CH. 19: Management of Patients with Chest and Lower Res- pir

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?

• Smoke particles compete for binding sites on hemoglobin.

• Smoking causes atrophy of the alveoli.

• Smoking damages the ciliary cleansing mechanism.

• Smoking decreases the amount of mucus production.

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