Respiratory system

1. A client with chronic obstructive pulmonary disease (COPD) presents with shortness of breath. What is the nurse's priority action? • A. Administer a bronchodilator • B. Position the client supine • C. Apply 6 L/min oxygen via nasal cannula • D. Encourage deep breathing exercises Answer: A. Administer a bronchodilator Rationale: The priority for COPD exacerbations is to improve airway patency, which is achieved through bronchodilation. Supplemental oxygen should be used with caution in COPD patients to avoid CO2 retention. ________________________________________ 2. A nurse is teaching a client about using a metered-dose inhaler (MDI) for asthma. Which of the following indicates correct use of the MDI? • A. The client breathes in quickly during administration • B. The client holds their breath for 5 to 10 seconds after inhaling • C. The client shakes the inhaler only after use • D. The client administers two puffs without waiting between doses Answer: B. The client holds their breath for 5 to 10 seconds after inhaling Rationale: Holding the breath allows the medication to be absorbed into the lungs more effectively. Shaking the inhaler before use and waiting between puffs are also important. ________________________________________ 3. Which assessment finding is most concerning in a client with pneumonia? • A. Fever of 101°F • B. Productive cough with green sputum • C. Respiratory rate of 28 breaths per minute • D. SpO2 of 88% on room air Answer: D. SpO2 of 88% on room air Rationale: Oxygen saturation below 90% indicates significant hypoxemia, which requires immediate intervention to prevent further respiratory compromise. ________________________________________ 4. Which nursing intervention is most effective in preventing atelectasis in a post-operative client? • A. Administering antibiotics • B. Encouraging incentive spirometry use • C. Limiting fluid intake • D. Providing supplemental oxygen Answer: B. Encouraging incentive spirometry use Rationale: Incentive spirometry promotes deep breathing and lung expansion, preventing atelectasis by reducing airway collapse. ________________________________________ 5. A nurse is caring for a client with pulmonary embolism. Which of the following clinical manifestations should the nurse expect? • A. Bradycardia and peripheral edema • B. Sudden chest pain and dyspnea • C. Fever and productive cough • D. Barrel-shaped chest and hyperresonance to percussion Answer: B. Sudden chest pain and dyspnea Rationale: Pulmonary embolism typically presents with acute onset of chest pain, dyspnea, and hypoxia. ________________________________________ 6. Which client statement indicates understanding of discharge instructions following a bronchoscopy? • A. "I will not eat or drink until my gag reflex returns." • B. "I can resume all my usual activities immediately." • C. "I can have fluids as soon as I get home." • D. "I will take a hot shower to relax my airway." Answer: A. "I will not eat or drink until my gag reflex returns." Rationale: To prevent aspiration, the client must wait for the gag reflex to return before eating or drinking following a bronchoscopy. ________________________________________ 7. The nurse is educating a client with asthma about peak flow meter use. Which action is correct? • A. Blow out slowly and steadily into the meter • B. Measure peak flow at bedtime • C. Record the highest of three readings • D. Use the meter after taking a short-acting bronchodilator Answer: C. Record the highest of three readings Rationale: The client should blow out forcefully into the meter and record the highest value obtained after three attempts, ensuring an accurate measurement of peak expiratory flow. ________________________________________ 8. A client with tuberculosis (TB) is prescribed isoniazid. Which lab value should the nurse monitor closely? • A. Creatinine • B. ALT and AST • C. Hemoglobin • D. Platelet count Answer: B. ALT and AST Rationale: Isoniazid can cause hepatotoxicity, so monitoring liver enzymes (ALT, AST) is essential. ________________________________________ 9. A client with cystic fibrosis is admitted with increased dyspnea and cough. What is the nurse’s priority intervention? • A. Start intravenous antibiotics • B. Administer chest physiotherapy • C. Restrict fluids • D. Provide a low-sodium diet Answer: B. Administer chest physiotherapy Rationale: Chest physiotherapy helps to mobilize and clear thick mucus from the lungs, improving ventilation and oxygenation. ________________________________________ 10. A nurse is caring for a client with status asthmaticus. Which of the following interventions should the nurse implement first? • A. Obtain a chest x-ray • B. Administer an albuterol nebulizer treatment • C. Administer oral prednisone • D. Initiate IV fluids Answer: B. Administer an albuterol nebulizer treatment Rationale: Albuterol, a rapid-acting bronchodilator, is the first-line treatment for relieving bronchospasm in status asthmaticus.