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 Syncope

B Hemoptysis

C Tachypnea

D Cough

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 becoming agitated and complains of pleuritic pain.”

B “Client is drowsy and complains of headache.”

C “Client has oxygen saturation of 93%.”

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

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 A blister

B Reddened area

C 5-mm induration

D 15-mm induration

Question #4

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

A Sit upright to promote ventilation.

B Lie supine to rest the lungs.

C Change positions frequently and cough up secretions.

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

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 7.36, PaCO2 32 mm Hg

D pH 7.35, PaCO2 48 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 tube will allow air to be restored to the lung.”

C “Chest tubes provide a route for medication instillation 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 vaccine will prevent typical pneumonias.”

B “Getting the flu can complicate pneumonia.”

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

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

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 staphylococcal pneumonia

B tracheobronchitis

C cardiovascular disease

D viral pneumonia

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 Simple pneumothorax

B Flail chest

C Pulmonary contusion

D Cardiac tamponade

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 Providing oral hygiene daily

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

C Turning the client every 4 hours to prevent fatigue

D Using strict hand hygiene

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 X-ray is inconclusive.

B The ET tube must be pulled back.

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 Pneumothorax

D ARDS

Question #13

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

A Absence of bloody drainage in the anterior/upper tube

B The tissues give a crackling sensation when palpated.

C Bloody drainage is seemed in the collection chamber.

D Skin around tube is pink

Question #14

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

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

B “The mucus-secreting glands are abnormal

C “There are fibrous cysts in the lungs.”

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 Heart failure

B Pulmonary embolism

C Myocardial infarction (MI)

D Pneumothorax

Question #16

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

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

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

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

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

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 exhibits restlessness and confusion.

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

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

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

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 3 to 5 days

B 6 to 12 months

C 1 to 3 weeks

D 2 to 4 months

Question #19

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

A Decreased heart rate

B Increased restlessness

C Decreased level of consciousness (LOC)

D Increased blood pressure

Question #20

The most diagnostic clinical symptom of pleurisy is:

A Fever and chills.

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

C Dyspnea and coughing.

D Stabbing pain during respiratory movements.

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 Hypertension

C Ascites

D Syncope

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 7.49, PaCO2 34, HCO3 25

B pH 7.87, PaCO2 38, HCO3 28

C pH 7.47, PaCO2 28, HCO3 30

D pH 7.25, PaCO2 48, HCO3 24

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 Increase oxygen administration

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

C Intubate the client and control breathing with mechanical ventilation

D Schedule the client for pulmonary surgery

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 Aspiration

B Drug ingestion

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 administer IV medication.

B ventilate the client.

C remove air from the pleural space.

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 Chest tubes allow air into the pleural space.

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

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

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

B A client who ambulates in the hallway every 4 hours

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

D A client with a nasogastric tube

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 Rapid onset of severe dyspnea

B Bilateral wheezing

C Inspiratory crackles

D Cyanosis

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 Atelectasis

B Acute respiratory distress syndrome

C Metabolic alkalosis

D Respiratory acidosis

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 there are leaks in the system.

B See if a kink has developed in the tubing.

C See if the chest tube is clogged.

D See if the wall suction unit has malfunctioned.

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 hemothorax.

B pneumothorax.

C pleural effusion.

D consolidation.

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 nasopharyngeal specimen for reverse-transcription polymerase chain reaction testing.

B Institute isolation precautions.

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

D Obtain a sputum specimen for enzyme immunoassay testing.

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

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

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

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

Question #36

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

A Hemoptysis and dysuria

B Dyspnea and wheezing

C Nonproductive cough and normal temperature

D Sore throat and abdominal pain

Question #37

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

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

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

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

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

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 Nonreactive

B Negative

C Not significant

D Significant

Question #39

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

A Administer bronchodilator as ordered.

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

C Send for STAT chest x-ray.

D Obtain arterial blood gases.

Question #40

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

A Pain in the feet

B Decreased urinary output

C Localized calf tenderness

D Coolness to lower extremities

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 pollen.

C silica.

D asbestos.

Question #42

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

A Vitamin E

B Vitamin D

C Vitamin B6

D Vitamin C

Question #43

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

A secondary drug resistance.

B tertiary drug resistance.

C multidrug resistance.

D primary drug resistance.

Question #44

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

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

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

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

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

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 Inspiratory wheezes in the right thorax

D Bilateral pleural friction rub

Question #46

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

A Elevating the head of the bed 30 degrees

B Encouraging increased fluid intake

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 Sibilant wheezes

B Crackles in the lung bases

C Low-pitched rhonchi during expiration

D Pleural friction rub

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 Positive

B Negative

C Uncertain

D Borderline

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 Encourage increased fluid intake.

B Give antibiotics as ordered.

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 Tracheobronchitis

D Bronchitis

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 latent infection with no disease

B disease that is not clinically active.

C no exposure and no infection.

D exposure and no evidence of infection.

Question #53

Which interventions does a nurse implement for clients with empyema?

A Encourage breathing exercises

B Place suspected clients together

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 diet low in calories

B A diet with limited fat

C A carbohydrate-dense diet

D A diet rich in protein

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 Wearing gloves during all client contact

B Placing the client in respiratory isolation

C Monitoring the client’s fluid intake and output

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 Enlarged cervical nodes

B Affected voice sounds

C Dysphagia

D Burning of the throat when hot liquids are ingested

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 buccal mucosa

B The tracheal mucosa

C The frontal sinuses

D The nasal mucosa

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 Sudden restlessness

B Copious mucous secretions

C Harsh cough

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 remain in place for at least a day postsurgery.”

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

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

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 No fluid normally is present

B 20–25 mL

C 5–10 mL

D 20–30 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 Post operative bleeding

B Plugged tracheostomy tube

C Infection

D Edema of the upper airway

Question #63

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

A Cold compresses to the sinus cavities

B Administration of oral antibiotics

C Use of a dehumidifier

D Saline lavages to the nares

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 dehydration.

C pulmonary embolism.

D carotid artery hemorrhage.

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

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

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

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 30%

B 10%

C 20%

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 Tension pneumothorax

C Pulmonary contusion

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 Fit all employees with protective masks.

B Insist on adequate breaks for each employee.

C Give workshops on disease prevention

D Provide employees with smoking cessation materials.

Question #69

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

A Hypotension, hyperoxemia, and hypercapnia

B Hyperventilation, hypertension, and hypocapnia

C Hyperoxemia, hypocapnia, and hyperventilation

D Hypercapnia, hypoventilation, and hypoxemia

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