Chapter 25- Respiratory Function
A patient who is scheduled for a bronchoscopy has arrived at the clinical facility. When
preparing for the test, the patient reports feeling hungry and asks the nurse when he will
be able to eat. What information should be provided by the nurse?
1.
“You will not be allowed to eat or drink until the physician has seen you.”
A)
“You may immediately resume your normal diet after the test.”
B)
“You will not be able to eat or drink until your gag reflex has returned.”
C)
“It will be at least 8 hours after the procedure before you are allowed to eat or
drink.”
D)
Ans: C
Feedback:
The bronchoscopy allows for the visualization of the airways. Nursing interventions for a
bronchoscopy include ensuring informed consent, teaching before the procedure, and
maintaining NPO status until the gag reflex returns after the procedure.
The nursing assessment reveals reduced fremitus. This manifestation is consistent with
which of the following conditions? Select all that apply.
2.
Right-sided heart failure
A)
Left-sided heart failure
B)
, Pneumonia
C)
Pulmonary edema
D)
Bronchial obstruction
E)
Ans: B, D, E
Feedback:
Fremitus refers to the vibration of air movement through the chest wall. It is best felt by
placing the balls of the palms of your hand on the patient’s back as he or she says “99.”
The intrascapular space is a good area to feel tactile fremitus because it diminishes as you
move out in the lung fields. Decreased fremitus may occur with pleural effusion,
pulmonary edema, emphysema, or bronchial obstruction. Left-sided heart failure will
result in pulmonary edema, causing decreased fremitus.
The nurse is reviewing the pulse oximeter readings from a postoperative patient. The
nurse correctly recognizes that readings below what level indicate the need for oxygen
therapy and further assessment?
3.
97%
A)
95%
B)
93%
C)
90%
D)
Ans: C
Feedback:
, An SaO2 greater than 95% is considered normal, whereas values lower than 93% usually
indicate the need for oxygen therapy and further assessment.
The nurse is talking with a patient who has COPD. The patient reports her chest shape
seems to have changed over the past year. What information should be provided by the
nurse?
4.
“Your chest diameter has increased as the musculature has matured in an effort to
obtain increased amounts of oxygen.”
A)
“Your lung condition limits the ability of the lungs to fully exhale, causing this
change in shape.”
B)
“Chronic lung conditions such as this are associated with fluid retention in the
lower lung fields, causing the change in the chest shape.”
C)
“The corticosteroids prescribed to manage the condition have caused a change in
the shape of the chest wall.”
D)
Ans: B
Feedback:
In COPD, the patient’s chest becomes overinflated over time because of an inability to
exhale fully. This increases the anterior– posterior chest diameter, resulting in a barrel-
shaped appearance.
A patient has edema of the feet and ankles, along with crackles in the lower lobes and a
frothy, productive cough. The patient is suffering from
5.
A patient who is scheduled for a bronchoscopy has arrived at the clinical facility. When
preparing for the test, the patient reports feeling hungry and asks the nurse when he will
be able to eat. What information should be provided by the nurse?
1.
“You will not be allowed to eat or drink until the physician has seen you.”
A)
“You may immediately resume your normal diet after the test.”
B)
“You will not be able to eat or drink until your gag reflex has returned.”
C)
“It will be at least 8 hours after the procedure before you are allowed to eat or
drink.”
D)
Ans: C
Feedback:
The bronchoscopy allows for the visualization of the airways. Nursing interventions for a
bronchoscopy include ensuring informed consent, teaching before the procedure, and
maintaining NPO status until the gag reflex returns after the procedure.
The nursing assessment reveals reduced fremitus. This manifestation is consistent with
which of the following conditions? Select all that apply.
2.
Right-sided heart failure
A)
Left-sided heart failure
B)
, Pneumonia
C)
Pulmonary edema
D)
Bronchial obstruction
E)
Ans: B, D, E
Feedback:
Fremitus refers to the vibration of air movement through the chest wall. It is best felt by
placing the balls of the palms of your hand on the patient’s back as he or she says “99.”
The intrascapular space is a good area to feel tactile fremitus because it diminishes as you
move out in the lung fields. Decreased fremitus may occur with pleural effusion,
pulmonary edema, emphysema, or bronchial obstruction. Left-sided heart failure will
result in pulmonary edema, causing decreased fremitus.
The nurse is reviewing the pulse oximeter readings from a postoperative patient. The
nurse correctly recognizes that readings below what level indicate the need for oxygen
therapy and further assessment?
3.
97%
A)
95%
B)
93%
C)
90%
D)
Ans: C
Feedback:
, An SaO2 greater than 95% is considered normal, whereas values lower than 93% usually
indicate the need for oxygen therapy and further assessment.
The nurse is talking with a patient who has COPD. The patient reports her chest shape
seems to have changed over the past year. What information should be provided by the
nurse?
4.
“Your chest diameter has increased as the musculature has matured in an effort to
obtain increased amounts of oxygen.”
A)
“Your lung condition limits the ability of the lungs to fully exhale, causing this
change in shape.”
B)
“Chronic lung conditions such as this are associated with fluid retention in the
lower lung fields, causing the change in the chest shape.”
C)
“The corticosteroids prescribed to manage the condition have caused a change in
the shape of the chest wall.”
D)
Ans: B
Feedback:
In COPD, the patient’s chest becomes overinflated over time because of an inability to
exhale fully. This increases the anterior– posterior chest diameter, resulting in a barrel-
shaped appearance.
A patient has edema of the feet and ankles, along with crackles in the lower lobes and a
frothy, productive cough. The patient is suffering from
5.
