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WorksheetsRespiratory Test
Total questions: 40
Worksheet time: 43mins
The nurse teaches a patient about the transmission of pulmonary tuberculosis (TB). Which statement, if made by the patient, indicates that teaching was effective?
“I will avoid being outdoors whenever possible.”
“My husband will be sleeping in the guest bedroom.”
“I will take the bus instead of driving to visit my friends.”
“I will keep the windows closed at home to contain the germs.”
An alcoholic and homeless patient is diagnosed with active tuberculosis (TB). Which intervention by the nurse will be most effective in ensuring adherence with the treatment regimen?
Arrange for a friend to administer the medication on schedule.
Give the patient written instructions about how to take the medications.
Teach the patient about the high risk for infecting others unless treatment is followed.
Arrange for a daily noon meal at a community center where the drug will be administered.
After 2 months of tuberculosis (TB) treatment with isoniazid (INH), rifampin (Rifadin), pyrazinamide (PZA), and ethambutol, a patient continues to have positive sputum smears for acid-fast bacilli (AFB). Which action should the nurse take next?
Teach about treatment for drug-resistant TB treatment.
Ask the patient whether medications have been taken as directed.
Schedule the patient for directly observed therapy three times weekly.
Discuss with the health care provider the need for the patient to use an injectable antibiotic.
Employee health test results reveal a tuberculosis (TB) skin test of 16-mm induration and a negative chest x-ray for a staff nurse working on the pulmonary unit. The nurse has no symptoms of TB. Which information should the occupational health nurse plan to teach the staff nurse?
Standard four-drug therapy for TB
Need for annual repeat TB skin testing
Use and side effects of isoniazid (INH)
Bacille Calmette-Guérin (BCG) vaccine
A lobectomy is scheduled for a patient with stage I non–small cell lung cancer. The patient tells the nurse, “I would rather have chemotherapy than surgery.” Which response by the nurse is most appropriate?
“Are you afraid that the surgery will be very painful?”
“Did you have bad experiences with previous surgeries?”
“Surgery is the treatment of choice for stage I lung cancer.”
“Tell me what you know about the various treatments available.”
A patient with a pleural effusion is scheduled for a thoracentesis. Which action should the nurse take to prepare the patient for the procedure?
Start a peripheral IV line to administer the necessary sedative drugs.
Position the patient sitting upright on the edge of the bed and leaning forward.
Obtain a large collection device to hold 2 to 3 liters of pleural fluid at one time.
Remove the water pitcher and remind the patient not to eat or drink anything for 6 hours.
A patient has just been admitted with probable bacterial pneumonia and sepsis. Which order should the nurse implement first?
Chest x-ray via stretcher
Blood cultures from two sites
Ciprofloxacin (Cipro) 400 mg IV
Acetaminophen (Tylenol) rectal suppository
31. The nurse cares for a patient who has just had a thoracentesis. Which assessment information obtained by the nurse is a priority to communicate to the health care provider?
Oxygen saturation is 88%.
Blood pressure is 145/90 mm Hg.
Respiratory rate is 22 breaths/minute when lying flat.
Pain level is 6 (on 0 to 10 scale) with a deep breath.
A patient who has just been admitted with community-acquired pneumococcal pneumonia has a temperature of 101.6° F with a frequent cough and is complaining of severe pleuritic chest pain. Which prescribed medication should the nurse give first?
Codeine
Guaifenesin (Robitussin)
Acetaminophen (Tylenol)
Piperacillin/tazobactam (Zosyn)
A patient is diagnosed with both human immunodeficiency virus (HIV) and active tuberculosis (TB) x. Which information obtained by the nurse is most important to communicate to the health care provider?
The Mantoux test had an induration of 7 mm.
The chest-x-ray showed infiltrates in the lower lobes.
The patient is being treated with antiretrovirals for HIV infection.
The patient has a cough that is productive of blood-tinged mucus.
38. The nurse is performing tuberculosis (TB) skin tests in a clinic that has many patients who have immigrated to the United States. Which question is most important for the nurse to ask before the skin test?
“Is there any family history of TB?”
“How long have you lived in the United States?”
“Do you take any over-the-counter (OTC) medications?”
“Have you received the bacille Calmette-Guérin (BCG) vaccine for TB?”
The nurse notes that a patient has incisional pain, a poor cough effort, and scattered rhonchi after a thoracotomy. Which action should the nurse take first?
Assist the patient to sit upright in a chair.
Splint the patient’s chest during coughing.
Medicate the patient with prescribed morphine.
Observe the patient use the incentive spirometer.
The nurse teaches a patient about pursed lip breathing. Which action by the patient would indicate to the nurse that further teaching is needed?
The patient inhales slowly through the nose.
The patient puffs up the cheeks while exhaling.
The patient practices by blowing through a straw.
The patient’s ratio of inhalation to exhalation is 1:3.
Which finding by the nurse for a patient with a nursing diagnosis of impaired gas exchange will be most useful in evaluating the effectiveness of treatment?
Even, unlabored respirations
Pulse oximetry reading of 92%
Respiratory rate of 18 breaths/minute
Absence of wheezes, rhonchi, or crackles
The nurse develops a teaching plan to help increase activity tolerance at home for an older adult with severe chronic obstructive pulmonary disease (COPD). Which instructions would be most appropriate for the nurse to include in the plan of care?
Stop exercising when short of breath.
Walk until pulse rate exceeds 130 beats/minute.
Limit exercise to activities of daily living (ADLs).
Walk 15 to 20 minutes daily at least 3 times/week.
The nurse provides dietary teaching for a patient with chronic obstructive pulmonary disease (COPD) who has a low body mass index (BMI). Which patient statement indicates that the teaching has been effective?
“I will drink lots of fluids with my meals.”
“I can have ice cream as a snack every day.”
“I will exercise for 15 minutes before meals.”
“I will decrease my intake of meat and poultry.”
The nurse assesses a patient with a history of asthma. Which assessment finding indicates that the nurse should take immediate action?
Pulse oximetry reading of 91%
Respiratory rate of 26 breaths/minute
Use of accessory muscles in breathing
Peak expiratory flow rate of 240 L/minute
The nurse in the emergency department receives arterial blood gas results for four recently admitted patients with obstructive pulmonary disease. Which patient will require the most rapid action by the nurse?
22-year-old with ABG results: pH 7.28, PaCO2 60 mm Hg, and PaO2 58 mm Hg
34-year-old with ABG results: pH 7.48, PaCO2 30 mm Hg, and PaO2 65 mm Hg
45-year-old with ABG results: pH 7.34, PaCO2 33 mm Hg, and PaO2 80 mm Hg
65-year-old with ABG results: pH 7.31, PaCO2 58 mm Hg, and PaO2 64 mm Hg
The nurse receives a change-of-shift report on the following patients with chronic obstructive pulmonary disease (COPD). Which patient should the nurse assess first?
A patient with loud expiratory wheezes
A patient with a respiratory rate of 38/minute
A patient who has a cough productive of thick, green mucus
A patient with jugular venous distention and peripheral edema
The nurse is caring for an older adult who reports experiencing frequent asthma attacks and severe arthritic pain. What action by the nurse is most appropriate?
Review pulmonary function test results.
Assess use of medication for arthritis.
Assess frequency of bronchodilator use.
Review arterial blood gas results.
The nurse is evaluating a client’s response to medication therapy for asthma. The client has a peak flowmeter reading in the yellow zone. What does the nurse do next?
Nothing; this is an acceptable range.
Teach the client to take deeper breaths.
Assist the client to use a rescue inhaler.
Assess the client’s lungs.
Which statement indicates that a client understands teaching about the correct use of a corticosteroid medication?
“This drug can reverse my symptoms during an asthma attack.”
“This drug is effective in decreasing the frequency of my asthma attacks.”
“This drug can be used most effectively as a rescue agent.”
“This drug can be used safely on a long-term basis for multiple applications daily.”
The nurse assesses a client receiving chemotherapy for lung cancer and notes red swollen mucous membranes and open sores in the mouth. The client reports mouth pain and difficulty swallowing. Which action does the nurse perform first?
Document the size of the sores.
Perform mouth hygiene.
Have the client rinse his or her mouth.
Call the health care provider and hold chemotherapy.
A client is undergoing radiation therapy as treatment for lung cancer and has developed esophagitis. Which is the best diet selection for this client?
Spaghetti with meat sauce, ice cream
Scrambled eggs, bacon, toast
Omelet, whole wheat bread
Pasta salad, custard, orange juice
A client with lung cancer refuses pain medications because he or she is “afraid of addiction.” What is the nurse’s best response?
“I can ask the physician to change your medication to a drug that is less potent.”
“I can use other measures such as music therapy to distract you.”
“It is unlikely you will become addicted from taking medicine for pain.”
“I can just give you aspirin or acetaminophen (Tylenol) if you like.”
Which statement indicates that a client needs additional teaching about using an inhaler?
“I will not exhale into the inhaler.”
“I will store the inhaler in a drawer in my bedroom.”
“I will soak my inhaler in water to clean it.”
“I will inhale and hold my breath.”
The nurse is teaching a client about different medications for asthma. Which medication does the nurse teach the client to administer to control the prolonged inflammatory response?
Diphenhydramine (Benadryl)
Montelukast (Singulair)
Aspirin
Bitolterol (Tornalate)
A client with chronic obstructive pulmonary disease (COPD) reports social isolation. What does the nurse encourage the client to do?
Join a support group for people with COPD.
Ask the client’s physician for an antianxiety agent.
Verbalize his or her thoughts and feelings.
Participate in community activities.
What information about nutrition does the nurse teach a client with chronic obstructive pulmonary disease (COPD)? (
“Avoid drinking fluids just before and during meals.”
“Rest before meals if you have dyspnea.”
“Have about six small meals a day.”
“Eat dry foods rather than wet foods, which are heavier.”
“Increase carbohydrate intake for energy.”
A client who is immune compromised develops muscle aches and fever. The client is admitted to the hospital for several days and is diagnosed with influenza. At discharge, the client asks when he can go back to work. What is the nurse’s best response?
“You should be able to return to work in 5 days.”
“You can return to work as soon as you feel ready.”
“You cannot return to work for several weeks.”
“You will need to have cultures performed before returning to work.”
The nurse assesses a client with pneumonia and notes decreased lung sounds on the left side and decreased lung expansion. What is the nurse’s best action?
Have the client cough and deep breathe.
Check oxygen saturation and notify the health care provider.
Perform an arterial blood gas analysis.
Increase oxygen flow to 10 L/min.
The nurse is teaching a client with pneumonia ways to clear secretions. Which intervention is the most effective?
Administering an antitussive medication
Administering an antiemetic medication
Increasing fluids to 2 L/day if tolerated
Having the client cough and deep breathe hourly
A client has multidrug-resistant tuberculosis (TB). What is the most important fact for the nurse to teach the client?
“You will need to take medications longer than clients with other strains.”
“You will need to remain in the hospital until cultures are negative.”
“You will need to wear a mask when you go out in public.”
“You will need to have drug cultures done weekly.”
A client is admitted with left lower lung pneumonia. Which assessment finding does the nurse correlate with this condition?
Expiratory wheeze on the right side
Dullness to percussion on the lower left side
Crepitus of the skin around the left lung
Crackles heard on expiration bilaterally
A client who previously had a bacillus Calmette-Guérin (BCG) vaccine has a positive tuberculosis (TB) test. What symptoms assist in determining that the client has active disease? (Select all that apply.)
nausea
weight loss
insomnia
night sweats
increased urination
A client develops epistaxis. Which conditions in the client’s history could have contributed to this problem? (Select all that apply.)
diabetes mellitus
hypertension
leukemia
cocaine use
high cholesterol
A nurse obtains a health history from a patient who has a 35 pack-year smoking history. The patient complains of hoarseness and tightness in the throat and difficulty swallowing. Which question is most important for the nurse to ask?
“How much alcohol do you drink in an average week?”
“Do you have a family history of head or neck cancer?”
“Have you had frequent streptococcal throat infections?”
“Do you use antihistamines for upper airway congestion?”
Which action should the nurse take first when a patient develops a nosebleed?
Pinch the lower portion of the nose for 10 minutes.
Pack the affected nare tightly with an epistaxis balloon.
Obtain silver nitrate that will be needed for cauterization.
Apply ice compresses over the patient’s nose and cheeks.
The nurse obtains the following assessment data on an older patient who has influenza. Which information will be most important for the nurse to communicate to the health care provider?
Fever of 100.4° F (38° C)
Diffuse crackles in the lungs
Sore throat and frequent cough
Myalgia and persistent headache
The nurse is reviewing the medical records for five patients who are scheduled for their yearly physical examinations in September. Which patients should receive the inactivated influenza vaccination (select all that apply)?
A 76-year-old nursing home resident
A 36-year-old female patient who is pregnant
A 42-year-old patient who has a 15 pack-year smoking history
A 30-year-old patient who takes corticosteroids for rheumatoid arthritis
A 24-year-old patient who has allergies to penicillin and cephalosporins
