Chapter 28. Respiratory Care
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. Which of the following mechanisms results in inhalation?
1. The intercostal muscles relax.
2. The ribs move inward.
3. The diaphragm contracts.
4. Pressure within the lungs raises above atmospheric pressure.
2. A nurse is caring for a patient with a high blood level of carbon dioxide. The nurse would expect which of the
following responses by the body’s respiratory system?
1. The breathing rate increases.
2. The breathing rate slows.
3. The breathing rate will not be affected.
4. The breathing stops.
3. A nurse is caring for an African American individual with a long history of lung disease. The nurse would
be most concerned if
1. The patient’s respiratory rate is 22.
2. The patient’s oxygen saturation was 96%.
3. The patient’s skin is warm and moist.
4. The patient’s mucous membranes are ashen.
4. A student nurse is providing care for a patient who becomes short of breath while ambulating to the bathroom.
The best way for the student to document this finding is to write:
1. “Patient cyanotic with ambulation.”
2. “Dyspnea noted after walking 15 feet.”
3. “Patient complains that he can’t catch his breath.”
4. “Hypoxemia present after walking to the bathroom.”
5. A nurse enters a room and notes that a patient has a very productive cough. The nurse would be most
concerned about a life-threatening situation if the sputum looks
1. Greenish yellow.
2. Frothy and pink-tinged.
3. Thick and white.
4. Rusty in color.
6. While caring for a patient with pneumonia, a nurse notes that the patient’s sputum is greenish and very thick.
The highest priority in the patient’s plan of care is to
1. Encourage the use of the incentive spirometer.
2. Provide pain medication every 4 hours as ordered.
3. Provide a bedside commode.
4. Encourage the patient to increase oral intake.
7. A nurse is caring for a patient with a chest tube who has notable crepitus at the chest tube site, extending
across the chest about 3 inches. The best statement the nurse can make is:
1. “Don’t worry. That happens with a lot of chest tubes. We’ll simply mark this and keep
an eye on it.”
2. “That is a local swelling caused by the trauma of having the tube placed. It will go down a
few days after the tube comes out.”
, 3. “There are some new, small pockets of air under your skin that I’d like to have the
doctor examine.”
4. “You may be developing an infection. I’d like to check your temperature and change
the chest tube dressing so that I can see the site.”
8. A nurse is caring for a number of patients on a medical unit. The patient of the highest priority is
1. A 22-year-old with pneumonia who is restless and confused.
2. A 41-year-old with a chest tube who has noted tidaling.
3. A 58-year-old with chronic obstructive pulmonary disease with a nonproductive cough.
4. A 72-year-old with pneumonia who has rusty-colored sputum.
9. A nurse notes a new order for sputum specimen for culture to be collected on a 91-year-old. The patient has
a weak cough. The best action by the nurse is to
1. Place a clean cup at the patient’s bedside and instruct him or her to spit into it whenever
he or she is able.
2. Contact respiratory therapy to induce sputum collection.
3. Explain the order to the patient and plan sputum collection for the following morning.
4. Encourage the patient to limit fluid intake so that sputum can be more readily collected.
10. A nurse working in a pediatrician’s office is preparing to do a throat culture for a 5-year-old. The child’s
parent asks, “Why do we have to do this?” The best statement the nurse could make to the child’s parent
is:
1. “It is important to identify and treat a Streptococcus infection quickly to prevent
major illness.”
2. “We need to test every sick child for whooping cough.”
3. “Doctors have really cut down on how many antibiotics are given because the insurance
companies won’t pay for them.”
4. “Throat cultures are primarily used to test children for the mumps.”
11. Which of the following pH values indicates the presence of alkalosis?
1. 7.28
2. 7.34
3. 7.43
4. 7.47
12. A nurse is reinforcing instructions to use the incentive spirometer. Further teaching is necessary if the patient
states:
1. “I was able to get the ball up to the marked level today.”
2. “I blew into that thing 10 times a little while ago.”
3. “I’ve been using the incentive spirometer every hour.”
4. “I feel so tired when I finish using the incentive spirometer.”
13. A nurse enters the room of a patient who is taking a nebulizer treatment set up by the respiratory therapist.
The nurse should intervene if
1. The patient is breathing in and out through the nose.
2. Mist is coming out of the end of the nebulizer hose.
3. The nebulizer is connected to compressor tubing.
4. Liquid is seen in the nebulizer cup.
14. Which type of airway would not be used on a conscious patient?
1. Tracheostomy
2. Nasal trumpet
3. Oropharyngeal airway
4. Endotracheal tube
, 15. While preparing to feed a patient with a tracheostomy tube connected to mechanical ventilation, a nurse notes
that the cuff is deflated. Which of the following actions should the nurse take first?
1. No action is required.
2. The nurse should check the most recent ABG (arterial blood gas) results.
3. The nurse should inflate the cuff.
4. The nurse should listen to breath sounds.
16. While observing a student nurse perform open tracheostomy suctioning, a nurse recognizes that further
instruction is required if
1. The student dons sterile gloves before touching the suction catheter.
2. The student suctions the patient’s mouth and then uses the same catheter to suction
the tracheostomy.
3. The student discards the suction catheter and other supplies into the patient’s
bedside biohazard trashcan.
4. The student lubricates the suction catheter with sterile normal saline.
17. A nurse is caring for a patient with a tracheostomy collar who has a weak cough and has rattling sounds in her
throat. The best action by the nurse is to
1. Reduce the humidity of the oxygen.
2. Replace the obturator.
3. Remove the outer cannula.
4. Suction the patient.
18. A student nurse is observing care given to a patient who had cardiothoracic surgery and who now has two
chest tubes in the left chest connected by Y tubing. One of the patient’s family members asks why the lower
chest tube has a great deal of drainage while the upper chest tube has minimal drainage. The best response
by
the student nurse is:
1. “The upper chest tube is being used to drain air from the chest while the lower one drains
blood and fluid.”
2. “The upper chest tube is there in case the fluid accumulates near the level of the heart.”
3. “The lower chest tube serves as the first drainage system, and if it fills up, the upper tube
will begin to drain.”
4. “How much drainage is seen in each tube really depends on the type of surgery done.
Sometimes the upper one drains more than it does for this case.”
19. A nurse is caring for a patient with a pneumothorax and a newly placed right-sided anterior chest tube
connected to dry suction. The nurse notes bubbles in the middle chamber. What should the nurse
should conclude?
1. This is expected with a pneumothorax and will not be seen once the pneumothorax has
resolved.
2. This indicates an air leak; the nurse should examine and secure all connections with tape.
3. This indicates a malfunction in the suction setup; the nurse should stop the suction and
notify the physician.
4. This is expected with all chest tubes and indicates that the suction is functioning properly.
20. An instructor explains that the alveoli are air sacs encircled by tiny capillaries and that oxygen moves via
diffusion from an area of higher concentration to an area of lower concentration. A student identifies this
process as
1. Internal respiration.
2. External respiration.
3. Inspiration.
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. Which of the following mechanisms results in inhalation?
1. The intercostal muscles relax.
2. The ribs move inward.
3. The diaphragm contracts.
4. Pressure within the lungs raises above atmospheric pressure.
2. A nurse is caring for a patient with a high blood level of carbon dioxide. The nurse would expect which of the
following responses by the body’s respiratory system?
1. The breathing rate increases.
2. The breathing rate slows.
3. The breathing rate will not be affected.
4. The breathing stops.
3. A nurse is caring for an African American individual with a long history of lung disease. The nurse would
be most concerned if
1. The patient’s respiratory rate is 22.
2. The patient’s oxygen saturation was 96%.
3. The patient’s skin is warm and moist.
4. The patient’s mucous membranes are ashen.
4. A student nurse is providing care for a patient who becomes short of breath while ambulating to the bathroom.
The best way for the student to document this finding is to write:
1. “Patient cyanotic with ambulation.”
2. “Dyspnea noted after walking 15 feet.”
3. “Patient complains that he can’t catch his breath.”
4. “Hypoxemia present after walking to the bathroom.”
5. A nurse enters a room and notes that a patient has a very productive cough. The nurse would be most
concerned about a life-threatening situation if the sputum looks
1. Greenish yellow.
2. Frothy and pink-tinged.
3. Thick and white.
4. Rusty in color.
6. While caring for a patient with pneumonia, a nurse notes that the patient’s sputum is greenish and very thick.
The highest priority in the patient’s plan of care is to
1. Encourage the use of the incentive spirometer.
2. Provide pain medication every 4 hours as ordered.
3. Provide a bedside commode.
4. Encourage the patient to increase oral intake.
7. A nurse is caring for a patient with a chest tube who has notable crepitus at the chest tube site, extending
across the chest about 3 inches. The best statement the nurse can make is:
1. “Don’t worry. That happens with a lot of chest tubes. We’ll simply mark this and keep
an eye on it.”
2. “That is a local swelling caused by the trauma of having the tube placed. It will go down a
few days after the tube comes out.”
, 3. “There are some new, small pockets of air under your skin that I’d like to have the
doctor examine.”
4. “You may be developing an infection. I’d like to check your temperature and change
the chest tube dressing so that I can see the site.”
8. A nurse is caring for a number of patients on a medical unit. The patient of the highest priority is
1. A 22-year-old with pneumonia who is restless and confused.
2. A 41-year-old with a chest tube who has noted tidaling.
3. A 58-year-old with chronic obstructive pulmonary disease with a nonproductive cough.
4. A 72-year-old with pneumonia who has rusty-colored sputum.
9. A nurse notes a new order for sputum specimen for culture to be collected on a 91-year-old. The patient has
a weak cough. The best action by the nurse is to
1. Place a clean cup at the patient’s bedside and instruct him or her to spit into it whenever
he or she is able.
2. Contact respiratory therapy to induce sputum collection.
3. Explain the order to the patient and plan sputum collection for the following morning.
4. Encourage the patient to limit fluid intake so that sputum can be more readily collected.
10. A nurse working in a pediatrician’s office is preparing to do a throat culture for a 5-year-old. The child’s
parent asks, “Why do we have to do this?” The best statement the nurse could make to the child’s parent
is:
1. “It is important to identify and treat a Streptococcus infection quickly to prevent
major illness.”
2. “We need to test every sick child for whooping cough.”
3. “Doctors have really cut down on how many antibiotics are given because the insurance
companies won’t pay for them.”
4. “Throat cultures are primarily used to test children for the mumps.”
11. Which of the following pH values indicates the presence of alkalosis?
1. 7.28
2. 7.34
3. 7.43
4. 7.47
12. A nurse is reinforcing instructions to use the incentive spirometer. Further teaching is necessary if the patient
states:
1. “I was able to get the ball up to the marked level today.”
2. “I blew into that thing 10 times a little while ago.”
3. “I’ve been using the incentive spirometer every hour.”
4. “I feel so tired when I finish using the incentive spirometer.”
13. A nurse enters the room of a patient who is taking a nebulizer treatment set up by the respiratory therapist.
The nurse should intervene if
1. The patient is breathing in and out through the nose.
2. Mist is coming out of the end of the nebulizer hose.
3. The nebulizer is connected to compressor tubing.
4. Liquid is seen in the nebulizer cup.
14. Which type of airway would not be used on a conscious patient?
1. Tracheostomy
2. Nasal trumpet
3. Oropharyngeal airway
4. Endotracheal tube
, 15. While preparing to feed a patient with a tracheostomy tube connected to mechanical ventilation, a nurse notes
that the cuff is deflated. Which of the following actions should the nurse take first?
1. No action is required.
2. The nurse should check the most recent ABG (arterial blood gas) results.
3. The nurse should inflate the cuff.
4. The nurse should listen to breath sounds.
16. While observing a student nurse perform open tracheostomy suctioning, a nurse recognizes that further
instruction is required if
1. The student dons sterile gloves before touching the suction catheter.
2. The student suctions the patient’s mouth and then uses the same catheter to suction
the tracheostomy.
3. The student discards the suction catheter and other supplies into the patient’s
bedside biohazard trashcan.
4. The student lubricates the suction catheter with sterile normal saline.
17. A nurse is caring for a patient with a tracheostomy collar who has a weak cough and has rattling sounds in her
throat. The best action by the nurse is to
1. Reduce the humidity of the oxygen.
2. Replace the obturator.
3. Remove the outer cannula.
4. Suction the patient.
18. A student nurse is observing care given to a patient who had cardiothoracic surgery and who now has two
chest tubes in the left chest connected by Y tubing. One of the patient’s family members asks why the lower
chest tube has a great deal of drainage while the upper chest tube has minimal drainage. The best response
by
the student nurse is:
1. “The upper chest tube is being used to drain air from the chest while the lower one drains
blood and fluid.”
2. “The upper chest tube is there in case the fluid accumulates near the level of the heart.”
3. “The lower chest tube serves as the first drainage system, and if it fills up, the upper tube
will begin to drain.”
4. “How much drainage is seen in each tube really depends on the type of surgery done.
Sometimes the upper one drains more than it does for this case.”
19. A nurse is caring for a patient with a pneumothorax and a newly placed right-sided anterior chest tube
connected to dry suction. The nurse notes bubbles in the middle chamber. What should the nurse
should conclude?
1. This is expected with a pneumothorax and will not be seen once the pneumothorax has
resolved.
2. This indicates an air leak; the nurse should examine and secure all connections with tape.
3. This indicates a malfunction in the suction setup; the nurse should stop the suction and
notify the physician.
4. This is expected with all chest tubes and indicates that the suction is functioning properly.
20. An instructor explains that the alveoli are air sacs encircled by tiny capillaries and that oxygen moves via
diffusion from an area of higher concentration to an area of lower concentration. A student identifies this
process as
1. Internal respiration.
2. External respiration.
3. Inspiration.
