Med Surg Respiratory 1 (Chapter 23) – Flashcards
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You are an occupational health nurse in a large ceramic manufacturing company. How would you intervene to prevent occupational lung disease in the employees of the company?
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Fit all employees with protective masks.
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A recent immigrant is diagnosed with pulmonary tuberculosis (TB). Which intervention is the most important for the nurse to implement with this client?
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Developing a list of people with whom the client has had contact
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Which of the following is a true statement regarding severe acute respiratory syndrome (SARS)?
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It is the most contagious during the second week of illness
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Which of the following community-acquired pneumonias demonstrates the highest occurrence during summer and fall?
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Legionnaires' disease
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What dietary recommendations should a nurse provide a patient with a lung abscess?
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A diet rich in protein
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A nurse is caring for a patient diagnosed with empyema. Which of the following interventions does a nurse implement for patients with empyema?
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Encourage breathing exercises.
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Which of the following interventions does a nurse implement for patients with empyema?
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Encourage breathing exercises
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A patient admitted to the hospital following a motor vehicle crash has suffered a flail chest. A nurse assesses the patient for what most common clinical manifestation of flail chest?
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Paradoxical chest movement
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The nurse is collaborating with a community group to develop plans to reduce the incidence of lung cancer in the community. Which of the following would be most effective?
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Classes at community centers to teach about smoking cessation strategies
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A patient has a Mantoux skin test prior to being placed on an immunosuppressant for the treatment of Crohn's disease. What results would the nurse determine is not significant for holding the medication?
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0 to 4 mm
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On auscultation, which finding suggests a right pneumothorax?
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Absence of breath sounds in the right thorax
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A nurse is caring for a client who was admitted with pneumonia, has a history of falls, and has skin lesions resulting from scratching. The priority nursing diagnosis for this client should be:
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Ineffective airway clearance.
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A victim has sustained a blunt force trauma to the chest. A pulmonary contusion is suspected. Which of the following clinical manifestations correlate with a moderate pulmonary contusion?
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Blood-tinged sputum
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The patient with a chest tube is being transported to X-ray. Which complication may occur if the chest tube is clamped during transportation?
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Tension pneumothorax
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A nurse is administering a purified protein derivative (PPD) test to a client. Which statement concerning PPD testing is true?
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A positive reaction indicates that the client has been exposed to the disease.
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You are an ICU nurse caring for a client who was admitted with a diagnosis of smoke inhalation. You know that this client is at increased risk for which of the following?
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Acute respiratory distress syndrome
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You are assessing a client's potential for pulmonary emboli. What finding indicates possible deep vein thrombosis?
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Pain in the calf
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Acute respiratory failure (ARF) occurs when oxygen tension (PaO2) falls to less than __________ mm Hg (hypoxemia) and carbon dioxide tension (PaCO2) rises to greater than __________ mm Hg (hypercapnia).
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50 and 50
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Which vitamin is usually administered with isoniazid (INH) to prevent INH-associated peripheral neuropathy?
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Vitamin B6
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You are a clinic nurse caring for a client with acute bronchitis. The client asks what may have caused the infection. What may induce acute bronchitis?
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Chemical irritation
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A client is brought to the emergency department following a motor vehicle accident. Which of the following nursing assessment is significant in diagnosing this client with flail chest?
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Paradoxical chest movement
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A nurse is caring for a client with chest trauma. Which nursing diagnosis takes the highest priority?
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Impaired gas exchange
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A physician stated to the nurse that the patient has fluid noted in the pleural space and will need a thoracentesis. The nurse would expect that the physician will document this fluid as which of the following?
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Pleural effusion
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A 65-year-old client who works construction, and has been demolishing an older building,is diagnosed with pneumoconiosis. The nurse is aware that his lung inflammation is most likely caused by exposure to which of the following?
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Asbestos
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You are caring for a client with chronic respiratory failure. What are the signs and symptoms of chronic respiratory failure?
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Progressive loss of lung function associated with chronic disease
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The nursing instructor is teaching students about the types of lung cancer. Which type of lung cancer is characterized as fast growing and can arise peripherally?
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Large cell carcinoma
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A patient who wears contact lenses is to be placed on rifampin for tuberculosis therapy. What should the nurse tell the patient?
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"You should switch to wearing your glasses while taking this medication."
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When caring for a client with acute respiratory failure, the nurse should expect to focus on resolving which set of problems?
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Hypercapnia, hypoventilation, and hypoxemia
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Which of the following techniques does a nurse suggest to a patient with pleurisy while teaching about splinting the chest wall?
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Turn onto affected side.
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You are caring for a client status post lung resection. When assessing your client you find that the bubbling in the water-seal chamber for the chest tubes is more than you expected. What should you check when bubbling in the water-seal chamber is excessive?
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See if there are leaks in the system.
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The nurse is providing discharge instructions to a patient with pulmonary sarcoidosis. The nurse concludes that the patient understands the information if the patient correctly states which of the following early signs of exacerbation?
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Shortness of breath
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A client hospitalized with pneumonia has thick, tenacious secretions. Which intervention should the nurse include when planning this client's care?
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Encouraging increased fluid intake
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A client who sustained a pulmonary contusion in a motor vehicle crash develops a pulmonary embolism. Which nursing diagnosis takes priority with this client?
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Ineffective breathing pattern related to tissue trauma
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The nurse knows that a sputum culture is necessary to identify the causative organism for acute tracheobronchitis. What causative fungal organism would the nurse suspect?
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Aspergillus
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You are an occupational nurse completing routine assessments on the employees where you work. What might be revealed by a chest radiograph for a client with occupational lung diseases?
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Fibrotic changes in lungs
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A patient arrives in the emergency department after being involved in a motor vehicle accident. The nurse observes paradoxical chest movement when removing the patient's shirt. What does the nurse know that this finding indicates?
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Flail chest
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What is the reason for chest tubes after thoracic surgery?
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Draining secretions, air, and blood from the thoracic cavity is necessary.
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A nurse is assessing the injection site of a client who has received a purified protein derivative test. Which finding indicates a need for further evaluation?
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15-mm induration
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After diagnosing a client with pulmonary tuberculosis, the physician tells family members that they must receive isoniazid (INH [Laniazid]) as prophylaxis against tuberculosis. The client's daughter asks the nurse how long the drug must be taken. What is the usual duration of prophylactic isoniazid therapy?
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6 to 12 months
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A client with suspected severe acute respiratory syndrome (SARS) comes to the emergency department. Which physician order should the nurse implement first?
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Institute isolation precautions.
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The ICU nurse caring for a 2-year-old near drowning victim monitors for what possible complication?
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Acute respiratory distress syndrome
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A 68-year-old male client who underwent thoracic surgery to remove a lung tumor had a chest tube placed anteriorly. The nurse knows that the surgical team places this catheter:
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To remove air from the pleural space
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A nurse assesses arterial blood gas results for a patient in acute respiratory failure (ARF). Which of the following results are consistent with this disorder?
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pH 7.28, PaO2 50 mm Hg
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A Class 1 with regards to TB indicates
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exposure and no evidence of infection.
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A nurse is assessing a client who comes to the clinic for care. Which findings in this client suggest bacterial pneumonia?
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Dyspnea and wheezing
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The most diagnostic clinical symptom of pleurisy is:
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Stabbing pain during respiratory movements.
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A 73-year-old client is admitted to the pulmonology unit of the hospital. She was admitted with a pleural effusion and was "tapped" to drain the fluid to reduce her mediastinal pressure. How much fluid is typically present between the pleurae, which surround the lungs, to prevent friction rub?
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5 - 15 ml
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A patient taking isoniazid (INH) therapy for tuberculosis demonstrates understanding when making which statement?
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"It is all right if I have a grilled cheese sandwich with American cheese."
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A client has been hospitalized for treatment of acute bacterial pneumonia. Which outcome indicates an improvement in the client's condition?
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The client has a partial pressure of arterial oxygen (PaO2) value of 90 mm Hg or higher.
