Chapter 19

A perioperative nurse is caring for a postoperative client. The client has a shallow

respiratory pattern and is reluctant to cough or to begin mobilizing. The nurse should

address the client's increased risk for what complication?

• Acute respiratory distress syndrome (ARDS)

• Atelectasis

• Aspiration

• Pulmonary embolism

A critical-care nurse is caring for a client diagnosed with pneumonia as a surgical

complication. The nurse's assessment reveals that the client has an increased work of

breathing due to copious tracheobronchial secretions. What should the nurse encourage

the client to do?

• Increase oral fluids unless contraindicated.

• Call the nurse for oral suctioning, as needed

• Lie in a low Fowler or supine position.

• Increase activity.

The nurse is caring for a client who has been in a motor vehicle accident and is

suspected of having developed pleurisy. Which assessment finding would best

corroborate this diagnosis?

•  The client is experiencing painless hemoptysis.

• The client's arterial blood gases (ABGs) are normal, but the client demonstrates

  increased work of breathing.

• The client's oxygen saturation level is below 88%, but the client denies

  shortness of breath.

• The client's pain intensifies when the client coughs or takes a deep breath.

The nurse caring for a client recently diagnosed with lung disease encourages the

client not to smoke. What is the primary rationale behind this nursing action?

• Smoking decreases the amount of mucus production.

• Smoke particles compete for binding sites on hemoglobin.

•  Smoking causes atrophy of the alveoli.

• Smoking damages the ciliary cleansing mechanism.

The nurse is caring for a client who is scheduled for a lobectomy for lung cancer. While

assisting with a subclavian vein central line insertion, the nurse notes that the client's

oxygen saturation is rapidly dropping. The client reports shortness of breath and

becomes tachypneic. The nurse suspects a pneumothorax has developed. Which further

assessment finding would support the presence of a pneumothorax?

• Diminished or absent breath sounds on the affected side

• Paradoxical chest wall movement with respirations

• Sudden loss of consciousness

• Muffled heart sounds

The nurse in the intensive care unit is caring for a client with pulmonary hypertension.

Which finding should the nurse expect to assess?

• Pulmonary artery pressure greater than 20 mm Hg

• Flat neck veins

• Dyspnea at rest

• Enlarged spleen

A new employee asks the occupational health nurse about measures to prevent

inhalation exposure to toxic substances. What should the nurse recommend?

• "Position a fan blowing toxic substances away from you to prevent you from

  being exposed."

• "Wear protective attire and devices when working with a toxic substance."

• "Make sure that you keep your immunizations up to date to prevent respiratory

  diseases resulting from toxins."

• "Always wear a disposable paper face mask when you are working with inhalable

  toxins."

An x-ray of a trauma client reveals rib fractures, and the client is diagnosed with a

small flail chest injury. Which intervention should the nurse include in the client's plan of

care?

• Initiate chest physiotherapy.

• Immobilize the ribs with an abdominal binder.

• Prepare the client for surgery.

• Immediately sedate and intubate the client.

A client has tested positive for tuberculosis (TB). While providing client teaching, which

information should the nurse prioritize?

• The importance of adhering closely to the prescribed medication regimen

• The disease being a lifelong, chronic condition that will affect activities of daily

  living (ADLs)

• TB being self-limiting but taking up to 2 years to resolve

• The need to work closely with the occupational and physical therapists

The nurse is assessing an adult client following a motor vehicle accident. The nurse

observes that the client has an increased use of accessory muscles and is reporting chest

pain and shortness of breath. The nurse should recognize the possibility of which

condition?

• Pneumothorax

• Cardiac ischemia

• Acute bronchitis

• Aspiration