WorksheetsMed-Surg 2 Exam 2
Total questions: 40
Worksheet time: 40mins
A critical-care nurse is caring for a patient diagnosed with pneumonia as a surgical complication. The nurse's assessment reveals that the patient has an increased work of breathing due to copious tracheobronchial secretions.
Increase oral fluids unless contraindicated.
Call the nurse for oral suctioning, as needed.
Lie in a low Fowlers or supine position.
Increase activity.
A hospital has been the site of an increased incidence of hospital-acquired pneumonia (HAP). What is an important measure for the prevention of HAP?
Administration of prophylactic antibiotics
Administration of pneumococcal vaccine to vulnerable individuals
Obtaining culture and sensitivity swabs from all newly admitted patients
Administration of antiretroviral medications to patients over age 65
The nurse is caring for a patient who is receiving oxygen therapy for pneumonia. How should the nurse best assess whether the patient is hypoxemic?
Assess the patients level of consciousness (LOC).
Assess the patients extremities for signs of cyanosis
Assess the patients oxygen saturation level.
Review the patients hemoglobin, hematocrit, and red blood cell levels
Agerontologic nurse is teaching a group of medical nurses about the high incidence and mortality of pneumonia in older adults. What is a contributing factor to this that the nurse should describe?
Older adults have less compliant lung tissue than younger adults.
Older adults are not normally candidates for pneumococcal vaccination.
Older adults often lack the classic signs and symptoms of pneumonia.
Older adults often cannot tolerate the most common antibiotics used to treat pneumonia
The nurse is reviewing the electronic health record of a patient with an empyema. What health problem in the patients history is most likely to have caused the empyema?
Smoking
Asbestosis
Pneumonia
Lung cancer
While assessing a patient who has pneumonia, the nurse has the patient repeat the letter E while the nurses auscultates. The nurse notes that the patients voice sounds are distorted and that the letter A is audible instead of the letter E. How should this finding be documented?
Bronchophony
Egophony
Whispered pectoriloquy
Sonorous wheezes
A school nurse is caring for a 10-year-old girl who is having an asthma attack. What is the preferred intervention to alleviate this clients airflow obstruction?
Administer corticosteroids by metered dose inhaler
Administer inhaled anticholinergics
Administer an inhaled beta-adrenergic agonist
Utilize a peak flow monitoring device
Astudent nurse is developing a teaching plan for an adult patient with asthma. Which teaching point should have the highest priority in the plan of care that the student is developing?
Gradually increase levels of physical exertion
Change filters on heaters and air conditioners frequently.
Take prescribed medications as scheduled
Avoid goose-down pillows.
Anurse is completing a focused respiratory assessment of a child with asthma. What assessment finding is most closely associated with the characteristic signs and symptoms of asthma?
Shallow respirations
Increased anterior-posterior (A-P) diameter
Bilateral wheezes
Bradypnea
A nurse is assessing a client who has a history of asthma. Which of the following factors should the nurse identify as a risk for asthma?
Sex
Environmental allergies
Alcohol use
History of diabetes
The nurse is caring for a patient with status asthmaticus in the intensive care unit (ICU). Which blood gas analysis related to hyperventilation does the nurse observe with this patient?
Metabolic acidosis
Metabolic alkalosis
Respiratory Acidosis
Respiratory alkalosis
A patient is being treated for status asthmaticus. Which arterial blood gas analysis does the nurse evaluate that can indicate impending respiratory failure?
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
A patients severe asthma has necessitated the use of a long-acting beta2-agonist (LABA). Which of the patients statements suggests a need for further education?
I know that these drugs can sometimes make my heart beat faster
Ive heard that this drug is particularly good at preventing asthma attacks during exercise.
Ill make sure to use this each time I feel an asthma attack coming on.
Ive heard that this drug sometimes gets less effective over time
Anurse is working with a child who is undergoing a diagnostic workup for suspected asthma. What are the signs and symptoms that are consistent with a diagnosis of asthma? Select all that apply
Chest tightness
Crackles
Bradypnea
Wheezing
Cough
Anurse is caring for a patient who has been hospitalized with an acute asthma exacerbation. What drugs should the nurse expect to be ordered for this patient to gain underlying control of persistent asthma?
Rescue inhalers
Anti-inflammatory drugs
Antibiotics
Antitussives
An asthma nurse educator is working with a group of adolescent asthma patients. What intervention is most likely to prevent asthma exacerbations among these patients?
Encouraging patients to carry a corticosteroid rescue inhaler at all times
Educating patients about recognizing and avoiding asthma triggers
Teaching patients to utilize alternative therapies in asthma management
Ensuring that patients keep their immunizations up to date
An asthma educator is teaching a patient newly diagnosed with asthma and her family about the use of a peak flowmeter. The educator should teach the patient that a peak flowmeter measures what value?
Highest airflow during a forced inspiration
Highest airflow during a forced expiration
Airflow during a normal inspiration
Airflow during a normal expiration
A nurse is creating a health promotion intervention focused on chronic obstructive pulmonary disease (COPD). What should the nurse identify as a complication of COPD?
lung cancer
cystic fibrosis
respiratory failure
hemothorax
A clinic nurse is caring for a patient who has just been diagnosed with chronic obstructive pulmonary disease (COPD). The patient asks the nurse what he could have done to minimize the risk of contracting this disease. What would be the nurses best answer?
The most important risk factor for COPD is exposure to occupational toxins
The most important risk factor for COPD is inadequate exercise
The most important risk factor for COPD is exposure to dust and pollen
The most important risk factor for COPD is cigarette smoking.
The nurse is assessing a patient whose respiratory disease in characterized by chronic hyperinflation of the lungs. What would the nurse most likely assess in this patient?
Signs of oxygen toxicity
Chronic chest pain
A barrel chest
Long, thin fingers
A nurse is providing discharge teaching to a client who has COPD and a new prescription for albuterol. Which of the following statements by the client indicates an understanding of the teaching?
"this medication can increase my blood sugar levels"
This medication can decrease my immune response
I can have an increase in my heart rate while taking this medication
I can have mouth sores while taking this medication
Anurse is providing discharge teaching for a client with COPD. When teaching the client about breathing exercises, what should the nurse include in the teaching?
Lie supine to facilitate air entry
Avoid pursed lip breathing
Use diaphragmatic breathing
Use chest breathing
An older adult patient has been diagnosed with COPD. What characteristic of the patients current health status would preclude the safe and effective use of a metered-dose inhaler (MDI)?
The patient has not yet quit smoking
The patient has severe arthritis in her hands
The patient requires both corticosteroids and beta2-agonists
The patient has cataracts.
Anurse is caring for a patient with COPD. The patients medication regimen has been recently changed and the nurse is assessing for therapeutic effect of a new bronchodilator. What assessment parameters suggest a consequent improvement in respiratory status? Select all that apply
Negative sputum culture
Increased viscosity of lung secretions
Increased respiratory rate
Increased expiratory flowrate
Relief of dyspnea
An adult patient has tested positive for tuberculosis (TB). While providing patient teaching, what information should the nurse prioritize?
The importance of adhering closely to the prescribed medication regimen
The fact that the disease is a lifelong, chronic condition that will affect ADLs
The fact that TB is self-limiting, but can take up to 2 years to resolve
The need to work closely with the occupational and physical therapists
The public health nurse is administering Mantoux tests to children who are being registered for kindergarten in the community. How should the nurse administer this test?
Administer intradermal injections into the childrens inner forearms.
Administer intramuscular injections into each childs vastus lateralis.
Administer a subcutaneous injection into each childs umbilical area.
Administer a subcutaneous injection at a 45-degree angle into each childs deltoid.
A nurse is preparing to administer a new prescription for isoniazid (INH) to a light-skinned client who has tuberculosis. The nurse should instruct the client to report which of the followings as an adverse effect of the medication?
You might notice a yellowing of your skin
You might experience pain in your joints
You might notice a tingling of your hands
You might experience a loss of appetite
A home health nurse is teaching a client who has active TB and is following a medication regimen that includes a combination of isoniazid, rifampin, pyrazinamide, and ethambutol. Which of the following statements indicate client understanding? (select all that apply)
I can substitute one medication for another if i run out because they all fight infection
I will wash my hands each time i cough
I will wear a mask when i am in a public area
I am glad i dont have to have any more sputum specimens
I dont need to worry where i go once i start taking my medications
A nurse is caring for a client who is extremely anxious and is hyperventilating. The client's ABG results are pH 7.50, PaCO2 27, and HCO3 25. The nurse should identify that the client has which of the following?
Respiratory acidosis
Metabolic acidosis
Respiratory alkalosis
Metabolic alkalosis
A patient who wears contact lenses is to be placed on rifampin for tuberculosis therapy. Which information will the nurse provide to the patient?
“Only wear your contact lenses during the day and take them out in the evening before bed.
“You should switch to wearing your glasses while taking this medication.”
“The health care provider can give you eye drops to prevent any problems.”
“There are no significant problems with wearing contact lenses.
The nurse assesses a patient for a possible pulmonary embolism. Which frequent sign of pulmonary embolus does the nurse identify on assessment?
Cough
Hemoptysis
Syncope
Tachypnea
The nurse is planning the care for a patient at risk for the development of a pulmonary embolism. Which nursing actions will be included in the care plan? (Select all that apply.)
Encourage a liberal fluid intake.
Assist the patient to do leg elevations above the level of the heart.
Instruct the patient to dangle the legs over the side of the bed for 30 minutes, four times a day.
Use elastic stockings, especially when decreased mobility would promote venous stasis.
Apply a sequential compression device.
The nurse is caring for a patient who is scheduled for a lobectomy for a diagnosis of lung cancer. While assisting with a subclavian vein central line insertion, the nurse notes the clients oxygen saturation rapidly dropping. The patient complains of shortness of breath and becomes tachypneic. The nurse suspects a pneumothorax has developed. Further assessment findings supporting the presence of a pneumothorax include what
Diminished or absent breath sounds on the affected side
Paradoxical chest wall movement with respirations
Sudden loss of consciousness
Muffled heart sounds
An x-ray of a trauma patient reveals rib fractures and the patient is diagnosed with a small flail chest injury. Which intervention should the nurse include in the patients plan of care?
Suction the patients airway secretions.
Immobilize the ribs with an abdominal binder
Prepare the patient for surgery.
Immediately sedate and intubate the patient.
Apatient presents to the ED stating she was in a boating accident about 3 hours ago. Now the patient has complaints of headache, fatigue, and the feeling that he just cant breathe enough. The nurse notes that the patient is restless and tachycardic with an elevated blood pressure. This patient may be in the early stages of what respiratory problem?
Pneumoconiosis
Pleural effusion
Acute respiratory failure
Pneumonia
Apatient who involved in a workplace accident suffered a penetrating wound of the chest that led to acute respiratory failure. What goal of treatment should the care team prioritize when planning this patients care?
Facilitation of long-term intubation
Restoration of adequate gas exchange
Attainment of effective coping
Self-management of oxygen therapy
Apatient is brought to the ED by ambulance after a motor vehicle accident in which the patient received blunt trauma to the chest. The patient is in acute respiratory failure, is intubated, and is transferred to the ICU. What parameters of care should the nurse monitor most closely? Select all that apply
Coping
Level of consciousness
Oral intake
ABGs
Vital signs
Apatient with thoracic trauma is admitted to the ICU. The nurse notes the patients chest and neck are swollen and there is a crackling sensation when palpated. The nurse consequently identifies the presence of subcutaneous emphysema. If this condition becomes severe and threatens airway patency, what intervention is indicated?
A chest tube
A tracheostomy
An endotracheal tube
A feeding tube
Analyze the ABG
pH: 7.50
CO2: 20
HCO3: 15
Respiratory alkalosis
Respiratory acidosis
Metabolic acidosis
Metabolic alkalosis
Analyze the ABG
pH: 7.24
CO2: 60
HCO3: 25
Respiratory alkalosis
Respiratory Acidosis
Metabolic alkalosis
Metabolic acidosis
