Aspiration of water - Answer A nurse is providing discharge instructions to a client who
has a new laryngectomy. The nurse should tell the client to be careful while bathing to
prevent which of the following complications?
Stabbing chest pain - Answer A nurse in a med surg unit is assessing a client. The
nurse should identify that which of the following findings is a manifestation of a
pulmonary embolism?
PaO2 50 mm Hg - Answer A nurse on a medical unit is caring for a client who aspirated
gastric contents prior to admission. The nurse administers 100% oxygen by
nonrebreather mask after the client reports severe dyspnea. Which of the following
findings is a clinical manifestation of acute respiratory distress syndrome (ARDS)?
Frequent swallowing - Answer A nurse is caring for a client who is postop following a
rhinoplasty. Which of the following findings should the nurse report to the surgeon?
Ensure an adequate airway - Answer A nurse is caring for a client who experiencing
acute opioid toxicity. Which of the following actions should the nurse identify as the
priority?
Evaluate the client for stridor - Answer A nurse is caring for a client for whom the
respiratory therapist has just removed the endotracheal tube. Which of the following
actions should the nurse take first?
"Try to drink at least 2 to 3 liters of fluid per day." - Answer A nurse is providing
discharge teaching to a client who has emphysema. Which of the following instructions
should the nurse include?
Crepitus - Answer A client is admitted to the emergency department following a
motorcycle crash. The nurse notes a crackling sensation upon palpation of the right side
of the client's chest. After notifying the provider, the nurse should document this findings
as which of the following?
The nurse auscultates coarse crackles in the lung fields - Answer A nurse is caring for a
client who has a tracheostomy with an inflated cuff in place. Which of the following
findings indicates that the nurse should suction the client's airway secretions?
Discuss ways the client can reduce the number of cigarettes smoked per day - Answer
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?
, Use pursed-lip breathing during periods of dyspnea - Answer A nurse is providing
discharge teaching about improving gas exchange for a client who has emphysema.
Which of the following instructions should the nurse include in the teaching?
Total lung capacity - Answer 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
hold at the end of maximum inhalation?
"You must return to the clinic to have the test read in 2 or 3 days." - Answer 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?
"Lie on your back with your head elevated 30 degrees when resting." - Answer A nurse
is providing discharge teaching to a client who is post op following a rhinoplasty. Which
of the following instructions should the nurse include?
Increase the oxygen flow and request an arterial blood gas determination - Answer A
nurse is caring for a client who has a 20 year history of COPD and is receiving oxygen
at 2 L/min via nasal cannula. The client is dyspneic and has an oxygen saturation via
pulse oximetry of 85%. Which of the following actions should the nurse take?
Confirming the gag reflex - Answer A nurse is preparing a client for discharge following
a bronchoscopy. Which of the following assessments is the nurse's monitoring priority?
Eat high-calorie foods first - Answer A nurse is planning care for a client ho has COPD
and is malnourished. Which of the following recommendations to promote nutritional
intake should the nurse include in the plan?
A leak within the ventilator's circuitry - Answer A nurse is caring for a client who has a
tracheostomy and is receiving mechanical ventilation. When the low-pressure alarm on
the ventilator sounds, it indicates which of the following to the nurse?
"I understand that I will have a permanent tracheostomy after the surgery." - Answer A
nurse is providing preoperative teaching to a client who will undergo a total
laryngectomy. Which of the following statements indicates that the client understands
the impact of the surgery?
Draining blood and fluid from the pleural space - Answer A nurse is providing post op
care for a client who has 2 chest tubes in place following a lobectomy. The client asks
the nurse the reason for having 2 chest tubes. The nurse should inform the client that
the lower chest tube is placed for which of the following reasons?
Nasal cannula - Answer A nurse is planning care for a client who is postop following a
hip arthroplasty. In the client's medical record, the nurse notes a history of COPD.
Which of the following oxygen-delivery methods should the nurse plan to use for this
client?