AH2 EXAM 1 LATEST ACTUAL EXAM QUESTIONS
AND DETAILED CORRECT ANSWERS | ALREADY
GRADED A+
A patient with a chronic cough has a bronchoscopy. After the procedure, which
intervention by the nurse is most appropriate?
a. Elevate the head of the bed to 80 to 90 degrees.
b. Keep the patient NPO until the gag reflex returns.
c. Place on bed rest for at least 4 hours after bronchoscopy.
d. Notify the health care provider about blood-tinged mucus.
- ans -ANS: B
Risk for aspiration and maintaining an open airway is the priority. Because a local
anesthetic is used to suppress the gag/cough reflexes during bronchoscopy, the
nurse should monitor for the return of these reflexes before allowing the patient
to take oral fluids or food. Blood-tinged mucus is not uncommon after
bronchoscopy. The patient does not need to be on bed rest, and the head of the
bed does not need to be in the high-Fowler's position
The nurse completes a shift assessment on a patient admitted in the early phase
of heart failure. When auscultating the patient's lungs, which finding would the
nurse most likely hear?
a. Continuous rumbling, snoring, or rattling sounds mainly on expiration
b. Continuous high-pitched musical sounds on inspiration and expiration
c. Discontinuous, high-pitched sounds of short duration heard on inspiration
d. A series of long-duration, discontinuous, low-pitched sounds during inspiration
- ans -ANS: C
Fine crackles are likely to be heard in the early phase of heart failure. Fine crackles
are discontinuous, high-pitched sounds of short duration heard on inspiration.
Rhonchi are continuous rumbling, snoring, or rattling sounds mainly on
expiration. Course crackles are a series of long-duration, discontinuous, low-
pitched sounds during inspiration. Wheezes are continuous high-pitched musical
sounds on inspiration and expiration
,While caring for a patient with respiratory disease, the nurse observes that the
patient's SpO2 drops from 93% to 88% while the patient is ambulating in the
hallway. What is the priority action of the nurse?
a. Notify the health care provider.
b. Document the response to exercise.
c. Administer the PRN supplemental O2.
d. Encourage the patient to pace activity.
- ans -ANS: C
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 won't 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."
- ans -ANS: 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 patient's 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.
- ans -ANS: 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 patient's caregiver to be present during the teaching.
- ans -ANS: D
Hypoxemia interferes with the patient's ability to learn and retain information, so
having the patient's 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.
, - ans -ANS: 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. "I've been taking Tylenol 650 mg every 6 hours for chest-wall pain."
d. "I've been using my albuterol inhaler more frequently over the last 4 days."
- ans -ANS: 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%
- ans -ANS: 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 premedicated before injection of
the contrast media. The increased pulse, low oxygen saturation, and tachypnea all
AND DETAILED CORRECT ANSWERS | ALREADY
GRADED A+
A patient with a chronic cough has a bronchoscopy. After the procedure, which
intervention by the nurse is most appropriate?
a. Elevate the head of the bed to 80 to 90 degrees.
b. Keep the patient NPO until the gag reflex returns.
c. Place on bed rest for at least 4 hours after bronchoscopy.
d. Notify the health care provider about blood-tinged mucus.
- ans -ANS: B
Risk for aspiration and maintaining an open airway is the priority. Because a local
anesthetic is used to suppress the gag/cough reflexes during bronchoscopy, the
nurse should monitor for the return of these reflexes before allowing the patient
to take oral fluids or food. Blood-tinged mucus is not uncommon after
bronchoscopy. The patient does not need to be on bed rest, and the head of the
bed does not need to be in the high-Fowler's position
The nurse completes a shift assessment on a patient admitted in the early phase
of heart failure. When auscultating the patient's lungs, which finding would the
nurse most likely hear?
a. Continuous rumbling, snoring, or rattling sounds mainly on expiration
b. Continuous high-pitched musical sounds on inspiration and expiration
c. Discontinuous, high-pitched sounds of short duration heard on inspiration
d. A series of long-duration, discontinuous, low-pitched sounds during inspiration
- ans -ANS: C
Fine crackles are likely to be heard in the early phase of heart failure. Fine crackles
are discontinuous, high-pitched sounds of short duration heard on inspiration.
Rhonchi are continuous rumbling, snoring, or rattling sounds mainly on
expiration. Course crackles are a series of long-duration, discontinuous, low-
pitched sounds during inspiration. Wheezes are continuous high-pitched musical
sounds on inspiration and expiration
,While caring for a patient with respiratory disease, the nurse observes that the
patient's SpO2 drops from 93% to 88% while the patient is ambulating in the
hallway. What is the priority action of the nurse?
a. Notify the health care provider.
b. Document the response to exercise.
c. Administer the PRN supplemental O2.
d. Encourage the patient to pace activity.
- ans -ANS: C
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 won't 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."
- ans -ANS: 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 patient's 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.
- ans -ANS: 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 patient's caregiver to be present during the teaching.
- ans -ANS: D
Hypoxemia interferes with the patient's ability to learn and retain information, so
having the patient's 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.
, - ans -ANS: 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. "I've been taking Tylenol 650 mg every 6 hours for chest-wall pain."
d. "I've been using my albuterol inhaler more frequently over the last 4 days."
- ans -ANS: 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%
- ans -ANS: 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 premedicated before injection of
the contrast media. The increased pulse, low oxygen saturation, and tachypnea all
