Chapter 23 Quiz

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Question #1

The nurse assesses a patient for a possible pulmonary embolism. What frequent sign of pulmonary embolus does the nurse anticipate finding on assessment?

A Hemoptysis

B Cough

C Tachypnea

D Syncope

Question #2

A nurse is caring for a client after a thoracentesis. Which sign, if noted in the client, should be reported to the physician immediately?

A “Client is drowsy and complains of headache.”

B “Client is becoming agitated and complains of pleuritic pain.”

C “Client has subcutaneous emphysema around needle insertion site.”

D “Client has oxygen saturation of 93%.”

Question #3

A nurse is assessing the injection site of a client who has received a purified protein derivative test. Which finding indicates a need for further evaluation?

A Reddened area

B 15-mm induration

C 5-mm induration

D A blister

Question #4

A nurse should include what instruction for the client during postural drainage?

A Change positions frequently and cough up secretions.

B Sit upright to promote ventilation.

C Remain in each position for 30 to 45 minutes for best results.

D Lie supine to rest the lungs.

Question #5

A nurse assesses arterial blood gas results for a patient in acute respiratory failure (ARF). Which results are consistent with this disorder?

A pH 7.28, PaO2 50 mm Hg

B pH 7.46, PaO2 80 mm Hg

C pH 7.35, PaCO2 48 mm Hg

D pH 7.36, PaCO2 32 mm Hg

Question #6

The client asks the nurse to explain the reason for a chest tube insertion in treating a pneumothorax. Which is the best response by the nurse?

A “The tube will drain secretions from the lung.”

B “Chest tubes provide a route for medication instillation to the lung.”

C “Chest tube will allow air to be restored to the lung.”

D “The tube will drain air from the space around the lung.”

Question #7

A client at risk for pneumonia has been ordered an influenza vaccine. Which statement from the nurse best explains the rationale for this vaccine?

A “Influenza is the major cause of death in the United States.”

B “Viruses like influenza are the most common cause of pneumonia.”

C “Getting the flu can complicate pneumonia.”

D “Influenza vaccine will prevent typical pneumonias.”

Question #8

Influenza, an annual epidemic in the U.S., creates a significant increase in hospitalizations and an rise in the death rates from pneumonia and cardiovascular disease. Besides death, what is the most serious complication of influenza?

A viral pneumonia

B cardiovascular disease

C staphylococcal pneumonia

D tracheobronchitis

Question #9

A victim of a motor vehicle accident has been brought to the emergency room. The patient is exhibiting paradoxical chest expansion and respiratory distress. Which of the following chest disorders should be suspected?

A Flail chest

B Pulmonary contusion

C Cardiac tamponade

D Simple pneumothorax

Question #10

A nurse is caring for a client who is at high risk for developing pneumonia. Which intervention should the nurse include on the client’s care plan?

A Keeping the head of the bed at 15 degrees or less

B Providing oral hygiene daily

C Using strict hand hygiene

D Turning the client every 4 hours to prevent fatigue

Question #11

A nurse is reviewing a client’s X-ray. The X-ray shows an endotracheal (ET) tube placed 3/4″ (2 cm) above the carina and reveals nodular lesions and patchy infiltrates in the upper lobe. Which interpretation of the X-ray is accurate?

A The ET tube must be pulled back.

B The X-ray is inconclusive.

C A disease process is present.

D The ET tube must be advanced.

Question #12

A patient arrives in the emergency department after being involved in a motor vehicle accident. The nurse observes paradoxical chest movement when removing the patient’s shirt. What does the nurse know that this finding indicates?

A Tension pneumothorax

B Flail chest

C ARDS

D Pneumothorax

Question #13

While caring for a client with a chest tube, which nursing assessment would alert the nurse to a possible complication?

A The tissues give a crackling sensation when palpated.

B Absence of bloody drainage in the anterior/upper tube

C Skin around tube is pink

D Bloody drainage is seemed in the collection chamber.

Question #14

Which statement would indicate that the parents of child with cystic fibrosis understand the disorder?

A “There are fibrous cysts in the lungs.”

B “Early treatment can stop the progression of the disease.”

C “The mucus-secreting glands are abnormal

D “Allergic reactions cause inflammation in the lungs.”

Question #15

A client who has just had a triple-lumen catheter placed in his right subclavian vein complains of chest pain and shortness of breath. His blood pressure is decreased from baseline and, on auscultation of his chest, the nurse notes unequal breath sounds. A chest X-ray is immediately ordered by the physician. What diagnosis should the nurse suspect?

A Pneumothorax

B Heart failure

C Myocardial infarction (MI)

D Pulmonary embolism

Question #16

A nurse recognizes that a client with tuberculosis needs further teaching when the client states:

A “I’ll need to have scheduled laboratory tests while I’m on the medication.”

B “The people I have contact with at work should be checked regularly.”

C “I’ll have to take these medications for 9 to 12 months.”

D “It won’t be necessary for the people I work with to take medication.”

Question #17

A client has been hospitalized for treatment of acute bacterial pneumonia. Which outcome indicates an improvement in the client’s condition?

A The client has a partial pressure of arterial carbon dioxide (PaCO2) value of 65 mm Hg or higher.

B The client exhibits bronchial breath sounds over the affected area.

C The client has a partial pressure of arterial oxygen (PaO2) value of 90 mm Hg or higher.

D The client exhibits restlessness and confusion.

Question #18

After diagnosing a client with pulmonary tuberculosis, the physician tells family members that they must receive isoniazid (INH [Laniazid]) as prophylaxis against tuberculosis. The client’s daughter asks the nurse how long the drug must be taken. What is the usual duration of prophylactic isoniazid therapy?

A 6 to 12 months

B 2 to 4 months

C 3 to 5 days

D 1 to 3 weeks

Question #19

In a client with amyotrophic lateral sclerosis (ALS) and respiratory distress, which finding is the earliest sign of reduced oxygenation?

A Increased blood pressure

B Decreased heart rate

C Increased restlessness

D Decreased level of consciousness (LOC)

Question #20

The most diagnostic clinical symptom of pleurisy is:

A Stabbing pain during respiratory movements.

B Dyspnea and coughing.

C Fever and chills.

D Dullness or flatness on percussion over areas of collected fluid.

Question #21

A patient is admitted to the hospital with pulmonary arterial hypertension. What assessment finding by the nurse is a significant finding for this patient?

A Dyspnea

B Syncope

C Hypertension

D Ascites

Question #22

The nurse is interpreting blood gases for a client with acute respiratory distress syndrome (ARDS). Which set of blood gas values indicates respiratory acidosis?

A pH 7.25, PaCO2 48, HCO3 24

B pH 7.47, PaCO2 28, HCO3 30

C pH 7.49, PaCO2 34, HCO3 25

D pH 7.87, PaCO2 38, HCO3 28

Question #23

A client diagnosed with acute respiratory distress syndrome (ARDS) is restless and has a low oxygen saturation level. If the client’s condition does not improve and the oxygen saturation level continues to decrease, what procedure will the nurse expect to assist with in order to help the client breathe more easily?

A Schedule the client for pulmonary surgery

B Intubate the client and control breathing with mechanical ventilation

C Administer a large dose of furosemide (Lasix) IVP stat

D Increase oxygen administration

Question #24

The clinic nurse is caring for a client with acute bronchitis. The client asks what may have caused the infection. What may induce acute bronchitis?

A Drug ingestion

B Aspiration

C Chemical irritation

D Direct lung damage

Question #25

A client who underwent thoracic surgery to remove a lung tumor had a chest tube placed anteriorly. The surgical team places this catheter to:

A remove air from the pleural space.

B ventilate the client.

C administer IV medication.

D remove fluid from the lungs.

Question #26

What is the reason for chest tubes after thoracic surgery?

A Draining secretions, air, and blood from the thoracic cavity is necessary.

B Draining secretions and blood while allowing air to remain in the thoracic cavity is necessary.

C Chest tubes indicate when the lungs have re-expanded by ceasing to bubble.

D Chest tubes allow air into the pleural space.

Question #27

A nurse is caring for a group of clients on a medical-surgical floor. Which client is at greatest risk for developing pneumonia?

A A client who is receiving acetaminophen (Tylenol) for pain

B A client with a history of smoking two packs of cigarettes per day until quitting 2 years ago

C A client with a nasogastric tube

D A client who ambulates in the hallway every 4 hours

Question #28

A patient has a Mantoux skin test prior to being placed on an immunosuppressant for the treatment of Crohn’s disease. What results would the nurse determine is not significant for holding the medication?

A 9 mm

B 7 to 8 mm

C 5 to 6 mm

D 0 to 4 mm

Question #29

The nurse is assessing a client who, after an extensive surgical procedure, is at risk for developing acute respiratory distress syndrome (ARDS). The nurse assesses for which most common early sign of ARDS?

A Inspiratory crackles

B Cyanosis

C Rapid onset of severe dyspnea

D Bilateral wheezing

Question #30

A victim has sustained a blunt force trauma to the chest. A pulmonary contusion is suspected. Which of the following clinical manifestations correlate with a moderate pulmonary contusion?

A Respiratory alkalosis

B Blood-tinged sputum

C Productive cough

D Bradypnea

Question #31

The ICU nurse caring for a 2-year-old near drowning victim monitors for what possible complication?

A Metabolic alkalosis

B Acute respiratory distress syndrome

C Respiratory acidosis

D Atelectasis

Question #32

You are caring for a client status post lung resection. When assessing your client you find that the bubbling in the water-seal chamber for the chest tubes is more than you expected. What should you check when bubbling in the water-seal chamber is excessive?

A See if the wall suction unit has malfunctioned.

B See if a kink has developed in the tubing.

C See if the chest tube is clogged.

D See if there are leaks in the system.

Question #33

A physician stated to the nurse that the client has fluid in the pleural space and will need a thoracentesis. The nurse expects the physician to document this fluid as

A pneumothorax.

B hemothorax.

C consolidation.

D pleural effusion.

Question #34

A client with suspected severe acute respiratory syndrome (SARS) comes to the emergency department. Which physician order should the nurse implement first?

A Obtain a sputum specimen for enzyme immunoassay testing.

B Begin an I.V. infusion of dextrose 5% in half-normal saline solution at 100 ml/hour.

C Obtain a nasopharyngeal specimen for reverse-transcription polymerase chain reaction testing.

D Institute isolation precautions.

Question #35

A client admitted to the facility for treatment for tuberculosis receives instructions about the disease. Which statement made by the client indicates the need for further instruction?

A “I’ll always have a positive test for tuberculosis.”

B “This disease may come back later if I am under stress.”

C “I’ll stay in isolation for 6 weeks.”

D “I’ll have to take the medication for up to a year.”

Question #36

A nurse is assessing a client who comes to the clinic for care. Which findings in this client suggest bacterial pneumonia?

A Sore throat and abdominal pain

B Nonproductive cough and normal temperature

C Hemoptysis and dysuria

D Dyspnea and wheezing

Question #37

A patient taking isoniazid (INH) therapy for tuberculosis demonstrates understanding when making which statement?

A “It is all right if I drink a glass of red wine with my dinner.”

B “I am going to have a tuna fish sandwich for lunch.”

C “It is fine if I eat sushi with a little bit of soy sauce.”

D “It is all right if I have a grilled cheese sandwich with American cheese.”

Question #38

After 48 hours, a Mantoux test is evaluated. At the site, there is a 10 mm induration. This finding would be considered:

A Not significant

B Significant

C Negative

D Nonreactive

Question #39

Which action should the nurse take first in caring for a client during an acute asthma attack?

A Send for STAT chest x-ray.

B Obtain arterial blood gases.

C Initiate oxygen therapy and reassess pulse oximetry in 10 minutes.

D Administer bronchodilator as ordered.

Question #40

The nurse is assessing a client’s potential for pulmonary emboli. What finding indicates possible deep vein thrombosis?

A Coolness to lower extremities

B Pain in the feet

C Decreased urinary output

D Localized calf tenderness

Question #41

A client who works construction and has been demolishing an older building is diagnosed with pneumoconiosis. This lung inflammation is most likely caused by exposure to:

A coal dust.

B asbestos.

C pollen.

D silica.

Question #42

Which vitamin is usually administered with isoniazid (INH) to prevent INH-associated peripheral neuropathy?

A Vitamin C

B Vitamin E

C Vitamin D

D Vitamin B6

Question #43

Resistance to a first-line antituberculotic agent in a client who has not received previous treatment is referred to as

A tertiary drug resistance.

B primary drug resistance.

C multidrug resistance.

D secondary drug resistance.

Question #44

Which statement indicates a client understands teaching about the purified protein derivative (PPD) test for tuberculosis?

A “I will come back in 1 week to have the test read.”

B “I will avoid contact with my family until I am done with the test.”

C “If the test area turns red that means I have tuberculosis.”

D “Because I had a previous reaction to the test, this time I need to get a chest X-ray.”

Question #45

On auscultation, which finding suggests a right pneumothorax?

A Bilateral inspiratory and expiratory crackles

B Absence of breath sounds in the right thorax

C Bilateral pleural friction rub

D Inspiratory wheezes in the right thorax

Question #46

A client hospitalized with pneumonia has thick, tenacious secretions. Which intervention should the nurse include when planning this client’s care?

A Encouraging increased fluid intake

B Elevating the head of the bed 30 degrees

C Turning the client every 2 hours

D Maintaining a cool room temperature

Question #47

The nurse is auscultating the patient’s lung sounds to determine the presence of pulmonary edema. What adventitious lung sounds are significant for pulmonary edema?

A Crackles in the lung bases

B Pleural friction rub

C Low-pitched rhonchi during expiration

D Sibilant wheezes

Question #48

A nurse reading a chart notes that the client had a Mantoux skin test result with no induration and a 1-mm area of ecchymosis. How does the nurse interpret this result?

A Negative

B Borderline

C Positive

D Uncertain

Question #49

You are caring for a client who has been diagnosed with viral pneumonia. You are making a plan of care for this client. What nursing interventions would you put into the plan of care for a client with pneumonia?

A Give antibiotics as ordered.

B Encourage increased fluid intake.

C Offer nutritious snacks 2 times a day.

D Place client on bed rest.

Question #50

The ICU nurse is caring for a client who was admitted with a diagnosis of smoke inhalation. The nurse knows that this client is at increased risk for which of the following?

A Lung cancer

B Acute respiratory distress syndrome

C Bronchitis

D Tracheobronchitis

Question #51

The occupational nurse is completing routine assessments on the employees where you work. What might be revealed by a chest radiograph for a client with occupational lung diseases?

A Damage to surrounding tissues

B Lung contusion

C Hemorrhage

D Fibrotic changes in lungs

Question #52

Class 1 with regard to TB indicates

A disease that is not clinically active.

B no exposure and no infection.

C exposure and no evidence of infection.

D latent infection with no disease

Question #53

Which interventions does a nurse implement for clients with empyema?

A Place suspected clients together

B Encourage breathing exercises

C Institute droplet precautions

D Do not allow visitors with respiratory infection

Question #54

What dietary recommendations should a nurse provide a client with a lung abscess?

A A carbohydrate-dense diet

B A diet rich in protein

C A diet with limited fat

D A diet low in calories

Question #55

A client is admitted to the facility with a productive cough, night sweats, and a fever. Which action is most important in the initial care plan?

A Monitoring the client’s fluid intake and output

B Placing the client in respiratory isolation

C Wearing gloves during all client contact

D Assessing the client’s temperature every 8 hours

Question #56

The nurse is assessing a patient who smokes 2 packs of cigarettes per day and has a strong family history of cancer. What early sign of cancer of the larynx does the nurse look for in this patient?

A Affected voice sounds

B Burning of the throat when hot liquids are ingested

C Dysphagia

D Enlarged cervical nodes

Question #57

A patient comes to the clinic complaining of a possible upper respiratory infection. What should the nurse inspect that would indicate that an upper respiratory infection may be present?

A The tracheal mucosa

B The nasal mucosa

C The buccal mucosa

D The frontal sinuses

Question #58

The nurse is caring for a client with an endotracheal tube. Which client data does the nurse interpret as a life-threatening situation?

A Harsh cough

B Copious mucous secretions

C Sudden restlessness

D Rhonchi in lung fields

Question #59

A client is scheduled for endotracheal intubation prior to surgery. What can the nurse tell this client about an endotracheal tube?

A “The ET tube will be inserted through an opening in your trachea.”

B “The ET tube will remain in place for at least a day postsurgery.”

C “The ET tube will be connected to a negative-pressure ventilator.”

D “The ET tube will maintain your airway while you’re under anesthesia.”

Question #60

Most cases of acute pharyngitis are caused by which of the following?

A Bacterial infection

B Viral infection

C Systemic infection

D Fungal infection

Question #61

A 73-year-old client is admitted to the pulmonology unit of the hospital. She was admitted with a pleural effusion and was “tapped” to drain the fluid to reduce her mediastinal pressure. How much fluid is typically present between the pleurae, which surround the lungs, to prevent friction rub?

A 5–10 mL

B 20–30 mL

C No fluid normally is present

D 20–25 mL

Question #62

You are caring for a client who is 42-years-old and status post adenoidectomy. You find the client in respiratory distress when you enter their room. You ask another nurse to call the physician and bring an endotracheal tube into the room. What do you suspect?

A Infection

B Post operative bleeding

C Edema of the upper airway

D Plugged tracheostomy tube

Question #63

A client is experiencing acute viral rhinosinusitis. The nurse is providing instructions about self–care activities and includes information about

A Saline lavages to the nares

B Cold compresses to the sinus cavities

C Administration of oral antibiotics

D Use of a dehumidifier

Question #64

When a client has undergone a laryngectomy and there is evidence of wound breakdown, the nurse monitors the client very carefully because of the high risk for

A pneumonia.

B carotid artery hemorrhage.

C pulmonary embolism.

D dehydration.

Question #65

A patient who wears contact lenses is to be placed on rifampin for tuberculosis therapy. What should the nurse tell the patient?

A “Only wear your contact lenses during the day and take them out in the evening before bed.”

B “There are no significant problems with wearing contact lenses.”

C “You should switch to wearing your glasses while taking this medication.”

D “The physician can give you eye drops to prevent any problems.”

Question #66

Approximately what percentage of people who are initially infected with TB develop active disease?

A 20%

B 10%

C 30%

D 40%

Question #67

The patient with a chest tube is being transported to X-ray. Which complication may occur if the chest tube is clamped during transportation?

A Flail chest

B Pulmonary contusion

C Tension pneumothorax

D Cardiac tamponade

Question #68

You are an occupational health nurse in a large ceramic manufacturing company. How would you intervene to prevent occupational lung disease in the employees of the company?

A Provide employees with smoking cessation materials.

B Give workshops on disease prevention

C Fit all employees with protective masks.

D Insist on adequate breaks for each employee.

Question #69

When caring for a client with acute respiratory failure, the nurse should expect to focus on resolving which set of problems?

A Hypercapnia, hypoventilation, and hypoxemia

B Hyperventilation, hypertension, and hypocapnia

C Hypotension, hyperoxemia, and hypercapnia

D Hyperoxemia, hypocapnia, and hyperventilation

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