NSG 3800 EXAM 1 COMPREHENSIVE
QUESTIONS WITH VERIFIED PRACTICE
SOLUTIONS
●● The nurse is caring for a patient who has just returned to the unit
after a colon resection. The patient is showing signs of hypoxia. The
nurse knows that this is probably caused by what?
A) Nitrogen narcosis
B) Infection
C) Impaired diffusion
D) Shunting
Answer: D
Feedback: Shunting appears to be the main cause of hypoxia after
thoracic or abdominal surgery and most types of respiratory failure.
Impairment of normal diffusion is a less common cause. Infection would
not likely be present at this early stage of recovery and nitrogen narcosis
only occurs from breathing compressed air.
●● The nurse is assessing a patient who frequently coughs after eating or
drinking. How should the nurse best follow up this assessment finding?
A) Obtain a sputum sample.
B) Perform a swallowing assessment.
C) Inspect the patients tongue and mouth.
,D) Assess the patients nutritional status.
Answer: B
Feedback: Coughing after food intake may indicate aspiration of
material into the tracheobronchial tree; a swallowing assessment is thus
indicated. Obtaining a sputum sample is relevant in cases of suspected
infection. The status of the patients tongue, mouth, and nutrition is not
directly relevant to the problem of aspiration.
●● The ED nurse is assessing a patient complaining of dyspnea. The
nurse auscultates the patients chest and hears wheezing throughout the
lung fields. What might this indicate?
A) The patient has a narrowed airway.
B) The patient has pneumonia.
C) The patient needs physiotherapy.
D) The patient has a hemothorax.
Answer: A
Feedback: Wheezing is a high-pitched, musical sound that is often the
major finding in a patient with bronchoconstriction or airway narrowing.
Wheezing is not normally indicative of pneumonia or hemothorax.
Wheezing does not indicate the need for physiotherapy.
●● The nurse is caring for a patient admitted with an acute exacerbation
of chronic obstructive pulmonary disease. During assessment, the nurse
finds that the patient is experiencing increased dyspnea. What is the
most accurate measurement of the concentration of oxygen in the
patients blood?
,A) A capillary blood sample
B) Pulse oximetry
C) An arterial blood gas (ABG) study
D) A complete blood count (CBC)
Answer: C
Feedback: The arterial oxygen tension (partial pressure or PaO2)
indicates the degree of oxygenation of the blood, and the arterial carbon
dioxide tension (partial pressure or PaCO2) indicates the adequacy of
alveolar
ventilation. ABG studies aid in assessing the ability of the lungs to
provide adequate oxygen and remove carbon dioxide and the ability of
the kidneys to reabsorb or excrete bicarbonate ions to maintain normal
body pH. Capillary blood samples are venous blood, not arterial blood,
so they are not as accurate as an ABG. Pulse oximetry is a useful clinical
tool but does not replace ABG measurement, because it is not as
accurate. A CBC does not indicate the concentration of oxygen.
●● The nurse is caring for a patient who has returned to the unit
following a bronchoscopy. The patient is asking for something to drink.
Which criterion will determine when the nurse should allow the patient
to drink fluids?
A)Presence of a cough and gag reflex
B)Absence of nausea
C) Ability to demonstrate deep inspiration
D) Oxygen saturation of 92%
, Answer: A
Feedback: After the procedure, it is important that the patient takes
nothing by mouth until the cough reflex returns because the preoperative
sedation and local anesthesia impair the protective laryngeal reflex and
swallowing for several hours. Deep inspiration, adequate oxygen
saturation levels, and absence of nausea do not indicate that oral intake
is safe from the risk of aspiration.
●● A patient with chronic lung disease is undergoing lung function
testing. What test result denotes the volume of air inspired and expired
with a normal breath?
A)Total lung capacity
B) Forced vital capacity
C) Tidal volume
D) Residual volume
Answer: C
Feedback: Tidal volume refers to the volume of air inspired and expired
with a normal breath. Total lung capacity is the maximal amount of air
the lungs and respiratory passages can hold after a forced inspiration.
Forced vital capacity is vital capacity performed with a maximally
forced expiration. Residual volume is the maximal amount of air left in
the lung after a maximal expiration.
●● In addition to heart rate, blood pressure, respiratory rate, and
temperature, the nurse needs to assess a patients arterial oxygen
saturation (SaO2). What procedure will best accomplish this?
QUESTIONS WITH VERIFIED PRACTICE
SOLUTIONS
●● The nurse is caring for a patient who has just returned to the unit
after a colon resection. The patient is showing signs of hypoxia. The
nurse knows that this is probably caused by what?
A) Nitrogen narcosis
B) Infection
C) Impaired diffusion
D) Shunting
Answer: D
Feedback: Shunting appears to be the main cause of hypoxia after
thoracic or abdominal surgery and most types of respiratory failure.
Impairment of normal diffusion is a less common cause. Infection would
not likely be present at this early stage of recovery and nitrogen narcosis
only occurs from breathing compressed air.
●● The nurse is assessing a patient who frequently coughs after eating or
drinking. How should the nurse best follow up this assessment finding?
A) Obtain a sputum sample.
B) Perform a swallowing assessment.
C) Inspect the patients tongue and mouth.
,D) Assess the patients nutritional status.
Answer: B
Feedback: Coughing after food intake may indicate aspiration of
material into the tracheobronchial tree; a swallowing assessment is thus
indicated. Obtaining a sputum sample is relevant in cases of suspected
infection. The status of the patients tongue, mouth, and nutrition is not
directly relevant to the problem of aspiration.
●● The ED nurse is assessing a patient complaining of dyspnea. The
nurse auscultates the patients chest and hears wheezing throughout the
lung fields. What might this indicate?
A) The patient has a narrowed airway.
B) The patient has pneumonia.
C) The patient needs physiotherapy.
D) The patient has a hemothorax.
Answer: A
Feedback: Wheezing is a high-pitched, musical sound that is often the
major finding in a patient with bronchoconstriction or airway narrowing.
Wheezing is not normally indicative of pneumonia or hemothorax.
Wheezing does not indicate the need for physiotherapy.
●● The nurse is caring for a patient admitted with an acute exacerbation
of chronic obstructive pulmonary disease. During assessment, the nurse
finds that the patient is experiencing increased dyspnea. What is the
most accurate measurement of the concentration of oxygen in the
patients blood?
,A) A capillary blood sample
B) Pulse oximetry
C) An arterial blood gas (ABG) study
D) A complete blood count (CBC)
Answer: C
Feedback: The arterial oxygen tension (partial pressure or PaO2)
indicates the degree of oxygenation of the blood, and the arterial carbon
dioxide tension (partial pressure or PaCO2) indicates the adequacy of
alveolar
ventilation. ABG studies aid in assessing the ability of the lungs to
provide adequate oxygen and remove carbon dioxide and the ability of
the kidneys to reabsorb or excrete bicarbonate ions to maintain normal
body pH. Capillary blood samples are venous blood, not arterial blood,
so they are not as accurate as an ABG. Pulse oximetry is a useful clinical
tool but does not replace ABG measurement, because it is not as
accurate. A CBC does not indicate the concentration of oxygen.
●● The nurse is caring for a patient who has returned to the unit
following a bronchoscopy. The patient is asking for something to drink.
Which criterion will determine when the nurse should allow the patient
to drink fluids?
A)Presence of a cough and gag reflex
B)Absence of nausea
C) Ability to demonstrate deep inspiration
D) Oxygen saturation of 92%
, Answer: A
Feedback: After the procedure, it is important that the patient takes
nothing by mouth until the cough reflex returns because the preoperative
sedation and local anesthesia impair the protective laryngeal reflex and
swallowing for several hours. Deep inspiration, adequate oxygen
saturation levels, and absence of nausea do not indicate that oral intake
is safe from the risk of aspiration.
●● A patient with chronic lung disease is undergoing lung function
testing. What test result denotes the volume of air inspired and expired
with a normal breath?
A)Total lung capacity
B) Forced vital capacity
C) Tidal volume
D) Residual volume
Answer: C
Feedback: Tidal volume refers to the volume of air inspired and expired
with a normal breath. Total lung capacity is the maximal amount of air
the lungs and respiratory passages can hold after a forced inspiration.
Forced vital capacity is vital capacity performed with a maximally
forced expiration. Residual volume is the maximal amount of air left in
the lung after a maximal expiration.
●● In addition to heart rate, blood pressure, respiratory rate, and
temperature, the nurse needs to assess a patients arterial oxygen
saturation (SaO2). What procedure will best accomplish this?
