Chapter 21 Respiratory Care Modalities
The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD). The patient has
been receiving high-flow oxygen therapy for an extended time. What symptoms should the nurse
1. anticipate if the patient were experiencing oxygen toxicity?
A) Bradycardia and frontal headache
B) Dyspnea and substernal pain
C) Peripheral cyanosis and restlessness
D) Hypotension and tachycardia
Ans: B
Feedback:
Oxygen toxicity can occur when patients receive too high a concentration of oxygen for an extended
period. Symptoms of oxygen toxicity include dyspnea, substernal pain, restlessness, fatigue, and
progressive respiratory difficulty. Bradycardia, frontal headache, cyanosis, hypotension, and tachycardia
are not symptoms of oxygen toxicity.
The nurse caring for a patient with an endotracheal tube recognizes several disadvantages of an
2. endotracheal tube. What would the nurse recognize as a disadvantage of endotracheal tubes?
A) Cognition is decreased.
,B) Daily arterial blood gases (ABGs) are necessary.
C) Slight tracheal bleeding is anticipated.
D) The cough reflex is depressed.
Ans: D
Feedback:
There are several disadvantages of an endotracheal tube. Disadvantages include suppression of the
patient’s cough reflex, thickening of secretions, and depressed swallowing reflexes. Ulceration and
stricture of the larynx or trachea may develop, but bleeding is not an expected finding. The tube should
not influence cognition and daily ABGs are not always required.
What would the critical care nurse recognize as a condition that may indicate a patient’s need to have a
3. tracheostomy?
A) A patient has a respiratory rate of 10 breaths per minute.
B) A patient requires permanent ventilation.
C) A patient exhibits symptoms of dyspnea.
D) A patient has respiratory acidosis.
Ans: B
, Feedback:
A tracheostomy permits long-term use of mechanical ventilation to prevent aspiration of oral and gastric
secretions in the unconscious or paralyzed patient. Indications for a tracheostomy do not include a
respiratory rate of 10 breaths per minute, symptoms of dyspnea, or respiratory acidosis.
The medical nurse is creating the care plan of an adult patient requiring mechanical ventilation. What
4. nursing action is most appropriate?
A) Keep the patient in a low Fowler’s position.
B) Perform tracheostomy care at least once per day.
C) Maintain continuous bedrest.
D) Monitor cuff pressure every 8 hours.
Ans: D
Feedback:
The cuff pressure should be monitored every 8 hours. It is important to perform tracheostomy care at least
every 8 hours because of the risk of infection. The patient should be encouraged to ambulate, if possible,
and a low Fowler’s position is not indicated.
The nurse is caring for a patient who is scheduled to have a thoracotomy. When planning preoperative
5. teaching, what information should the nurse communicate to the patient?
A) How to milk the chest tubing
The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD). The patient has
been receiving high-flow oxygen therapy for an extended time. What symptoms should the nurse
1. anticipate if the patient were experiencing oxygen toxicity?
A) Bradycardia and frontal headache
B) Dyspnea and substernal pain
C) Peripheral cyanosis and restlessness
D) Hypotension and tachycardia
Ans: B
Feedback:
Oxygen toxicity can occur when patients receive too high a concentration of oxygen for an extended
period. Symptoms of oxygen toxicity include dyspnea, substernal pain, restlessness, fatigue, and
progressive respiratory difficulty. Bradycardia, frontal headache, cyanosis, hypotension, and tachycardia
are not symptoms of oxygen toxicity.
The nurse caring for a patient with an endotracheal tube recognizes several disadvantages of an
2. endotracheal tube. What would the nurse recognize as a disadvantage of endotracheal tubes?
A) Cognition is decreased.
,B) Daily arterial blood gases (ABGs) are necessary.
C) Slight tracheal bleeding is anticipated.
D) The cough reflex is depressed.
Ans: D
Feedback:
There are several disadvantages of an endotracheal tube. Disadvantages include suppression of the
patient’s cough reflex, thickening of secretions, and depressed swallowing reflexes. Ulceration and
stricture of the larynx or trachea may develop, but bleeding is not an expected finding. The tube should
not influence cognition and daily ABGs are not always required.
What would the critical care nurse recognize as a condition that may indicate a patient’s need to have a
3. tracheostomy?
A) A patient has a respiratory rate of 10 breaths per minute.
B) A patient requires permanent ventilation.
C) A patient exhibits symptoms of dyspnea.
D) A patient has respiratory acidosis.
Ans: B
, Feedback:
A tracheostomy permits long-term use of mechanical ventilation to prevent aspiration of oral and gastric
secretions in the unconscious or paralyzed patient. Indications for a tracheostomy do not include a
respiratory rate of 10 breaths per minute, symptoms of dyspnea, or respiratory acidosis.
The medical nurse is creating the care plan of an adult patient requiring mechanical ventilation. What
4. nursing action is most appropriate?
A) Keep the patient in a low Fowler’s position.
B) Perform tracheostomy care at least once per day.
C) Maintain continuous bedrest.
D) Monitor cuff pressure every 8 hours.
Ans: D
Feedback:
The cuff pressure should be monitored every 8 hours. It is important to perform tracheostomy care at least
every 8 hours because of the risk of infection. The patient should be encouraged to ambulate, if possible,
and a low Fowler’s position is not indicated.
The nurse is caring for a patient who is scheduled to have a thoracotomy. When planning preoperative
5. teaching, what information should the nurse communicate to the patient?
A) How to milk the chest tubing
