RESP PART 2

The nurse assessing an 11 year old who is having an asthma attack expects to hear adventitious sounds of:

• 1. friction rub

• 1. sibilant wheezes

• 1. crackles

• 1. sonorous wheezes

A patient, age 69, has emphysema. On assessment, the nurse notes the presence of a “barrel chest.” What does this pathology result from?

• 1. An increase in the lateromedial area from hypertrophy of mucous glands in the bronchi

• 1. An increased anteroposterior diameter caused by overinflation of the alveoli

• 1. A decrease in anteroposterior diameter caused by chronic dilation of the bronchi

• 1. A widening of the sternocostal area secondary to chronic constriction of smooth

     muscles in the airways leading to bronchospasms

A patient, age 69, has emphysema. On assessment, the nurse notes the presence of a “barrel chest.” What does this pathology result from?

• 1. An increase in the lateromedial area from hypertrophy of mucous glands in the bronchi

• 1. An increased anteroposterior diameter caused by overinflation of the alveoli

• 1. A decrease in anteroposterior diameter caused by chronic dilation of the bronchi

• 1. A widening of the sternocostal area secondary to chronic constriction of smooth

     muscles in the airways leading to bronchospasms

A patient, age 22, is admitted with acute asthma. The patient shows a pulse oximetry level of SaO2 of 82%. How should the nurse interpret this?

• 1. Only 82% of the red blood cells are able to use oxygen.

• 1. There is only 82% of oxygen bound to the hemoglobin compared with the amount

     available.

• 1. Eighteen percent of oxygen is not dissolved in the blood.

• 1. The muscular respiratory effort is only 18% effective.

How should the newly diagnosed patient who has been prescribed isoniazid (INH) for the treatment of active tuberculosis (TB) be advised?

• 1. Report redness and swelling of extremities.

• 1. Accept that the therapy is long term.

• 1. Monitor renal function every several months.

• Rise slowly to avoid dizziness.

What is the appropriate nursing intervention for a patient, age 40, who is diagnosed with active tuberculosis?

• 1. Place the patient in drainage and secretion precautions.

• Place the patient in acid-fast bacillus (AFB) Isolation Precautions.

• 1. Maintain the patient in enteric isolation.

• 1. Place the patient in any Isolation Precautions.

A patient is on postoperative day 2 after undergoing a total hip replacement. The patient suddenly complains of chest pain and is coughing up blood-tinged sputum. What should be the nurse’s initial intervention?

• 1. Report signs to the charge nurse.

• 1. Elevate head of bed and administer oxygen.

• 1. Prevent patient from excessive coughing.

• 1. Increase IV flow rate.

The patient with long-term emphysema is admitted with a secondary diagnosis of cor

pulmonale. What should the nurse anticipate?

• 1. The patient will present with edema of the lower extremities and extended neck

     veins due to hypertension of the pulmonary circulation

• The patient will present with a dry hacking cough and chest pain due to

  constriction of the pulmonary vein.

• The patient will present with hypertension and a headache related to pulmonary

  hypertension.

• 1. The patient will present with unlabored respiration and cyanosis around the

     mouth.

What is a major advantage of video-assisted thoracoscopic surgery (VATS)?

• 1. The surgeon can record entire surgical procedure on a video.

• 1. The surgeon can remove tumors of the lung through a small keyhole incision.

• The surgeon can x-ray and excise tumor in the same procedure.

• 1. The surgeon can avoid the use of a closed chest drainage system after surgery.

How would the nurse examining a patient with pleurisy document a low-pitched grating

lung sound?

• Sonorous wheeze

• Friction rub

• Coarse crackles

• Crackles