HESI Exit Exam - Respiratory System
List four common symptoms of pneumonia the nurse might note on
physical
examination: tachypnea, fever with chills, productive cough, bronchial
breath sounds
State four nursing interventions for assisting the client to cough
productive-
ly: Encourage deep breathing; increase fluid intake to 3L/day; use
humidity to to loosen secretions; suction airway to stimulate coughing
What precautions are required for clients with TB when placed on
respiratory
isolation?: A mask for anyone entering room; private room; client must
wear mask if leaving room
What symptoms of pneumonia might the nurse expect to see in an older
client?: Confusion, lethargy, anorexia, rapid RR
How does the nurse prevent hypoxia during suctioning?: Deliver 100%
O2 (hyperinflating) before and after each endotracheal suctioning
During mechanical ventilation, what are three major nursing
interventions?: -
, Monitor client's respiratory status and secure connections; establish a
communication mechanism with the client; keep airway clear by
coughing and suctioning
When examining a client with emphysema, what physical findings is the
nurse
likely to see?: Barrel chest, dry or productive cough, decreased breath
sounds, dyspnea, crackles in lung fields
What is the most common risk factor associated with lung cancer?:
Smoking
(cigarettes and or marijuana)
Describe why preoperative nursing care is important to include for a
client undergoing a laryngectomy.: Involve family and client in
manipulation of tracheostomy equipment before surgery; plan acceptable
communication methods; refer to speech pathologist; discuss
rehabilitation program
List five nursing interventions after chest tube insertion: Maintain a dry
occlusive
dressing on chest tube. Keep all tubing connections tight and taped.
Monitor client's clinical staut. Encourage the client to breathe deeply
periodically. Monitor the fluid drainage, and mark the time of
measurement and the fluid level
List four common symptoms of pneumonia the nurse might note on
physical
examination: tachypnea, fever with chills, productive cough, bronchial
breath sounds
State four nursing interventions for assisting the client to cough
productive-
ly: Encourage deep breathing; increase fluid intake to 3L/day; use
humidity to to loosen secretions; suction airway to stimulate coughing
What precautions are required for clients with TB when placed on
respiratory
isolation?: A mask for anyone entering room; private room; client must
wear mask if leaving room
What symptoms of pneumonia might the nurse expect to see in an older
client?: Confusion, lethargy, anorexia, rapid RR
How does the nurse prevent hypoxia during suctioning?: Deliver 100%
O2 (hyperinflating) before and after each endotracheal suctioning
During mechanical ventilation, what are three major nursing
interventions?: -
, Monitor client's respiratory status and secure connections; establish a
communication mechanism with the client; keep airway clear by
coughing and suctioning
When examining a client with emphysema, what physical findings is the
nurse
likely to see?: Barrel chest, dry or productive cough, decreased breath
sounds, dyspnea, crackles in lung fields
What is the most common risk factor associated with lung cancer?:
Smoking
(cigarettes and or marijuana)
Describe why preoperative nursing care is important to include for a
client undergoing a laryngectomy.: Involve family and client in
manipulation of tracheostomy equipment before surgery; plan acceptable
communication methods; refer to speech pathologist; discuss
rehabilitation program
List five nursing interventions after chest tube insertion: Maintain a dry
occlusive
dressing on chest tube. Keep all tubing connections tight and taped.
Monitor client's clinical staut. Encourage the client to breathe deeply
periodically. Monitor the fluid drainage, and mark the time of
measurement and the fluid level
