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WorksheetsRespiratory Assessment and Interpretation Quiz
Total questions: 51
Worksheet time: 26mins
A client with congestive heart failure is receiving Furosemide IV, Lisinopril, and Digoxin. Based on the provided lab values (Na+ 130 mEq/L, K+ 3.3 mEq/L, BUN 32 mg/dL, Creatinine 1.6 mg/dL), which complication should the nurse most strategically monitor for?
Hyperkalemia
Hyponatremia and renal dysfunction
Hypotension only
Hypernatremia
Which nursing actions are appropriate when caring for a client receiving IV potassium chloride? (Select all that apply.)
Administer prescribed IV potassium chloride slowly via infusion pump
Place client on cardiac monitor
Encourage foods rich in magnesium (leafy greens, nuts)
Hold calcium supplement
A provider prescribes potassium chloride 20 mEq in 100 mL NS over 1 hour. What should the nurse do if IV infiltration occurs?
Stop infusion immediately and notify provider.
Continue infusion and monitor for changes.
Apply a warm compress and continue infusion.
Increase the infusion rate to flush the IV site.
A 22-year-old patient with epilepsy arrives postictal and unresponsive after a tonic-clonic seizure lasting more than 5 minutes. His vital signs are BP 140/88, HR 128, RR 8, and SpO₂ 84% on room air. Which finding is most critical to address immediately, and why?
Low blood pressure due to risk of shock
High heart rate due to risk of arrhythmia
RR 8 and SpO₂ 84% due to airway compromise
Unresponsiveness due to risk of aspiration
A nurse is caring for a patient experiencing an active seizure. Which combination of nursing actions demonstrates strategic planning to maintain patient safety and airway patency? (Select all that apply.)
Maintain airway patency, turn client to side position, loosen restrictive clothing, have suction equipment ready
Insert oral airway during seizure, restrain patient, administer oxygen, keep patient supine
Turn client to prone position, apply restraints, monitor vital signs, administer fluids
Loosen clothing, keep patient supine, administer sedatives, monitor blood pressure
Which problem is the nurse’s highest priority in a patient with elevated BUN, creatinine, and gentamicin trough?
Acute kidney injury due to drug toxicity
Hypertension due to fluid overload
Hyperkalemia due to diet
Dehydration due to vomiting
The provider discontinues gentamicin and orders IV fluids. Which fluid best supports renal perfusion?
0.9% Normal Saline
Dextrose 5% in Water
Lactated Ringer's Solution
0.45% Normal Saline
Which medication regimen should the nurse anticipate for a client diagnosed with tuberculosis?
RIPE therapy: Rifampin, Isoniazid, Pyrazinamide, Ethambutol
Penicillin, Amoxicillin, Azithromycin, Ceftriaxone
Metronidazole, Ciprofloxacin, Doxycycline, Clindamycin
Vancomycin, Gentamicin, Linezolid, Meropenem
After chest tube placement, which observation best demonstrates effective chest tube drainage and lung re-expansion?
No air leak, drainage less than 100 mL in 24 hours, lungs re-expanded
Continuous bubbling in the water-seal chamber, drainage over 200 mL in 24 hours, diminished breath sounds
Intermittent bubbling, drainage less than 50 mL in 24 hours, persistent cough
No drainage, lungs not re-expanded, patient cyanotic
A client’s blood glucose (BG) is 200 mg/dL. According to an insulin sliding scale order of 4 units for glucose 180-220 mg/dL, what is the most appropriate action?
Administer 4 units regular insulin.
Administer 2 units regular insulin.
Administer 6 units regular insulin.
Withhold insulin and monitor BG.
A client weighing 70 kg is prescribed phenytoin IV at 15 mg/kg. What is the correct total dose to administer, and what reasoning supports your calculation?
1,050 mg; because 15 mg/kg × 70 kg = 1,050 mg.
1,000 mg; because 15 mg/kg × 70 kg = 1,000 mg.
950 mg; because 15 mg/kg × 70 kg = 950 mg.
1,200 mg; because 15 mg/kg × 70 kg = 1,200 mg.
A client is prescribed 0.12 g Coreg PO. The available tablets are 60 mg each. How many tablets should you administer, and what is your calculation process?
2 tablets; because 0.12 g = 120 mg, and 120 mg ÷ 60 mg/tablet = 2 tablets.
1 tablet; because 0.12 g = 120 mg, and 120 mg ÷ 60 mg/tablet = 1 tablet.
3 tablets; because 0.12 g = 120 mg, and 120 mg ÷ 40 mg/tablet = 3 tablets.
4 tablets; because 0.12 g = 120 mg, and 120 mg ÷ 30 mg/tablet = 4 tablets.
Given a cystic fibrosis patient with a confirmed bacterial infection, which pathogen should be suspected and what is the strategic rationale for targeted therapy?
Streptococcus pneumoniae; treat with broad-spectrum antibiotics
Pseudomonas aeruginosa; confirm infection and use specific antibiotics
Staphylococcus aureus; treat with antiviral agents
Escherichia coli; use antifungal therapy
A patient with fluid volume excess/congestive heart failure (FVE/CHF) presents with crackles, weight gain, jugular venous distention (JVD), and pitting edema. Using strategic reasoning, explain why these findings occur and what underlying physiological process is responsible.
These findings are due to fluid redistribution and sodium/water retention.
These findings are caused by increased oxygenation in the lungs.
These findings result from decreased cardiac output only.
These findings are due to excessive potassium loss.
A patient is prescribed furosemide for heart failure. Before starting therapy, the potassium level is found to be 3.3 mEq/L. Strategically analyze why it is important to correct potassium before administering furosemide and what risk is associated if not corrected.
Furosemide can worsen hypokalemia, increasing arrhythmia risk.
Furosemide can cause hypernatremia, increasing seizure risk.
Furosemide can improve potassium levels, reducing arrhythmia risk.
Furosemide has no effect on potassium or arrhythmia risk.
After diuretic therapy, a patient with heart failure has clearer lungs and less edema. Strategically reason what this indicates about the effectiveness of the treatment.
Successful diuresis and improved gas exchange.
Worsening heart failure and decreased oxygenation.
Increased fluid overload and pulmonary congestion.
No change in patient status.
A patient presents with neuro changes such as confusion. Strategically reason which electrolyte imbalance is most likely and the underlying mechanism.
Hyponatremia, due to cerebral swelling from low sodium.
Hyperkalemia, due to increased neuronal activity.
Hypercalcemia, due to decreased neuronal activity.
Hypomagnesemia, due to increased muscle excitability.
When replacing potassium intravenously in a patient with hypokalemia, what strategic steps must be taken to ensure safety and effectiveness, and what should be avoided?
Use IV KCl via pump, cardiac monitor, Mg-rich foods, hold calcium supplement; avoid worsening hypercalcemia and hypotonic fluids.
Use IV KCl via gravity, increase calcium supplement, avoid cardiac monitoring.
Use oral potassium only, increase hypotonic fluids, avoid magnesium-rich foods.
Use IV KCl via pump, increase calcium supplement, avoid cardiac monitoring.
During post-thoracentesis care, you notice continuous bubbling in the water seal chamber of the chest drainage system. What strategic steps should you take, and what does this finding indicate about the location of the air leak?
Investigate for a leak distal to the patient and ensure all connections are secure.
Ignore the bubbling as it is always normal.
Remove the chest tube immediately.
Increase suction pressure without further assessment.
After tonsillectomy, a patient is frequently swallowing and clearing their throat silently. What strategic reasoning should guide your assessment and intervention, and what is the underlying concern?
Suspect silent oropharyngeal hemorrhage and monitor for signs of bleeding.
Ignore the behavior as it is normal post-surgery.
Encourage more swallowing to clear the throat.
Administer pain medication only.
A medication order requires you to infuse 50 mL over 0.5 hours. What is the correct infusion rate in mL/hr, and how do you determine it?
100 mL/hr; Volume divided by time in hours.
25 mL/hr; Volume divided by two.
50 mL/hr; Volume equals rate.
200 mL/hr; Double the volume for safety.
A prescription calls for 0.12 g of a medication, and each tablet contains 60 mg. How many tablets should you administer, and what is the correct conversion process?
2 tablets; Convert grams to mg, then mg to tablets.
1 tablet; Use the closest whole number.
3 tablets; Always round up.
0.5 tablet; Divide the dose for safety.
What is the most important initial intervention for a patient presenting with fluid overload and pitting edema due to congestive heart failure?
Provide potassium supplements to prevent cramps
Encourage bed rest to reduce cardiac workload
Increase oral fluid intake to dilute sodium
Administer IV diuretics to promote fluid removal
When caring for a patient after chest tube placement, which sign indicates a possible complication requiring immediate intervention?
Sudden increase in drainage and persistent air leak
Intermittent bubbling with stable vital signs
Drainage less than 50 mL in 24 hours and no air leak
No drainage and clear breath sounds
Which laboratory value should be closely monitored in a patient receiving loop diuretics for heart failure, and why is this important?
Chloride, because loop diuretics cause hyperchloremia.
Magnesium, because loop diuretics increase magnesium levels.
Calcium, because loop diuretics cause hypercalcemia.
Potassium, because loop diuretics can cause hypokalemia and increase arrhythmia risk.
A patient with congestive heart failure is started on IV furosemide. Which assessment finding would indicate a potential complication from this therapy?
Muscle weakness and irregular heart rhythm due to hypokalemia.
Increased blood pressure due to fluid retention.
Improved urine output and stable electrolytes.
Bradycardia due to hyperkalemia.
When administering intravenous magnesium sulfate for hypomagnesemia, what safety precautions should be taken, and what should be avoided?
Use oral magnesium only, increase hypotonic fluids, avoid monitoring reflexes.
Use IV pump, increase calcium supplement, avoid monitoring vital signs.
Use gravity infusion, increase potassium supplement, avoid cardiac monitoring.
Use IV pump, monitor deep tendon reflexes, cardiac monitor, avoid rapid infusion.
Which clinical sign would most likely indicate worsening fluid overload in a patient with congestive heart failure?
Increasing crackles and shortness of breath
Improved exercise tolerance and clear lung sounds
Decreased urine output and dry mucous membranes
Stable weight and no peripheral edema
What is the primary reason for monitoring serum creatinine in a patient receiving nephrotoxic antibiotics?
To monitor for electrolyte imbalances
To evaluate liver function
To check for anemia
To assess for potential kidney injury
When administering IV potassium chloride, which action is most important to prevent complications?
Infuse slowly using a pump and monitor cardiac rhythm
Administer as a rapid IV push for quick correction
Mix with dextrose and infuse by gravity
Give IM injection for faster absorption
After chest tube placement, which finding requires immediate intervention by the nurse?
Sudden cessation of drainage and increased respiratory distress
Intermittent bubbling in the water-seal chamber
Drainage less than 80 mL in 24 hours
Clear breath sounds and stable vital signs
A patient with heart failure is prescribed IV bumetanide. Which laboratory value should be monitored most closely, and what is the rationale?
Platelets, because bumetanide causes thrombocytopenia.
Glucose, because bumetanide increases blood sugar.
Potassium, because bumetanide can cause hypokalemia and arrhythmias.
Hemoglobin, because bumetanide causes anemia.
After chest tube placement, which assessment finding indicates a possible tension pneumothorax requiring urgent intervention?
Drainage less than 60 mL in 24 hours
Clear breath sounds and stable oxygen saturation
Intermittent bubbling in the water-seal chamber
Tracheal deviation, severe respiratory distress, and absent breath sounds on affected side
A patient’s arterial blood gas (ABG) results are: pH 7.30, PaCO₂ 55 mmHg, HCO₃⁻ 26 mEq/L. Which acid-base disturbance is present?
Respiratory alkalosis
Metabolic alkalosis
Metabolic acidosis
Respiratory acidosis
Which of the following is a common cause of atelectasis in postoperative patients?
Asthma exacerbation
Heart failure
Pulmonary embolism
Bronchial obstruction due to mucus plug
A patient develops sudden shortness of breath and decreased breath sounds in the right lower lung after abdominal surgery. What is the most likely diagnosis?
Atelectasis
Pneumothorax
Pleural effusion
Pneumonia
Which intervention is most effective in preventing atelectasis in a patient after surgery?
Keeping the patient in a supine position
Administering sedatives
Restricting fluid intake
Encouraging deep breathing and use of incentive spirometry
Which of the following is a classic clinical feature of chronic obstructive pulmonary disease (COPD)?
Sudden onset chest pain and hemoptysis
Intermittent fever and night sweats
Progressive dyspnea and chronic productive cough
Acute abdominal pain and vomiting
What is the primary goal of long-term oxygen therapy in patients with severe COPD?
To treat acute infections
To improve survival and reduce complications of hypoxemia
To prevent pulmonary embolism
To cure the underlying lung disease
Which medication class is most commonly used as a first-line maintenance therapy for stable COPD?
Beta-blockers
Long-acting bronchodilators (e.g., LABA or LAMA)
Antibiotics
Systemic corticosteroids
Which of the following is a primary defect in cystic fibrosis?
Defective chloride transport across epithelial cells
Overproduction of red blood cells
Impaired insulin secretion from the pancreas
Decreased oxygen binding to hemoglobin
A child with cystic fibrosis presents with frequent respiratory infections and thick sputum. What is the most strategic nursing intervention to help clear airway secretions?
Encourage bed rest and limit activity
Administer bronchodilators only
Perform chest physiotherapy and encourage coughing
Restrict fluid intake to prevent aspiration
Which nutritional strategy is most important for children diagnosed with cystic fibrosis?
Low-fat, low-calorie diet
High-protein, high-calorie diet with pancreatic enzyme supplementation
Salt-restricted diet
Strict vegan diet
A patient presents with muscle weakness, cardiac arrhythmias, and flattened T waves on ECG. Which electrolyte imbalance is most likely responsible for these findings?
Hypernatremia
Hypomagnesemia
Hypercalcemia
Hypokalemia
A client with chronic alcoholism is admitted with confusion, tremors, and positive Chvostek's sign. Which electrolyte imbalance should the nurse suspect?
Hyperkalemia
Hypocalcemia
Hypermagnesemia
Hyperphosphatemia
Which of the following symptoms is most commonly associated with severe hyperkalemia?
Polyuria and polydipsia
Bradycardia and hypothermia
Muscle weakness and cardiac arrhythmias
Increased deep tendon reflexes and tetany
A patient presents with confusion, dry mucous membranes, and a serum sodium of 155 mEq/L. What is the most appropriate initial intervention?
Administer loop diuretics
Restrict fluid intake
Encourage oral water intake and monitor sodium levels
Rapid infusion of hypotonic saline
Which clinical sign is most indicative of severe hypernatremia?
Hypotension
Peripheral edema
Muscle weakness and seizures
Bradycardia
Which of the following is a common clinical manifestation of hypomagnesemia?
Hyperactive deep tendon reflexes and muscle cramps
Bradycardia and hypotension
Polyuria and polydipsia
Facial flushing and warm skin
Which electrolyte imbalance is most likely to occur concurrently with hypomagnesemia?
Hypernatremia
Hypokalemia
Hypercalcemia
Hyperphosphatemia
What is the most appropriate initial nursing intervention for a patient with severe hypomagnesemia and new-onset seizures?
Encourage increased dietary magnesium intake
Restrict fluid intake to prevent dilutional hyponatremia
Start intravenous magnesium sulfate as ordered and place the patient on cardiac monitoring
Administer oral magnesium supplements
