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WorksheetsOXY/CIRC
Total questions: 80
Worksheet time: 1hrs 20mins
The structure that is responsible for returning oxygenated blood to the heart
Pulmonary Artery
Pulmonary Vein
Superior Vena Cana
Inferior VenaCava
While performing an assessment, the nurse hears crackles in the patient's lung fields. The nurse also learns that the patient is sleeping on three pillows. What do these symptoms most likely indicate
Left-sided heart failure
Right sided heart failure
Atrial Fibrillation
Myocardial Ischemia
Myocardial blood flow is unidirectional; the nurse knows that the correct pathway is which of the following
right atrium, right ventricle, left ventricle, left atrium
right atrium, left atrium, right ventricle, left ventricle
right atrium, right ventricle, left atrium, left ventricle
right atrium, left atrium, left ventricle, right ventricle
A nurse is assisting a patient with ambulation. The patient becomes short of breath and begins to complain of sharp chest pain. Which action by the nurse is the first priority
call for emergency response team to bring the defibrillator
have the patient sit down in the nearest chair
return the patient to the room and apply 100% oxygen
ask a coworker to get the ECG machine STAT
A nonmodifiable risk factor for lung disease is
Allergies
Smoking
Stress
Asbestos Exposure
A nurse assesses a client who is experiencing an acid-base imbalance. The clients arterial blood gas values
are pH 7.34, PaO2 88 mm Hg, PaCO2 38 mm Hg, and HCO3 19 mEq/L. Which assessment should the nurse
perform first?
a. Cardiac rate and rhythm
b. Skin and mucous membranes
c. Musculoskeletal strength
d. Level of orientation
(a)
A nurse assesses a client who is prescribed furosemide (Lasix) for hypertension. For which acid-base
imbalance should the nurse assess to prevent complications of this therapy?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
(a)
A nurse is caring for a client who is experiencing moderate metabolic alkalosis. Which action should the nurse take?
a. Monitor daily hemoglobin and hematocrit values.
b. Administer Furosemide intravenously.
c. Encourage the client to take deep breaths.
d. Teach the client fall prevention measures
(a)
A nurse is assessing a client who has acute pancreatitis and is at risk for an acid-base imbalance. For which
manifestation of this acid-base imbalance should the nurse assess?
a. Agitation
b. Kussmaul respirations
c. Seizures
d. Positive Chvosteks sign
(a)
After teaching a client who was malnourished and is being discharged, a nurse assesses the clients
understanding. Which statement indicates the client correctly understood teaching to decrease risk for the
development of metabolic acidosis?
a. I will drink at least three glasses of milk each day.
b. I will eat three well-balanced meals and a snack daily.
c. I will not take pain medication and antihistamines together.
d. I will avoid salting my food when cooking or during meals.
(a)
A nurse evaluates a clients arterial blood gas values (ABGs): pH 7.30, PaO2 86 mm Hg, PaCO2 55 mm
Hg, and HCO3 22 mEq/L. Which intervention should the nurse implement first?
A. Assess the airway.
B. Administer prescribed bronchodilators.
C. Apply oxygen
D. Give morphine
(a)
A nurse assesses several clients who have a history of asthma. Which client should the nurse assess first?
a. A 66-year-old client with a barrel chest and clubbed fingernails
b. A 48-year-old client with an oxygen saturation level of 92% at rest
c. A 35-year-old client who has a longer expiratory phase than inspiratory phase
d. A 27-year-old client with a heart rate of 120 beats/min
(a)
A nurse cares for a client with arthritis who reports frequent asthma attacks. Which action should the nurse
take first?
a. Review the clients pulmonary function test results.
b. Ask about medications the client is currently taking.
c. Assess how frequently the client uses a bronchodilator.
d. Consult the provider and request arterial blood gases.
(a)
After teaching a client who is prescribed a long-acting beta2 agonist medication, a nurse assesses the clients
understanding. Which statement indicates the client comprehends the teaching?
a. I will carry this medication with me at all times in case I need it.
b. I will take this medication when I start to experience an asthma attack.
c. I will take this medication every morning to help prevent an acute attack.
d. I will be weaned off this medication when I no longer need it.
(a)
After teaching a client who is prescribed salmeterol (Serevent), the nurse assesses the clients understanding. Which statement by the client indicates a need for additional teaching?
a. I will be certain to shake the inhaler well before I use
b. It may take a while before I notice a change in my asthma.
c. I will use the drug when I have an asthma attack.
d. I will be careful not to let the drug escape out of my nose and mouth.
(a)
A nurse is teaching a client who has cystic fibrosis (CF). Which statement should the nurse include in this
clients teaching?
a. Take an antibiotic each day. b. Contact your provider to obtain genetic screening.
b. Contact your provider to obtain genetic screening.
c. Eat a well balanced nutrition diet
d. Plan to exercise for 30 minutes every day
(a)
A nurse assesses a client who is prescribed fluticasone (Flovent) and notes oral lesions. Which action
should the nurse take?
a. Encourage oral rinsing after fluticasone administration.
b. Obtain an oral specimen for culture and sensitivity
c. Start the client on a broad-spectrum antibiotic
d. Document the findings as a known side effect
(a)
A nurse cares for a client who is infected with Burkholderia cepacia. Which action should the nurse take
first when admitting this client to a pulmonary care unit?
a. Instruct the client to wash his or her hands after contact
b. Implement Droplet Precautions and don a surgical mask.
c. Keep the client isolated from other clients with cystic fibrosis.
d. Obtain blood, sputum, and urine culture specimens.
(a)
A nurse cares for a client with a 40-year smoking history who is experiencing distended neck veins and
dependent edema. Which physiologic process should the nurse correlate with this clients history and clinical
manifestations?
a. Increased pulmonary pressure creating a higher workload on the right side of the heart
b. Exposure to irritants resulting in increased inflammation of the bronchi and bronchioles
c. Increased number and size of mucus glands producing large amounts of thick mucus
d. Left ventricular hypertrophy creating a decrease in cardiac output
(a)
A nurse cares for a client with chronic obstructive pulmonary disease (COPD) who appears thin and
disheveled. Which question should the nurse ask first?
a. Do you have a strong support system?
b. What do you understand about your disease?
c. Do you experience shortness of breath with basic activities?
d. What medications are you prescribed to take each day?
(a)
The nurse is caring for a client who is prescribed a long-acting beta2 agonist. The client states, The
medication is too expensive to use every day. I only use my inhaler when I have an attack. How should the
nurse respond?
a. You are using the inhaler incorrectly. This medication should be taken daily.
b. If you decrease environmental stimuli, it will be okay for you to use the inhaler only for asthma attacks.
c. Tell me more about your fears related to feelings of breathlessness.
d. It is important to use this type of inhaler every day. Lets identify potential community services to help you.
(a)
A pulmonary nurse cares for clients who have chronic obstructive pulmonary disease (COPD). Which
client should the nurse assess first?
a. A 46-year-old with a 30pack-year history of smoking
b. A 52-year-old in a tripod position using accessory muscles to breathe
c. A 68-year-old who has dependent edema and clubbed fingers
d. A 74-year-old with a chronic cough and thick, tenacious secretions
(a)
22. A nurse cares for a female client who has a family history of cystic fibrosis. The client asks, Will my
children have cystic fibrosis? How should the nurse respond?
a. Since many of your family members are carriers, your children will also be carriers of the gene.
b. Cystic fibrosis is an autosomal recessive disorder. If you are a carrier, your children will have the disorder.
c. Since you have a family history of cystic fibrosis, I would encourage you and your partner to be tested.
d. Cystic fibrosis is caused by a protein that controls the movement of chloride. Adjusting your diet will
decrease the spread of this disorder.
(a)
A nurse administers medications to a client who has asthma. Which medication classification is paired
correctly with its physiologic response to the medication?
a. Bronchodilator Stabilizes the membranes of mast cells and prevents the release of inflammatory mediators
b. Cholinergic antagonist Causes bronchodilation by inhibiting the parasympathetic nervous system
c. Corticosteroid Relaxes bronchiolar smooth muscles by binding to and activating pulmonary beta2 receptors
d. Cromone Disrupts the production of pathways of inflammatory mediators
(a)
Which of the following people is at GREATEST risk of a pulmonary embolism, all else equal?
A. A person who is sitting still on a 15-hour flight
B. A person who is swimming
C. A person who is sitting on a couch for 30 minutes
D. A person who is out for a jog
(a)
The nurse knows that anemia will result in
a. Hypoxemia.
b. Impaired ventilation.
c. Hypovolemia.
d. Decreased lung compliance.
(a)
Myocardial blood flow is unidirectional; the nurse knows that the correct pathway is which of the following?
Right atrium, right ventricle, left ventricle, left atrium
Right atrium, left atrium, right ventricle, left ventricle
Right atrium, right ventricle, left atrium, left ventricle
Right atrium, left atrium, left ventricle, right ventricle
A nurse is assisting a patient with ambulation. The patient becomes short of breath and begins to complain of sharp chest pain. Which action by the nurse is the first priority?
Call for the emergency response team to bring the defibrillator.
Have the patient sit down in the nearest chair.
Return the patient to the room and apply 100% oxygen.
Ask a coworker to get the ECG machine STAT.
Which of the following ABG abnormalities should the nurse anticipate in a client with advanced COPD?
Increased PaCO2
Increased PaO2
Increased pH
Increased oxygen saturation
The nurse would anticipate which of the following ABG results in a client experiencing a prolonged, severe asthma attack?
Decreased PaCO2, increased PaO2, and decreased pH.
Increased PaCO2, decreased PaO2, and decreased pH.
Increased PaCO2, increased PaO2, and increased pH
Decreased PaCO2, decreased PaO2, and increased pH.
A client with acute asthma is prescribed short-term corticosteroid therapy. What is the rationale for the use of steroids in clients with asthma?
Corticosteroids promote bronchodilation.
Corticosteroids act as an expectorant.
Corticosteroids have an anti-inflammatory effect.
Corticosteroids prevent development of respiratory infections.
The client with asthma should be taught which of the following is one of the mostcommon precipitating factors of an acute asthma attack?
Occupational exposure to toxins.
Viral respiratory infections
Exposure to cigarette smoke
Exercising in cold temperatures.
A cyanotic client with an unknown diagnosis is admitted to the E.R. In relation to oxygen, the first nursing action would be to:
Wait until the client’s lab work is done.
Not administer oxygen unless ordered by the physician.
Administer oxygen at 2 L flow per minute.
Administer oxygen at 10 L flow per minute and check the client’s nail beds.
An elderly client with pneumonia may appear with which of the following symptoms first?
Altered mental status and dehydration
Fever and chills
Hemoptysis and dyspnea
Pleuritic chest pain and cough
The term “blue bloater” refers to which of the following conditions?
Adult respiratory distress syndrome (ARDS)
Asthma
Chronic obstructive bronchitis
Emphysema
The term “pink puffer” refers to the client with which of the following conditions?
ARDS
Asthma
Chronic obstructive bronchitis
Emphysema
The parents of a child with cystic fibrosis ask
what determines the prognosis of the
disease. The nurse knows that the greatest
determinant of the prognosis is:
The degree of pulmonary involvement
The ability to maintain an ideal weight
The secretion of lipase by the
pancreas
The regulation of sodium & cholride
excretion
A 66-year-old client has marked dyspnea at rest, is thin, and uses accessory muscles to breathe. He’s tachypneic, with a prolonged expiratory phase. He has no cough. He leans forward with his arms braced on his knees to support his chest and shoulders for breathing. This client has symptoms of which of the following respiratory disorders?
ARDS
Asthma
Chronic obstructive bronchitis
Emphysema
It’s highly recommended that clients with asthma, chronic bronchitis, and emphysema have Pneumovax and flu vaccinations for which of the following reasons?
All clients are recommended to have these vaccines.
These vaccines produce bronchodilation and improve oxygenation.
Respiratory infections can cause severe hypoxia and possibly death in these clients.
These vaccines help reduce the tachypnea these clients experience.
Clients with chronic obstructive bronchitis are given diuretic therapy. Which of the following reasons best explains why?
Reducing fluid volume reduces oxygen demand.
Reducing fluid volume improves clients’ mobility.
Restricting fluid volume reduces sputum production.
Reducing fluid volume improves respiratory function.
A 69-year-old client appears thin and cachectic. He’s short of breath at rest and his dyspnea increases with the slightest exertion. His breath sounds are diminished even with deep inspiration. These signs and symptoms fit which of the following conditions?
ARDS
Asthma
Chronic obstructive bronchitis
Emphysema
A client’s ABG results are as follows: pH: 7.16; PaCO2 80 mm Hg; PaO2 46 mm Hg; HCO3- 24 mEq/L; SaO2 81%. This ABG result represents which of the following conditions?
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
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?
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
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?
Sodium level of 145 mEq/L
Potassium level of 3.0 mEq/L
Magnesium level of 2.0 mg/L
Phosphorus level of 4.0 mg/dl
Which of the following organisms mostcommonly causes community-acquired pneumonia in adults?
Haemophilus influenzae
Klebsiella pneumoniae
Streptococcus pneumoniae
Staphylococcus aureus
When auscultating the chest of a client with pneumonia, the nurse would expect to hear which of the following sounds over areas of consolidation?
Bronchial
Bronchovesicular
Tubular
Vesicular
A diagnosis of pneumonia is typically achieved by which of the following diagnostic tests?
ABG analysis
Chest x-ray
Blood cultures
Sputum culture and sensitivity
A high level of oxygen exerts which of the following effects on the lung?
Improves oxygen uptake.
Increases carbon dioxide levels.
Stabilizes carbon dioxide levels.
Reduces amount of functional alveolar surface area.
The primary treatment for heart failure (HF) is (a) .
A. Increasing the heart rate so the heart can pump more blood
B. Decreasing the heart rate so the heart can rest C. Increasing contractility so the heart will be able to pump more blood
D. Decreasing contractility to prevent muscle fatigue
Which figure represented ?
Atrial fibrillation
Atrial flutter
Supraventricular tachycardia
Sinus Tachycardia
Which figure is represented ?
Atrial flutter
Atrial fibrillation
Atrial dysrhythmia
Tachycardia
(a)
What rhythm is presented?
(a)
The nurse understands adenosine (Adenocard) is used to treat which condition?
A. Atrial fibrillation
B. Second-degree atrioventricular block
C. Paroxysmal supraventricular tachycardia (PSVT)
D. Atrial flutter
(a)
A client with newly diagnosed heart failure after myocardial infarction calls the clinic to ask about his new medications. Which of the following statements made by the patient concerns the triage nurse?
“I keep nitroglycerin spray with me at all times.”
“I do not like to take my digoxin because it makes me nauseous.”
“I get out of bed very slowly in the morning.”
I take hydrochlorothiazide in the morning with breakfast.”
When auscultating the apical pulse of a client who has atrial fibrillation, the nurse would expect to hear a rhythm that is characterized by:
A. The presence of occasional coupled beats.
B. Long pauses in an otherwise regular rhythm.
C. A continuous and totally unpredictable irregularity.
D. Slow but strong and regular beats.
(a)
A client has developed atrial fibrillation, which has a ventricular rate of 150 beats per minute. A nurse assesses the client for:
A. Hypotension and dizziness
B. Nausea and vomiting
C. Hypertension and headache
D. Flat neck veins
(a)
A client with rapid rate atrial fibrillation asks a nurse why the physician is going to perform carotid massage. The nurse responds that this procedure may stimulate the:
Vagus nerve to slow the heart rate.
Vagus nerve to increase the heart rate; overdriving the rhythm.
Diaphragmatic nerve to slow the heart rate.
Diaphragmatic nerve to overdrive the rhythm.
Which are characteristics of asthma? (Select all that apply.)
Narrowed airway lumen due to inflammation
Increased eosinophils
Decreased breathing cycle
Intermittent bronchospasm
Stimulation of disease process by allergies
A patient who is allergic to dogs experiences a sudden "asthma attack." Which assessment findings does the nurse expect for this patient?
Slow, deep, pursed-lip respirations
Breathlessness and difficulty completing sentences
Clubbing of the fingers and cyanosis of the nailbeds
Bradycardia and irregular pulse
A patient is experiencing an asthma attack and shows an increased respiratory effort. Which arterial blood gas value is more associated with the early phase of the attack?
A. PaCO2 of 60 mmHg
B. PaCO2 of 30 mmHg
C. pH of 7.40
D. PaCO2 of 98 mmHg
(a)
The patient with COPD is taking systemic theophylline. What specific precautions must the nurse use when caring for this patient? (Select all that apply.)
Monitor serum theophylline levels.
Alert the healthcare provider for any abnormal values.
Administer the drug using a metered-dose inhaler (MDI).
Assess the patient for adverse reactions related to a toxic level.
Monitor the patient's heart rate.
A patient with a history of bronchitis for more than 20 years is hospitalized. With this patient's history, what is a potential complication?
Right-sided heart failure
Left-sided heart failure
Renal disease
Stroke
The nurse is interviewing a patient reporting chest discomfort that occurs with moderate to prolonged exertion. The patient describes the pain as being "about the same over the past several months and going away with nitroglycerin or rest." Based on the patient's description of symptoms, what does the nurse suspect in this patient? (SATA)
Chronic stable angina (CSA)
Unstable angina
Acute coronary syndrome (ACS)
Acute myocardial infarction (MI)
Coronary artery disease (CAD)
A patient reports chest pain that is unrelieved with a sublingual nitroglycerin tablet. What does the nurse administer next to this patient?
A. Valium intramuscularly
b. Morphine sulfate IV
c. Supplemental oxygen
d. Chewable aspirin
(a)
Which are characteristics of angina? (SATA)
Pain is precipitated by exertion or stress
Pain occurs without cause, usually in the morning
Pain is relieved only by opioids
Pain is relieved by nitroglycerin or rest
Pain lasts less than 15 minutes
A patient is admitted for acute MI, but the nurse notes that the traditional manifestation of a STEMI is not occurring. What other evidence for acute MI does the nurse expect to find in the patient? (SATA)
Positive troponin markers
Chronic stable angina
non-STEMI on ECG
Cardiac dysrhythmia
Heart failure
The nurse is caring for a patient admitted with unstable angina and elevated lipid levels. What does the nurse include in teaching this patient about his or her elevated lipid levels? (SATA)
Begin a vigorous exercise program
Avoid trans-fatty acids
Reduce intake of saturated fats
Monitor the amount of cholesterol ingested, staying below 200 mg/day
Consider a weight loss program
Which diagnostic tests are used to assess myocardial damage caused by an MI? (SATA)
Creatine kinase (CK) elevation
ECG: ST depression
CK-MB isoenzymes elevation
Troponin I isoenzyme elevation
The ED nurse, caring for a patient with severe chest pain and ECG changes, gives supplemental oxygen to the patient as ordered. Which other medications does the nurse anticipate giving to this patient? (SATA)
IV nitroglycerin
Beta blocker
IV morphine
Oral aspirin
ACE inhibitor
Which drug is given within 1 to 2 hours of an MI when the patient is hemodynamically stable, to help the heart to perform more work without ischemia?
A. Vasodilators, such as sublingual or spray nitroglycerin (NTG)
B. Beta-adrenergic blocking agents, such as metoprolol (Lopressor)
C. Antiplatelet agents, such as clopidogrel (Plavix)
D. Calcium channel blockers, such as diltiazem (Cardizem)
(a)
A patient with angina is taking calcium channel blockers. For which complication does the nurse monitor with this patient?
A. Wheezes
b. Hypotension
c. Bradycardia
d. Forgetfulness
(a)
A patient had CABG surgery with the radial artery used as a graft. The nurse performs which assessment specific to this patient?
Check the blood pressure every hour on the unaffected arm or use the legs
Check the fingertips, hand, and arm for sensation and mobility every shift
Assess hand color, temperature, ulnar/radial pulses, and capillary refill every hour initially
Note edema, bleeding, and swelling at the donor site, which are expected
A client has been treated for a deep vein thrombus and today presents to the clinic with petechiae. Laboratory results show a platelet count of 42,000/mm3. The nurse reviews the clients medication list to determine if the client is taking which drug?
a. Enoxaparin (Lovenox)
b. Salicylates (aspirin)
c. Unfractionated heparin
d. Warfarin (Coumadin)
(a)
A student nurse is assessing the peripheral vascular system of an older adult. What action by the student would cause the faculty member to intervene?
Assessing blood pressure in both upper extremities
Auscultating the carotid arteries for any bruits
Classifying capillary refill of 4 seconds as normal
Palpating both carotid arteries at the same time
The nurse is reviewing the lipid panel of a male client who has atherosclerosis. Which finding is most concerning?
a. Cholesterol: 126 mg/dL
b. High-density lipoprotein cholesterol (HDL-C): 48 mg/dL
c. Low-density lipoprotein cholesterol (LDL-C): 122 mg/dL
d. Triglycerides: 198 mg/dL
(a)
The nurse is caring for four hypertensive clients. Which drug-laboratory value combination should the nurse report immediately to the health care provider?
a. Furosemide (Lasix)/potassium: 2.1 mEq/L
b. Hydrochlorothiazide (Hydrodiuril)/potassium: 4.2 mEq/L
c. Spironolactone (Aldactone)/potassium: 5.1 mEq/L
d. Torsemide (Demadex)/sodium: 142 mEq/L
Furosemide (Lasix)/potassium: 2.1 mEq/L
Hydrochlorothiazide (Hydrodiuril)/potassium: 4.2 mEq/L
Spironolactone (Aldactone)/potassium: 5.1 mEq/L
Torsemide (Demadex)/sodium: 142 mEq/L
An older client with PVD is explaining the daily foot care regimen to the family practices clinic nurse. What statement by the client may indicate a barrier to proper foot care?
a. "I nearly always wear comfy sweatpants and house shoes."
b. "I'm glad I get energy assistance so my house isn't so cold."
c. "My daughter makes sure I have plenty of lotion for my feet."
d. "My hands shake when I try to do things requiring coordination.
(a)
A client with a history of heart failure and hypertension is in the clinic for a follow up visit. The client is on Lisinopril ( Prinvil ) and warfarin ( Coumadin ). The client reports new onset cough. What action by the nurse is most appropriate?
Assess the client's lung sounds and oxygenation.
Instruct the client on another antihypertensive.
Obtain a set of vital signs and document them.
Remind the client that cough is a side effect of Prinivil.
A nurse is caring for a client on IV infusion of heparin. What action does this nurse include in the client's plan of care? SATA
Assess the client for bleeding.
Monitor the daily activated partial thromboplastin time (aPTT) results
Stop the IV for aPTT above baseline.
Use an IV pump for the infusion.
Weigh the client daily on the same scale.
