RN Respiratory System EAQ
A client with pneumonia now requires use of a nonrebreathing mask to maintain
adequate oxygen saturation levels. How does the nurse interpret this information? -
ANSWER: Mechanical ventilator may be required next
The patient having pulmonary function studies performed has a spirometry test and
a FEV1/FVC ratio of 60%. What does this indicate?
A) Strong exercise tolerance
B) Exhalation volume is normal
C) Healthy lung volumes
D) Obstructive lung disease - ANSWER: D) Obstructive lung disease
-Obstructive lung disease is characterized by a FEV1/FVC ratio less than 70%.
A patient with COPD who has been receiving oxygen therapy for an extended time
on high flow may be at risk for which of the following acid-base imbalances?
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis - ANSWER: A) Respiratory acidosis
The nurse is planning to assess the effectiveness of a patient's coughing and deep
breathing exercises. What assessment will provide the nurse with information on the
effectiveness of the patient's coughing and deep breathing?
A) Assessing activity tolerance
B) Checking nail bed perfusion
C) Auscultating the lungs
D) Monitoring pulse - ANSWER: C) Auscultating the lungs
When teaching a patient with asthma how to use a metered dose inhaler (MDI)
correctly, it is important to emphasize which of the following?
A) Rapid breathing during treatment to facilitate more medication in lungs
,B) Allow 5 minutes between each puff
C) Hold breath as medication is released
D) Position inhaler approximately 1 to 2 inches from the open mouth - ANSWER: D)
Position inhaler approximately 1 to 2 inches from the open mouth
-When using an MDI, the patient should position the inhaler approximately 1 to 2
inches from the open mouth, or use a spacer/holding chamber. Repeat puffs are
given as directed,
allowing 1-2 minutes between puffs. The patient should continue breathing in as
medication is
released (by pressing cartridge down). Then breathe in slowly and deeply for 3 to 5
seconds.
After this has occurred, the patient should hold his breath for 8 to 10 seconds to
allow the
medication to reach down into the airways.
The nurse is assessing a patient admitted with pulmonary tuberculosis (TB). What
clinical manifestations are consistent with this diagnosis?
A) High fever, fatigue, muscle aches, and cough
B) Low-grade fever, night sweats, fatigue, and weight loss
C) Cough, night sweats, weight gain, and fatigue
D) Muscle aches, night sweats, cough, and fatigue - ANSWER: B) Low-grade fever,
night sweats, fatigue, and weight loss
Which nursing action takes priority when admitting a patient with right lower lobe
pneumonia?
A) Elevating the head of the bed 45 to 90 degrees
B) Auscultating the chest for adventitious sounds
C) Obtaining a sputum specimen for culture
D) Notifying the physician of the patient's admission - ANSWER: A) Elevating the
head of the bed 45 to 90 degrees
,A nurse caring for a 68-year-old patient diagnosed with mycoplasmal pneumonia
observes that the patient has difficulty breathing due to copious tracheobronchial
secretions. The patient should be encouraged to do which of the following?
A) Increase oral fluids unless contraindicated.
B) Call the nurse for deep suctioning.
C) Lie in a low-Fowler's position.
D) Increase activity. - ANSWER: A) Increase oral fluids unless contraindicated.
A goal in the plan of care of a patient with COPD includes prevention of pulmonary
hypertension. The nurse knows that which of the following is a common
manifestation of
pulmonary hypertension?
A) Left-sided heart failure
B) Right-sided heart failure
C) Clubbing of extremities
D) Increased A-P diameter - ANSWER: B) Right-sided heart failure
The nurse is planning to assist a patient who has COPD and limited energy with ADLs.
When is the best time for the nurse to schedule the patient's activities?
A) 1 hour before bed
B) First thing in the morning
C) 1 hour after the patient has been awake
D) Late afternoon following visiting hours - ANSWER: C) 1 hour after the patient has
been awake
What is the best position for the patient experiencing orthopnea for relief of
symptoms?
A) Sitting upright leaning forward slightly
B) Low-Fowler's
C) Prone
D) Trendelenburg - ANSWER: A) Sitting upright leaning forward slightly
, A client is admitted to the hospital with a tentative diagnosis of pneumonia. The
client has a high fever and is short of breath. Bed rest, oxygen via nasal cannula, an
intravenous antibiotic, and blood and sputum specimens for culture and sensitivity
(C & S) are prescribed. Place these interventions in the order in which they should be
implemented. - ANSWER: 1.Bed rest
2. Oxygen via nasal cannula
3.Specimens for C & S
4. Administration of an antibiotic
A client has been admitted for an upper respiratory tract infection secondary to
chronic obstructive pulmonary disease (COPD). The nurse should expect which
findings when auscultating the client's breath sounds?
1
Coarse crackles
2
Prolonged inspiration
3
Short, rapid inspiration
4
Normal breath sounds - ANSWER: Coarse crackles
A client with emphysema is admitted to the hospital with pneumonia. On the third
hospital day, the client complains of a sharp pain on the right side of the chest. The
nurse suspects a pneumothorax. What breath sound is most likely to be present
when the nurse assesses the client's right side?
Crackling
Wheezing
Decreased sounds
Adventitious sounds - ANSWER: Decreased sounds
-affected lung will not expand, incomplete aeration
A client is admitted to the hospital for medical treatment of bronchopneumonia.
Which test result should the nurse examine to help determine the effectiveness of
the client's therapy?
Bronchoscopy
Pulse oximetry
A client with pneumonia now requires use of a nonrebreathing mask to maintain
adequate oxygen saturation levels. How does the nurse interpret this information? -
ANSWER: Mechanical ventilator may be required next
The patient having pulmonary function studies performed has a spirometry test and
a FEV1/FVC ratio of 60%. What does this indicate?
A) Strong exercise tolerance
B) Exhalation volume is normal
C) Healthy lung volumes
D) Obstructive lung disease - ANSWER: D) Obstructive lung disease
-Obstructive lung disease is characterized by a FEV1/FVC ratio less than 70%.
A patient with COPD who has been receiving oxygen therapy for an extended time
on high flow may be at risk for which of the following acid-base imbalances?
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis - ANSWER: A) Respiratory acidosis
The nurse is planning to assess the effectiveness of a patient's coughing and deep
breathing exercises. What assessment will provide the nurse with information on the
effectiveness of the patient's coughing and deep breathing?
A) Assessing activity tolerance
B) Checking nail bed perfusion
C) Auscultating the lungs
D) Monitoring pulse - ANSWER: C) Auscultating the lungs
When teaching a patient with asthma how to use a metered dose inhaler (MDI)
correctly, it is important to emphasize which of the following?
A) Rapid breathing during treatment to facilitate more medication in lungs
,B) Allow 5 minutes between each puff
C) Hold breath as medication is released
D) Position inhaler approximately 1 to 2 inches from the open mouth - ANSWER: D)
Position inhaler approximately 1 to 2 inches from the open mouth
-When using an MDI, the patient should position the inhaler approximately 1 to 2
inches from the open mouth, or use a spacer/holding chamber. Repeat puffs are
given as directed,
allowing 1-2 minutes between puffs. The patient should continue breathing in as
medication is
released (by pressing cartridge down). Then breathe in slowly and deeply for 3 to 5
seconds.
After this has occurred, the patient should hold his breath for 8 to 10 seconds to
allow the
medication to reach down into the airways.
The nurse is assessing a patient admitted with pulmonary tuberculosis (TB). What
clinical manifestations are consistent with this diagnosis?
A) High fever, fatigue, muscle aches, and cough
B) Low-grade fever, night sweats, fatigue, and weight loss
C) Cough, night sweats, weight gain, and fatigue
D) Muscle aches, night sweats, cough, and fatigue - ANSWER: B) Low-grade fever,
night sweats, fatigue, and weight loss
Which nursing action takes priority when admitting a patient with right lower lobe
pneumonia?
A) Elevating the head of the bed 45 to 90 degrees
B) Auscultating the chest for adventitious sounds
C) Obtaining a sputum specimen for culture
D) Notifying the physician of the patient's admission - ANSWER: A) Elevating the
head of the bed 45 to 90 degrees
,A nurse caring for a 68-year-old patient diagnosed with mycoplasmal pneumonia
observes that the patient has difficulty breathing due to copious tracheobronchial
secretions. The patient should be encouraged to do which of the following?
A) Increase oral fluids unless contraindicated.
B) Call the nurse for deep suctioning.
C) Lie in a low-Fowler's position.
D) Increase activity. - ANSWER: A) Increase oral fluids unless contraindicated.
A goal in the plan of care of a patient with COPD includes prevention of pulmonary
hypertension. The nurse knows that which of the following is a common
manifestation of
pulmonary hypertension?
A) Left-sided heart failure
B) Right-sided heart failure
C) Clubbing of extremities
D) Increased A-P diameter - ANSWER: B) Right-sided heart failure
The nurse is planning to assist a patient who has COPD and limited energy with ADLs.
When is the best time for the nurse to schedule the patient's activities?
A) 1 hour before bed
B) First thing in the morning
C) 1 hour after the patient has been awake
D) Late afternoon following visiting hours - ANSWER: C) 1 hour after the patient has
been awake
What is the best position for the patient experiencing orthopnea for relief of
symptoms?
A) Sitting upright leaning forward slightly
B) Low-Fowler's
C) Prone
D) Trendelenburg - ANSWER: A) Sitting upright leaning forward slightly
, A client is admitted to the hospital with a tentative diagnosis of pneumonia. The
client has a high fever and is short of breath. Bed rest, oxygen via nasal cannula, an
intravenous antibiotic, and blood and sputum specimens for culture and sensitivity
(C & S) are prescribed. Place these interventions in the order in which they should be
implemented. - ANSWER: 1.Bed rest
2. Oxygen via nasal cannula
3.Specimens for C & S
4. Administration of an antibiotic
A client has been admitted for an upper respiratory tract infection secondary to
chronic obstructive pulmonary disease (COPD). The nurse should expect which
findings when auscultating the client's breath sounds?
1
Coarse crackles
2
Prolonged inspiration
3
Short, rapid inspiration
4
Normal breath sounds - ANSWER: Coarse crackles
A client with emphysema is admitted to the hospital with pneumonia. On the third
hospital day, the client complains of a sharp pain on the right side of the chest. The
nurse suspects a pneumothorax. What breath sound is most likely to be present
when the nurse assesses the client's right side?
Crackling
Wheezing
Decreased sounds
Adventitious sounds - ANSWER: Decreased sounds
-affected lung will not expand, incomplete aeration
A client is admitted to the hospital for medical treatment of bronchopneumonia.
Which test result should the nurse examine to help determine the effectiveness of
the client's therapy?
Bronchoscopy
Pulse oximetry
