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WorksheetsMedications and Care of the Patient With a Respiratory Disorder
Total questions: 80
Worksheet time: 46mins
Which action is the purpose of the cilia?
Warm and moisturize inhaled air.
Sweep debris toward nasal cavity.
Stimulate cough reflex.
Produce mucus.
Which event 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.
A problem for the patient with a new laryngectomy would be feelings of isolation due to being unable to communicate verbally. Which nursing intervention is appropriate?
Complete care quickly.
Provide a pad and pencil or magic slate.
Refrain from conversations with the patient to reduce stress level.
Offer books or jigsaw puzzles for entertainment.
A patient comes to the health nurse at the workplace with epistaxis. The patient reports frequent nosebleeds that have usually been controlled without intervention. Which assessment would be the most helpful after the nurse has stopped the bleeding?
Obtain a blood pressure.
Record the approximate amount of blood lost.
Inquire about a headache.
Record the last episode of epistaxis.
The nurse assessing an 11 year old who is having an asthma attack expects to hear which adventitious sounds
Friction rub.
Expiratory wheezes
Crackles.
Absent breath sounds.
How will the kidneys respond in respiratory acidosis?
Retain bicarbonate to increase the pH.
Excrete more urine to reduce potassium.
Concentrate the urine to conserve circulating fluid in the bloodstream.
Lower the pH by excretion of bicarbonate.
An 83-year-old patient is admitted with a temperature of 102°F (38.8°C), chest pain, and fatigue. Which term describes the infected fluid that the health care provider removes from the pleural cavity?
Emboli
Emphysema
Sputum
Empyema
Which instruction by the nurse is inappropriate for teaching the proper technique for collection of a sputum specimen?
Bring the sputum up from the lungs.
Rinse mouth with water before expectorating in specimen cup.
Collect specimens after meals.
Send specimen to the lab without delay.
When assessing the SaO2 with a pulse oximeter, the nurse will place the oximeter on a finger with which consideration?
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." Which pathology causes this to occur?
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.
Which nursing intervention is for a patient, age 40, who is diagnosed with active tuberculosis?
Place the patient in drainage and secretion precautions.
Place the patient in acid-fast bacillus (AFB) Isolation Precautions.
Maintain the patient in enteric isolation.
Place the patient in any Isolation Precautions.
How should the newly diagnosed patient who has been prescribed isoniazid (INH) for the treatment of active tuberculosis (TB) be advised?
Report redness and swelling of extremities.
Be aware that the therapy is long term.
Monitor renal function every several months.
Rise slowly to avoid dizziness.
The patient has advanced emphysema and reports experiencing dyspnea and fatigue. Which nursing intervention would be appropriate for the patient who is having difficulty with activity tolerance?
Direct patient in vigorous independent ROM.
Allow to exercise until respirations are over 20 breaths/min over baseline.
Plan care to provide optimum rest.
Provide frequent cool showers.
A patient is on postoperative day 2 after undergoing a total hip replacement. The patient suddenly complains of chest pain and is coughing up blood-tinged sputum. Which action should be the nurse’s initial intervention?
Report signs to the charge nurse.
Elevate head of bed and administer oxygen.
Prevent patient from excessive coughing.
Increase IV flow rate.
Activities, such as walking, will have which benefit for the patient with emphysema?
Repair dilated alveoli.
Increase capacity to use oxygen.
Lessen the oxygen needs.
Lessen metabolic oxygen needs.
The patient with long-term emphysema is admitted with a secondary diagnosis of cor pulmonale. Which symptoms will the patient likely exhibit?
Edema of the lower extremities and extended neck veins due to hypertension of the pulmonary circulation.
A dry hacking cough and chest pain due to constriction of the pulmonary vein.
Hypertension and a headache related to pulmonary hypertension.
Unlabored respiration and cyanosis around the mouth.
Which feature is a major advantage of video-assisted thoracoscopic surgery (VATS)?
The surgeon can record entire surgical procedure on a video.
The surgeon can remove tumors of the lung through a small keyhole incision.
The surgeon can x-ray and excise tumor in the same procedure.
The surgeon can avoid the use of a closed chest drainage system after surgery.
In which manner would the nurse examining a patient with pleurisy document a low-pitched grating lung sound?
Sonorous wheeze
Friction rub
Coarse crackles
Crackles
In which way is inspiratory capacity defined?
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 older adult patient with long-term emphysema reports experiencing a sharp pleuritic pain after a severe period of coughing. The patient’s heart rate and respiratory rate have increased. Auscultation reveals no breath sounds on the left side. These are signs and symptoms of which condition?
Pulmonary embolus
Spontaneous pneumothorax
Early signs of unilateral pneumonia
An attack of asthma
Which important precaution should the nurse include when instructing a patient with emphysema on the use of home oxygen?
Use oxygen only when extremely short of breath.
Keep the home oxygen regulator set on 6 L.
Use home oxygen at night while sleeping.
Limit to 1 to 2 L oxygen flow.
The patient who had a bronchoscopy 1 hour ago asks when eating will be possible. 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. Which action is appropriate 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.
In which way 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 decreases breathing efforts.
It increases PACO2.
In which way do leukotriene modifiers reduce the symptoms of asthma?
By drying up mucus
By causing bronchodilation and anti-inflammation effects
By suppressing cough
By liquefying mucus
In which way 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 intervention should the nurse use to keep the chest tubes from becoming occluded?
Irrigate tubes as needed.
Prevent the patient from lying on it.
Loop the tube over the bed rail.
“Milk” the tube frequently.
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%
In which part of the pharynx is the superior portion of the pharynx located?
Nasopharynx
Posteriorpharynx
Oropharynx
Laryngopharynx
Exposure to an asthma trigger can cause which aspect of asthma to occur next?
Inflammatory process in the mast cells of the lungs
Increase in edema and mucus production in the bronchioles
Release of histamine
Narrowing of the airways
The (a) are the structures of the lung in which gas exchange occurs.
The nurse prepares a patient for the procedure of a(n) (a) , which will remove the fluid from around the lung to improve respiration and obtain a specimen.
The nurse explains that the opening between the vocal cords is the (a) .
The nurse recognizes that the (a) reading in an arterial gas report indicates the amount of oxygen dissolved in the plasma.
The nurse explains that the diagnostic test that can scan the chest and the abdomen in less than 30 seconds is the (a) CT scan.
Which is a serious adverse effect of decongestants?
Hypotension
Hypertension
Orbital edema
Facial flushing
Which time should antihistamines be administered?
PRN throughout the day
After contact with an allergen
45 minutes before exposure to an allergen
Once nasal congestion begins
Which effect can result if a patient overuses topical decongestants?
Hypertensive crisis
Allergic reaction
Secondary congestion
Permanent olfactory damage
A patient at sports camp is complaining of itchy and watery eyes, coughing, and sneezing when outdoors. the patient‘s chart states that he has an allergy to grasses. Which medication will the nurse administer?
Antitussive
Expectorant
Antihistamine
Decongestant
Which medication may be given to patients with allergic seasonal rhinitis who do not respond to antihistamines and sympathomimetics?
Leukotrienes
Mineralocorticoids
Corticosteroids
Cortisol
Which physiologic rationale explains what initiates the sneeze reflex?
Stimulation of the vagus nerve
Irritation of the nasal mucosa by foreign particulate matter
Stimulation of the tonsils
Enervation of the olfactory cranial nerve
Which reaction occurs in the nasal structures when cholinergic fibers are stimulated?
Dryness of mucous membranes in the nostrils
Bleeding in the mucous membranes in the nostrils
Production of serous and mucous secretions in the nostrils
Enhanced olfactory perception in the mucous membranes of the nostrils
Which process in the antigen-antibody reaction causes the symptoms of allergies?
Release of antihistamines
Production of antibodies
Suppression of histamine
Release of histamine
Which instruction will the nurse include when teaching a patient with seasonal rhinitis and blocked nasal passages about intranasal corticosteroid therapy?
Clear your nasal passage after administration
Anticipate a therapeutic benefit within 24 hours
Use a decongestant prior to administration
Report nasal burning to your healthcare provider
Which symptom should the nurse prioritize as the most important when assessing a patient being seen for a severe allergic reaction to environmental allergens?
Hypotension
Urticaria
Dyspnea
Rhinorrhea
A college student is being seen at an outpatient clinic with reports of allergic rhinitis and conjunctivitis. Which information will be provided when the health care provider orders fexofenadine (Allegra)?
Fexofenadine (Allegra) is one of the least sedating antihistamines.
Tolerance will not develop.
Antihistamines are more effective if taken after histamine is released.
Histamine release will be prevented by this medication.
Which rationale explains when allergic rhinitis occurs? (Select all that apply.)
Nasal mucosa become inflamed.
Exposure as a result of an allergen produces inflammation.
Histamine is released following allergen exposure.
The weather is cold during the winter.
A person has an initial exposure to an antigen.
Which action(s) is/are true of antihistamines? (Select all that apply.)
Reduce inflammation locally.
Antagonize H1 receptors.
May be administered orally.
Are systemically distributed.
Reduce nasal congestion.
Which information will the nurse include when preparing education for a patient who has developed rebound nasal congestion resulting from use of topical decongestants? (Select all that apply.)
For future topical decongestant use, follow the dosage directions daily. Do not overuse.
Stop the topical decongestant at once.
A decrease in congestion will occur immediately.
Nasal steroid solutions can be used but may take several days to reduce inflammation and congestion.
Use nasal saline spray to moisturize irritated mucosa.
Which patient(s) would be able to take an alpha-adrenergic decongestant safely? (Select all that apply.)
24-year-old woman with allergic rhinitis
18-year-old man with cold symptoms
64-year-old woman with a history of heart disease
70-year-old woman with glaucoma
56-year-old man with prostatic hypertrophy
Which principle(s) will the nurse include in a teaching plan for antihistamine therapy? (Select all that apply.)
It is typical to experience an increase in energy.
Dietary fiber and fluids should be increased.
Do not take with prescription medications unless approved by a physician.
Blurred vision is an expected adverse effect.
Over-the-counter (OTC) medications are safe to use with any currently prescribed prescription medications.
Which topically active aerosol steroids are highly effective for reducing sneezing, nasal itching, stuffiness, and rhinorrhea? (Select all that apply.)
Beclomethasoe (Beconase AQ)
Prednisone (Deltasone)
Fluticasone (Flonase)
Flunisolide (Nasarel)
Budesonide (Rhinocort Aqua)
Which information should be relayed to thepatient when providing counseling on cromolyn sodium (Nasalcrom) nasal spray? (Select all that apply.)
Cromolyn must be taken immediately following exposure to the stimulus.
The patient should blow the nose before nasal instillation.
Therapeutic effects are immediate.
Inhalation will cause coughing.
The maximum is six sprays in each nostril daily.
Which response by the nurse is the best when a patient has questions regarding a recently prescribed antitussive agent?
It will eliminate your cough at night
It will reduce the frequency of your cough
It should be used in the morning
It should be taken before sleep
Which is a common expectorant in over-the-counter medications?
Dextromethorphan
Diphenhydramine
Guaifenesin
Codeine
Which reason is correct for administering sodium chloride to a patient with emphysema?
Increases blood sodium levels
Decreases mucus viscosity
Reduces metabolic needs of the body
Decreases bronchial irritation
Which action will the nurse take when within minutes of the initiation of a nebulizer treatment with a sympathomimetic bronchodilator, the patient turns on their call light and states that they feels ―panicky and their heart is racing?
Reassure the patient this is expected.
Add more diluents to the nebulizer.
Administer a sedative.
Stop treatment and notify the healthcare provider.
Which condition will premedication assessments before the use of anticholinergic bronchodilating agents verify that the patient does not have in their history?
Diabetes
Hypertension
Liver disease
Glaucoma
A patient is seen in the emergency department. the patient had been maintained on theophylline (Theo Dur), and a blood sample reveals the serum theophylline level is subtherapeutic. Which may cause a subtherapeutic serum level?
Cimetidine use
Drug tolerance
Smoking
Overuse of the inhaler
Which action is accurate when referencing zafirlukast (Accolate)?
Dilates the alveolar sacs
Decreases leukotriene release
Inhibits histamine release
Increases viscosity of secretions
Which condition is albuterol (Proventil) used to treat?
Acute bronchospasm
Acute allergies
Nasal congestion
Dyspnea on exertion
Which explanation describes where fluids of the respiratory tract originate?
Specialized mucous glands called goblet cells
Lymph fluid drawn across nasal membranes by osmosis
Specialized beta cells in the islets of Langerhans
Cells that produce aqueous humor
Which structures in the respiratory tract assist in removing foreign bodies such as smoke and bacteria?
Villi
Golgi bodies
Ciliary hairs
Erector pili
The nurse is providing instruction about ipratropium (Atrovent) to a patient with chronic obstructive pulmonary disease (COPD). Which common adverse effect tends to resolve with therapy?
Anxiety
Dry mouth
Tachycardia
Urine retention
An adult patient is admitted for an asthma attack. Which assessment obtained by the nurse would support that albuterol (Proventil) was effective?
Decrease in wheezing present on auscultation
Less dyspnea while positioned in a high Fowler‘s position
Sputum production is clear and watery
Respiratory rate decreased to 38 breaths/min
Which statement by a mother whose child has been diagnosed with asthma indicates a need for further teaching?
I will place the stuffed animals in the freezer overnight.
We will confine our dog to the kitchen area.
I should wash bedding in hot water.
A damp cloth should be used when I dust.
The nurse is providing nutrition information to a patient diagnosed with a lower respiratory tract disease. Which rationale is correct for limiting caffeine?
Caffeine increases the respiratory rate
Caffeine can result in thicker lung secretions.
Caffeine will increase the anxiety response associated with dyspnea.
Caffeine can cause bronchospasm.
Which information provided by the nurse is accurate when teaching a patient with a history of COPD to self-administer tiotropium (Spiriva) by dry powder inhalation?
The medication capsules can be used multiple times.
Press on the canister while inhaling.
Avoid breathing into the mouthpiece.
Wash the device with cold water.
The healthcare provider in an outpatient clinic has prescribed omalizumab (Xolair) to a patient. Which primary outcome will the nurse teach the patient to expect?
Easier expectoration of phlegm
Less frequent asthma exacerbations
Increased moisture of the mucous membranes
Liquefaction of thick secretions
Which number indicates the correct calculation of the pack years when a patient reports smoking one pack of cigarettes per day for the past 20 years?
5
10
20
40
A resident in a long-term care facility diagnosed with COPD has a new medication order for indacaterol. Which information will be included when the nurse is providing medication education to the resident?
It is a short-acting beta antagonist.
The patient should wait approximately 5 minutes between inhalations.
Onset of action is within 5 minutes.
Duration of action is about 12 hours.
Which statement(s) is/are true regarding the nursing assessment of a patient with a respiratory disorder? (Select all that apply.)
Central cyanosis typically is observed on the fingers and earlobes.
Clubbing of the fingernails is a sign of hypoxia.
As oxygen levels diminish, mental alertness will progressively deteriorate.
The normal respiratory rate in an adult is 10 breaths/min.
Episodes of apnea are present in Cheyne-Stokes.
Which statement is true about arterial blood gases (ABGs)? (Select all that apply.)
They are measured from an arterial sample.
They measure partial pressures of carbon dioxide.
They measure blood pH.
They measure partial pressures of sodium.
They measure partial pressures of oxygen.
Which assessments would be most important to include in obtaining the history on an older adult patient with a history of COPD whose diagnosis is pneumonia? (Select all that apply.)
Smoking history and exposure to secondhand smoke
Current medications
Chief complaint and onset of symptoms
Support system
Home oxygen use
Which physical assessment(s) would be pertinent to thepatient with asthma? (Select all that apply.)
Lung sounds
Patient color
Respiratory rate and effort
Peak expiratory flow
Pulse oximetry reading
Which principle(s) would be when teaching a patient to use a steroid inhaler? (Select all that apply.)
Frequent oral hygiene is necessary
The inhaler should be used on a PRN basis only
Rinse and spit after inhalation of the medication
When taking a steroid drug as well as a bronchodilator, the bronchodilator should be administered first
Hold the breath for 10 seconds during inhalation of the medication
Which statement(s) about acetylcysteine is/are true? (Select all that apply.)
It reduces viscosity of secretions.
It treats acetaminophen toxicity.
It is stored at room temperature.
It is given to improve airway flow.
It is administered by inhalation.
Which statement(s) about ipratropium bromide (Atrovent) is/are true? (Select all that apply.)
It is administered by aerosol inhalation.
It relieves nasal congestion.
It decreases mucus secretion
It has minimal effect on ciliary activity.
It may cause tachycardia or urinary retention.
Which instructions will be provided to the patient when administering two inhalations of ipratropium bromide (Atrovent)? (Select all that apply.)
Hold the canister horizontally.
Keep the eyes closed.
Exhale through the mouthpiece.
Wait 15 seconds before the second inhalation.
Shake the canister thoroughly prior to use.
