NU 300 EXAM 3 | COMPREHENSIVE MEDICAL-SURGICAL NURSING STUDY GUIDE,
PRACTICE QUESTIONS & ANSWERS 2026/2027
identify the reason for the use of accessory muscles for breathing - ANS ✔✔the pt is experiencing some
form of respiratory distress
what will the nurse seen upon physical assessment if a patient is using accessory muscles to breathe? -
ANS ✔✔use of neck, chest, abdominal muscles when breathing
many changes occur in the respiratory system as a person ages. what impact do these changes have on
the function of the respiratory system of an older adult? - ANS ✔✔alveolar surface area decreases,
ability to cough decreases, elasticity decreases, muscle atrophy
what are key interventions to promote health in the older population related to the respiratory system? -
ANS ✔✔encourage pulmonary hygiene, encourage upright position, encourage frequent oral hygiene
what drugs are contraindicated due to CV and mental health risks? - ANS ✔✔bupropion and chantix
(mania, hallucination), nicotine patches (stroke, MI)
identify strategies to help a person stop smoking - ANS ✔✔write pros and cons, set a stop date and stick
to in, seek support, remove stimulus and replace, find hand busying activities, keep low cal snacks,
positive comments, 8 glasses of water per day
high flow nasal cannula - ANS ✔✔30-60 L/min, heat and humidity provide higher concentration, less
tissue trauma and improve end expiratory volume
venturi mask - ANS ✔✔most accurate, humidification not needed, best for patients with chronic lung
diseases
low flow nasal cannula - ANS ✔✔1-6 L/min, apply water soluble jelly to nares PRN
simple face mask - ANS ✔✔5-8 L/min, skin care to area covered by mask
partial rebreather mask - ANS ✔✔6-11 L/min, keep reservoir bag inflated
what complications should the nurse monitor for following placement of a trach? - ANS ✔✔tube
obstruction, dislodgement/decannulation, pneumothorax, subq emphysema, bleeding, infection
tracheomalacia s/s - ANS ✔✔increased amt of air required in cuff to maintain seal, larger tube is
required to prevent air leak, food particles seen in tracheal secretions, pt does not receive set tidal
volume on ventilator
tracheomalacia management - ANS ✔✔nothing unless bleeding occurs
tracheomalacia prevention - ANS ✔✔use an uncuffed tube as soon as possible, monitor cuff pressure
and air volumes closely and detect changes
, tracheal stenosis s/s - ANS ✔✔increased coughing, inability to expectorate secretions, dyspnea, difficulty
talking
tracheal stenosis management - ANS ✔✔tracheal dilation, surgical intervention
tracheal stenosis prevention - ANS ✔✔prevent pulling of and traction on the tube, properly secure the
tube, maintain proper cuff pressure, minimize oronasal intubation time
tracheoesophageal fistula (TEF) s/s - ANS ✔✔food particles in tracheal secretions, increased air in cuff
needed to achieve seal, increased coughing and choking while eating, does not receive set tidal volume
on ventilator
TEF management - ANS ✔✔manually administer oxygen, small/soft feeding tube instead of NG tube,
gastrostomy/jejunostomy
TEF prevention - ANS ✔✔maintain cuff pressure, monitor amt of air needed for inflation/changes,
progress to deflated cuff/cuffless tube asap
trachea-innominate artery fistula s/s - ANS ✔✔tube pulsates with heartbeat, heavy bleeding from
stoma, LIFE THREATENING
trachea-innominate artery fistula management - ANS ✔✔remove tube immediately, apply direct
pressure to innominate artery at stoma site, prep patient for repair surgery
trachea-innominate artery fistula prevention - ANS ✔✔correct tube size/length/position, prevent
pulling/tugging on tube, notify DR of pulsating tube
identify strategies to prevent aspiration with trach patients - ANS ✔✔avoid serving meals when pt
fatigued, provide smaller and more frequent meals, close supervision, avoid water and thin liquids
(thicken them), avoid foods generating thin liquids, upright position, deflate tube cuff during meals, dry
swallow after each bite
how will the nurse know someone has a nasal fracture? - ANS ✔✔deviations, misaligned nasal bridge,
change in nasal breathing pattern, crepitus on palpation, bruising, pain, blood or CSF drainage from the
nose
key interventions r/t nasal fracture/surgery - ANS ✔✔pain relief, cold compress, semi-fowlers, move
slowly
nasal cancer s/s - ANS ✔✔asian american, HX of exposure to dusts, mustard gas, smoking, nasal
stuffiness, obstruction drainage, bleeding, persistent pain, lymphadenopathy, change in taste or smell
with radiation
facial fracture/trauma s/s - ANS ✔✔stridor, hypercarbia, SOB, anxiety, altered O2 sat, edema, altered
symmetry, pain, leaking CSF from ears or nose, vision EOM, battle sign
PRACTICE QUESTIONS & ANSWERS 2026/2027
identify the reason for the use of accessory muscles for breathing - ANS ✔✔the pt is experiencing some
form of respiratory distress
what will the nurse seen upon physical assessment if a patient is using accessory muscles to breathe? -
ANS ✔✔use of neck, chest, abdominal muscles when breathing
many changes occur in the respiratory system as a person ages. what impact do these changes have on
the function of the respiratory system of an older adult? - ANS ✔✔alveolar surface area decreases,
ability to cough decreases, elasticity decreases, muscle atrophy
what are key interventions to promote health in the older population related to the respiratory system? -
ANS ✔✔encourage pulmonary hygiene, encourage upright position, encourage frequent oral hygiene
what drugs are contraindicated due to CV and mental health risks? - ANS ✔✔bupropion and chantix
(mania, hallucination), nicotine patches (stroke, MI)
identify strategies to help a person stop smoking - ANS ✔✔write pros and cons, set a stop date and stick
to in, seek support, remove stimulus and replace, find hand busying activities, keep low cal snacks,
positive comments, 8 glasses of water per day
high flow nasal cannula - ANS ✔✔30-60 L/min, heat and humidity provide higher concentration, less
tissue trauma and improve end expiratory volume
venturi mask - ANS ✔✔most accurate, humidification not needed, best for patients with chronic lung
diseases
low flow nasal cannula - ANS ✔✔1-6 L/min, apply water soluble jelly to nares PRN
simple face mask - ANS ✔✔5-8 L/min, skin care to area covered by mask
partial rebreather mask - ANS ✔✔6-11 L/min, keep reservoir bag inflated
what complications should the nurse monitor for following placement of a trach? - ANS ✔✔tube
obstruction, dislodgement/decannulation, pneumothorax, subq emphysema, bleeding, infection
tracheomalacia s/s - ANS ✔✔increased amt of air required in cuff to maintain seal, larger tube is
required to prevent air leak, food particles seen in tracheal secretions, pt does not receive set tidal
volume on ventilator
tracheomalacia management - ANS ✔✔nothing unless bleeding occurs
tracheomalacia prevention - ANS ✔✔use an uncuffed tube as soon as possible, monitor cuff pressure
and air volumes closely and detect changes
, tracheal stenosis s/s - ANS ✔✔increased coughing, inability to expectorate secretions, dyspnea, difficulty
talking
tracheal stenosis management - ANS ✔✔tracheal dilation, surgical intervention
tracheal stenosis prevention - ANS ✔✔prevent pulling of and traction on the tube, properly secure the
tube, maintain proper cuff pressure, minimize oronasal intubation time
tracheoesophageal fistula (TEF) s/s - ANS ✔✔food particles in tracheal secretions, increased air in cuff
needed to achieve seal, increased coughing and choking while eating, does not receive set tidal volume
on ventilator
TEF management - ANS ✔✔manually administer oxygen, small/soft feeding tube instead of NG tube,
gastrostomy/jejunostomy
TEF prevention - ANS ✔✔maintain cuff pressure, monitor amt of air needed for inflation/changes,
progress to deflated cuff/cuffless tube asap
trachea-innominate artery fistula s/s - ANS ✔✔tube pulsates with heartbeat, heavy bleeding from
stoma, LIFE THREATENING
trachea-innominate artery fistula management - ANS ✔✔remove tube immediately, apply direct
pressure to innominate artery at stoma site, prep patient for repair surgery
trachea-innominate artery fistula prevention - ANS ✔✔correct tube size/length/position, prevent
pulling/tugging on tube, notify DR of pulsating tube
identify strategies to prevent aspiration with trach patients - ANS ✔✔avoid serving meals when pt
fatigued, provide smaller and more frequent meals, close supervision, avoid water and thin liquids
(thicken them), avoid foods generating thin liquids, upright position, deflate tube cuff during meals, dry
swallow after each bite
how will the nurse know someone has a nasal fracture? - ANS ✔✔deviations, misaligned nasal bridge,
change in nasal breathing pattern, crepitus on palpation, bruising, pain, blood or CSF drainage from the
nose
key interventions r/t nasal fracture/surgery - ANS ✔✔pain relief, cold compress, semi-fowlers, move
slowly
nasal cancer s/s - ANS ✔✔asian american, HX of exposure to dusts, mustard gas, smoking, nasal
stuffiness, obstruction drainage, bleeding, persistent pain, lymphadenopathy, change in taste or smell
with radiation
facial fracture/trauma s/s - ANS ✔✔stridor, hypercarbia, SOB, anxiety, altered O2 sat, edema, altered
symmetry, pain, leaking CSF from ears or nose, vision EOM, battle sign
