WorksheetsExam 3 NSG 229 Application Day
Total questions: 24
Worksheet time: 29mins
A nurse is caring for a patient requiring Positive Pressure Ventilation (PPV). The client is fighting the ventilator. Which intervention by the nurse is MOST appropriate?
Place the client in prone position
Notify respiratory therapy & anticipate a ventilator setting change
Prepare to administer aminophylline
Assess the patient for cause of ventilator asynchrony
A nurse hears the low-pressure limit alarm on a client requiring mechanical ventilation. Which action should the nurse take?
Silence the alarm and restart the ventilator
Increase the tidal volume being delivered to the client
Check the ventilator tubing for disconnections
Allow patient to stop coughing and auscultate lung sounds
Which of the following statement accurately describes positive-end-expiratory-pressure?
Used to prevent lung damage for a client being mechanically ventilated
The maximal pressure the ventilator can generate to deliver the tidal volume
Prevents alveolar collapse and restores previously collapsed alevoli
Provides pressure during spontaneous inspiration
Which of the following statements regarding chest tube drainage systems are true? Select All That Apply.
A small amount of subcutaneous emphysema at the insertion stie is normal immediately following tube insertion
The drainage system should remain on the bedside table to avoid overturning
Bubbling in the water-seal changer is expected
The amount of suction is always controlled by the wall suction settings
Tidaling will gradually stop when the lung re-expands
A patient with a chest tube has had an accidental disconnection. Which of the following action is considered priority?
Clamp the drainage tube
Place the distal end of tube in sterile water
Replace the drainage system
Lay patient flat and assist them onto their left side
The classic sign of flail chest is (a)
A patient is being seen in the emergency department for a penetrating chest wound. Which of the following actions is contraindicated?
Stabilize the foreign object
If tolerated, place patient in semi-fowlers position to assist with breathing
Remove the foreign object and place an occlusive dressing over wound
Assess for life-threatening injuries
What size syringe should the nurse use when administering medications via central venous access devices?
(a)
Which information will the nurse include in the teaching plan for a patient newly diagnosed with asthma?
Ipratropium is a 1st line medication for use in long-term treatment
How to complete a peak flow & use results to guide treatment
Inhale slowly and deeply when using a dry powder inhaler (DPI)
Hold your breath for 5 seconds after using bronchodilator inhaler
The nurse is completing an admission history on a patient with asthma how has new onset wheezing and shortness of breath. Which information may indicate a need for changes to therapy?
The patient has chronic inflammatory bowel disease
The patient has a history of pneumonia 6 months ago
The patient takes propranolol for hypertension
The patient takes acetaminophen for headaches
Interventions used in managing patients with Acute Respiratory Distress Syndrome (ARDS) include which of the following? Select All That Apply.
IV injection of surfactant
Aggressive IV fluid resuscitation
Giving adequate sedation and analgesia
Elevate the head of bed 30-45 degrees
Monitoring hemodynamic parameters and obtaining daily weights
All of the following are considered appropriate education topics for a patient with asthma except which?
Pursed Lip Breathing
Avoidance of known triggers
Peak flow meter readings weekly at home
Development of asthma action plan
Which statement is true regarding oxygen delivery to a patient with COPD
Minimize oxygen delivery because it will decrease patient's drive to breathe
Provide supplemental oxygen to maintain acceptable SaO2 levels
Venturi masks and ventilators are never used in patients with COPD because they are high flow systems
COPD patients should never receive more than 2LPM via nasal canula of oxygen
A client participating in community health class about COPD asks why "lip breathing" is important. The nurse should respond by explaining that pursed lip breathing can help to
Reduced upper airway inflammation
Reduce Anxiety
Strengthen respiratory muscles and keep alveoli open
Increase lung residual capacity
Which of the following are adverse side effects of beta 2 adrenergic agonists? Select All That Apply
bradycardia
tremors
dysrrythmias
headache
sweating
Which of the following diagnostic findings are expected in a patient with advanced COPD? Select All That Apply
pH 7.32
PaO2 90
PaCO2 58
flattened diaphragm and hyperinflated lungs on xray
Decreased residual lung capacity
Which of the following statement(s) are true regarding tension pneumothorax? Select All That Apply
Caused by air entering the pleural space that cannot escape
Occurs from blebs on surface of the lung ruputuring
Is considered a medical emergency
Treatment is needle decompression and chest tube placement
tracheal deviation & mediastinal shift away from affected side
What is the classic sign of Acute Respiratory Distress Syndrome (ARDS)?
(a)
All of the following are considered complications related to COPD except which?
Right-sided heart failure
cor pulmonale
pulmonary hypertension
Shunting
Inhalers
Excellent for those with decreased hand dexterity
Spacers should be used
Shake inhaler before use
Breathe slowly and deeply
Breathe in deeply and quickly
Keep in an area that is not high humidity
Rinse the mouthpiece in warm water and dry overnight
Pharmacology
albuterol
formoterol
fluticasone
ipratropium
Use caution in patients with cardiac disorders due to CNS stimulation
Not used for rapid relief of dyspnea
1st line medication in tx and prevention of asthma attacks
blocks action of acetylcholine in bronchial smooth muscle
Order: NS 1750mL @ 125mL/hr. How many hours will it take to infuse the total volume?
(a)
Order: 60mg furosemide IV push
Available: 100mg/10mL
(a)
A 1 liter infusion is started at 1830. The pump is running at 50mL/hr. When will the infusion be complete? Answer using military time
(a)
