NSG 4100 (AH111) EXAM 3 NEWEST 2025 ACTUAL
EXAM COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+
A nurse is teaching a pt how to perform flow type incentive spirometry prior
to his scheduled thoracic surgery. What instruction should the nurse provide to
the pt?
a. hold the spirometer at your lips and breathe in and out like you normally
would
b. when you're ready, blow hard into the spirometer for as long as you can
c. take a deep breath and then blow short, forceful breaths into the spirometer
d. breathe in deeply through the spirometer, hold your breath briefly, and then
exhale - ans -D
The nurse is assessing a pt who has a chest tube in place for the treatment of
a pneumothorax. The nurse observes that the water level in the water seal
rises and falls in rhythm w/ the pt's respiration's. How should the nurse best
respond to this assessment finding?
a. gently reinsert the chest tube 1-2cm and observe if the water level stabilizes
b. inform the physician property that there is an imminent leak in the
drainage system
c. encourage pt to do deep breathing and coughing exercises
The home care nurse is visiting a pt newly discharged home after a lobectomy.
What would be most important for the home care nurse to assess?
a. resumption of the pt's ADLs
b. the family's willingness to care for the pt
c. nutritional status and fluid balance
d. s/s of respiratory complications - ans -D
A pt is being admitted to the preoperative holding area for a thoracotomy.
Preoperative teaching includes what?
a. correct use of a ventilator
b. correct use of incentive spirometry
c. correct use of a mini-nebulizer
c. correct technique for rhythmic breathing - ans -B
,d. document that the chest drainage is operating as it is intended - ans -D
The home care nurse is assessing the home environment of a pt who will be
discharged from the hospital shortly after his laryngectomy. The nurse should
inform the pt that he may need to arrange for the installation of which
system in his home?
a. a humidification system
b. an air conditioning system
c. a water purification system
d. a radiant heating system - ans -A
The nurse is caring for a pt whose recent unexplained weight loss and hx of
smoking have prompted diagnostic testing for cancer. What sx is most closely
associated w/ the early stages of laryngeal caner?
a. hoarseness
b. dyspnea
c. dysphagia
d. frequent nosebleeds - ans -A
The nurse is conducting a presurgical interview for a pt w/ laryngeal cancer.
The pt states that he drinks approx 6-8 shots of vodka per day. it is imperative
that the nurse inform the surgical team so the pt can be assessed for what?
a. increased risk for infection
b. delirium tremens
c. depression
d. non-adherence to postop care - ans -B
The nurse is caring for a pt who is post-op day 2 following a total laryngectomy
for supraglottic cancer. The nurse should prioritize what assessment?
a. assessment of body image
b. assessment of jugular venous pressure
c. assessment of carotid pulse
d. assessment of swallowing ability - ans -D
The nurse is performing an assessment on a pt who has been diagnosed w/
cancer of the larynx. Part of the nurses assessment addresses the pt's
general
,state of nutrition. Which lab values would be assessed when determine the
nutritional status of the pt? Select all that apply.
a. WBC count
b. protein level
c. albumin level
d. platelet count
e. glucose level - ans -B, C, E
The nurse recognizes that aspiration is a potential complication of a
laryngectomy. How should the nurse best manage this risk?
a. facilitate total parenteral nutrition (TPN)
b. keep a complete suction setup at the bedside
c. feed the pt several small meals daily
d. refer the pt for occupational therapy - ans -B
The nurse is providing care for a pt who has just been admitted to the post
surgical unit following a laryngecotomy. What assessment should the nurse
prioritize?
a. the pt's swallowing ability
b. the pt's airway patency
c. the pt's carotid pulses
d. s/s of infection - ans -B
The nurse has noted the emergency of a significant amount of fresh blood at
the drain site of a pt who is postoperative day 1 following total laryngecomy.
How should the nurse respond to this development?
a. remove the pt's drain and apply pressure w/ a sterile gauze
b. assess the pt, reposition the pt supine, and apply wall suction to the drain
c. rapidly assess the pt and notify the surgeon about the pt's bleeding
d. administer a STAT dose of vitamin K to aid coagulation - ans -C
The nurse is creating a care plan for a pt who is status post-total
laryngectomy. Much of the plan consists of a ling-term postoperative
communication plan for alaryngeal communication. What form of alaryngeal
communication will likely be chosen?
a. esophageal speech
b. electric larynx
, c. tracheoesophageal puncture
d. American sign language (ASL) - ans -C
The nurse is performing preoperative teaching w/ a pt who has cancer of the
larynx. After completing the pt teaching, what would be most important for
the nurse to do?
a. give the pt his/her cell phone number
b. refer pt to a social worker or psychologist
c. provide the pt w/ audiovisual materials about the surgery
d. reassure the pt and family that everything will be alright - ans -C
A pt's total laryngectomy has created a need for alaryngeal speech which will be
achieved through the use of tracheoesophageal puncture. What action should the
nurse describe to the pt when teaching him about this process?
a. training on how to perform controlled bleeding
b. use of an electronically enhanced artificial pahrynx
c. insertion of a specialized nasogastric tube
d. fitting for a voice prosthesis - ans -D
The nurse caring for a pt w/ and endotracheal tube recognizes several
disadvantages of an endotracheal tube. What would the nurse recognize as a
disadvantage?
a. cognition is decreased
b. Daily ABGs are necessary
c. slight tracheal bleeding is anticipated
d. the cough reflex is depressed - ans -D
What would the critical care nurse recognize as a condition that may indicate a
pt's need to have a tracheotomy?
a. a pt has a respiratory rate of 10 breaths/min
b. a pt required permanent ventilation
c. a pt exhibits sx of dyspnea
d. a pt has respiratory acidosis - ans -B
EXAM COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+
A nurse is teaching a pt how to perform flow type incentive spirometry prior
to his scheduled thoracic surgery. What instruction should the nurse provide to
the pt?
a. hold the spirometer at your lips and breathe in and out like you normally
would
b. when you're ready, blow hard into the spirometer for as long as you can
c. take a deep breath and then blow short, forceful breaths into the spirometer
d. breathe in deeply through the spirometer, hold your breath briefly, and then
exhale - ans -D
The nurse is assessing a pt who has a chest tube in place for the treatment of
a pneumothorax. The nurse observes that the water level in the water seal
rises and falls in rhythm w/ the pt's respiration's. How should the nurse best
respond to this assessment finding?
a. gently reinsert the chest tube 1-2cm and observe if the water level stabilizes
b. inform the physician property that there is an imminent leak in the
drainage system
c. encourage pt to do deep breathing and coughing exercises
The home care nurse is visiting a pt newly discharged home after a lobectomy.
What would be most important for the home care nurse to assess?
a. resumption of the pt's ADLs
b. the family's willingness to care for the pt
c. nutritional status and fluid balance
d. s/s of respiratory complications - ans -D
A pt is being admitted to the preoperative holding area for a thoracotomy.
Preoperative teaching includes what?
a. correct use of a ventilator
b. correct use of incentive spirometry
c. correct use of a mini-nebulizer
c. correct technique for rhythmic breathing - ans -B
,d. document that the chest drainage is operating as it is intended - ans -D
The home care nurse is assessing the home environment of a pt who will be
discharged from the hospital shortly after his laryngectomy. The nurse should
inform the pt that he may need to arrange for the installation of which
system in his home?
a. a humidification system
b. an air conditioning system
c. a water purification system
d. a radiant heating system - ans -A
The nurse is caring for a pt whose recent unexplained weight loss and hx of
smoking have prompted diagnostic testing for cancer. What sx is most closely
associated w/ the early stages of laryngeal caner?
a. hoarseness
b. dyspnea
c. dysphagia
d. frequent nosebleeds - ans -A
The nurse is conducting a presurgical interview for a pt w/ laryngeal cancer.
The pt states that he drinks approx 6-8 shots of vodka per day. it is imperative
that the nurse inform the surgical team so the pt can be assessed for what?
a. increased risk for infection
b. delirium tremens
c. depression
d. non-adherence to postop care - ans -B
The nurse is caring for a pt who is post-op day 2 following a total laryngectomy
for supraglottic cancer. The nurse should prioritize what assessment?
a. assessment of body image
b. assessment of jugular venous pressure
c. assessment of carotid pulse
d. assessment of swallowing ability - ans -D
The nurse is performing an assessment on a pt who has been diagnosed w/
cancer of the larynx. Part of the nurses assessment addresses the pt's
general
,state of nutrition. Which lab values would be assessed when determine the
nutritional status of the pt? Select all that apply.
a. WBC count
b. protein level
c. albumin level
d. platelet count
e. glucose level - ans -B, C, E
The nurse recognizes that aspiration is a potential complication of a
laryngectomy. How should the nurse best manage this risk?
a. facilitate total parenteral nutrition (TPN)
b. keep a complete suction setup at the bedside
c. feed the pt several small meals daily
d. refer the pt for occupational therapy - ans -B
The nurse is providing care for a pt who has just been admitted to the post
surgical unit following a laryngecotomy. What assessment should the nurse
prioritize?
a. the pt's swallowing ability
b. the pt's airway patency
c. the pt's carotid pulses
d. s/s of infection - ans -B
The nurse has noted the emergency of a significant amount of fresh blood at
the drain site of a pt who is postoperative day 1 following total laryngecomy.
How should the nurse respond to this development?
a. remove the pt's drain and apply pressure w/ a sterile gauze
b. assess the pt, reposition the pt supine, and apply wall suction to the drain
c. rapidly assess the pt and notify the surgeon about the pt's bleeding
d. administer a STAT dose of vitamin K to aid coagulation - ans -C
The nurse is creating a care plan for a pt who is status post-total
laryngectomy. Much of the plan consists of a ling-term postoperative
communication plan for alaryngeal communication. What form of alaryngeal
communication will likely be chosen?
a. esophageal speech
b. electric larynx
, c. tracheoesophageal puncture
d. American sign language (ASL) - ans -C
The nurse is performing preoperative teaching w/ a pt who has cancer of the
larynx. After completing the pt teaching, what would be most important for
the nurse to do?
a. give the pt his/her cell phone number
b. refer pt to a social worker or psychologist
c. provide the pt w/ audiovisual materials about the surgery
d. reassure the pt and family that everything will be alright - ans -C
A pt's total laryngectomy has created a need for alaryngeal speech which will be
achieved through the use of tracheoesophageal puncture. What action should the
nurse describe to the pt when teaching him about this process?
a. training on how to perform controlled bleeding
b. use of an electronically enhanced artificial pahrynx
c. insertion of a specialized nasogastric tube
d. fitting for a voice prosthesis - ans -D
The nurse caring for a pt w/ and endotracheal tube recognizes several
disadvantages of an endotracheal tube. What would the nurse recognize as a
disadvantage?
a. cognition is decreased
b. Daily ABGs are necessary
c. slight tracheal bleeding is anticipated
d. the cough reflex is depressed - ans -D
What would the critical care nurse recognize as a condition that may indicate a
pt's need to have a tracheotomy?
a. a pt has a respiratory rate of 10 breaths/min
b. a pt required permanent ventilation
c. a pt exhibits sx of dyspnea
d. a pt has respiratory acidosis - ans -B
