Acute Respiratory Questions – Flashcards

Unlock all answers in this set

Unlock answers
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.
Get an explanation on any task
Get unstuck with the help of our AI assistant in seconds
New