Exam 2 Module 3 & Module 4 FSCJ
1460C
The nurse assesses a patient with chronic obstructive pulmonary disease (COPD). Which finding
does the nurse anticipate when inspecting the chest?
a. A ratio of 1 : 2 when comparing the side and front views of the chest
b. A barrel chest
c. A concave shape to the sternum
d. A severe lateral curvature of the spine - ANSWER b. A barrel chest
Which is a goal for a patient with the nursing diagnosis of Impaired Airway Clearance?
a. Patient's respiratory secretions will become thicker so they are not moved when coughing.
b. Patient's respiratory secretions will have a thinner consistency after being given a mucolytic
agent.
c. Patient will have improved range of motion while in bed.
d. Patient's respiratory rate will increase to 28 breaths/min during hospitalization. - ANSWER b.
Patient's respiratory secretions will have a thinner consistency after being given a mucolytic
agent.
Which position is the priority for a patient experiencing acute shortness of breath?
a. Supine position
b. Reverse Trendelenburg position
c. Face-down position
d. Upright position - ANSWER d. Upright position
Which oxygen delivery setting places a patient in danger of receiving inadequate oxygen?
a. Nasal cannula at a flow rate of 2 L/min
,b. Nasal cannula at a rate of 5 L/min
c. Simple mask at a flow rate of 5 L/min
d. Nonrebreather mask at a flow rate of 5 L/min - ANSWER d. Nonrebreather mask at a flow rate
of 5 L/min
Which action does a nurse anticipate when suctioning a patient with excessive secretions?
a. Decrease the patient's oxygen flow rate before beginning the deep suctioning.
b. Avoid lubricating the catheter tip to prevent getting the substance in the lung tissues.
c. Limit the time that the catheter is suctioning to prevent excessive loss of oxygen during the
process.
d. Flush the artificial airway with 3 mL of tap water to loosen secretions before suctioning. -
ANSWER c. Limit the time that the catheter is suctioning to prevent excessive loss of oxygen
during the process.
Which of the chambers of the heart becomes enlarged when mitral valve stenosis occurs?
a. Right atrium
b. Right ventricle
c. Left atrium
d. Left ventricle - ANSWER c. Left atrium
Which situation contributes to cyanosis in the pulmonary patient?
a. Increased PaCO2 levels
b. Hemoglobin that is not saturated with oxygen
c. Elevated white blood cell count
d. Decreased PaCO2 levels - ANSWER b. Hemoglobin that is not saturated with oxygen
A patient with chronic pneumonia may be evaluated by a speech therapist for which cause?
,a. Persistent aspiration of liquids
b. Hypoventilation due to smoking
c. Hyperventilation due to anxiety
d. Decreased respiratory effort due to scoliosis - ANSWER a. Persistent aspiration of liquids
A patient with chronic obstructive pulmonary disease (COPD) uses which drive to breathe?
a. Increased PaCO2
b. Decreased hemoglobin
c. Decreased PaO2 levels
d. Increased PaO2 levels - ANSWER c. Decreased PaO2 levels
Which questions are included in a focused history for a cardiac patient? (Select all that apply.)
a. Are you having pain?
b. Where is the pain located?
c. Do you attend religious services regularly?
d. Do you have increased fatigue?
e. Do you have any episodes of dizziness? - ANSWER a. Are you having pain?
b. Where is the pain located?
d. Do you have increased fatigue?
e. Do you have any episodes of dizziness?
A client who was bitten by a spider develops cellulitis of the left lower arm. What assessment
findings will the nurse expect when caring for this client? Select all that apply.
A. Fever
B. Pain
C. Redness around the spider bite
, D. Warmth in the affected arm
E. Swelling of the affected arm - ANSWER A. Fever
B. Pain
C. Redness around the spider bite
D. Warmth in the affected arm
E. Swelling of the affected arm
A client is diagnosed with C. difficile infection. What nursing action is the priority for the client?
A. Provide meticulous skin care.
B. Place the client on Contact Precautions.
C. Give the client an antipyretic medication.
D. Encourage the client to drink extra fluids. - ANSWER B. Place the client on Contact
Precautions.
Which statements by assistive personnel indicate understanding regarding infection control
measures needed to care for a client who has possible Clostridium difficile infection? Select all
that apply.
A. "I'll wear an isolation gown when providing direct care."
B. "I'll wear gloves when providing direct care."
C. "I'll wear a mask each time I enter the client's room."
D. "I'll use a hand sanitizer when I can't wash my hands."
E. "I'll wear goggles to protect my eyes." - ANSWER A. "I'll wear an isolation gown when
providing direct care."
B. "I'll wear gloves when providing direct care."
D. "I'll use a hand sanitizer when I can't wash my hands."
1460C
The nurse assesses a patient with chronic obstructive pulmonary disease (COPD). Which finding
does the nurse anticipate when inspecting the chest?
a. A ratio of 1 : 2 when comparing the side and front views of the chest
b. A barrel chest
c. A concave shape to the sternum
d. A severe lateral curvature of the spine - ANSWER b. A barrel chest
Which is a goal for a patient with the nursing diagnosis of Impaired Airway Clearance?
a. Patient's respiratory secretions will become thicker so they are not moved when coughing.
b. Patient's respiratory secretions will have a thinner consistency after being given a mucolytic
agent.
c. Patient will have improved range of motion while in bed.
d. Patient's respiratory rate will increase to 28 breaths/min during hospitalization. - ANSWER b.
Patient's respiratory secretions will have a thinner consistency after being given a mucolytic
agent.
Which position is the priority for a patient experiencing acute shortness of breath?
a. Supine position
b. Reverse Trendelenburg position
c. Face-down position
d. Upright position - ANSWER d. Upright position
Which oxygen delivery setting places a patient in danger of receiving inadequate oxygen?
a. Nasal cannula at a flow rate of 2 L/min
,b. Nasal cannula at a rate of 5 L/min
c. Simple mask at a flow rate of 5 L/min
d. Nonrebreather mask at a flow rate of 5 L/min - ANSWER d. Nonrebreather mask at a flow rate
of 5 L/min
Which action does a nurse anticipate when suctioning a patient with excessive secretions?
a. Decrease the patient's oxygen flow rate before beginning the deep suctioning.
b. Avoid lubricating the catheter tip to prevent getting the substance in the lung tissues.
c. Limit the time that the catheter is suctioning to prevent excessive loss of oxygen during the
process.
d. Flush the artificial airway with 3 mL of tap water to loosen secretions before suctioning. -
ANSWER c. Limit the time that the catheter is suctioning to prevent excessive loss of oxygen
during the process.
Which of the chambers of the heart becomes enlarged when mitral valve stenosis occurs?
a. Right atrium
b. Right ventricle
c. Left atrium
d. Left ventricle - ANSWER c. Left atrium
Which situation contributes to cyanosis in the pulmonary patient?
a. Increased PaCO2 levels
b. Hemoglobin that is not saturated with oxygen
c. Elevated white blood cell count
d. Decreased PaCO2 levels - ANSWER b. Hemoglobin that is not saturated with oxygen
A patient with chronic pneumonia may be evaluated by a speech therapist for which cause?
,a. Persistent aspiration of liquids
b. Hypoventilation due to smoking
c. Hyperventilation due to anxiety
d. Decreased respiratory effort due to scoliosis - ANSWER a. Persistent aspiration of liquids
A patient with chronic obstructive pulmonary disease (COPD) uses which drive to breathe?
a. Increased PaCO2
b. Decreased hemoglobin
c. Decreased PaO2 levels
d. Increased PaO2 levels - ANSWER c. Decreased PaO2 levels
Which questions are included in a focused history for a cardiac patient? (Select all that apply.)
a. Are you having pain?
b. Where is the pain located?
c. Do you attend religious services regularly?
d. Do you have increased fatigue?
e. Do you have any episodes of dizziness? - ANSWER a. Are you having pain?
b. Where is the pain located?
d. Do you have increased fatigue?
e. Do you have any episodes of dizziness?
A client who was bitten by a spider develops cellulitis of the left lower arm. What assessment
findings will the nurse expect when caring for this client? Select all that apply.
A. Fever
B. Pain
C. Redness around the spider bite
, D. Warmth in the affected arm
E. Swelling of the affected arm - ANSWER A. Fever
B. Pain
C. Redness around the spider bite
D. Warmth in the affected arm
E. Swelling of the affected arm
A client is diagnosed with C. difficile infection. What nursing action is the priority for the client?
A. Provide meticulous skin care.
B. Place the client on Contact Precautions.
C. Give the client an antipyretic medication.
D. Encourage the client to drink extra fluids. - ANSWER B. Place the client on Contact
Precautions.
Which statements by assistive personnel indicate understanding regarding infection control
measures needed to care for a client who has possible Clostridium difficile infection? Select all
that apply.
A. "I'll wear an isolation gown when providing direct care."
B. "I'll wear gloves when providing direct care."
C. "I'll wear a mask each time I enter the client's room."
D. "I'll use a hand sanitizer when I can't wash my hands."
E. "I'll wear goggles to protect my eyes." - ANSWER A. "I'll wear an isolation gown when
providing direct care."
B. "I'll wear gloves when providing direct care."
D. "I'll use a hand sanitizer when I can't wash my hands."
