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    Practice Exam II > Care of the Client with Respiratory Disorders

    Care of the Client with Respiratory Disorders

    1.A client with chronic obstructive lung disease has an order for chest physiotherapy. When performing chest percussion, the nurse should strike the client’s back with:

    A.The palms of the hands
    B.The side of the hands
    C.Cupped hands
    D.A loosely clenched fist


    2.Which client has the greatest risk for developing adult respiratory distress syndrome (ARDS)?

    A.A 34-year old client with diabetes mellitus
    B.A 65-year old with Addison’s disease
    C.A 22-year old with ulcerative colitis
    D.A 40-year old with acute pancreatitis


    3.While caring for a client with a three-chamber chest drainage system, the nurse notes that there is no fluctuation in the second chamber. An explanation for the nurse’s observation is:

    A.The lung has re-collapsed.
    B.The amount of suction is excessive.
    C.The lung has re-expanded.
    D.The chamber needs emptying.


    4.Which one of the following clients is at greatest risk for developing Pneumocystis carinii pneumonia?

    A.A client with a 20-year history of smoking
    B.A client who received a renal transplant
    C.A client with a left hip replacement
    D.A client with a past history of tuberculosis


    5.Which nutritional intervention best meets the nutritional needs of a client with emphysema?

    A.Serving the client three calorie-laden meals each day
    B.Providing small frequent meals with added fat and protein
    C.Supplementing the client’s intake with protein milk shakes
    D.Increasing the amount of carbohydrates in the client’s diet


    6.Which statement is true regarding the client with symptoms of pulmonary embolus?

    A.The client’s symptoms develop slowly over time and are often mistaken for other conditions.
    B.The client’s symptoms are detectable if checks for Homan’s sign are done correctly.
    C.The client’s symptoms depend on the size and the location of the pulmonary embolus.
    D.The client’s symptoms include flattened neck veins and oral petechiae.


    7.The nurse is preparing to suction a client with a tracheostomy. Before suctioning the tracheostomy, the nurse should give priority to:

    A.Providing the client with 100% oxygen
    B.Explaining the procedure
    C.Checking the dressing for soiling
    D.Changing the neck ties


    8.A client who has been using a Flovent (fluticasone) inhaler has developed a sore throat and white patches on the back of the tongue and throat. The nurse should anticipate an order for:

    A.Omnipen (ampicillin)
    B.Nystatin (mycostatin)
    C.Xylocaine viscous
    D.Benadryl (diphenhydramine)


    9.The nurse is planning care for a client hospitalized with bacterial pneumonia. Which nursing diagnosis should receive priority?

    A.Ineffective airway clearance related to increased sputum production
    B.Activity intolerance related to changes in respiratory function
    C.Anxiety related to hospitalization
    D.Fluid volume deficit related to fever


    10.The nurse has just completed performing tracheostomy care. Which finding indicates that the tracheostomy ties have been properly applied?

    A.There is a slight movement in the tracheostomy tube with each respiratory cycle.
    B.The ties are snuggly fitted against the client’s neck.
    C.The nurse can place one to two fingers between the ties and the client’s neck.
    D.The ties should be loosely fitted to prevent the stimulation of coughing.


    11.A client with a history of asthma is admitted with audible wheezing over both lung fields. The nurse knows that the wheezing associated with asthma is due to:

    A.Narrowing of the bronchial lumen
    B.Partial obstruction of the larynx
    C.Infection of the tracheobronchial tree
    D.Chronic dilation of the alveoli


    12.While assessing a client with blunt trauma to the right rib cage, the nurse notes reduced breath sounds on the affected side and tracheal deviation toward the unaffected side. The nurse’s findings suggest the presence of:

    A.Open pneumothorax
    B.Flail chest
    C.Tension pneumothorax
    D.Blood in the pleural space


    13.The CBC of a client with emphysema reveals a red blood cell count of 8,000,000. The nurse recognizes that extreme elevations in the number of red blood cells predisposes the client to:

    A.Migraine headaches
    B.Development of clots
    C.Intermittent claudication
    D.Increased susceptibility to infection


    14.The physician has prescribed cyclophosphamide (Cytoxan) for a client with pulmonary fibrosis. An adverse reaction associated with the medication’s use is:

    A.Alopecia
    B.Anorexia
    C.Stomatitis
    D.Anemia


    15.Which statement is true regarding the interpretation of the Mantoux test?

    A.The Mantoux test provides a definitive diagnosis for tuberculosis.
    B.A positive skin test can be accurately measured for up to seven days after the test is administered.
    C.Immunization with the BCG vaccine can result in a false negative reading.
    D.Negative reactions can be measured accurately for only 48 hours after the test is given.


    16.An elderly client has a diagnosis of pneumonia. Which manifestation is most common in the elderly client with pneumonia?

    A.Fever
    B.Cough
    C.Anorexia
    D.Confusion


    17.The nurse is teaching a client with asthma regarding the safe use of over-the-counter medications. Which antipyretic is suitable for the client with asthma?

    A.Aleve (naproxen sodium)
    B.Motrin (ibuprofen)
    C.Tylenol (acetaminophen)
    D.Aspirin (acetylsalicylic acid)


    18.A client with emphysema has a morning theophylline level of 25mcg/mL. The nurse should give priority to:

    A.Continuing the medication as prescribed
    B.Notifying the physician of the drug level
    C.Requesting an additional bronchodilator
    D.Asking the client about changes in smoking pattern


    19.As a part of the treatment for pulmonary tuberculosis, the physician has prescribed ethambutol (Myambutol). The nurse should instruct the client to:

    A.Schedule frequent eye examinations
    B.Report discoloration of the urine
    C.Increase daily fluid intake
    D.Schedule a hearing test every six months


    20.The nurse is caring for a client with primary pulmonary hypertension (PPH). Which finding indicates a severe complication of PPH?

    A.Expectoration of frothy, pink-tinged sputum
    B.Decreased daytime voiding
    C.Edema of the legs and sacrum
    D.Hacking cough which worsens at night


    21.The physician has prescribed anticoagulation therapy with heparin for a client with a pulmonary embolus. The nurse should give priority to checking the client’s:

    A.Fibrinogen level
    B.Prothrombin time
    C.Platelet count
    D.Partial thromboplastin time


    22.Pulse oximetry has been ordered for an elderly client admitted with pneumonia. The best site for placement of the probe is the:

    A.Toe
    B.Finger
    C.Earlobe
    D.Nose


    23.A client with pleural effusion has just undergone a thoracentesis. Which finding suggests that the client has developed subcutaneous emphysema?

    A.A crackling sensation is felt when the skin near the puncture site is palpated.
    B.Reduced breath sounds are auscultated on the affected side.
    C.Paradoxical movement is noted when the client inhales and exhales.
    D.Chest asymmetry and distended neck veins are noted.


    24.The nurse is caring for an elderly client. Which intervention best gives the client a sense of control?

    A.Allowing visits with family and friends
    B.Keeping the call light within reach
    C.Explaining procedures before they are done
    D.Providing writing paper and pen


    25.A client with hospital acquired pneumonia is receiving amikacin (Amikin). Which of the following complaints should alert the nurse to a possible adverse reaction to the medication?

    A.Burning at the injection site
    B.Dizziness and ringing in the ears
    C.Loss of appetite
    D.Bloating and constipation



      

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