NURS EXAM TB QUIZ WITH QUESTIONS AND VERIFIED
ANSWERS 2023-2024 A GRADED
DEWIT 2e
Chapter 15: Care of Patients with Disorders of the Lower Respiratory System
Chapter 15: Care of Patients with Disorders of the Lower Respiratory System
MULTIPLE CHOICE
14. When caring for a patient who is on a closed-chest drainage system with chest tubes, the nurse can confirm that
the system is intact and working when:
a. the water level in the water-seal chamber fluctuates.
b. the level of fluid in the collection chamber rises.
c. there are constant bubbles in the water-seal chamber.
d. the suction has been attached.
ANS: A
If the level of the water in the water-seal chamber rises and falls with the patient’s respiration, the system is intact.
Constant bubbles in the water-seal chamber indicate a leak in the system. The fluid in the collection container drains
by gravity whether the closed-chest drainage system is intact or not. Suction is not significant with respect to
whether the system is intact.
DIF: Cognitive Level: Analysis REF: 316-317 OBJ: 6 (theory)
TOP: Closed-Chest Drainage KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
15. When the nurse assesses that the level of drainage has not increased over the last 3 hours on a first-day
postoperative thoracotomy patient, the nurse should initially:
a. inform the charge nurse.
b. rearrange tubing to correct dependent loops.
c. splint the patient with a pillow and coach to cough.
d. gently massage the tube toward the collection bottle.
ANS: B
Dependent loops can capture drainage and plug the tube, not allowing any more drainage to leave the chest.
Massaging (milking) the tube can be implemented after the dependent loops have been corrected. It would not be
necessary to notify the charge nurse unless there is a problem, and having the patient cough would not correct the
drainage problem.
DIF: Cognitive Level: Application REF: 316-317 OBJ: 6 (theory)
TOP: Closed-Chest Drainage KEY: Nursing Process Step:
Implementation MSC: NCLEX: Physiological Integrity: Basic Care and
Comfort
16. The nurse schedules the postural drainage treatments to be done before breakfast because:
a. fluids that have accumulated overnight can be expelled.
b. bronchial openings are still more fully open after a night’s rest.
c. appetite will be stimulated for a meal after fluid is expelled.
d. the empty stomach reduces gagging.
ANS: A
,Morning postural drainage can expel the fluids collected overnight. After a postural drainage, the patient is tired and
may not want to eat at all. The empty stomach prevents excessive vomiting but not gagging.
, DIF: Cognitive Level: Application REF: 321 OBJ: 2 (theory)
TOP: Postural Drainage KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
17. The patient with sleep apnea is fitted with a continuous positive airway pressure (CPAP) mask and asks the nurse
h w this device will help. The nurse correctly responds with which statement?
“The device delivers constant positive pressure to keep your airway
a. open.”
b. “The device will require you to be intubated to open your airway.”
c. “The device delivers oxygen only when you are apneic.”
d. “The device delivers negative pressure to stimulate your respirations.”
ANS: A
The CPAP mask delivers a constant positive pressure to keep the airway open. CPAP does not require intubation
and does not deliver negative pressure.
DIF: Cognitive Level: Application REF: 326 OBJ: 6 (theory)
TOP: Continuous Positive Airway Pressure Mask
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
Chapter 16: The Hematologic System
MULTIPLE CHOICE
1. The stem cells in the marrow are stimulated to make blood cells by the erythropoietin- stimulating factor in the:
a. brain.
b. lung.
c. kidney.
d. liver.
ANS: C
The kidney secrets the erythropoietin-stimulating factor to stimulate the stem cells to make blood cells.
DIF: Cognitive Level: Comprehension REF: 332 OBJ: 2 (theory)
TOP: Erythropoiesis KEY: Nursing Process Step: NA
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
2. Red blood cells only live about days.
a. 30
b. 90
c. 100
d. 120
ANS: D
Red blood cells live approximately 120 days.
DIF: Cognitive Level: Knowledge REF: 332 OBJ: 1 (theory)
TOP: Life of RBCs KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance
3. The nurse explains that, in the event of a massive hemorrhagic episode, the contracts and adds blood to the
circulating volume.
, a. Spleen
b. Liver
c. Pancreas
d. bone marrow
ANS: A
The spleen has the ability to contract and add blood to the circulating volume in the event of massive hemorrhage.
DIF: Cognitive Level: Comprehension REF: 332 OBJ: 1 (clinical)
TOP: Spleen KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
4. The nurse evaluates the lab reports for the patients on the unit, and recognizes the report requiring the most
immediate attention is for the patient with RBCs, mil/mm3; WBCs, mil/mm3; and Hb, g/dL.
a. 4.2; 4500; 9.1
b. 5.9; 4500; 12.7
c. 6.0; 6000; 13.2
d. 7.6; 8000; 18.0
ANS: A
The low RBCs and low hemoglobin suggests possible anemia or blood loss. The normal range for adults is red
blood cell (RBC) count 4.2 to 6.2 mil/mm3 ; white blood cell (WBC) count: 4500 to 11,000/mm3; and hemoglobin
(Hb): females, 12.0 to 16.7 g/dL; males, 13.0 to 18.0 g/dL.
DIF: Cognitive Level: Analysis REF: 337 | Table 16-1
OBJ: 5 (theory) TOP: Blood Counts
KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance
5. The nurse notes a rise in the eosinophil count and suspects the patient has a(n):
a. bacterial infection.
b. allergy.
c. viral infection.
d. blood dyscrasia.
ANS: B
In the event of an allergy or the infestation of pinworms, the eosinophil count will rise. Bacterial infection stimulates
the production of neutrophils and segmented neutrophils; lymphocytes are increased with viral infections. Blood
dyscrasia refers to an imbalance in numbers of types of cells or other pathologic conditions of the blood.
DIF: Cognitive Level: Application REF: 333 OBJ: 5 (theory)
TOP: Eosinophil Count KEY: Nursing Process Step:
Assessment MSC: NCLEX: Health Promotion and Maintenance
6. The nurse uses a visual aid to depict the several kinds of hemoglobin. The hemoglobin that changes the shape
of the red blood cell (RBC) on which it resides is hemoglobin:
a. A.
b. A1c.
c. F.
d. S.
ANSWERS 2023-2024 A GRADED
DEWIT 2e
Chapter 15: Care of Patients with Disorders of the Lower Respiratory System
Chapter 15: Care of Patients with Disorders of the Lower Respiratory System
MULTIPLE CHOICE
14. When caring for a patient who is on a closed-chest drainage system with chest tubes, the nurse can confirm that
the system is intact and working when:
a. the water level in the water-seal chamber fluctuates.
b. the level of fluid in the collection chamber rises.
c. there are constant bubbles in the water-seal chamber.
d. the suction has been attached.
ANS: A
If the level of the water in the water-seal chamber rises and falls with the patient’s respiration, the system is intact.
Constant bubbles in the water-seal chamber indicate a leak in the system. The fluid in the collection container drains
by gravity whether the closed-chest drainage system is intact or not. Suction is not significant with respect to
whether the system is intact.
DIF: Cognitive Level: Analysis REF: 316-317 OBJ: 6 (theory)
TOP: Closed-Chest Drainage KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
15. When the nurse assesses that the level of drainage has not increased over the last 3 hours on a first-day
postoperative thoracotomy patient, the nurse should initially:
a. inform the charge nurse.
b. rearrange tubing to correct dependent loops.
c. splint the patient with a pillow and coach to cough.
d. gently massage the tube toward the collection bottle.
ANS: B
Dependent loops can capture drainage and plug the tube, not allowing any more drainage to leave the chest.
Massaging (milking) the tube can be implemented after the dependent loops have been corrected. It would not be
necessary to notify the charge nurse unless there is a problem, and having the patient cough would not correct the
drainage problem.
DIF: Cognitive Level: Application REF: 316-317 OBJ: 6 (theory)
TOP: Closed-Chest Drainage KEY: Nursing Process Step:
Implementation MSC: NCLEX: Physiological Integrity: Basic Care and
Comfort
16. The nurse schedules the postural drainage treatments to be done before breakfast because:
a. fluids that have accumulated overnight can be expelled.
b. bronchial openings are still more fully open after a night’s rest.
c. appetite will be stimulated for a meal after fluid is expelled.
d. the empty stomach reduces gagging.
ANS: A
,Morning postural drainage can expel the fluids collected overnight. After a postural drainage, the patient is tired and
may not want to eat at all. The empty stomach prevents excessive vomiting but not gagging.
, DIF: Cognitive Level: Application REF: 321 OBJ: 2 (theory)
TOP: Postural Drainage KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
17. The patient with sleep apnea is fitted with a continuous positive airway pressure (CPAP) mask and asks the nurse
h w this device will help. The nurse correctly responds with which statement?
“The device delivers constant positive pressure to keep your airway
a. open.”
b. “The device will require you to be intubated to open your airway.”
c. “The device delivers oxygen only when you are apneic.”
d. “The device delivers negative pressure to stimulate your respirations.”
ANS: A
The CPAP mask delivers a constant positive pressure to keep the airway open. CPAP does not require intubation
and does not deliver negative pressure.
DIF: Cognitive Level: Application REF: 326 OBJ: 6 (theory)
TOP: Continuous Positive Airway Pressure Mask
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
Chapter 16: The Hematologic System
MULTIPLE CHOICE
1. The stem cells in the marrow are stimulated to make blood cells by the erythropoietin- stimulating factor in the:
a. brain.
b. lung.
c. kidney.
d. liver.
ANS: C
The kidney secrets the erythropoietin-stimulating factor to stimulate the stem cells to make blood cells.
DIF: Cognitive Level: Comprehension REF: 332 OBJ: 2 (theory)
TOP: Erythropoiesis KEY: Nursing Process Step: NA
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
2. Red blood cells only live about days.
a. 30
b. 90
c. 100
d. 120
ANS: D
Red blood cells live approximately 120 days.
DIF: Cognitive Level: Knowledge REF: 332 OBJ: 1 (theory)
TOP: Life of RBCs KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance
3. The nurse explains that, in the event of a massive hemorrhagic episode, the contracts and adds blood to the
circulating volume.
, a. Spleen
b. Liver
c. Pancreas
d. bone marrow
ANS: A
The spleen has the ability to contract and add blood to the circulating volume in the event of massive hemorrhage.
DIF: Cognitive Level: Comprehension REF: 332 OBJ: 1 (clinical)
TOP: Spleen KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
4. The nurse evaluates the lab reports for the patients on the unit, and recognizes the report requiring the most
immediate attention is for the patient with RBCs, mil/mm3; WBCs, mil/mm3; and Hb, g/dL.
a. 4.2; 4500; 9.1
b. 5.9; 4500; 12.7
c. 6.0; 6000; 13.2
d. 7.6; 8000; 18.0
ANS: A
The low RBCs and low hemoglobin suggests possible anemia or blood loss. The normal range for adults is red
blood cell (RBC) count 4.2 to 6.2 mil/mm3 ; white blood cell (WBC) count: 4500 to 11,000/mm3; and hemoglobin
(Hb): females, 12.0 to 16.7 g/dL; males, 13.0 to 18.0 g/dL.
DIF: Cognitive Level: Analysis REF: 337 | Table 16-1
OBJ: 5 (theory) TOP: Blood Counts
KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance
5. The nurse notes a rise in the eosinophil count and suspects the patient has a(n):
a. bacterial infection.
b. allergy.
c. viral infection.
d. blood dyscrasia.
ANS: B
In the event of an allergy or the infestation of pinworms, the eosinophil count will rise. Bacterial infection stimulates
the production of neutrophils and segmented neutrophils; lymphocytes are increased with viral infections. Blood
dyscrasia refers to an imbalance in numbers of types of cells or other pathologic conditions of the blood.
DIF: Cognitive Level: Application REF: 333 OBJ: 5 (theory)
TOP: Eosinophil Count KEY: Nursing Process Step:
Assessment MSC: NCLEX: Health Promotion and Maintenance
6. The nurse uses a visual aid to depict the several kinds of hemoglobin. The hemoglobin that changes the shape
of the red blood cell (RBC) on which it resides is hemoglobin:
a. A.
b. A1c.
c. F.
d. S.
