. Which
comments from the patient assure the nurse that the teaching has been effective? Select all
that apply.
"I will be careful not to shake up the canister before using it."
"I will hold the canister upside down when using it."
"I will inhale the medication through my nose."
"I will continue to inhale when the cold propellant is in my throat."
"I will only inhale one spray with one breath."
"I will activate the device while continuing to inhale." d, e, f. Common mistakes that patients
make when using MDIs include failing to shake the canister, holding the inhaler upside down,
inhaling through the nose rather than the mouth, inhaling too rapidly, stopping the inhalation
when the cold propellant is felt in the throat, failing to hold their breath after inhalation, and
inhaling two sprays with one breath.
A nurse is caring for a patient with chronic lung disease who is receiving oxygen through a nasal
cannula. What nursing action is performed correctly?
The nurse assures that the oxygen is flowing into the prongs.
The nurse adjusts the fit of the cannula so it fits snug and tight against the skin.
,The nurse encourages the patient to breathe through the nose with the mouth closed.
The nurse adjusts the flow rate to 6 L/min or more. c. The nurse should encourage the
patient to breathe through the nose with the mouth closed. The nurse should assure that the
oxygen is flowing out of the prongs prior to inserting them into the patient's nostrils. The nurse
should adjust the fit of the cannula so it is snug but not tight against the skin. The nurse should
adjust the flow rate as ordered.
A nurse is securing a patient's endotracheal tube with tape and observes that the tube depth
changed during the retaping. Which action would be appropriate related to this incident?
Instruct the assistant to notify the primary care provider.
Assess the patient's vital signs.
Remove the tape, adjust the depth to ordered depth and reapply the tape.
No action is required as depth will adjust automatically. c. The tube depth should be
maintained at the same level unless otherwise ordered by the health care provider. If the depth
changes, the nurse should remove the tape, adjust the tube to ordered depth, and reapply the
tape.
What action does the nurse perform to follow safe technique when using a portable oxygen
cylinder?
Checking the amount of oxygen in the cylinder before using it
Using a cylinder for a patient transfer that indicates available oxygen is 500 psi
Placing the oxygen cylinder on the stretcher next to the patient
Discontinuing oxygen flow by turning the cylinder key counterclockwise until tight a. The
cylinder must always be checked before use to ensure that enough oxygen is available for the
, patient. It is unsafe to use a cylinder that reads 500 psi or less because not enough oxygen
remains for a patient transfer. A cylinder that is not secured properly may result in injury to the
patient. Oxygen flow is discontinued by turning the valve clockwise until it is tight.
A nurse providing care of a patient's chest drainage system observes that the chest tube has
become separated from the drainage device. What would be the first action that should be
taken by the nurse in this situation?
Notify the health care provider.
Apply an occlusive dressing on the site.
Assess the patient for signs of respiratory distress.
Put on gloves and insert the chest tube in a bottle of sterile saline. d. When a chest tube
becomes separated from the drainage device, the nurse should submerge the end in water,
creating a water seal, but allowing air to escape, until a new drainage unit can be attached. This
is done instead of clamping to prevent another pneumothorax. Then the nurse should assess
vital signs and notify the health care provider.
An emergency department nurse is using a manual resuscitation bag (Ambu bag) to assist
ventilation in a patient with lung cancer who has stopped breathing on his own. What is an
appropriate step in this procedure?
Tilt the patient's head forward.
Hold the mask tightly over the patient's nose and mouth.
Pull the patient's jaw backward.
Compress the bag twice the normal respiratory rate for the patient. b. With the patient's
head tilted back, jaw pulled forward, and airway cleared, the mask is held tightly over the
patient's nose and mouth. The bag also fits easily over tracheostomy and endotracheal tubes.
ALREADY GRADED A+
A nurse working in a long-term care facility is providing teaching to patients with altered
oxygenation due to conditions such as asthma and COPD. Which measures would the nurse
recommend? Select all that apply.
Refrain from exercise.
Reduce anxiety.
Eat meals 1 to 2 hours prior to breathing treatments.
Eat a high-protein/high-calorie diet.
Maintain a high-Fowler's position when possible.
Drink 2 to 3 pints of clear fluids daily. b, d, e. When caring for patients with COPD, it is
important to create an environment that is likely to reduce anxiety and ensure that they eat a
high-protein/high-calorie diet. People with dyspnea and orthopnea are most comfortable in a
high-Fowler's position because accessory muscles can easily be used to promote respiration.
Patients with COPD should pace physical activities and schedule frequent rest periods to
conserve energy. Meals should be eaten 1 to 2 hours after breathing treatments and exercises,
and drinking 2 to 3 quarts (1.9 to 2.9 L) of clear fluids daily is recommended.
A nurse is assisting a respiratory therapist with chest physiotherapy for patients with ineffective
cough. For which patient might this therapy be recommended?
A postoperative adult
An adult with COPD
A teenager with cystic fibrosis
,A child with pneumonia c. Chest physiotherapy may help loosen and mobilize secretions,
increasing mucus clearance. This is especially helpful for patients with large amounts of
secretions or an ineffective cough, such as patients with cystic fibrosis. Chest physiotherapy has
limited evidence for its effectiveness and is not recommended for use in numerous patient
populations, including children with pneumonia, adults with COPD, and postoperative adults
(Andrews et al., 2013; Lisy, 2014; Strickland et al., 2013).
A nurse is teaching a patient how to use a meter-dosed inhaler for her asthma. Which
comments from the patient assure the nurse that the teaching has been effective? Select all
that apply.
"I will be careful not to shake up the canister before using it."
"I will hold the canister upside down when using it."
"I will inhale the medication through my nose."
"I will continue to inhale when the cold propellant is in my throat."
"I will only inhale one spray with one breath."
"I will activate the device while continuing to inhale." d, e, f. Common mistakes that patients
make when using MDIs include failing to shake the canister, holding the inhaler upside down,
inhaling through the nose rather than the mouth, inhaling too rapidly, stopping the inhalation
when the cold propellant is felt in the throat, failing to hold their breath after inhalation, and
inhaling two sprays with one breath.
A nurse is caring for a patient with chronic lung disease who is receiving oxygen through a nasal
cannula. What nursing action is performed correctly?
The nurse assures that the oxygen is flowing into the prongs.
The nurse adjusts the fit of the cannula so it fits snug and tight against the skin.
,The nurse encourages the patient to breathe through the nose with the mouth closed.
The nurse adjusts the flow rate to 6 L/min or more. c. The nurse should encourage the
patient to breathe through the nose with the mouth closed. The nurse should assure that the
oxygen is flowing out of the prongs prior to inserting them into the patient's nostrils. The nurse
should adjust the fit of the cannula so it is snug but not tight against the skin. The nurse should
adjust the flow rate as ordered.
A nurse is securing a patient's endotracheal tube with tape and observes that the tube depth
changed during the retaping. Which action would be appropriate related to this incident?
Instruct the assistant to notify the primary care provider.
Assess the patient's vital signs.
Remove the tape, adjust the depth to ordered depth and reapply the tape.
No action is required as depth will adjust automatically. c. The tube depth should be
maintained at the same level unless otherwise ordered by the health care provider. If the depth
changes, the nurse should remove the tape, adjust the tube to ordered depth, and reapply the
tape.
What action does the nurse perform to follow safe technique when using a portable oxygen
cylinder?
Checking the amount of oxygen in the cylinder before using it
Using a cylinder for a patient transfer that indicates available oxygen is 500 psi
Placing the oxygen cylinder on the stretcher next to the patient
Discontinuing oxygen flow by turning the cylinder key counterclockwise until tight a. The
cylinder must always be checked before use to ensure that enough oxygen is available for the
, patient. It is unsafe to use a cylinder that reads 500 psi or less because not enough oxygen
remains for a patient transfer. A cylinder that is not secured properly may result in injury to the
patient. Oxygen flow is discontinued by turning the valve clockwise until it is tight.
A nurse providing care of a patient's chest drainage system observes that the chest tube has
become separated from the drainage device. What would be the first action that should be
taken by the nurse in this situation?
Notify the health care provider.
Apply an occlusive dressing on the site.
Assess the patient for signs of respiratory distress.
Put on gloves and insert the chest tube in a bottle of sterile saline. d. When a chest tube
becomes separated from the drainage device, the nurse should submerge the end in water,
creating a water seal, but allowing air to escape, until a new drainage unit can be attached. This
is done instead of clamping to prevent another pneumothorax. Then the nurse should assess
vital signs and notify the health care provider.
An emergency department nurse is using a manual resuscitation bag (Ambu bag) to assist
ventilation in a patient with lung cancer who has stopped breathing on his own. What is an
appropriate step in this procedure?
Tilt the patient's head forward.
Hold the mask tightly over the patient's nose and mouth.
Pull the patient's jaw backward.
Compress the bag twice the normal respiratory rate for the patient. b. With the patient's
head tilted back, jaw pulled forward, and airway cleared, the mask is held tightly over the
patient's nose and mouth. The bag also fits easily over tracheostomy and endotracheal tubes.
