Adult Medical-Surgical Respiratory Assessment

1. 20-year history of COPD and is receiving oxygen at 2 L/min via nasal cannula. - Increase the oxygen flow and request and arterial blood gas determination 2. A nurse is assisting with the care of a client who has a chest tube in place following a thoracotomy. Which of the following actions should the nurse take? - Place the drainage unit below the client's chest level 3. A nurse in a medical-surgical unit is assessing a client. The nurse should identify that which of the following findings is a manifestation of a pulmonary embolism? - Stabbing chest pain 4. A nurse is reinforcing teaching about breathing techniques with a client who has emphysema. Which of the following statement should the nurse identify as an indication that the client understands the mechanics behind pursed-lip breathing? - When I breathe out through pursed lips, my airways don't collapse between breaths. 5. A nurse is reviewing the laboratory results of a client who has metabolic alkalosis. Which of the following laboratory values should the nurse expect? - pH 7.49, HCO3-32 mEq/L, PaCO2 40 mmHg 6. A nurse is reinforcing teaching about pursed-lip breathing with a client who has COPD and emphysema. The nurse should explain that this breathing technique does which of the following? - Keeps the airways open on exhalation 7. A nurse is reinforcing preoperative teaching with a client who has lung cancer and will undergo a pneumonectomy. Which of the following pieces of information should the nurse include? - You will have a chest tube in place after surgery. We'll help you turn, cough, and breath deeply frequently after surgery. We'll give you oxygen to support your breathing if you need it. 8. A nurse is caring for a client who smokes cigarettes and has a new diagnosis of emphysema. Which of the following actions should the nurse take to assist the client with smoking cessation? - Discuss ways the client can reduce the number of cigarettes smokes per day 9. A nurse is assisting with discharge teaching for a client who is postoperative following a rhinoplasty. Which of the following instructions should the nurse include? - Lie on your back with your head elevated 30' when resting. 10. A nurse is caring for a client who has a tracheostomy with an inflated cuff in place. Which of the following findings indicates that the nurse should suction the client's airway secretions? - The clients has corse cracked in the lung fields 11. A nurse is caring for a client who is experiencing acute opioid toxicity. Which of the following actions should the nurse identify as the priority? - Ensure an adequate airway 12. A nurse is reinforcing preoperative teaching with a client who is scheduled to undergo a pneumonectomy. The client sates, "I am afraid that coughing will hurt after the surgery." Which of the following responses should the nurse make? - I will show you how to splint your incision while coughing. 13. A nurse is assisting with planning postoperative education for a client who will undergo a radical neck dissection for cancer of the larynx. The nurse should suggest including which of the following topics? - NPO status Alternative methods of communications Changes in body images Swallowing exercises 14. A nurse is caring for a client who is postoperative following a thoracic lobectomy. The client has 2 chest tubes in place, 1 in the lower portion of the thorax and the other higher up on the chest wall. When the family asks the nurse why the client has 2 chest tubes, which of the following responses should the nurse make? - The lower tube will drain blood, the higher tube will remove air. 15. A nurse on a medical unit is assisting with the care of a client who has a possible closed pneumothorax and significant bruising on the left chest following a motorvehicle crash. The client reports severe left chest pain on inspiration. The nurse should hear which of the following findings when auscultating the client's lung sounds? - Absence of breath sounds 16. A nurse is caring for a client who has a chest tube. The nurse notes that the chest tube has become disconnected from the chest drainage system. Which of the following actions should the nurse take? - Immerse the end of the chest tube in bottle of sterile water. 17. A nurse is caring for an older adult client who as COPD and pneumonia. The nurse should monitor the client for whose which of the following acid-base imbalances? - Respiratory acidosis 18. A nurse is caring for a client who is postoperative following a rhinoplasty. Which of the following should the nurse report to the surgeon? - Frequent swallowing 19. A nurse is assisting with the plan of care for a client following placement of a chest tube 1 hour ago. Which of the following actions should the nurse include in the plan of care? - Tape all connections between the chest tube and drainage system. 20. A nurse in a clinic is reinforcing teaching with a client who is scheduled to have a tuberculin skin test. Which of the following pieces of information should the nurse include? - You must return to the clinic to have the test read in 2 or 3 days. 21. A nurse is helping the provider prepare a client for a thoracentesis. The nurse should instruct the client that which of the following positions will be used for this procedure? - Sitting while leaning forward over the bedside table 22. A nurse is reinforcing discharge instructions with a client who has new laryngectomy. The nurse should tell the client to be careful while bathing to prevent which of the following complications? - Aspiration of water 23. A nurse on a medical-surgical unit is caring for a client who is postoperative following a hip replacement. The client reports feeling apprehensive and restless. The nurse collects additional data from the client. Which of the following findings is an indication of pulmonary embolism? - Sudden onset of dyspnea 24. A nurse is assisting with the development of teaching plan about how to prevent an acute asthma attach for a young adult client. Which of the following points should the nurse plan to discuss first? - Determine the client's perception of the disease process and what might have triggered the current attack. 25. A nurse is assisting with the plan of care for a client who has COPD and is malnourished. Which of the following recommendations to promote nutritional intake should the nurse include in the plan? - Eat high-calories food first. 26. A nurse on a medical-surgical unit is caring for 4 clients. Which of the following clients should the nurse monitor for crepitus? - A client who has a chest tube following pneumothorax. 27. A nurse is caring for a client who is scheduled to have his chest tube removed. Which of the following actions should the nurse take? - Auscultate the lungs after removal. 28. A nurse is auscultating the lung of a client who is having an acute asthma attack. Which of the following sounds should the nurse expect to hear? - Noisy wheezing 29. A nurse is caring for a client following a high pleural thoracentesis. The nurse measures a total of 35 mL of purulent drainage. Which of the following findings indicate a tension pneumothorax? (Select all that apply) - Tracheal deviation to the left Absent breath sounds on the right side Neck vein distention