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WorksheetsGas Exchange/Diabetes
Total questions: 40
Worksheet time: 1hrs 23mins
What is the purpose of the cilia?
Warm and moisturize inhaled air
Sweep debris toward nasal cavity
Stimulate cough reflex
Produce mucus
What happens when there is a decrease in the oxygen level in the blood?
Pituitary stimulates the respiratory system to increase respiratory rate
The alveoli diffuse more oxygen into the blood
Chemoreceptors in the carotid body and aortic body stimulate the respiratory centers to modify respiratory rates
The parietal pleura increases the negative pressure
When assessing the SaO2 with a pulse oximeter, the nurse will place the oximeter on a finger:
on the same side as the blood pressure cuff.
while exercising the arm to stimulate circulation.
that is a normal temperature.
on the same side as an arterial catheter.
A patient, age 69, has emphysema. On assessment, the nurse notes the presence of a “barrel chest.” What does this pathology result from?
An increase in the lateromedial area from hypertrophy of mucous glands in the bronchi
An increased anteroposterior diameter caused by overinflation of the alveoli
A decrease in anteroposterior diameter caused by chronic dilation of the bronchi
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?
Only 82% of the red blood cells are able to use oxygen.
There is only 82% of oxygen bound to the hemoglobin compared with the amount available.
Eighteen percent of oxygen is not dissolved in the blood.
The muscular respiratory effort is only 18% effective.
What is inspiratory capacity?
The amount of air in the lung after a maximal inhalation
The amount of air moved with each normal inhalation and expiration
The amount of air that can be inhaled in one breath from the resting expiratory level
The amount of air that can be forcefully exhaled after maximum inhalation
The young man who had a bronchoscopy 1 hour ago asks when he can eat. Which response would be most helpful?
In 24 hours, but must take cold liquids for the rest of the day
If there is no blood in his sputum
In 8 hours after a period of nothing by mouth
When the gag reflex returns
The nurse caring for a patient who has a closed chest drainage system notes that there is fluctuation (tidaling) in the water seal chamber. What is the most appropriate nursing action based on this assessment?
Document the tidaling
Elevate the head of the bed and notify charge nurse of malfunction of drainage system
Add more sterile water to the water seal chamber
Turn patient to the affected side
How does pursed lip breathing assist patients with asthma during an attack?
It distracts the patient with breathing technique to reduce anxiety.
It gets rid of CO2 faster.
It opens bronchioles by backflow air pressure.
It increases PACO2..
How should a patient be positioned after a thoracentesis is completed and the dressing applied?
High Fowler
Semi-Fowler
Side lying on unaffected side
Prone
Which patient assessment indicates the most severe respiratory distress?
Nasal flaring, symmetrical chest wall expansion, SaO2 88%
Abdominal breathing, SaO2 97%
Substernal retraction, SaO2 84%
Substernal retraction, SaO2 90%
Which independent nursing measures are effective in aiding a patient to expectorate? (Select all that apply.)
Positioning in orthopneic position
Suctioning
Assisting to cough
Providing hydration
Starting IV fluids
Identify the purposes of chest drainage. (Select all that apply.)
Drains air, blood, and fluid from pleural space
Restores positive pressure in chest cavity
Restores negative intrapleural pressure
Allows lung to collapse and rest
Allows route for medication administration
Which diagnostic test for diabetes mellitus provides a measure of glucose levels for the previous 8 to 12 weeks?
Fasting blood sugar (FBS)
Oral glucose tolerance test (OGT)
Glycosylated hemoglobin (HbA1c)
Postprandial glucose test (PPBG)
Which test will furnish immediate feedback for a newly diagnosed diabetic who is not yet under control?
Fasting blood sugar (FBS)
Glycosylated hemoglobin (HgbA1c)
Oral glucose tolerance test (OGTT)
Clinitest
The patient is a 20-year-old college student who has type 1 diabetes and normally walks each evening as part of an exercise regimen. The patient plans to enroll in a swimming class. Which adjustment should be made based on this information?
Time the morning insulin injection so that the peak action will occur during swimming class.
Delete normal walks on swimming class days.
Delay the meal before the swimming class until the session is over.
Monitor glucose level before, during, and after swimming to determine the need for alterations in food or insulin.
The physician orders an 1800-calorie diabetic diet and 40 units of (Humulin N) insulin U-100 subcutaneously daily for a patient with diabetes mellitus. Why would a mid-afternoon snack of milk and crackers be given?
To improve nutrition
To improve carbohydrate metabolism
To prevent an insulin reaction
To prevent diabetic coma
The nurse teaching a patient with type 1 diabetes mellitus (IDDM) about early signs of
insulin reaction would include information about:
abdominal pain and nausea.
dyspnea and pallor.
flushing of the skin and headache.
hunger and a trembling sensation.
The nurse discovers the type 1 diabetic patient drowsy and tremulous, the skin is cool and moist, and the respirations are 32 and shallow. These are signs of:
hypoglycemic reaction; give 6 oz of orange juice.
hyperglycemic reaction; give ordered regular insulin.
hyperglycemic hyperosmolar nonketotic reaction; squeeze glucagon gel in buccal cavity.
hypoglycemic reaction; give ordered insulin.
What instructions should a nurse give to a diabetic patient to prevent injury to the feet?
Soak feet in warm water every day.
Avoid going barefoot and always wear shoes with soles.
Use of commercial keratolytic agents to remove corns and calluses are preferred to cutting off corns and calluses.
Use a heating pad to warm feet when they feel cool to the touch.
While a patient is receiving hygiene care, her chest tube becomes disconnected from the water-seal chest drainage system (CDU). Which action should the nurse take immediately?
Clamp the chest tube close to the insertion site.
Set up a new drainage system, and connect it to the chest tube.
Have the patient take and hold a deep breath while the nurse reconnects the tube to the CDU.
Place the disconnected end nearest the patient into a bottle of sterile water.
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?
Audible wheezing or stridor
A slightly increased ventilatory rate, large tidal volumes, and no expiratory pause
Rapid respirations with periods of apnea
Very slow inhalations and rapid expirations
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?
Cheyne-Stokes
Frank-Starling
Apnea
Orthopnea
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?
Hyperventilation
Hypoventilation
Apnea
Cyanosis
A nurse is reviewing the results of an ABG and finds reduced oxygenation of arterial blood. What term should the nurse use to describe this condition?
Ischemia
Hypoxia
Hypoxemia
Hypocapnia
A nurse is teaching staff about pulmonary edema. Which information should the nurse include? The most common cause of pulmonary edema is:
Right heart failure
Left heart failure
Asthma
Lung cancer
A 65-year-old male recently had a cerebrovascular accident that resulted in dysphagia. He now has aspiration of gastric contents. The nurse assesses the patient for which complication?
pneumonia
bronchiectasis
pneumothorax
emphysema
A 30-year-old male prison inmate contracted tuberculosis during an outbreak. While planning interactions, the nurse realizes the patient can transmit this disease through:
Skin contact
Fecal-oral contact
Airborne droplets
Blood transfusions
Which of the following patients is at highest risk for developing pulmonary embolism (PE)?
21-year-old male with a hemophilia bleeding disorder
28-year-old woman who had a baby 6 months earlier
36-year-old woman with a history of alcohol abuse who is recovering from a gastric ulcer
72-year-old male who is recovering from hip replacement surgery in the hospital
A 60-year-old male undergoes surgery for a bone fracture. Which of the following nursing measures would be most effective for preventing pulmonary embolism (PE) in this patient?
Ensure that patient uses supplemental oxygen.
Prevent deep vein thrombosis formation.
Check hematocrit and hemoglobin levels frequently during the postoperative period.
Promote aggressive fluid intake.
A nurse is reviewing lab results for glycos
Measure fasting glucose levels.
Monitor long-term serum glucose control.
Detect acute complications of diabetes.
Check for hyperlipidemia.
patient asks the nurse if stress can be a potential cause of type 2 diabetes. What should be included in the response provided by the nurse?
Stress decreases the number of alpha cells in the pancreas, thus increasing the workload on the beta cells.
Periods of stress cause increases in glycogen production by the adrenal cortex.
Stress is directly associated with decreased insulin tolerance.
The inhibition of beta cells to glucose is increased in periods of stress.
The nurse is caring for a patient who was hospitalized with ketosis. The nurse recognizes that the patient correctly understands the phenomenon when she reports what about the condition?
“I had taken too much insulin to decrease my body’s levels of glucose.”
“The condition resulted when my body tried to break down and use my stores of fats.”
“When my blood glucose goes over 150 mg/dL, I am at risk for this condition.”
“I was exercising too much and had too sharp reductions in my blood glucose level.”
The diet of the diabetic is geared toward adequate nutrition and:
control of weight.
exclusion of all sweets.
increase in fats for energy.
avoidance of all fast foods.
The patient takes his NovoLog 70-30 at 7:00 AM. The nurse suggests the best time to schedule exercise would be at:
7:30 AM before peak action of insulin.
10:00 AM at peak action of insulin.
1:00 PM after peak action of insulin.
any time after injection.
The nurse is reviewing the patient’s prescribed insulin regimen. The nurse notes that the physician has ordered a long-lasting insulin. Which medication will best meet this criteria?
Lantus
NovoLog
Humalog
Regular
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?
The amount of sputum the patient expectorates decreases with each dose administered.
Cough is completely suppressed, and she is able to sleep through the night.
Dry, unproductive cough is reduced, but her voluntary coughing is more productive.
Involuntary coughing produces large amounts of thick yellow sputum.
The nurse is admitting to the medical-surgical unit an older adult woman with a diagnosis of pulmonary hypertension and right-sided heart failure. The patient is complaining of shortness of breath, and the nurse observes conversational dyspnea. What is the first action the nurse should take?
Review and implement the primary care provider’s prescriptions for treatments.
Perform a quick physical examination of breathing, circulation, and oxygenation.
Gather a thorough medical history, including current symptoms, from the family.
Administer oxygen to the patient through a nasal cannula.
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?
Nonrebreather mask
Nasal cannula
Partial rebreather mask
Venturi mask
You are caring for an adult patient with a tracheostomy who is being mechanically ventilated. His pulse oximetry reading is 85%, heart rate is 113, and respiratory rate is 30. The patient is very restless. His respirations are labored, and you hear gurgling sounds. You auscultate crackles and rhonchi in both lungs. What is the most appropriate action to take?
Call the respiratory therapist to check the ventilator settings.
Provide endotracheal suctioning.
Provide tracheostomy care.
Notify the physician of the patient’s signs of fluid overload.
