Respiratory NCLEX Questions and Answers Graded A

Respiratory NCLEX Questions and Answers Graded A A client comes to the emergency department with a productive cough. Which symptom does the nurse look for that will require immediate attention? A. Blood in the sputum B. Mucoid sputum C. Pink frothy sputum D. Yellow sputum - ANS- C) Pink frothy sputum is common with pulmonary edema and requires immediate attention and intervention to prevent the client's condition from getting worse. A client complains of worsening nasal congestion despite the use of oxymetazoline (Afrin) nasal spray every 2 hours. What is the nurse's best response? A. "Oxymetazoline is not an effective nasal decongestant." B. "Overuse of nasal decongestants results in rebound congestion." C. "Oxymetazoline should be administered every hour for severe congestion." D. "You are probably displaying an idiosyncratic reaction to oxymetazoline." - ANS- B) Oxymetazoline (Afrin) is an effective nasal decongestant, but overuse results in worsening or "rebound" congestion. It should not be used more than every 4 hours. To avoid future rebound congestion with nasal sprays, it is recommended that they be used for no more than 3 to 5 days. A client demonstrates understanding of flunisolide (AeroBid) by saying that he will do what? a. Take two puffs to treat an acute asthma attack. b. Rinse his mouth with water after each use. c. Immediately stop taking his oral prednisone when he starts using AeroBid. d. Not use his albuterol inhaler while he is taking AeroBid. - ANS- B) Flunisolide (AeroBid) is an inhaled corticosteroid. Rinsing the mouth will help prevent oral candidal infections. It is not used to treat an acute asthma attack and should be taken with the client's bronchodilator medications. If the client is taking oral prednisone, it needs to be tapered off to prevent acute adrenal crisis because flunisolide is minimally absorbed systemically. A client had a thoracentesis 1 day ago. He calls the home health agency and tells the nurse that he is very short of breath and anxious. What is the major concern of the nurse? A. Abscess B. Pneumonia C. Pneumothorax D. Pulmonary embolism - ANS- C) A pneumothorax would be the complication of thoracentesis that causes the greatest concern, along with these symptoms. A client has been diagnosed with asthma. Which statement below indicates that he correctly understands how to use an inhaler with a spacer correctly? A. "I don't have to wait between the two puffs if I use a spacer." B. "If the spacer makes a whistling sound, I am breathing in too rapidly." C. "I should rinse my mouth and then swallow the water to get all of the medicine." D. "Shake the inhaler only if you want to see whether it is empty." - ANS- B) Slow and deep breaths ensure that the medication is reaching deeply into the lungs. The whistling noise serves as a reminder to the client of which technique needs to be used. A client has just been admitted to the intensive care unit (ICU) after having a left lower lobectomy with a video-assisted thoracoscopic surgery (VATS). Which of these requests will the nurse implement first? A. Adjust oxygen flow rate to keep O2 saturation at 93% to 100%. B. Administer 2 g of cephalothin (Keflin) IV now. C. Give morphine sulfate 4 to 6 mg IV for pain. D. Infuse 1 unit of packed red blood cells (PRBCs) over the next 2 hours. - ANS- A) Airway and oxygenation are main priorities in the immediate postoperative period. The client will likely be intubated, so coordination of care with Respiratory Therapy will be important. A client has returned to the postanesthesia care unit (PACU) after a bronchoscopy. Which of these nursing tasks is best for the charge nurse to delegate to the experienced nursing assistant working in PACU? A. Assess breath sounds. B. Check gag reflex. C. Determine level of consciousness. D. Monitor blood pressure and pulse. - ANS- D) A nursing assistant working in the PACU would have experience in taking client vital signs after the client has had conscious sedation or anesthesia. A client is admitted to the medical floor with a new diagnosis of lung cancer. How can the nurse assist the client initially with the anxiety associated with the new diagnosis? A. Encourage client to ask questions and verbalize concerns. B. Leave client alone to deal with his own feelings. C. Medicate client with diazepam (Valium) for anxiety every 8 hours. D. Provide journals about cancer treatment. - ANS- A) Anxiety causes increased oxygen consumption. Oxygen availability is limited in lung cancer. The availability of the nurse to answer questions and listen to the client's concerns will decrease anxiety. A client is admitted to the surgical floor with chest pain, shortness of breath, and hypoxemia after having a knee replacement. What diagnostic test will the nurse teach the client about to help confirm the diagnosis? A. Bronchoscopy B. Chest x-ray C. Computed tomography (CT) scan D. Thoracoscopy - ANS- C) CT scans, especially spiral or helical CT scans, with injected contrast can detect pulmonary emboli. A client is admitted with asthma. How is this disease differentiated from other chronic lung disorders? A. It affects only young people. B. The client has dyspnea. C. The client is coughing. D. The client is symptom free between exacerbations. - ANS- D) The client may be completely symptom free between exacerbations. A client is having surgery. He asks his nurse, "When they put that tube in my throat, where does it really go?" What is the name of the opening of the vocal cords? A. Arytenoid cartilage B. Epiglottis C. Glottis D. Palatine tonsils - ANS- C) The glottis is the opening of the vocal cords into which the endotracheal tube is passed during intubation for surgery. A client is prescribed an antitussive medication. What is the most important thing for the nurse to teach the client? A. "This medication may cause drowsiness and dizziness." B. "Watch out for diarrhea and abdominal cramping." C. "This may cause tremors and anxiety." D. "Headache and hypertension are common side effects." - ANS- A) Antitussive medications also affect the CNS, thus causing drowsiness and dizziness. A client is prescribed ipratropium and cromolyn sodium. What will the nurse teach the client? a. "Do not take these medications within 4 hours of each other." b. "Take the ipratropium at least 5 minutes before the cromolyn." c. "Administer both medications together in a metered-dose inhaler." d. "Take the ipratropium only in the mornings." - ANS- B) When using an anticholinergic in conjunction with an inhaled glucocorticoid or cromolyn, the ipratropium should be used 5 minutes before the steroid. This causes the bronchioles to dilate so the steroid or cromolyn can get deeper into the lungs. A client who has fallen off a roof arrives in the emergency department with possible head, neck, and chest trauma. All of these physician requests are received. Which action will the nurse take first? A. Give oxygen to keep O2 saturation greater than 93%. B. Immobilize the neck with a cervical collar. C. Infuse normal saline by large-bore IV catheter.