question

...

answer

ACUTE RESPIRATORY STUDY QUESTIONS

question

A client is in danger of respiratory arrest following the administration of an opioid analgesic. An arterial blood gas value is obtained. The nurse should expect the PaCO2 to be which value?

answer

1.

question

15 mm Hg

answer

a.

question

30 mm Hg

answer

b.

question

40 mm Hg

answer

c.

question

80 mm Hg

answer

d.

question

A client's arterial blood gas (ABG) results are as follows: pH, 7.16; PaCO2, 80 mm Hg; PaO2 46 mm Hg; HCO3-, 24 mEq/L; SaO2, 81%. These ABG results represent which condition?

answer

2.

question

Metabolic acidosis

answer

a.

question

Metabolic alkalosis

answer

b.

question

Respiratory acidosis

answer

c.

question

Respiratory alkalosis

answer

d.

question

A firefighter was involved in extinguishing a house fire and is being treated for smoke inhalation. He develops severe hypoxia 48 hours after the incident, requiring intubation and mechanical ventilation. He most likely has developed which condition?

answer

3.

question

Acute respiratory distress syndrome (ARDS)

answer

a.

question

Atelectasis

answer

b.

question

Bronchitis

answer

c.

question

Pneumonia

answer

d.

question

In a client with smoke inhalation who develops pulmonary edema, the nurse should expect to hear which breath sound?

answer

4.

question

Crackles

answer

a.

question

Decreased breath sounds

answer

b.

question

Inspiratory and expiratory wheezing

answer

c.

question

Upper airway rhonchi

answer

d.

question

Which nursing diagnosis would be the priority for a client with acute respiratory distress syndrome (ARDS)?

answer

5.

question

Ineffective breathing pattern

answer

a.

question

Risk for infection

answer

b.

question

Imbalanced nutrition: Less than body requirements

answer

c.

question

Impaired skin integrity

answer

d.

question

Which statement best describes what happens to the alveoli in acute respiratory distress syndrome (ARDS)?

answer

6.

question

Alveoli are overexpanded.

answer

a.

question

Alveoli increase perfusion.

answer

b.

question

Alveolar spaces are filled with fluid.

answer

c.

question

Alveoli improve gaseous exchange.

answer

d.

question

A 69-year-old client develops acute shortness of breath and progressive hypoxia requiring mechanical ventilation after repair of a fractured right femur. The hypoxia was probably caused by which condition?

answer

7.

question

Asthma attack

answer

a.

question

Atelectasis

answer

b.

question

Bronchitis

answer

c.

question

Fat embolism

answer

d.

question

A client with a fat embolism is receiving 100% FIO2 on a mechanical ventilator and continues to be hypoxic. Which measure can improve his oxygenation?

answer

8.

question

Add positive end-expiratory pressure (PEEP).

answer

a.

question

Give beta-adrenergic blockers.

answer

b.

question

Give diuretics.

answer

c.

question

Increase the FIO2 on the ventilator.

answer

d.

question

...

answer

ACUTE RESPIRATORY STUDY QUESTIONS, pg 2

question

If a client with a fat embolism continues to be hypoxic following therapy with positive end-expiratory pressure, what can be done to reduce oxygen demand?

answer

9.

question

Give diuretics.

answer

a.

question

Give neuromuscular blockers.

answer

b.

question

Put the head of the bed flat.

answer

c.

question

Use bronchodilators.

answer

d.

question

Positive end-expiratory pressure (PEEP) therapy has which initial effect on the heart?

answer

10.

question

Bradycardia

answer

a.

question

Tachycardia

answer

b.

question

Increased blood pressure

answer

c.

question

Reduced cardiac output

answer

d.

question

Occasionally, clients with acute respiratory distress syndrome (ARDS) are placed in the prone position. How does this position help the client?

answer

11.

question

It improves cardiac output.

answer

a.

question

It makes the client more comfortable.

answer

b.

question

It prevents skin breakdown.

answer

c.

question

It recruits more alveoli.

answer

d.

question

Which condition could lead to acute respiratory distress syndrome (ARDS)?

answer

12.

question

Appendicitis

answer

a.

question

Massive trauma

answer

b.

question

Receiving conscious sedation

answer

c.

question

Right meniscus injury

answer

d.

question

Which indicators would show if the condition of a client with acute respiratory distress syndrome (ARDS) is improving?

answer

13.

question

Arterial blood gas (ABG) values

answer

a.

question

Bronchoscopy results

answer

b.

question

Increased blood pressure

answer

c.

question

Sputum culture and sensitivity results

answer

d.

question

A 24-year-old client comes into the clinic complaining of right-sided chest pain and shortness of breath. He reports that it started suddenly. The assessment should include which intervention?

answer

14.

question

Auscultation of breath sounds

answer

a.

question

Chest x-ray

answer

b.

question

Echocardiogram

answer

c.

question

Electrocardiogram (ECG)

answer

d.

question

The client in the previous question has decreased-to-absent breath sounds on the right side, from the apex to the base. Which condition best explains this?

answer

15.

question

Acute asthma

answer

a.

question

Chronic bronchitis

answer

b.

question

Pneumonia

answer

c.

question

Spontaneous pneumothorax

answer

d.

question

Which treatment should a nurse expect for a client with spontaneous pneumothorax?

answer

16.

question

Antibiotics

answer

a.

question

Bronchodilators

answer

b.

question

Chest tube placement

answer

c.

question

Hyperbaric chamber

answer

d.

question

...

answer

ACUTE RESPIRATORY STUDY QUESTIONS, pg 3

question

A 60-year-old client was in a motor vehicle collision as an unrestrained driver. He's now in the emergency department complaining of difficulty breathing and chest pain. On auscultation of his lung fields, no breath sounds are present in the left upper lobe. This client may have which condition?

answer

17.

question

Bronchitis

answer

a.

question

Pneumonia

answer

b.

question

Pneumothorax

answer

c.

question

Tuberculosis (TB)

answer

d.

question

Which method is the best way to confirm the diagnosis of a pneumothorax?

answer

18.

question

Auscultate for breath sounds.

answer

a.

question

Have the client use an incentive spirometer.

answer

b.

question

Take a chest x-ray.

answer

c.

question

Stick a needle in the area of the decreased breath sounds.

answer

d.

question

After a motor vehicle collision, a client has a chest tube inserted in the left upper chest. When the tube is inserted, it begins to drain a large amount of dark red fluid. Which explanation best describes what caused this?

answer

19.

question

The chest tube was inserted improperly.

answer

a.

question

This always happens when a chest tube is inserted.

answer

b.

question

An artery was nicked when the chest tube was placed.

answer

c.

question

The client had a hemothorax instead of a pneumothorax.

answer

d.

question

A hospitalized client needs a central IV catheter inserted. The physician places the catheter in the subclavian vein. Shortly afterward, the client develops shortness of breath and appears restless. Which action should the nurse perform first?

answer

20.

question

Administer a sedative.

answer

a.

question

Advise the client to calm down.

answer

b.

question

Auscultate for breath sounds.

answer

c.

question

Check to see if the client can have medication.

answer

d.

question

Which measure would be ordered for a client who recently had a central venous catheter inserted and who now appears short of breath and anxious?

answer

21.

question

Chest x-ray

answer

a.

question

Electrocardiogram

answer

b.

question

Laboratory tests

answer

c.

question

Sedation

answer

d.

question

A client needs to have a chest tube inserted in the right upper chest. Which action is part of the nurse's role?

answer

22.

question

The nurse isn't needed.

answer

a.

question

Prepare the chest tube drainage system.

answer

b.

question

Bring the chest x-ray to the client's room.

answer

c.

question

Insert the chest tube.

answer

d.

question

Which result shows that a chest tube insertion was done correctly?

answer

23.

question

Bronchial sounds heard at both bases

answer

a.

question

Vesicular sounds heard over upper lung fields

answer

b.

question

Bronchovesicular sounds heard over both lung fields

answer

c.

question

Crackles heard on the affected side

answer

d.

question

Which measure best determines that a chest tube is no longer needed for a client who had a pneumothorax?

answer

24.

question

The drainage from the chest tube is minimal.

answer

a.

question

Arterial blood gas (ABG) levels are obtained to ensure proper oxygenation.

answer

b.

question

It's removed and the client is assessed to see if he's breathing adequately.

answer

c.

question

No fluctuation in the water seal chamber occurs when no suction is applied.

answer

d.

question

...

answer

ACUTE RESPIRATORY STUDY QUESTIONS, pg 4

question

Which intervention should be done before a chest tube is removed?

answer

25.

question

Disconnect the drainage system from the tube.

answer

a.

question

Obtain a chest x-ray to document reexpansion.

answer

b.

question

Obtain an arterial blood gas level to document oxygen status.

answer

c.

question

Sedate the client, and the physician will slip the tube out without warning the client.

answer

d.

question

A client with a chest tube has accidentally removed it. What action should the nurse perform first?

answer

26.

question

Position the client on his left side.

answer

a.

question

Position the client on his right side.

answer

b.

question

Apply an occlusive dressing over the site.

answer

c.

question

Reinsert the chest tube that fell out.

answer

d.

question

A 165-lb client with a pulmonary embolus is ordered to receive heparin 20 units/kg/hour by IV infusion. How many units of heparin should he receive each hour?

answer

27.

question

1,000

answer

a.

question

1,200

answer

b.

question

1,500

answer

c.

question

1,700

answer

d.

question

Which source is the most common origin for a pulmonary embolism?

answer

28.

question

Amniotic fluid

answer

a.

question

Bone marrow

answer

b.

question

Septic thrombi

answer

c.

question

Venous thrombi

answer

d.

question

Clients most at risk for pulmonary embolism are those with which condition?

answer

29.

question

Arthritis

answer

a.

question

Diabetes

answer

b.

question

Pregnancy

answer

c.

question

Trauma to the pelvis or lower extremities

answer

d.

question

Which measure to prevent pulmonary embolism after lower extremity surgery is the best?

answer

30.

question

Early ambulation

answer

a.

question

Frequent chest x-rays to find a pulmonary embolism

answer

b.

question

Frequent lower extremity scans

answer

c.

question

Intubation of the client

answer

d.

question

Which physiologic effects of a pulmonary embolism would initially affect oxygenation?

answer

31.

question

A blood clot blocks ventilation; perfusion is unaffected.

answer

a.

question

A blood clot blocks ventilation, producing hypoxia despite normal perfusion.

answer

b.

question

A blood clot blocks perfusion and ventilation, producing profound hypoxia.

answer

c.

question

A blood clot blocks perfusion, producing hypoxia despite normal or hypernormal ventilation.

answer

d.

question

Which statement best describes the ventilation-perfusion mismatch that occurs with a pulmonary embolism?

answer

32.

question

The area of the lung being ventilated isn't being perfused.

answer

a.

question

The area of the lung being perfused isn't being ventilated.

answer

b.

question

The area of the lung being ventilated is also being perfused.

answer

c.

question

The amount of ventilation occurring doesn't equal perfusion.

answer

d.

question

When a client has a pulmonary embolism, he develops chest pain caused by which condition?

answer

33.

question

Costochondritis

answer

a.

question

Myocardial infarction (MI)

answer

b.

question

Inflammatory reaction

answer

c.

question

Referred pain from the pelvis to the chest

answer

d.

question

...

answer

ACUTE RESPIRATORY STUDY QUESTIONS, pg 5

question

A client with a pulmonary embolism frequently feels apprehension or a sense of "impending doom" because of which reason?

answer

34.

question

Inflammatory reaction in the lung parenchyma

answer

a.

question

Loss of chest expansion

answer

b.

question

Loss of lung tissue

answer

c.

question

Sudden reduction in adequate oxygenation

answer

d.

question

Hemoptysis may be present in a client with a pulmonary embolism because of which reason?

answer

35.

question

Alveolar damage in the infarcted area

answer

a.

question

Involvement of major blood vessels where the clot formed

answer

b.

question

Loss of lung parenchyma

answer

c.

question

Loss of lung tissue

answer

d.

question

A client with a massive pulmonary embolism will have an arterial blood gas analysis performed to determine the extent of hypoxia. The acid-base disorder that may be present is:

answer

36.

question

metabolic acidosis.

answer

a.

question

metabolic alkalosis.

answer

b.

question

respiratory acidosis.

answer

c.

question

respiratory alkalosis.

answer

d.

question

A ventilation-perfusion (VQ) scan is commonly performed to diagnose a pulmonary embolism. This test provides what type of information?

answer

37.

question

Amount of perfusion present in the lung

answer

a.

question

Extent of the occlusion and amount of perfusion lost

answer

b.

question

Location of the pulmonary embolism

answer

c.

question

Location and size of the pulmonary embolism

answer

d.

question

Which test can be used to definitively diagnose a pulmonary embolism?

answer

38.

question

Arterial blood gas (ABG) analysis

answer

a.

question

Chest x-ray

answer

b.

question

Pulmonary angiogram

answer

c.

question

Ventilation-perfusion (VQ) scan

answer

d.

question

Which medication is prescribed after a pulmonary embolism is diagnosed?

answer

39.

question

Warfarin (Coumadin)

answer

a.

question

Heparin

answer

b.

question

Streptokinase (Streptase)

answer

c.

question

Urokinase (Abbokinase)

answer

d.

question

IV Heparin is given to clients with pulmonary embolism for which reason?

answer

40.

question

To dissolve the clot

answer

a.

question

To break up the pulmonary embolism

answer

b.

question

To slow the development of other clots

answer

c.

question

To prevent clots from breaking off and embolizing to the lung

answer

d.

question

A client with a pulmonary embolism is discharged but will remain on warfarin (Coumadin) therapy for up to 6 months to:

answer

41.

question

prevent further embolism formation.

answer

a.

question

minimize the growth of new or existing thrombi.

answer

b.

question

continue to reduce the size of the pulmonary embolism.

answer

c.

question

break up the existing pulmonary embolism until it's totally gone.

answer

d.

question

...

answer

ACUTE RESPIRATORY STUDY QUESTIONS, pg 6

question

The goal of oxygen therapy for a client with a pulmonary embolism is to obtain which value?

answer

42.

question

PaCO2 greater than 40 mm Hg

answer

a.

question

PaCO2 less than 40 mm Hg

answer

b.

question

PaO2 greater than 60 mm Hg

answer

c.

question

PaO2 less than 60 mm Hg

answer

d.

question

A client may develop hypotension caused by a pulmonary embolism that produces which result?

answer

43.

question

Pressure on the heart and reduced cardiac output

answer

a.

question

Reduced blood flow to the lung, which causes hypotension

answer

b.

question

Reduced blood return to the right side of the heart leading to lower blood pressure

answer

c.

question

Increased pulmonary vascular resistance and reduced blood delivery to the left side of the heart

answer

d.

question

A client with a pulmonary embolism typically has chest pain and apprehension, which can be treated by which method?

answer

44.

question

Administering analgesics

answer

a.

question

Using guided imagery

answer

b.

question

Positioning the client on his left side

answer

c.

question

Providing emotional support

answer

d.

question

A client with a pulmonary embolism may have an umbrella filter placed in the vena cava for which reason?

answer

45.

question

The filter prevents further clot formation.

answer

a.

question

The filter collects clots so they don't go to the lung.

answer

b.

question

The filter breaks up clots into insignificantly small pieces.

answer

c.

question

The filter contains anticoagulants that are slowly released, dissolving any clots.

answer

d.

question

A client with a pulmonary embolism may need an embolectomy, which involves which action?

answer

46.

question

Removing an embolism in the lower extremity

answer

a.

question

Sucking the embolism out of the lung by bronchoscopy

answer

b.

question

Surgically removing the embolism source in the pelvis

answer

c.

question

Surgically removing the embolism in the pulmonary vasculature

answer

d.

question

Nursing management of a client with a pulmonary embolism focuses on which action?

answer

47.

question

Assessing oxygenation status

answer

a.

question

Monitoring the oxygen delivery device

answer

b.

question

Monitoring other sources of clots

answer

c.

question

Determining whether the client requires another ventilation-perfusion (VQ) scan

answer

d.

question

How does positive end-expiratory pressure (PEEP) improve oxygenation?

answer

48.

question

It provides more oxygen to the client.

answer

a.

question

It opens up bronchioles and allows oxygen to get in the lungs.

answer

b.

question

It opens up collapsed alveoli and helps keep them open.

answer

c.

question

It adds pressure to the lung tissue, which improves gaseous exchange.

answer

d.

question

Continuous positive airway pressure (CPAP) can be provided through an oxygen mask to improve oxygenation in hypoxic clients by which method?

answer

49.

question

The mask provides 100% oxygen to the client.

answer

a.

question

The mask provides continuous air that the patient can breathe.

answer

b.

question

The mask provides pressurized oxygen so that the client can breathe more easily.

answer

c.

question

The mask provides pressurized oxygen at the end of expiration to open collapsed alveoli.

answer

d.

question

...

answer

ACUTE RESPIRATORY STUDY QUESTIONS, pg 7

question

Bi-level positive airway pressure (BiPAP) is delivered through a special oxygen mask that performs which function?

answer

50.

question

The mask provides 100% oxygen at both inspiration and expiration.

answer

a.

question

The mask provides pressurized oxygen so the client can breathe more easily.

answer

b.

question

The mask provides pressurized oxygen at the end of expiration to open collapsed alveoli.

answer

c.

question

The mask provides both continuous positive airway pressure (CPAP) and positive end-expiratory pressure (PEEP) to provide optimal oxygenation and ventilation.

answer

d.

question

After a motor vehicle collision, an 18-year-old client is admitted with a pneumothorax. The surgeon inserts a chest tube and attaches it to a chest drainage system. Bubbling soon appears in the water seal chamber. Which factor is the most likely cause of the bubbling?

answer

51.

question

Air leak

answer

a.

question

Adequate suction

answer

b.

question

Inadequate suction

answer

c.

question

Kinked chest tube

answer

d.

question

A client's arterial blood gas (ABG) analysis reveals a pH of 7.18, PaCO2 of 73 mm Hg, PaO2 of 77 mm Hg, and HCO3- of 24 mEq/L. What do these values indicate?

answer

52.

question

Metabolic acidosis

answer

a.

question

Respiratory alkalosis

answer

b.

question

Metabolic alkalosis

answer

c.

question

Respiratory acidosis

answer

d.

question

An unrestrained passenger is thrown 20 feet (6.1 m) from a care. On admission to the emergency department, he has a heart rate of 130 beats/minute, shallow respirations at a rate of 32 breaths/minute, and a blood pressure of 90/60 mm Hg. His skin is pale and cool, and capillary refill is delayed. Breath sounds are diminished on the right side and paradoxical chest-wall movement appears on the right side. A chest x-ray reveals a right pneumothorax with multiple rib fractures (4th to 7th right ribs). Which diagnosis is the most probable?

answer

53.

question

Tension pneumothorax

answer

a.

question

Flail chest

answer

b.

question

Ruptured diaphragm

answer

c.

question

Massive hemothorax

answer

d.

question

To obtain an arterial blood gas sample from a client's radial artery, which action should the nurse perform first?

answer

54.

question

Perform Allen's test.

answer

a.

question

Place a rolled towel under the client's wrist.

answer

b.

question

Clean the puncture site with an alcohol or povidone-iodine pad.

answer

c.

question

Palpate the artery with the index and middle fingers of one hand.

answer

d.

question

After experiencing an anxiety attack, a client comes to the emergency department complaining of dizziness and light-headedness. Arterial blood gas (ABG) analysis reveals a pH of 7.62, PaCO2 of 22 mm Hg, PaO2 of 96 mm Hg, and HCO3- of 24 mEq/L. Which action should the nurse take?

answer

55.

question

Do nothing; these ABG values are normal.

answer

a.

question

Encourage the client to breathe into a paper bag.

answer

b.

question

Notify the physician and prepare to give sodium bicarbonate.

answer

c.

question

Notify the physician and prepare to give supplemental oxygen.

answer

d.

question

A physician places an order in the computer for a nurse to change a client's chest drainage system from suction to gravity drainage. How should the nurse proceed?

answer

56.

question

Detach the tubing from the suction to provide a vent.

answer

a.

question

Clamp the client's drainage tube.

answer

b.

question

Question the physician's order.

answer

c.

question

Turn off the suction source and leave the tubing connected.

answer

d.

question

...

answer

ACUTE RESPIRATORY STUDY QUESTIONS, pg 8

question

A client with acute respiratory failure is admitted to the intensive care unit with an arterial line for frequent measurement of arterial blood gas levels and continuous measurement of blood pressure. The nurse is evaluating the waveform. Identify the area that indicates that the aortic valve has closed.

answer

57.

question

A client with a suspected pulmonary embolus is brought to the emergency department. He complains of shortness of breath and chest pain. Which other signs and symptoms would support this diagnosis? Select all that apply:

answer

58.

question

Low-grade fever

answer

a.

question

Thick green sputum

answer

b.

question

Bradycardia

answer

c.

question

Frothy sputum

answer

d.

question

Tachycardia

answer

e.

question

Blood-tinged sputum

answer

f.

question

A nurse begins her shift by reading the following shift report note on a client.

answer

59.

question

...

answer

H.B. age 78

question

...

answer

Hyperventilating, RR 36

question

...

answer

bpm, c/o dizziness,

question

...

answer

shortness of breath,

question

...

answer

tingling in hands and feet,

question

...

answer

weakness. Anxious.

question

...

answer

ABG: pH 7.48

question

PaCO2: 33 mm Hg

answer

...

question

...

answer

Without further information, the nurse plans to reevaluate the client's status for which problem?

question

Metabolic acidosis

answer

a.

question

Acute respiratory failure

answer

b.

question

Respiratory alkalosis

answer

c.

question

Anxiety reaction

answer

d.

question

A 28-year-old client with human immunodeficiency virus (HIV) is admitted to the hospital with flulike symptoms. He has dyspnea and a cough. He's placed on a 100% nonrebreather mask and arterial blood gases are drawn. Which result indicates the need for intubation?

answer

60.

question

PaO2, 90 mm Hg; PaCO2, 40 mm Hg

answer

a.

question

PaO2, 85 mm Hg; PaCO2, 45 mm Hg

answer

b.

question

PaO2, 80 mm Hg; PaCO2, 45 mm Hg

answer

c.

question

PaO2, 70 mm Hg; PaCO2, 55 mm Hg

answer

d.

question

...

answer

ACUTE RESPIRATORY STUDY QUESTIONS, pg 9

question

A client with acquired immunodeficiency syndrome is intubated, leaving him prone to skin breakdown from the endotracheal (ET) tube. Which intervention is best to prevent this?

answer

61.

question

Use lubricant on the lips.

answer

a.

question

Provide oral care every 2 hours.

answer

b.

question

Suction the oral cavity every 2 hours.

answer

c.

question

Reposition the ET tube every 24 hours.

answer

d.

question

A 31-year-old client is admitted to the hospital with respiratory failure. He's intubated in the emergency department, placed on 100% FiO2, and is coughing up copious secretions. Which intervention should be done first?

answer

62.

question

Get and x-ray.

answer

a.

question

Suction the client.

answer

b.

question

Restrain the client.

answer

c.

question

Obtain an arterial blood gas (ABG) analysis.

answer

d.

question

A client with an endotracheal (ET) tube has copious, brown-tinged secretions. Which intervention is a priority?

answer

63.

question

Use a trap to obtain a specimen.

answer

a.

question

Instill saline to break up secretions.

answer

b.

question

Culture the specimen with a culturette swab.

answer

c.

question

Obtain an order for a liquefying agent for the sputum.

answer

d.

question

An x-ray shows an endotracheal (ET) tube is 2 cm above the carina, and there are nodular lesions and patchy infiltrates in the upper lobe. Which interpretation of the x-ray is accurate?

answer

64.

question

The x-ray is inconclusive.

answer

a.

question

The client has a disease process going on.

answer

b.

question

The ET tube needs to be advanced.

answer

c.

question

The ET tube needs to be pulled back.

answer

d.

question

A client has arterial blood gases drawn. The results are as follows: pH, 7.52; PaO2, 50 mm Hg; PaCO2, 28 mm Hg; HCO3-, 24 mEq/L. Which condition is indicated?

answer

65.

question

Metabolic acidosis

answer

a.

question

Metabolic alkalosis

answer

b.

question

Respiratory acidosis

answer

c.

question

Respiratory alkalosis

answer

d.

Acute Respiratory Questions – Flashcards

Unlock all answers in this set

Haven't found what you were looking for?

Search for samples, answers to your questions and flashcards