NSG 4067: RESPIRATORY FUNCTION
1. A nurse assesses an older adult's overall respiratory function. Which of the following
interview questions would be most appropriate?
A) "Would you be interested in finding out more about environmental smoke?"
B) "Did either of your parents experience lung diseases?"
C) "Have you ever worked in a job where you were exposed to dust, fumes, smoke, or other
pollutants?"
D) "What do you do to actively maintain your respiratory health?"
Ans: C
Feedback:
The effects of air pollution are cumulative over many years. Thus, there is an increased impact
on older adults over their lifetimes. Hazards in the workplace were unregulated before 1970.
Therefore, there are older adults who have experienced cumulative and long-term effects from
toxic substances.
2. A 65-year-old client with a long-standing history of chronic obstructive pulmonary disease
(COPD) was placed recently on Coumadin after experiencing atrial fibrillation. Upon discharge
from the hospital, which of the following statements by the client indicates a need for further
teaching?
A) "I will continue to use smokeless tobacco since it's a lot better than smoking."
B) "I will avoid using over-the-counter antihistamines since they can dry my mucosal
secretions."
C) "I will watch my intake of dark green leafy vegetables since they may impact the effects
of Coumadin."
D) "I will not take any herbal preparations without my health care provider's knowledge."
Ans: A
Feedback:
Smokeless tobacco is associated with mouth cancer, gingivitis, and tooth loss and may be
carcinogenic to the pancreas. The other noted actions are appropriate to the maintenance of
health.
3. A 70-year-old client smoked for 30 years and has a history of COPD. The spouse assists with
cooking, cleaning, and transportation. The spouse has become ill, and they now receive
assistance from a home health nurse. Which of the following interventions should be the
priority?
, A) Assisting the clients to perform instrumental activities of daily living (IADLs)
B) Determining a plan for providing meals
C) Setting up medications for the clients
D) Smoking cessation plan
Ans: B
Feedback:
The nurse's role is not to perform the IADLs, but to plan for the IADLs including meals,
cleaning, and transportation. There is no indication that the clients need their medications set up,
smoking cession is important, but basic needs come first.
4. A nurse completes assessment of an older adult. Which of the following physical assessment
findings is within normal limits?
A) Kyphosis and increased anteroposterior diameter of the chest
B) Increased intensity of lung sounds
C) Decreased resonance on percussion
D) Decreased adventitious sounds in lower lungs
Ans: A
Feedback:
Minor differences in assessment findings for healthy older adults include shortened thorax, chest
wall stiffness, increased anteroposterior diameter of the chest, and forward-leaning posture
because of kyphosis.
5. A nurse plans interventions in a skilled nursing facility to prevent lower respiratory infections.
Which of the following nursing interventions should be included in the plan? (Select all that
apply.)
A) Encourage annual pneumonia vaccinations.
B) Encourage annual influenza vaccinations.
C) Encourage annual chest radiographs to detect tuberculosis.
D) Encourage influenza vaccinations every 5 years.
E) Encourage hand hygiene for residents and staff.
Ans: B, E
Feedback:
Influenza vaccinations should be given yearly to older adults. The Centers for Disease Control
and Prevention (CDC) recommends a one-time booster dose of the pneumonia vaccination for all
people 65 years of age or older if they received an initial pneumonia vaccination 5 or more years
earlier or were younger than 65 years of age when they first received the pneumonia vaccine.
1. A nurse assesses an older adult's overall respiratory function. Which of the following
interview questions would be most appropriate?
A) "Would you be interested in finding out more about environmental smoke?"
B) "Did either of your parents experience lung diseases?"
C) "Have you ever worked in a job where you were exposed to dust, fumes, smoke, or other
pollutants?"
D) "What do you do to actively maintain your respiratory health?"
Ans: C
Feedback:
The effects of air pollution are cumulative over many years. Thus, there is an increased impact
on older adults over their lifetimes. Hazards in the workplace were unregulated before 1970.
Therefore, there are older adults who have experienced cumulative and long-term effects from
toxic substances.
2. A 65-year-old client with a long-standing history of chronic obstructive pulmonary disease
(COPD) was placed recently on Coumadin after experiencing atrial fibrillation. Upon discharge
from the hospital, which of the following statements by the client indicates a need for further
teaching?
A) "I will continue to use smokeless tobacco since it's a lot better than smoking."
B) "I will avoid using over-the-counter antihistamines since they can dry my mucosal
secretions."
C) "I will watch my intake of dark green leafy vegetables since they may impact the effects
of Coumadin."
D) "I will not take any herbal preparations without my health care provider's knowledge."
Ans: A
Feedback:
Smokeless tobacco is associated with mouth cancer, gingivitis, and tooth loss and may be
carcinogenic to the pancreas. The other noted actions are appropriate to the maintenance of
health.
3. A 70-year-old client smoked for 30 years and has a history of COPD. The spouse assists with
cooking, cleaning, and transportation. The spouse has become ill, and they now receive
assistance from a home health nurse. Which of the following interventions should be the
priority?
, A) Assisting the clients to perform instrumental activities of daily living (IADLs)
B) Determining a plan for providing meals
C) Setting up medications for the clients
D) Smoking cessation plan
Ans: B
Feedback:
The nurse's role is not to perform the IADLs, but to plan for the IADLs including meals,
cleaning, and transportation. There is no indication that the clients need their medications set up,
smoking cession is important, but basic needs come first.
4. A nurse completes assessment of an older adult. Which of the following physical assessment
findings is within normal limits?
A) Kyphosis and increased anteroposterior diameter of the chest
B) Increased intensity of lung sounds
C) Decreased resonance on percussion
D) Decreased adventitious sounds in lower lungs
Ans: A
Feedback:
Minor differences in assessment findings for healthy older adults include shortened thorax, chest
wall stiffness, increased anteroposterior diameter of the chest, and forward-leaning posture
because of kyphosis.
5. A nurse plans interventions in a skilled nursing facility to prevent lower respiratory infections.
Which of the following nursing interventions should be included in the plan? (Select all that
apply.)
A) Encourage annual pneumonia vaccinations.
B) Encourage annual influenza vaccinations.
C) Encourage annual chest radiographs to detect tuberculosis.
D) Encourage influenza vaccinations every 5 years.
E) Encourage hand hygiene for residents and staff.
Ans: B, E
Feedback:
Influenza vaccinations should be given yearly to older adults. The Centers for Disease Control
and Prevention (CDC) recommends a one-time booster dose of the pneumonia vaccination for all
people 65 years of age or older if they received an initial pneumonia vaccination 5 or more years
earlier or were younger than 65 years of age when they first received the pneumonia vaccine.
