Exam 1 Test Bank Questions with
Correct Answers Latest Update
The drop in SpO2 to 85% indicates that the patient is hypoxemic and needs
supplemental oxygen when exercising.
The other actions are also important, but the first action should be to correct the
hypoxemia.
The nurse teaches a patient about pulmonary function testing (PFT). Which
statement, if made by the patient, indicates teaching was effective?
a. I will use my inhaler right before the test.
b. I wont eat or drink anything 8 hours before the test.
c. I should inhale deeply and blow out as hard as I can during the test.
d. My blood pressure and pulse will be checked every 15 minutes after the test. -
Answer-C
For PFT, the patient should inhale deeply and exhale as long, hard, and fast as
possible.
The other actions are not needed with PFT. The administration of inhaled
bronchodilators should be avoided 6 hours before the procedure.
.
The nurse observes a student who is listening to a patients lungs who is having no
problems with breathing. Which action by the student indicates a need to review
respiratory assessment skills?
a. The student starts at the apices of the lungs and moves to the bases.
b. The student compares breath sounds from side to side avoiding bony areas.
c. The student places the stethoscope over the posterior chest and listens during
inspiration.
d. The student instructs the patient to breathe slowly and a little more deeply than
normal through the mouth. - Answer-C
Listening only during inspiration indicates the student needs a review of respiratory
assessment skills. At each placement of the stethoscope, listen to at least one cycle
of inspiration and expiration.
During chest auscultation, instruct the patient to breathe slowly and a little deeper
than normal through the mouth. Auscultation should proceed from the lung apices to
the bases, comparing opposite areas of the chest, unless the patient is in respiratory
distress or will tire easily. If so, start at the bases (see Fig. 26-7). Place the
stethoscope over lung tissue, not over bony prominences.
,A patient who has a history of chronic obstructive pulmonary disease (COPD) was
hospitalized for increasing shortness of breath and chronic hypoxemia (SaO2 levels
of 89% to 90%). In planning for discharge, which action by the nurse will be most
effective in improving compliance with discharge teaching?
a. Start giving the patient discharge teaching on the day of admission.
b. Have the patient repeat the instructions immediately after teaching.
c. Accomplish the patient teaching just before the scheduled discharge.
d. Arrange for the patients caregiver to be present during the teaching. - Answer-D
Hypoxemia interferes with the patients ability to learn and retain information, so
having the patients caregiver present will increase the likelihood that discharge
instructions will be followed.
Having the patient repeat the instructions will indicate that the information is
understood at the time, but it does not guarantee retention of the information.
Because the patient is likely to be distracted just before discharge, giving discharge
instructions just before discharge is not ideal. The patient is likely to be anxious and
even more hypoxemic than usual on the day of admission, so teaching about
discharge should be postponed.
A patient is admitted to the emergency department complaining of sudden onset
shortness of breath and is diagnosed with a possible pulmonary embolus. How
should the nurse prepare the patient for diagnostic testing to confirm the diagnosis?
a. Start an IV so contrast media may be given.
b. Ensure that the patient has been NPO for at least 6 hours.
c. Inform radiology that radioactive glucose preparation is needed.
d. Instruct the patient to undress to the waist and remove any metal objects -
Answer-A
Spiral computed tomography (CT) scans are the most commonly used test to
diagnose pulmonary emboli, and contrast media may be given IV.
A chest x-ray may be ordered but will not be diagnostic for a pulmonary embolus.
Preparation for a chest x-ray includes undressing and removing any metal.
Bronchoscopy is used to detect changes in the bronchial tree, not to assess for
vascular changes, and the patient should be NPO 6 to 12 hours before the
procedure. Positron emission tomography (PET) scans are most useful in
determining the presence of malignancy, and a radioactive glucose preparation is
used.
The nurse admits a patient who has a diagnosis of an acute asthma attack. Which
statement indicates that the patient may need teaching regarding medication use?
a. I have not had any acute asthma attacks during the last year.
b. I became short of breath an hour before coming to the hospital.
c. Ive been taking Tylenol 650 mg every 6 hours for chest-wall pain.
d. Ive been using my albuterol inhaler more frequently over the last 4 days - Answer-
D
,The increased need for a rapid-acting bronchodilator should alert the patient that an
acute attack may be imminent and that a change in therapy may be needed. The
patient should be taught to contact a health care provider if this occurs.
The other data do not indicate any need for additional teaching.
A patient with acute dyspnea is scheduled for a spiral computed tomography (CT)
scan. Which information obtained by the nurse is a priority to communicate to the
health care provider before the CT?
a. Allergy to shellfish
b. Apical pulse of 104
c. Respiratory rate of 30
d. Oxygen saturation of 90% - Answer-A
Because iodine-based contrast media is used during a spiral CT, the patient may
need to have the CT scan without contrast or be pre-medicated before injection of
the contrast media.
The increased pulse, low oxygen saturation, and tachypnea all indicate a need for
further assessment or intervention but do not indicate a need to modify the CT
procedure.
The nurse analyzes the results of a patients arterial blood gases (ABGs). Which
finding would require immediate action?
a. The bicarbonate level (HCO3) is 31 mEq/L.
b. The arterial oxygen saturation (SaO2) is 92%.
c. The partial pressure of CO2 in arterial blood (PaCO2) is 31 mm Hg.
d. The partial pressure of oxygen in arterial blood (PaO2) is 59 mm Hg. - Answer-D
All the values are abnormal, but the low PaO2 indicates that the patient is at the
point on the oxyhemoglobin dissociation curve where a small change in the PaO2
will cause a large drop in the O2 saturation and a decrease in tissue oxygenation.
The nurse should intervene immediately to improve the patients oxygenation.
.
When assessing the respiratory system of an older patient, which finding indicates
that the nurse should take immediate action?
a. Weak cough effort
b. Barrel-shaped chest
c. Dry mucous membranes
d. Bilateral crackles at lung bases - Answer-D
Crackles in the lower half of the lungs indicate that the patient may have an acute
problem such as heart failure. The nurse should immediately accomplish further
assessments, such as oxygen saturation, and notify the health care provider.
, A barrel-shaped chest, hyperresonance to percussion, and a weak cough effort are
associated with aging. Further evaluation may be needed, but immediate action is
not indicated. An older patient has a less forceful cough and fewer and less
functional cilia. Mucous membranes tend to be drier.
A patient in metabolic alkalosis is admitted to the emergency department, and pulse
oximetry (SpO2) indicates that the O2 saturation is 94%. Which action should the
nurse take next?
a. Administer bicarbonate.
b. Complete a head-to-toe assessment.
c. Place the patient on high-flow oxygen.
d. Obtain repeat arterial blood gases (ABGs). - Answer-C
Although the O2 saturation is adequate, the left shift in the oxyhemoglobin
dissociation curve will decrease the amount of oxygen delivered to tissues, so high
oxygen concentrations should be given.
Bicarbonate would worsen the patients condition. A head-to-toe assessment and
repeat ABGs may be implemented. However, the priority intervention is to give high-
flow oxygen.
After the nurse has received change-of-shift report, which patient should the nurse
assess first?
a. A patient with pneumonia who has crackles in the right lung base
b. A patient with possible lung cancer who has just returned after bronchoscopy
c. A patient with hemoptysis and a 16-mm induration with tuberculin skin testing
d. A patient with chronic obstructive pulmonary disease (COPD) and pulmonary
function testing (PFT) that indicates low forced vital capacity - Answer-B
Because the cough and gag are decreased after bronchoscopy, this patient should
be assessed for airway patency.
The other patients do not have clinical manifestations or procedures that require
immediate assessment by the nurse.
.
The laboratory has just called with the arterial blood gas (ABG) results on four
patients. Which result is most important for the nurse to report immediately to the
health care provider?
a. pH 7.34, PaO2 82 mm Hg, PaCO2 40 mm Hg, and O2 sat 97%
b. pH 7.35, PaO2 85 mm Hg, PaCO2 45 mm Hg, and O2 sat 95%
c. pH 7.46, PaO2 90 mm Hg, PaCO2 32 mm Hg, and O2 sat 98%
d. pH 7.31, PaO2 91 mm Hg, PaCO2 50 mm Hg, and O2 sat 96% - Answer-D
Correct Answers Latest Update
The drop in SpO2 to 85% indicates that the patient is hypoxemic and needs
supplemental oxygen when exercising.
The other actions are also important, but the first action should be to correct the
hypoxemia.
The nurse teaches a patient about pulmonary function testing (PFT). Which
statement, if made by the patient, indicates teaching was effective?
a. I will use my inhaler right before the test.
b. I wont eat or drink anything 8 hours before the test.
c. I should inhale deeply and blow out as hard as I can during the test.
d. My blood pressure and pulse will be checked every 15 minutes after the test. -
Answer-C
For PFT, the patient should inhale deeply and exhale as long, hard, and fast as
possible.
The other actions are not needed with PFT. The administration of inhaled
bronchodilators should be avoided 6 hours before the procedure.
.
The nurse observes a student who is listening to a patients lungs who is having no
problems with breathing. Which action by the student indicates a need to review
respiratory assessment skills?
a. The student starts at the apices of the lungs and moves to the bases.
b. The student compares breath sounds from side to side avoiding bony areas.
c. The student places the stethoscope over the posterior chest and listens during
inspiration.
d. The student instructs the patient to breathe slowly and a little more deeply than
normal through the mouth. - Answer-C
Listening only during inspiration indicates the student needs a review of respiratory
assessment skills. At each placement of the stethoscope, listen to at least one cycle
of inspiration and expiration.
During chest auscultation, instruct the patient to breathe slowly and a little deeper
than normal through the mouth. Auscultation should proceed from the lung apices to
the bases, comparing opposite areas of the chest, unless the patient is in respiratory
distress or will tire easily. If so, start at the bases (see Fig. 26-7). Place the
stethoscope over lung tissue, not over bony prominences.
,A patient who has a history of chronic obstructive pulmonary disease (COPD) was
hospitalized for increasing shortness of breath and chronic hypoxemia (SaO2 levels
of 89% to 90%). In planning for discharge, which action by the nurse will be most
effective in improving compliance with discharge teaching?
a. Start giving the patient discharge teaching on the day of admission.
b. Have the patient repeat the instructions immediately after teaching.
c. Accomplish the patient teaching just before the scheduled discharge.
d. Arrange for the patients caregiver to be present during the teaching. - Answer-D
Hypoxemia interferes with the patients ability to learn and retain information, so
having the patients caregiver present will increase the likelihood that discharge
instructions will be followed.
Having the patient repeat the instructions will indicate that the information is
understood at the time, but it does not guarantee retention of the information.
Because the patient is likely to be distracted just before discharge, giving discharge
instructions just before discharge is not ideal. The patient is likely to be anxious and
even more hypoxemic than usual on the day of admission, so teaching about
discharge should be postponed.
A patient is admitted to the emergency department complaining of sudden onset
shortness of breath and is diagnosed with a possible pulmonary embolus. How
should the nurse prepare the patient for diagnostic testing to confirm the diagnosis?
a. Start an IV so contrast media may be given.
b. Ensure that the patient has been NPO for at least 6 hours.
c. Inform radiology that radioactive glucose preparation is needed.
d. Instruct the patient to undress to the waist and remove any metal objects -
Answer-A
Spiral computed tomography (CT) scans are the most commonly used test to
diagnose pulmonary emboli, and contrast media may be given IV.
A chest x-ray may be ordered but will not be diagnostic for a pulmonary embolus.
Preparation for a chest x-ray includes undressing and removing any metal.
Bronchoscopy is used to detect changes in the bronchial tree, not to assess for
vascular changes, and the patient should be NPO 6 to 12 hours before the
procedure. Positron emission tomography (PET) scans are most useful in
determining the presence of malignancy, and a radioactive glucose preparation is
used.
The nurse admits a patient who has a diagnosis of an acute asthma attack. Which
statement indicates that the patient may need teaching regarding medication use?
a. I have not had any acute asthma attacks during the last year.
b. I became short of breath an hour before coming to the hospital.
c. Ive been taking Tylenol 650 mg every 6 hours for chest-wall pain.
d. Ive been using my albuterol inhaler more frequently over the last 4 days - Answer-
D
,The increased need for a rapid-acting bronchodilator should alert the patient that an
acute attack may be imminent and that a change in therapy may be needed. The
patient should be taught to contact a health care provider if this occurs.
The other data do not indicate any need for additional teaching.
A patient with acute dyspnea is scheduled for a spiral computed tomography (CT)
scan. Which information obtained by the nurse is a priority to communicate to the
health care provider before the CT?
a. Allergy to shellfish
b. Apical pulse of 104
c. Respiratory rate of 30
d. Oxygen saturation of 90% - Answer-A
Because iodine-based contrast media is used during a spiral CT, the patient may
need to have the CT scan without contrast or be pre-medicated before injection of
the contrast media.
The increased pulse, low oxygen saturation, and tachypnea all indicate a need for
further assessment or intervention but do not indicate a need to modify the CT
procedure.
The nurse analyzes the results of a patients arterial blood gases (ABGs). Which
finding would require immediate action?
a. The bicarbonate level (HCO3) is 31 mEq/L.
b. The arterial oxygen saturation (SaO2) is 92%.
c. The partial pressure of CO2 in arterial blood (PaCO2) is 31 mm Hg.
d. The partial pressure of oxygen in arterial blood (PaO2) is 59 mm Hg. - Answer-D
All the values are abnormal, but the low PaO2 indicates that the patient is at the
point on the oxyhemoglobin dissociation curve where a small change in the PaO2
will cause a large drop in the O2 saturation and a decrease in tissue oxygenation.
The nurse should intervene immediately to improve the patients oxygenation.
.
When assessing the respiratory system of an older patient, which finding indicates
that the nurse should take immediate action?
a. Weak cough effort
b. Barrel-shaped chest
c. Dry mucous membranes
d. Bilateral crackles at lung bases - Answer-D
Crackles in the lower half of the lungs indicate that the patient may have an acute
problem such as heart failure. The nurse should immediately accomplish further
assessments, such as oxygen saturation, and notify the health care provider.
, A barrel-shaped chest, hyperresonance to percussion, and a weak cough effort are
associated with aging. Further evaluation may be needed, but immediate action is
not indicated. An older patient has a less forceful cough and fewer and less
functional cilia. Mucous membranes tend to be drier.
A patient in metabolic alkalosis is admitted to the emergency department, and pulse
oximetry (SpO2) indicates that the O2 saturation is 94%. Which action should the
nurse take next?
a. Administer bicarbonate.
b. Complete a head-to-toe assessment.
c. Place the patient on high-flow oxygen.
d. Obtain repeat arterial blood gases (ABGs). - Answer-C
Although the O2 saturation is adequate, the left shift in the oxyhemoglobin
dissociation curve will decrease the amount of oxygen delivered to tissues, so high
oxygen concentrations should be given.
Bicarbonate would worsen the patients condition. A head-to-toe assessment and
repeat ABGs may be implemented. However, the priority intervention is to give high-
flow oxygen.
After the nurse has received change-of-shift report, which patient should the nurse
assess first?
a. A patient with pneumonia who has crackles in the right lung base
b. A patient with possible lung cancer who has just returned after bronchoscopy
c. A patient with hemoptysis and a 16-mm induration with tuberculin skin testing
d. A patient with chronic obstructive pulmonary disease (COPD) and pulmonary
function testing (PFT) that indicates low forced vital capacity - Answer-B
Because the cough and gag are decreased after bronchoscopy, this patient should
be assessed for airway patency.
The other patients do not have clinical manifestations or procedures that require
immediate assessment by the nurse.
.
The laboratory has just called with the arterial blood gas (ABG) results on four
patients. Which result is most important for the nurse to report immediately to the
health care provider?
a. pH 7.34, PaO2 82 mm Hg, PaCO2 40 mm Hg, and O2 sat 97%
b. pH 7.35, PaO2 85 mm Hg, PaCO2 45 mm Hg, and O2 sat 95%
c. pH 7.46, PaO2 90 mm Hg, PaCO2 32 mm Hg, and O2 sat 98%
d. pH 7.31, PaO2 91 mm Hg, PaCO2 50 mm Hg, and O2 sat 96% - Answer-D
