PNVN 1631 QUIZ 2 RESPIRATORY SYSTEM 2024/25. EXAM
QUESTIONS WITH 100% CORRECT ANSWERS
1. What is the purpose of the cilia?
a. Warm and moisturize inhaled air
b. Sweep debris toward nasal cavity
c. Stimulate cough reflex
d. Produce mucus - ANSWER-ANS: B
The cilia are fine hairlike processes on the outer surfaces of small cells that produce a motion that
sweeps the debris toward the nasal cavity. Large particles that are swept away stimulate the cough
reflex, but not the cilia themselves.
PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 1609 OBJ: 2 TOP: Secretions KEY: Nursing Process Step:
Planning
MSC: NCLEX: Physiological Integrity
QUESTION: 2. What happens when there is a decrease in the oxygen level in the blood?
a. Pituitary stimulates the respiratory system to increase respiratory rate
b. The alveoli diffuse more oxygen into the blood
c. Chemoreceptors in the carotid body and aortic body stimulate the respiratory centers to modify
respiratory rates
d. The parietal pleura increases the negative pressure - ANSWER-ANS: C
The chemoreceptors in the carotid bodies and the aortic bodies send a message to the respiratory
centers to modify respirations.
PTS: 1 DIF: Cognitive Level: Application REF: Page 1611
OBJ: 1 TOP: Respiratory rate modification
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
QUESTION: 3. A nursing diagnosis for the patient with a new laryngectomy would be Social isolation
related to impaired verbal communication related to removal of the larynx. What is an appropriate
nursing intervention?
,a. Complete care quickly
b. Provide a pad and pencil or magic slate
c. Refrain from conversations with the patient to reduce stress level
d. Offer books or jigsaw puzzles for entertainment - ANSWER-ANS: B
Provide patient with implements for communication. Rapidly completing care and provision of solitary
activities does not reduce social isolation.
PTS: 1 DIF: Cognitive Level: Application REF: Page 1534
OBJ: 10 TOP: Laryngectomy
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
QUESTION: 4. A 55-year-old man comes to the health nurse at his place of work with epistaxis. He
reports he has frequent nosebleeds that he can usually control himself. What would be the most helpful
assessment after the nurse has stopped the bleeding? a. Obtain a blood pressure
b. Record the approximate amount of blood lost
c. Inquire about a headache
d. Record the last episode of epistaxis - ANSWER-ANS: A
Check the blood pressure for hypotension to assess for hypovolemic shock. Adults can lose as much as 1
L of blood in an hour with heavy epistaxis.
PTS: 1 DIF: Cognitive Level: Application REF: Page 1618
OBJ: 9 TOP: Epistaxis KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
QUESTION: 5. The nurse assessing an 11-year-old who is having an asthma attack expects to hear
adventitious sounds of: a. friction rub.
b. sibilant wheezes.
c. crackles.
d. sonorous wheezes. - ANSWER-ANS: B
,The narrowed bronchioles characteristic of an asthma attack would produce sibilant wheezes, which are
high-pitched whistling sounds.
PTS: 1 DIF: Cognitive Level: Application REF: Page 1612
OBJ: 16 TOP: Asthma KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
QUESTION: 6. How will the kidneys behave in respiratory acidosis?
a. Retain bicarbonate to increase the pH
b. Excrete more urine to reduce potassium
c. Concentrate the urine to conserve circulating fluid in the blood stream
d. Lower the pH by excretion of bicarbonate - ANSWER-ANS: A
In respiratory acidosis the pH is low. The kidneys will retain bicarbonate to increase the pH.
PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1617, Table 48-2
OBJ: 11 TOP: Respiratory acidosis
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
QUESTION: 7. An 83-year-old patient is admitted with a temperature of 102° F (38.8° C), chest pain, and
fatigue. What is the infected fluid that the physician removes called? a. Emboli
b. Emphysema
c. Sputum
d. Empyema - ANSWER-ANS: D
If the fluid between the lung and the membrane lining the pleural cavity becomes infected, it is called
empyema.
PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 1642
OBJ: 11 TOP: Empyema KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
, QUESTION: 8. Which instruction by the nurse is inappropriate for teaching the proper technique for
collection of a sputum specimen?
a. Bring the sputum up from the lungs
b. Rinse mouth with water before expectorating in specimen cup
c. Collect specimens before meals
d. Send specimen to the lab without delay - ANSWER-ANS: C
Collecting specimens before meals will avoid possible emesis from coughing after eating.
PTS: 1 DIF: Cognitive Level: Application REF: Page 1615, Box 48-2
OBJ: 12 TOP: Diagnostic procedures KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
QUESTION: 9. When assessing the SaO2 with a pulse oximeter, the nurse will place the oximeter on a
finger:
a. on the same side as the blood pressure cuff.
b. while exercising the arm to stimulate circulation.
c. that is a normal temperature.
d. on the same side as an arterial catheter. - ANSWER-ANS: C
The pulse oximeter should be placed on a finger of the hand that is normal temperature because
hypothermia will affect the reading. The device should not be put on a finger on the same side as a
blood pressure cuff or arterial line.
PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1617, Safety Alert
OBJ: 9 TOP: Pulse oximeter
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
QUESTION: 10. A patient, age 69, has emphysema. On assessment, the nurse notes the presence of a
"barrel chest." What does this pathology result from?
a. An increase in the lateromedial area from hypertrophy of mucous glands in the bronchi
b. An increased anteroposterior diameter caused by overinflation of the alveoli
QUESTIONS WITH 100% CORRECT ANSWERS
1. What is the purpose of the cilia?
a. Warm and moisturize inhaled air
b. Sweep debris toward nasal cavity
c. Stimulate cough reflex
d. Produce mucus - ANSWER-ANS: B
The cilia are fine hairlike processes on the outer surfaces of small cells that produce a motion that
sweeps the debris toward the nasal cavity. Large particles that are swept away stimulate the cough
reflex, but not the cilia themselves.
PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 1609 OBJ: 2 TOP: Secretions KEY: Nursing Process Step:
Planning
MSC: NCLEX: Physiological Integrity
QUESTION: 2. What happens when there is a decrease in the oxygen level in the blood?
a. Pituitary stimulates the respiratory system to increase respiratory rate
b. The alveoli diffuse more oxygen into the blood
c. Chemoreceptors in the carotid body and aortic body stimulate the respiratory centers to modify
respiratory rates
d. The parietal pleura increases the negative pressure - ANSWER-ANS: C
The chemoreceptors in the carotid bodies and the aortic bodies send a message to the respiratory
centers to modify respirations.
PTS: 1 DIF: Cognitive Level: Application REF: Page 1611
OBJ: 1 TOP: Respiratory rate modification
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
QUESTION: 3. A nursing diagnosis for the patient with a new laryngectomy would be Social isolation
related to impaired verbal communication related to removal of the larynx. What is an appropriate
nursing intervention?
,a. Complete care quickly
b. Provide a pad and pencil or magic slate
c. Refrain from conversations with the patient to reduce stress level
d. Offer books or jigsaw puzzles for entertainment - ANSWER-ANS: B
Provide patient with implements for communication. Rapidly completing care and provision of solitary
activities does not reduce social isolation.
PTS: 1 DIF: Cognitive Level: Application REF: Page 1534
OBJ: 10 TOP: Laryngectomy
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
QUESTION: 4. A 55-year-old man comes to the health nurse at his place of work with epistaxis. He
reports he has frequent nosebleeds that he can usually control himself. What would be the most helpful
assessment after the nurse has stopped the bleeding? a. Obtain a blood pressure
b. Record the approximate amount of blood lost
c. Inquire about a headache
d. Record the last episode of epistaxis - ANSWER-ANS: A
Check the blood pressure for hypotension to assess for hypovolemic shock. Adults can lose as much as 1
L of blood in an hour with heavy epistaxis.
PTS: 1 DIF: Cognitive Level: Application REF: Page 1618
OBJ: 9 TOP: Epistaxis KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
QUESTION: 5. The nurse assessing an 11-year-old who is having an asthma attack expects to hear
adventitious sounds of: a. friction rub.
b. sibilant wheezes.
c. crackles.
d. sonorous wheezes. - ANSWER-ANS: B
,The narrowed bronchioles characteristic of an asthma attack would produce sibilant wheezes, which are
high-pitched whistling sounds.
PTS: 1 DIF: Cognitive Level: Application REF: Page 1612
OBJ: 16 TOP: Asthma KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
QUESTION: 6. How will the kidneys behave in respiratory acidosis?
a. Retain bicarbonate to increase the pH
b. Excrete more urine to reduce potassium
c. Concentrate the urine to conserve circulating fluid in the blood stream
d. Lower the pH by excretion of bicarbonate - ANSWER-ANS: A
In respiratory acidosis the pH is low. The kidneys will retain bicarbonate to increase the pH.
PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1617, Table 48-2
OBJ: 11 TOP: Respiratory acidosis
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
QUESTION: 7. An 83-year-old patient is admitted with a temperature of 102° F (38.8° C), chest pain, and
fatigue. What is the infected fluid that the physician removes called? a. Emboli
b. Emphysema
c. Sputum
d. Empyema - ANSWER-ANS: D
If the fluid between the lung and the membrane lining the pleural cavity becomes infected, it is called
empyema.
PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 1642
OBJ: 11 TOP: Empyema KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
, QUESTION: 8. Which instruction by the nurse is inappropriate for teaching the proper technique for
collection of a sputum specimen?
a. Bring the sputum up from the lungs
b. Rinse mouth with water before expectorating in specimen cup
c. Collect specimens before meals
d. Send specimen to the lab without delay - ANSWER-ANS: C
Collecting specimens before meals will avoid possible emesis from coughing after eating.
PTS: 1 DIF: Cognitive Level: Application REF: Page 1615, Box 48-2
OBJ: 12 TOP: Diagnostic procedures KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
QUESTION: 9. When assessing the SaO2 with a pulse oximeter, the nurse will place the oximeter on a
finger:
a. on the same side as the blood pressure cuff.
b. while exercising the arm to stimulate circulation.
c. that is a normal temperature.
d. on the same side as an arterial catheter. - ANSWER-ANS: C
The pulse oximeter should be placed on a finger of the hand that is normal temperature because
hypothermia will affect the reading. The device should not be put on a finger on the same side as a
blood pressure cuff or arterial line.
PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1617, Safety Alert
OBJ: 9 TOP: Pulse oximeter
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
QUESTION: 10. A patient, age 69, has emphysema. On assessment, the nurse notes the presence of a
"barrel chest." What does this pathology result from?
a. An increase in the lateromedial area from hypertrophy of mucous glands in the bronchi
b. An increased anteroposterior diameter caused by overinflation of the alveoli
