ATI Respiratory, Board Vitals EXAM REVIEW - NURS 406 / NURS406

RESPIRATORY 1- A charge nurse receives notification of the admission of a client who is coughing frequently and whose sputum is pink, frothy, and copious. The client has history of night sweats, anorexia, and weight loss. Which of the following actions should the nurse take? (SATA) -Assign the client to a private room with negative-pressure airflow -Wear an N95 respirator when entering the client’s room. 2- A nurse is assisting a provider with a comprehensive physical examination of a client. When the provider uses transillumination, the nurse should explain to the client that this technique help evaluate which of the following structures? -Maxillary sinuses 3- A nurse is caring for a client who smokes cigarettes and has a new diagnosis of emphysema. How should the nurse assist the client with smoking cessation? -Discuss ways the client can reduce the number of cigarettes smoked per day. 4- A nurse is planning care for a client who has chronic obstructive pulmonary disease (COPD) and is malnourished. Which of the following recommendations to promote nutritional intake should the nurse include in the plan? -Eat high-calorie food first. Rational: client who has COPD experience early satiety. Client should eat calorie-dense food first. 5- A nurse is preparing to administer cisplatin IV to a client who has lung cancer. The nurse should identify that which of the following findings is an adverse effect of this medication? -Tinnitus. Rational: An adverse effect of cisplatin is ototoxicity, which can cause tinnitus. 6- A nurse in a medical-surgical unit is assessing a client. The nurse should identify that which of the following findings is a manifestation of a pulmonary embolism? -Stabbing chest pain Rational: sudden chest pain that is sharp and stabbing is a manifestation of pulmonary embolism. Other manifestations include dyspnea, coughing, hemoptysis (coughing up blood), tachypnea, tachycardia, diaphoresis, and feeling of impending doom. 7- A nurse in the PACU is assessing a newly admitted client and observes intercostal retractions and a high-pitched inspiratory sound (stridor). The nurse should identify theses findings as manifestations of which of the following complications? -Respiratory obstruction 8- A nurse is reviewing the laboratory results of a client who has metabolic alkalosis. Which of the following laboratory values should the nurse expect? -ph 7.49,HCO3-32mEq/L, PaCO2 40mmHg Rational: Metabolic alkalosis: pH and bicarbonate values are greater than the expected references range, and the PaCO2 is within the expected reference range. 9- A nurse is providing teaching to a client who has a chronic cough and is scheduled for a bronchoscopy. Which of the following client statements indicates an understanding of the teaching? -“A tissue sample might be obtained during the procedure” 10- A nurse is preparing a client for a bronchoscopy. Which of the following actions should the nurse take? (SATA) -Explain that the client will receive sedation and will not remember the procedure. -Verify that the client understands the purpose and nature of the procedure. 11- A nurse is preparing a client for discharge following a bronchoscopy. Which of the following assessment is the nurse’s monitoring priority? -Confirming the gag reflex Rational: The greater risk to the client’s safety is aspiration resulting from a depressed gag reflex. 12- A nurse is caring for a client who is postoperative following a thoracic lobectomy. The client has 2 chest tubes in place: 1 in the lower portion of the thorax and the other higher on the chest wall. When a family member asks why the client has 2 chest tubes, which of the following responses should the nurse make? -“The lower tube will drain blood, and the higher tube will remove air.” 13- A nurse is providing teaching to a client who will undergo a total laryngectomy. Which of the following statements indicate that the client understands the impact of the surgery? - “I understands that I will have a permanent tracheostomy after the surgery.” Rational: With a partial laryngectomy, the tracheostomy is temporary. With the total laryngectomy the tracheostomy will be permanent. 14- A nurse is providing discharge instructions to a client who has a new laryngectomy. The nurse tells the client to be careful while bathing to prevent which of the following complications? -Aspiration of water. Rational: This is a client with a tracheostomy, so he will need to use a shower shield over the stoma when bathing or showering to keep water out of the airway. 15- A nurse is caring for a client who is extremely anxious and is hyperventilating. The client’s ABG results are pH 7.50, PaCO2 27 mmHg, and HCO3-25 mEq/L. The nurse should identify that the client has which of the following acid-base imbalances? -Respiratory alkalosis. 16- A nurse is planning postoperative education for a client who will undergo a radical neck dissection for cancer of the larynx. The nurse should include which of the following topics? (SATA) -NPO status -Alternative methods of communication - Changes in body image -Swallowing exercises. 17- A nurse in a clinic is providing teaching for a client who is scheduled to have a tuberculin skin test. Which of the following pieces of information should the nurse include? - “You must return to the clinic to have the test read in 2 or 3 days.” 18- A nurse is providing discharge teaching to a client who is postoperative following a rhinoplasty/ Which of the following instructions should the nurse include? “Lie on your back with your head elevated 30º when resting.” 19- A nurse is preparing to assist provider with an arterial blood withdrawal from a client’s radial artery for ABG measurements. Which of the following actions the nurse plan to take? -Perform an Allen’s test prior to obtaining the specimen. Rational: the nurse should ensure that the circulation of the hands is adequate from the ulnar artery in case the radial artery is injured from the blood draw. The most common site for withdrawal of arterial blood gases is the radial artery. 20- A nurse is providing teaching to a client about pulmonary function testing. Which of the following tests measures the volume of air the lungs can holds at the end of maximum inhalation? Board vitals 1- A nurse is reviewing the discharge instruction for a client who is recovering from pneumonia. Which of the following statements should the nurse make? -“You should avoid crowed areas.” 2- A nurse in an emergency department is assessing a client who has a flail chest from blunt chest trauma. Which of the following findings should the nurse expect: (SATA) -Cyanosis -Dyspnea -Paradoxical chest movement 3- A nurse is caring for an adolescent with cystic fibrosis. Which finding requires immediate intervention when caring for this client? -Chest pain with dyspnea Rational: chest pain and dyspnea are signs of pneumothorax and should be treated immediately. 4- A nurse in the emergency department is assessing a client admitted to the emergency department who has sustained crushing chest injuries in a car accident. Which of the following signs indicate a possible pneumothorax? -Diminished or absent breath sounds on the affected side 5- A client who had extensive pelvic surgery 24 hr ago becomes cyanotic, is gasping for breath, and complains of right-sided chest pain. What should the nurse do first? -Administer oxygen using a face mask 6- A client is admitted with second degree burns on face, neck, anterior chest, and hands. The nurse’s priority action would be: -Assess for dyspnea and stridor 7- A client who underwent a left lower lobectomy is forty-eight hrs post op. The client is receiving morphine sulfate via a patient-controlled analgesia (PCA) system and report having pain in the left thorax that worsens coughing. The nurse should: -Obtain a more detailed assessment of the client’s pain using a pain scale. 8- A nurse is caring for a client who is undergoing tracheostomy. The nurse understands that which of the following is a complication of this procedure? -Damage to the recurrent laryngeal nerve. 9- A nurse is assessing a client’s arterial blood results. The results are pH 7.50, bicarbonate 32mEq/L, and PaCO2 36 mmHg. Which of the following do these arterial gas results indicate? -Metabolic alkalosis 10- A nurse is caring for a client on a ventilator who has ventilator settings with a preset tidal volume. Which best describes the tidal volume (VT) in this setting: -The amount of air inhaled with each breath 11- The nurse is caring for a client who has just been intubated for respiratory failure. The physician orders the ventilator to be set SIMV mode. Which best describes SIMV? -A preset number of breaths delivered to the client at certain volume 12- A client with asthma is scheduled for treatment with methylxanthine for nocturnal wheezing. Which of the following drugs are methylxanthine drugs that are appropriate for the treatment of this client? (SATA) -Theophylline -Aminophylline 13- The nurse is administering cromolyn sodium (Intal) for client with asthma. Which of the following are true about this drug? (SATA) -It causes headache -It prevents an attack 14- A nurse caring for a client with hemothorax. The physician plans to insert a right-sided chest tube. (La pregunta pide ordenar los cuadritos en el orden correcto) -Check the physician order and gather the chest tube supplies -Assist the client to the correct position for placement. -Assist the provider with the chest tube insertion -Move the drainage system unit so that it is below the level of the chest -Administer pain medication as required -Encourage the client to cough and deep breathe. 15- A 33-year-old client is in the ICU for treatment of acute respiratory distress syndrome (ARDS). (la pregunta pide ordenar los pasos para realizar endotraqueal suctioning en orden) -Turn on the suction to 80-120 mmHg -Pre-oxygenate the client by providing 100% oxygen through the ET tube -Insert the suction catheter into the ET tube until resistance is met, taking care not to apply suction with insertion. -Apply suction while withdrawing the catheter from the ET tube -Suction the in-line catheter with saline to clear for next use. 16- The nurse is assessing a client with ARDS (acute respiratory distress syndrome). Which of the following may have caused the client’s condition? (SATA) - Heroin - Pancreatitis - Burns - Fat emboli 17- The nurse is assessing a client with extrapulmonary tuberculosis. Which of the following is true about this type of condition? (SATA) -Genitourinary system is affected -Osteomyelitis occurs 18- Which of the following devices is most appropriate for delivering a predicted oxygen concentration in a client with unstable chronic obstructive pulmonary disease (COPD)? -Venturi mask Rational: this mas allowing delivery of fixed FiO2 that depends on the flow rate and size of the entrainment port. It can delivery oxygen concentration ranging from 24-60 % and flow rates between 4-12 L/min. Used to titrate the oxygen concentration in clients with unstable COPD. 19- A nurse is assessing a client with emphysema. Which assessment findings does the nurse anticipate in this form of COPD? (SATA) -Hyperresonance on percussion of the lung area -Increased respiratory effort -Increased chest diameter when measured anteriorly and posteriorly 20- A nurse is caring for 4 new clients. When receiving reports, the nurse should prioritize assessment of which of the following? -A 70-year-old client after knee replacement complaining of sudden-onset dyspnea accompanied by chest pain