RN Respiratory System EAQ
Which value is within the normal range of values for arterial blood gas? - ANSWER:
7.44
An arterial blood gas report indicates the client's pH is 7.25, PCO2 is 35 mmHg, and
HCO3 is 20 mEq/L. Which disturbance should the nurse identify based on these
results? - ANSWER: Metabolic acidosis
A client with impaired peripheral pulses and signs of chronic hypoxia in a lower
extremity has a femoral angiogram. What is the priority nursing action after the
angiogram? - ANSWER: Assess the client's affected extremity.
A nurse is suctioning a client's airway. Which nursing action will limit hypoxia? -
ANSWER: Apply suction only after catheter is inserted
The nurse is caring for a client admitted with chronic obstructive pulmonary disease
(COPD). The nurse should monitor the results of which laboratory test to evaluate
the client for hypoxia? - ANSWER: Arterial blood gas
What nursing action will limit hypoxia when suctioning a client's airway? - ANSWER:
Apply suction only after catheter is inserted
An emergency tracheotomy has been performed on a 6-year-old child with acute
epiglottitis, and the child is receiving humidified air through a tracheotomy collar.
What early clinical manifestations of hypoxia should alert the nurse to suction the
tracheotomy? - ANSWER: Restlessness and increase in pulse
A client with respiratory disorder complains of fatigue. Which nursing intervention
will be beneficial for this client? - ANSWER: Encouraging adequate periods of rest
The laboratory data of four clients are shown below. Which client may have
respiratory alkalosis? - ANSWER: Client A
A nurse is providing immediate postoperative care to a client with a tracheostomy
tube in place. The client suddenly develops noisy, increased respirations and an
elevated heart rate. What action should the nurse take immediately? - ANSWER:
Suction the tracheostomy.
A nurse reviews the use of an incentive spirometer with a client. What client action
indicates the need for further instruction? - ANSWER: Blowing vigorously into the
mouthpiece
The nurse provides instructions to a client who will be using an incentive spirometer
postoperatively. During the client's return demonstration, the nurse concludes that
, the teaching has been effective when the client does what? - ANSWER: Inhales
deeply through the mouthpiece, holds the breath for four seconds, and then exhale
A nurse is caring for a postoperative client who had general anesthesia during
surgery. What independent nursing intervention may prevent an accumulation of
secretions? - ANSWER: Frequent changes of position
A 13-year-old child is hospitalized with an exacerbation of chronic bronchitis. What
action should a nurse take to decrease retained secretions? - ANSWER: Increase fluid
intake to at least 2000 mL/day
After a subtotal gastrectomy a client is returned to the surgical unit. Which is the
best nursing action to prevent pulmonary complications? - ANSWER: Promoting
frequent turning and deep breathing to mobilize secretions
A client with a history of hemoptysis and cough for the last six months is suspected
of having lung cancer. A bronchoscopy is performed. Two hours after the procedure
the nurse identifies an increase in the amount of bloody sputum. What is the nurse's
priority? - ANSWER: Immediately contact the primary health care provider
The nurse evaluates that the preoperative teaching regarding a bronchoscopy was
understood when the client states that he cannot eat or drink for several hours after
the procedure to prevent what? - ANSWER: Aspiration of food
A client is receiving albuterol to relieve severe bronchospasms caused by asthma.
For which clinical indicators should the nurse monitor the client? Select all that
apply. - ANSWER: Tremors
Palpitations
A client with a 30-year history of smoking has several episodes of blood in the
sputum. A bronchoscopy with a lung biopsy is performed. After the procedure, what
is the most important nursing intervention? - ANSWER: Ensure nothing by mouth
(NPO) until the gag reflex returns
Which are the nursing actions for a client with a chest injury? Select all that apply. -
ANSWER: Palpating for bony crepitus
Assessing for external signs of injury
Observing the rate, depth, and effort of breathing
A nurse is providing preoperative teaching for a client regarding use of an incentive
spirometer and should include what instructions? - ANSWER: "Inhale deeply through
the spirometer, hold it as long as possible, and slowly exhale."
A child who reports shortness of breath, wheezing, and coughing is found to have
pulmonary edema and is prescribed furosemide. Which nursing interventions would
be beneficial to the client? Select all that apply. - ANSWER: Checking the child's
weight every day
Which value is within the normal range of values for arterial blood gas? - ANSWER:
7.44
An arterial blood gas report indicates the client's pH is 7.25, PCO2 is 35 mmHg, and
HCO3 is 20 mEq/L. Which disturbance should the nurse identify based on these
results? - ANSWER: Metabolic acidosis
A client with impaired peripheral pulses and signs of chronic hypoxia in a lower
extremity has a femoral angiogram. What is the priority nursing action after the
angiogram? - ANSWER: Assess the client's affected extremity.
A nurse is suctioning a client's airway. Which nursing action will limit hypoxia? -
ANSWER: Apply suction only after catheter is inserted
The nurse is caring for a client admitted with chronic obstructive pulmonary disease
(COPD). The nurse should monitor the results of which laboratory test to evaluate
the client for hypoxia? - ANSWER: Arterial blood gas
What nursing action will limit hypoxia when suctioning a client's airway? - ANSWER:
Apply suction only after catheter is inserted
An emergency tracheotomy has been performed on a 6-year-old child with acute
epiglottitis, and the child is receiving humidified air through a tracheotomy collar.
What early clinical manifestations of hypoxia should alert the nurse to suction the
tracheotomy? - ANSWER: Restlessness and increase in pulse
A client with respiratory disorder complains of fatigue. Which nursing intervention
will be beneficial for this client? - ANSWER: Encouraging adequate periods of rest
The laboratory data of four clients are shown below. Which client may have
respiratory alkalosis? - ANSWER: Client A
A nurse is providing immediate postoperative care to a client with a tracheostomy
tube in place. The client suddenly develops noisy, increased respirations and an
elevated heart rate. What action should the nurse take immediately? - ANSWER:
Suction the tracheostomy.
A nurse reviews the use of an incentive spirometer with a client. What client action
indicates the need for further instruction? - ANSWER: Blowing vigorously into the
mouthpiece
The nurse provides instructions to a client who will be using an incentive spirometer
postoperatively. During the client's return demonstration, the nurse concludes that
, the teaching has been effective when the client does what? - ANSWER: Inhales
deeply through the mouthpiece, holds the breath for four seconds, and then exhale
A nurse is caring for a postoperative client who had general anesthesia during
surgery. What independent nursing intervention may prevent an accumulation of
secretions? - ANSWER: Frequent changes of position
A 13-year-old child is hospitalized with an exacerbation of chronic bronchitis. What
action should a nurse take to decrease retained secretions? - ANSWER: Increase fluid
intake to at least 2000 mL/day
After a subtotal gastrectomy a client is returned to the surgical unit. Which is the
best nursing action to prevent pulmonary complications? - ANSWER: Promoting
frequent turning and deep breathing to mobilize secretions
A client with a history of hemoptysis and cough for the last six months is suspected
of having lung cancer. A bronchoscopy is performed. Two hours after the procedure
the nurse identifies an increase in the amount of bloody sputum. What is the nurse's
priority? - ANSWER: Immediately contact the primary health care provider
The nurse evaluates that the preoperative teaching regarding a bronchoscopy was
understood when the client states that he cannot eat or drink for several hours after
the procedure to prevent what? - ANSWER: Aspiration of food
A client is receiving albuterol to relieve severe bronchospasms caused by asthma.
For which clinical indicators should the nurse monitor the client? Select all that
apply. - ANSWER: Tremors
Palpitations
A client with a 30-year history of smoking has several episodes of blood in the
sputum. A bronchoscopy with a lung biopsy is performed. After the procedure, what
is the most important nursing intervention? - ANSWER: Ensure nothing by mouth
(NPO) until the gag reflex returns
Which are the nursing actions for a client with a chest injury? Select all that apply. -
ANSWER: Palpating for bony crepitus
Assessing for external signs of injury
Observing the rate, depth, and effort of breathing
A nurse is providing preoperative teaching for a client regarding use of an incentive
spirometer and should include what instructions? - ANSWER: "Inhale deeply through
the spirometer, hold it as long as possible, and slowly exhale."
A child who reports shortness of breath, wheezing, and coughing is found to have
pulmonary edema and is prescribed furosemide. Which nursing interventions would
be beneficial to the client? Select all that apply. - ANSWER: Checking the child's
weight every day
