RESPIRATORY EXAM MED-SURG
QUESTIONS AND ANSWERS
The nurse is caring for a patient with chronic obstructive pulmonary disorder (COPD)
and pneumonia who has an order for arterial blood gases to be drawn. What is the
minimum length of time the nurse should plan to hold pressure on the puncture site?
A. 2 minutes
B. 5 minutes
C. 10 minutes
D. 15 minutes - Answer-B. 5 minutes
After obtaining blood for an arterial blood gas measurement, the nurse should hold
pressure on the puncture site for 5 minutes by the clock to be sure that bleeding has
stopped. An artery is an elastic vessel under much higher pressure than veins, and
significant blood loss or hematoma formation could occur if the time is insufficient.
A patient with a recent history of a dry cough has had a chest x-ray that revealed the
presence of nodules. In an effort to determine whether the nodules are malignant or
benign, what is the primary care provider likely to order?
A. Thoracentesis
B. Pulmonary angiogram
C. CT scan of the patient's chest
D. Positron emission tomography (PET) - Answer-D. Positron emission tomography
(PET)
PET is used to distinguish benign and malignant pulmonary nodules. Because
malignant lung cells have an increased uptake of glucose, the PET scan (which uses an
IV radioactive glucose preparation) can demonstrate increased uptake of glucose in
malignant lung cells. This differentiation cannot be made using CT, a pulmonary
angiogram, or thoracentesis.
After assisting at the bedside with a thoracentesis, the nurse should continue to assess
the patient for signs and symptoms of what?
A. Bronchospasm
B. Pneumothorax
C. Pulmonary edema
D. Respiratory acidosis - Answer-B. Pneumothorax
Because thoracentesis involves the introduction of a catheter into the pleural space,
there is a risk of pneumothorax. Thoracentesis does not carry a significant potential for
causing bronchospasm, pulmonary edema, or respiratory acidosis.
, The patient had abdominal surgery yesterday. Today the lung sounds in the lower lobes
have decreased. The nurse knows this could be due to what occurring?
A. Pain
B. Atelectasis
C. Pneumonia
D. Pleural effusion - Answer-B. Atelectasis
Postoperatively there is an increased risk for atelectasis from anesthesia as well as
restricted breathing from pain. Without deep breathing to stretch the alveoli, surfactant
secretion to hold the alveoli open is not promoted. Pneumonia will occur later after
surgery. Pleural effusion occurs because of blockage of lymphatic drainage or an
imbalance between intravascular and oncotic fluid pressures, which is not expected in
this case
The patient is hospitalized with pneumonia. Which diagnostic test should be used to
measure the efficiency of gas transfer in the lung and tissue oxygenation?
A. Thoracentesis
B. Bronchoscopy
C. Arterial blood gases
D. Pulmonary function tests - Answer-C. Arterial blood gases
Arterial blood gases are used to assess the efficiency of gas transfer in the lung and
tissue oxygenation as is pulse oximetry. Thoracentesis is used to obtain specimens for
diagnostic evaluation, remove pleural fluid, or instill medication into the pleural space.
Bronchoscopy is used for diagnostic purposes, to obtain biopsy specimens, and to
assess changes resulting from treatment. Pulmonary function tests measure lung
volumes and airflow to diagnose pulmonary disease, monitor disease progression,
evaluate disability, and evaluate response to bronchodilators
The nurse is interpreting a tuberculin skin test (TST) for a 58-year-old female patient
with end-stage kidney disease secondary to diabetes mellitus. Which finding would
indicate a positive reaction?
A. Acid-fast bacilli cultured at the injection site
B. 15-mm area of redness at the TST injection site
C. 11-mm area of induration at the TST injection site
D. Wheal formed immediately after intradermal injection - Answer-C. 11-mm area of
induration at the TST injection site
An area of induration ≥ 10 mm would be a positive reaction in a person with end-stage
kidney disease. Reddened, flat areas do not indicate a positive reaction. A wheal
appears when the TST is administered that indicates correct administration of the
QUESTIONS AND ANSWERS
The nurse is caring for a patient with chronic obstructive pulmonary disorder (COPD)
and pneumonia who has an order for arterial blood gases to be drawn. What is the
minimum length of time the nurse should plan to hold pressure on the puncture site?
A. 2 minutes
B. 5 minutes
C. 10 minutes
D. 15 minutes - Answer-B. 5 minutes
After obtaining blood for an arterial blood gas measurement, the nurse should hold
pressure on the puncture site for 5 minutes by the clock to be sure that bleeding has
stopped. An artery is an elastic vessel under much higher pressure than veins, and
significant blood loss or hematoma formation could occur if the time is insufficient.
A patient with a recent history of a dry cough has had a chest x-ray that revealed the
presence of nodules. In an effort to determine whether the nodules are malignant or
benign, what is the primary care provider likely to order?
A. Thoracentesis
B. Pulmonary angiogram
C. CT scan of the patient's chest
D. Positron emission tomography (PET) - Answer-D. Positron emission tomography
(PET)
PET is used to distinguish benign and malignant pulmonary nodules. Because
malignant lung cells have an increased uptake of glucose, the PET scan (which uses an
IV radioactive glucose preparation) can demonstrate increased uptake of glucose in
malignant lung cells. This differentiation cannot be made using CT, a pulmonary
angiogram, or thoracentesis.
After assisting at the bedside with a thoracentesis, the nurse should continue to assess
the patient for signs and symptoms of what?
A. Bronchospasm
B. Pneumothorax
C. Pulmonary edema
D. Respiratory acidosis - Answer-B. Pneumothorax
Because thoracentesis involves the introduction of a catheter into the pleural space,
there is a risk of pneumothorax. Thoracentesis does not carry a significant potential for
causing bronchospasm, pulmonary edema, or respiratory acidosis.
, The patient had abdominal surgery yesterday. Today the lung sounds in the lower lobes
have decreased. The nurse knows this could be due to what occurring?
A. Pain
B. Atelectasis
C. Pneumonia
D. Pleural effusion - Answer-B. Atelectasis
Postoperatively there is an increased risk for atelectasis from anesthesia as well as
restricted breathing from pain. Without deep breathing to stretch the alveoli, surfactant
secretion to hold the alveoli open is not promoted. Pneumonia will occur later after
surgery. Pleural effusion occurs because of blockage of lymphatic drainage or an
imbalance between intravascular and oncotic fluid pressures, which is not expected in
this case
The patient is hospitalized with pneumonia. Which diagnostic test should be used to
measure the efficiency of gas transfer in the lung and tissue oxygenation?
A. Thoracentesis
B. Bronchoscopy
C. Arterial blood gases
D. Pulmonary function tests - Answer-C. Arterial blood gases
Arterial blood gases are used to assess the efficiency of gas transfer in the lung and
tissue oxygenation as is pulse oximetry. Thoracentesis is used to obtain specimens for
diagnostic evaluation, remove pleural fluid, or instill medication into the pleural space.
Bronchoscopy is used for diagnostic purposes, to obtain biopsy specimens, and to
assess changes resulting from treatment. Pulmonary function tests measure lung
volumes and airflow to diagnose pulmonary disease, monitor disease progression,
evaluate disability, and evaluate response to bronchodilators
The nurse is interpreting a tuberculin skin test (TST) for a 58-year-old female patient
with end-stage kidney disease secondary to diabetes mellitus. Which finding would
indicate a positive reaction?
A. Acid-fast bacilli cultured at the injection site
B. 15-mm area of redness at the TST injection site
C. 11-mm area of induration at the TST injection site
D. Wheal formed immediately after intradermal injection - Answer-C. 11-mm area of
induration at the TST injection site
An area of induration ≥ 10 mm would be a positive reaction in a person with end-stage
kidney disease. Reddened, flat areas do not indicate a positive reaction. A wheal
appears when the TST is administered that indicates correct administration of the
