WorksheetsRespiratory 2
Total questions: 74
Worksheet time: 1hrs 15mins
Name
Class
Date
1.
A nurse is caring for a child who has a chest tube. After ambulating and returning the child to bed, the nurse notes that the child has dyspnea and decreasing oxygen saturation readings. Which nursing action is the priority?
a)
Assess the tubing for kinks.
b)
Call the rapid response team.
c)
Facilitate a portable chest x-ray.
d)
Provide bag-valve-mask breathing.
2.
The nurse suspects a pediatric patient is experiencing acute respiratory distress syndrome (ARDS). What laboratory finding correlates to this condition?
a)
HCO3 of 22 mEq/L
b)
PCO2 of 88 mm Hg
c)
pH of 7.34
d)
PO2 of 60 mm Hg
3.
A father brings his 1-year-old son to the clinic and states that when he kisses the child’s cheek, it tastes salty. Which diagnostic test does the nurse educate the father on based on the father’s statement?
a)
Large bowel barium series
b)
Pancreatic enzyme analysis
c)
Pulmonary function studies
d)
Quantitative sweat chloride test
4.
The parents of a child diagnosed with cystic fibrosis (CF) consult the nurse, stating they want to have more children but are worried about subsequent children also having the disease. Which information does the nurse provide the parents?
a)
“Each child has a 25% chance of inheriting the disease.”
b)
“This disease is rare, so other children should not be affected.”
c)
“Unfortunately, there is no way to predict if they will have it.”
d)
“You should have genetic testing to see who the carrier is.”
5.
An 11-year-old child who has a history of asthma is brought to the family practice clinic by a parent who reports that the child has white plaque over the inside of the mouth and coating the tongue. Which question by the nurse would elicit the most useful information?
a)
“Are you brushing your teeth and tongue regularly?”
b)
“Do you rinse your mouth after using your inhaler?”
c)
“Have you ever had something like this before?”
d)
“When was the last time you went to the dentist?”
6.
The patient with acute respiratory distress syndrome (ARDS) would exhibit which of the following symptoms?
a)
Elevated alveolar surfactant levels
b)
Increased lung compliance with increased FiO2 administration
c)
Decreasing PaO2 levels despite increased FiO2 administration
d)
Respiratory acidosis associated with hyperventilation
7.
Intrapulmonary shunting refers to:
a)
alveoli that are not perfused.
b)
blood that is shunted from the left side of the heart to the right and causes heart failure.
c)
blood that is shunted from the right side of the heart to the left without oxygenation.
8.
Which of the following acid-base disturbances commonly occurs with the hyperventilation and impaired gas exchange seen in severe exacerbation of asthma?
a)
Metabolic acidosis
b)
Metabolic alkalosis
c)
Respiratory acidosis
d)
Respiratory alkalosis
9.
The nurse is caring for a patient with a diagnosis of pulmonary embolism. The nurse understands that the most common cause of a pulmonary embolus is:
a)
amniotic fluid embolus.
b)
deep vein thrombosis from lower extremities.
c)
fat embolus from a long bone fracture.
d)
vegetation that dislodges from an infected central venous catheter.
10.
The etiology of noncardiogenic pulmonary edema in acute respiratory distress syndrome (ARDS) is related to damage to the:
a)
alveolar-capillary membrane.
b)
left ventricle.
c)
mainstem bronchus.
d)
trachea.
11.
A client is demonstrating a crescendo-decrescendo pattern of breathing with periods of apnea. The nurse would document this breathing pattern as being:
a)
Cheyne-Stokes.
b)
apnea
c)
bradypnea
d)
Kussmaul
12.
The spouse of a client diagnosed with tuberculosis is to begin isoniazid prophylactic therapy. Which of the following should the nurse instruct the spouse regarding length of time to take this medication? The medication should be taken for:
a)
10 to 24 days.
b)
1 to 3 months.
c)
4 to 7 months.
d)
6 to 12 months.
13.
A client’s chest tube has been accidentally dislodged while the client was being transferred from the bed to a stretcher. Which of the following should the nurse do to help this client?
a)
Cover the site with occlusive petroleum jelly gauze and tape to four sides.
b)
Cover the site with occlusive petroleum jelly gauze and tape to three sides.
c)
Cover the site with occlusive petroleum jelly gauze and tape to two sides.
d)
Cover the site with occlusive petroleum jelly gauze and tape to one side.
14.
The nurse is caring for a client who has completed pulmonary function testing. Which of the following indicates the amount of air inhaled or exhaled with each breath during normal breathing?
a)
Expiratory reserve volume
b)
Minute volume
c)
Tidal volume
d)
Vital capacity
15.
A client diagnosed with asthma is receiving instructions about the use of albuterol. The client should be aware that albuterol may cause:
a)
bradycardia.
b)
drowsiness
c)
nasal congestion.
d)
nervousness
16.
What would be the most effective compensation for respiratory acidosis?
a)
The kidneys eliminating more bicarbonate ions
b)
The kidneys producing more bicarbonate ions
c)
The kidneys reabsorbing more hydrogen ions
d)
An increase in respiratory rate
17.
What cause the expanded anteroposterior (A-P) thoracic diameter (barrel chest) in patients with emphysema?
a)
Air trapping and hyperinflation
b)
Persistent coughing to remove mucus
c)
Recurrent damage to lung tissues
d)
Dilated bronchi and increased mucous secretions
18.
Which of the following drugs in an inhaler would likely be carried by individuals to provide immediate control of acute asthma attacks?
a)
A glucocorticoid
b)
Epinephrine
c)
Cromolyn
d)
A β2-adrenergic agent
19.
A client with pulmonary tuberculosis is being discharged with a prescription for Rifampin. The nurse should plan to include which of the following in the client's discharge teaching plan?
a)
Ringing in the ears is expected
b)
Purified Protein Derivative skin tests will improve in 4 months.
c)
Urine and other secretions will be orange in color.
d)
Medication should be taken with meals.
20.
A client who is postoperative develops an acute onset of severe chest pain that is worse with inspiration. The client is anxious and tachypneic. The nurse should anticipate taking which of the following actions first?
a)
Apply supplemental oxygen
b)
Auscultate lung sounds
c)
Administer pain medication
d)
Initiate heparin therapy
21.
A nurse is caring for a client receiving mechanical ventilation. The low pressure alarm sounds. Which of the following should the nurse recognize as a cause of the alarm?
a)
Excess secretions
b)
Kinks in the tubing
c)
Artificial airway cuff leak
d)
Biting on the endotracheal tube
22.
A nurse is caring for a client who was just diagnosed with a pulmonary embolism. Which of the following interventions is the highest priority?
a)
Provide for a quiet environment.
b)
Encourage use of incentive spirometry every 1-2 hours.
c)
Apply electrodes for continuous cardiac monitoring.
d)
Administer IV heparin at 1300 units/hr.
23.
A nurse is caring for a client with ARDS. Which of the following assessment findings indicates that the client's work of breathing has worsened?
a)
Increase in respiratory rate
b)
Increase in oxygen saturation
c)
Decrease in carbon dioxide retention
d)
Decrease in adventitious breath sounds
24.
A nurse is caring for a client diagnosed with bacterial pneumonia. In this situation, the nurse should expect which of the following assessment findings?
a)
Nonproductive cough
b)
SaO2 96%
c)
Temperature 101.8 degrees F
d)
Bradypnea
25.
A nurse is positioning a client with emphysema to promote effective breathing. The nurse should place the client in which of the following positions?
a)
Lateral position with a pillow over the chest to support the arm
b)
High-Fowler's position with arms supported on the overbed table
c)
Semi-Fowler's position with pillows supporting both arms
d)
Supine position with the head of the bed elevated 15 degrees
26.
A nurse is caring for a client following the insertion of a chest tube. The nurse should plan to have which of the following items in the client's room?
a)
Extra drainage system
b)
Suture removal set
c)
Bottle of sterile water
d)
Nonadherent pads
27.
When caring for a client immediately following a laryngectomy, the nurse should give priority to which of the following assessments?
a)
Airway patency
b)
Oxygen saturation
c)
Breath sounds
d)
Gag reflex
28.
A nurse is assessing a client who has a chest tube in place following thoracic surgery. Which of the following findings indicates a need for further action?
a)
Fluctuation of drainage in the tubing with inspiration
b)
Continuous bubbling in the water seal chamber
c)
Drainage of 75 mL in the first hours after surgery
d)
Several small dark-red blood clots in the tubing
29.
A nurse receives an order from the primary care provider to perform nasopharyngeal suctioning for each of the following clients. The nurse should question the provider's order for which of the following clients?
a)
a client admitted with a closed-head injury who is lethargic
b)
a client admitted with a fractured femur who is in severe pain
c)
a client admitted with a ruptured appendix who has a temperature of 102.2 degrees F
d)
a client admitted with emphysema who has a respiratory rate of 36/min
30.
A nurse is providing instruction to a client on how to use montelukast (Singulair) to treat chronic asthma. The nurse should recognize that the client understands the teaching when he states
a)
"I will take this medication with each meal"
b)
"I will take this medication during my asthma attacks."
c)
"I will take this medication up to 3 times per day when I begin to wheeze."
d)
"I will take this medication every evening, even when I don't have symptoms."
31.
A nurse is providing discharge instructions to a client following a tracheostomy. Which of the following statements by the client indicates a need for further instruction?
a)
"I need to inspect the stoma for signs of infection or skin irritation."
b)
"I will clean the cannula with half-strength peroxide and rinse with saline."
c)
"I can remove the old twill tape once the new tape is in place."
d)
"I should apply suction while inserting the catheter into my tracheostomy."
32.
A nurse is caring for a client in the emergency department following a chest trauma. Which of the following findings should the nurse recognize as indicating a tension pneumothorax?
a)
Collapsed neck veins on the affected side
b)
Collapsed neck veins on the unaffected side
c)
Tracheal deviation to the affected side
d)
Tracheal deviation to the unaffected side
33.
Which of the following pathophysiological mechanisms that occurs in the lung parenchyma allows pneumonia to develop?
a)
Atelectasis
b)
Bronchiectasis
c)
Effusion
d)
Inflammation
34.
Which of the following assessment findings would help confirm a diagnosis of asthma in a client suspected of having the disorder?
a)
Circumoral cyanosis
b)
Increased forced expiratory volume
c)
Inspiratory and expiratory wheezing
d)
Normal breath sounds
35.
A nurse plans care for a client with chronic obstructive pulmonary disease, knowing that the client is most likely to experience what type of acid-base imbalance?
a)
Respiratory acidosis
b)
Respiratory alkalosis
c)
Metabolic acidosis
d)
Metabolic alkalosis
36.
A nurse is caring for a client who is on a mechanical ventilator. Blood gas results indicate a pH of 7.50 and a PCO2 of 30 mm Hg. The nurse has determined that the client is experiencing respiratory alkalosis. Which laboratory value would most likely be noted in this condition?
a)
Sodium level of 145 mEq/L
b)
Potassium level of 3.0 mEq/L
c)
Magnesium level of 2.0 mg/L
d)
Phosphorus level of 4.0 mg/dl
37.
A client is scheduled for blood to be drawn from the radial artery for an ABG determination. Before the blood is drawn, an Allen’s test is performed to determine the adequacy of the:
a)
Popliteal circulation
b)
Ulnar circulation
c)
Femoral circulation
d)
Carotid circulation
38.
A nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client, knowing that the client is at risk for which acid-base disorder?
a)
Respiratory acidosis
b)
Respiratory alkalosis
c)
Metabolic acidosis
d)
Metabolic alkalosis
39.
A nurse is caring for a client with diabetic ketoacidosis and documents that the client is experiencing Kussmaul’s respirations. Based on this documentation, which of the following did the nurse observe?
a)
Respirations that are abnormally deep, regular, and increased in rate.
b)
Respirations that are regular but abnormally slow.
c)
Respirations that are labored and increased in depth and rate
d)
Respirations that cease for several seconds.
40.
A nurse is caring for a client hospitalized with acute exacerbation of COPD. Which of the following would the nurse expect to note on assessment of this client?
a)
Increased oxygen saturation with exercise
b)
Hypocapnia
c)
A hyperinflated chest on x-ray film
d)
A widened diaphragm noted on chest x-ray film
41.
An oxygenated delivery system is prescribed for a client with COPD to deliver a precise oxygen concentration. Which of the following types of oxygen delivery systems would the nurse anticipate to be prescribed?
a)
Venturi mask
b)
Aerosol mask
c)
Face tent
d)
Tracheostomy collar
42.
A nurse instructs a client to use the pursed lip method of breathing. The client asks the nurse about the purpose of this type of breathing. The nurse responds, knowing that the primary purpose of pursed lip breathing is:
a)
Promote oxygen intake
b)
Strengthen the diaphragm
c)
Strengthen the intercostal muscles
d)
Promote carbon dioxide elimination
43.
A 34-year-old woman with a history of asthma is admitted to the emergency department. The nurse notes that the client is dyspneic, with a respiratory rate of 35 breaths/minute, nasal flaring, and use of accessory muscles. Auscultation of the lung fields reveals greatly diminished breath sounds. Based on these findings, what action should the nurse take to initiate care of the client?
a)
Initiate oxygen therapy and reassess the client in 10 minutes.
b)
Draw blood for an ABG analysis and send the client for a chest x-ray.
c)
Encourage the client to relax and breathe slowly through the mouth
d)
Administer bronchodilators
44.
Basilar crackles are present in a client’s lungs on auscultation. The nurse knows that these are discrete, noncontinuous sounds that are:
a)
Caused by the sudden opening of alveoli
b)
Usually more prominent during expiration
c)
Produced by airflow across passages narrowed by secretions
d)
Found primarily in the pleura.
45.
The physician has scheduled a client for a left pneumonectomy. The position that will most likely be ordered postoperatively for his is the:
a)
Unoperative side or back
b)
Operative side or back
c)
Back only
d)
Back or either side.
46.
A client with pneumonia develops dyspnea with a respiratory rate of 32 breaths/minute and difficulty expelling his secretions. The nurse auscultates his lung fields and hears bronchial sounds in the left lower lobe. The nurse determines that the client requires which of the following treatments first?
a)
Antibiotics
b)
Bed rest
c)
Oxygen
d)
Nutritional intake
47.
A client with a positive Mantoux test result will be sent for a chest x-ray. For which of the following reasons is this done?
a)
To confirm the diagnosis
b)
To determine if a repeat skin test is needed
c)
To determine the extent of the lesions
d)
To determine if this is a primary or secondary infection
48.
A client with shortness of breath has decreased to absent breath sounds on the right side, from the apex to the base. Which of the following conditions would best explain this?
a)
Acute asthma
b)
Chronic bronchitis
c)
Pneumonia
d)
Spontaneous pneumothorax
49.
Continuous positive airway pressure (CPAP) can be provided through an oxygen mask to improve oxygenation in hypoxic patients by which of the following methods?
a)
The mask provides 100% oxygen to the client.
b)
The mask provides continuous air that the client can breathe.
c)
The mask provides pressurized oxygen so the client can breathe more easily.
d)
The mask provides pressurized at the end of expiration to open collapsed alveoli.
50.
If a pleural effusion develops, which of the following actions best describes how the fluid can be removed from the pleural space and proper lung status restored?
a)
Inserting a chest tube
b)
Performing thoracentesis
c)
Performing paracentesis
d)
Allowing the pleural effusion to drain by itself.
51.
A 76-year old client is admitted for elective knee surgery. Physical examination reveals shallow respirations but no signs of respiratory distress. Which of the following is a normal physiologic change related to aging?
a)
Increased elastic recoil of the lungs
b)
Increased number of functional capillaries in the alveoli
c)
Decreased residual volume
d)
Decreased vital capacity.
52.
During a history, a nurse notices a patient is short of breath, is using pursed-lip breathing, and maintains a tripod position. Based on these data, what abnormal finding should the nurse expect to find during the examination?
a)
Increased tactile fremitus
b)
Inspiratory and expiratory wheezing
c)
Tracheal deviation
d)
An increased anteroposterior diameter
53.
A patient is admitted to the emergency department with a tracheal obstruction. What sound does the nurse expect to hear as this patient breathes?
a)
Dull sounds on percussion
b)
Soft, muffled rhonchi heard over the trachea
c)
Bubbling or rasping sounds heard over the trachea
d)
High-pitched sounds on inspiration and exhalation
54.
A nurse in the emergency department is assessing a patient with a moderate left pneumothorax. What does this nurse expect to find during the respiratory examination?
a)
Increased fremitus over the left chest
b)
Tracheal deviation to the left side
c)
Hyporesonant percussion tones over the left chest
d)
Distant to absent breath sounds over the left chest
55.
A patient has right lower lobe pneumonia, creating a consolidation in that lung. In assessing for vocal fremitus, the nurse found increased fremitus over the right lower lung. What finding does the nurse anticipate when assessing vocal resonance to confirm the consolidation?
a)
Bronchophony reveals the patient’s spoken “99” as clear and loud.
b)
No sounds are expected since sounds cannot be transmitted through consolidation.
c)
Egophony reveals indistinguishable sounds when the patient says “e-e-e.”
d)
Whispered pectoriloquy reveals a muffled sound when the patient says “1-2-3.”
56.
A nurse examines a patient with a pleural effusion and finds decreased fremitus. What additional abnormal finding should the nurse anticipate during further examination?
a)
An increase in the anteroposterior to lateral ratio
b)
Hyperresonance over the affected area
c)
Absent breath sounds in the affected area
d)
Increased vocal fremitus over the affected area
57.
A 50-year-old diabetic male did not take his medication and is now in metabolic acidosis. He is experiencing Kussmaul respirations. What type of breathing will the nurse observe upon assessment?
a)
Audible wheezing or stridor
b)
A slightly increased ventilatory rate, large tidal volumes, and no expiratory pause
c)
Rapid respirations with periods of apnea
d)
Very slow inhalations and rapid expirations
58.
A 30-year-old female received a severe head injury in a motor vehicle accident. She is now experiencing respiratory abnormalities characterized by alternating periods of deep and shallow breathing with periods of apnea. What term should the nurse use when charting this condition?
a)
Cheyne-Stokes
b)
Frank-Starling
c)
Apnea
d)
Orthopnea
59.
A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide (CO2) levels. Which of the following does the nurse suspect is the most likely cause?
a)
Hyperventilation
b)
Hypoventilation
c)
Apnea
d)
Cyanosis
60.
How does pursed lip breathing assist patients with asthma during an attack?
a)
It distracts the patient with breathing technique to reduce anxiety.
b)
It gets rid of CO2 faster.
c)
It opens bronchioles by backflow air pressure.
d)
It increases PACO2..
61.
While a patient is receiving hygiene care, her chest tube becomes disconnected from the water-seal drainage system (CDU). Which action should the nurse take immediately?
a)
Clamp the chest tube close to the insertion site.
b)
Set up a new drainage system, and connect it to the chest tube
c)
Have the patient take and hold a deep breath while the nurse reconnects the tube to the CDU.
d)
Place the disconnected end nearest the patient into a bottle of sterile water.
62.
The nurse administers an antitussive/expectorant cough preparation to a patient with bronchitis. Which of the following responses indicates to the nurse that the medication is effective?
a)
The amount of sputum the patient expectorates decreases with each dose administered.
b)
Cough is completely suppressed, and she is able to sleep through the night.
c)
Dry, unproductive cough is reduced, but her voluntary coughing is more productive.
d)
Involuntary coughing produces large amounts of thick yellow sputum.
63.
You are admitting a 54-year-old patient with chronic obstructive pulmonary disease (COPD). The physician prescribes O2 at 24% FIO2. What is the most appropriate oxygen delivery method for this patient?
a)
Nonrebreather mask
b)
Nasal cannula
c)
Partial rebreather mask
d)
Venturi mask
64.
Which of the following provide the most reliable data about the effectiveness of airway suctioning?
a)
The amount, color, consistency and odor of secretions
b)
The patient’s tolerance for the procedure
c)
Breath sounds, vital signs, and pulse oximetry before and after suctioning
d)
The number of suctioning passes required to clear secretions
65.
Chest percussion and postural drainage would be an appropriate intervention for which of the following conditions?
a)
Congestive heart failure
b)
Pulmonary edema
c)
Pneumonia
d)
Pulmonary embolus
66.
The patient is experiencing shortness of breath. Which of the following lab tests indirectly indicates the oxygen level in the blood system?
a)
Hemoglobin
b)
White Blood Cell Count
c)
Electrolytes
d)
Creatinine
67.
The nurse is admitting a patient with chronic obstructive pulmonary disease (COPD). During the initial head-to-toe assessment the patient’s pulse oximetry reading is 89% on room air. What is the nurse’s first priority?
a)
Administer oxygen immediately @ 4L/NC.
b)
Call the primary health care provider for an order for oxygen.
c)
Assist the patient into a recumbent position.
d)
Determine the patient’s normal pulse oximetry reading.
68.
A 5-year-old child is brought to the emergency department with copious drooling and a croaking sound on inspiration. Her mother states that the child is very agitated and only wants to sit upright. What should be the nurse’s first action in this situation?
a)
Prepare intubation equipment and call the physician.
b)
Examine the child’s oropharynx and call the physician.
c)
Obtain a throat culture for respiratory syncytial virus (RSV).
d)
Obtain vital signs and listen to breath sounds.
69.
Which intervention is appropriate for the infant hospitalized with bronchiolitis?
a)
Position on the side with neck slightly flexed.
b)
Administer antibiotics as ordered.
c)
Restrict oral and parenteral fluids if tachypneic.
d)
Give cool, humidified oxygen.
70.
What should the nurse teach a child about using an albuterol metered-dose inhaler for exercise-induced asthma?
a)
Take two puffs every 6 hours around the clock.
b)
Use the inhaler only when he is short of breath.
c)
Use the inhaler 15 minutes before exercise.
d)
Take one to two puffs every morning on awakening.
71.
Which statement made by a parent would indicate an understanding about the genetic transmission of cystic fibrosis (CF)?
a)
“Only one parent carries the cystic fibrosis gene.”
b)
“Both parents are carriers of the cystic fibrosis gene.”
c)
“The presence of the disease is most likely the result of a genetic mutation.”
d)
“The mother is usually the carrier of the cystic fibrosis gene.”
72.
After auscultating a coarse low-pitched sonorous rattling in the left lower lobe, the nurse is concerned that the patient may be developing:
a)
an accumulation of secretions in the larger air passages.
b)
narrowing in the lower lobe of the lung.
c)
irritation in the pleurae.
d)
crackles in the left lower lobe.
73.
The 79-year-old patient with bacterial pneumonia becomes increasingly restless and confused. Temperature is 100° F and pulse, blood pressure, and respirations are elevated since the last assessment 6 hours ago. The initial intervention by the nurse should be to:
a)
take the patient off oral fluids.
b)
assess oxygen saturation.
c)
give the ordered mild sedative.
d)
administer an NSAID for discomfort.
74.
The patient with asthma is prescribed a leukotriene modifier drug, montelukast (Singulair). The nurse points out that the major advantage of this drug is it:
a)
has no GI side effects.
b)
provides bronchodilation and anti-inflammatory effects.
c)
controls acute asthma episodes.
d)
can be substituted for all other asthma remedies.
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