Chapter 24- Patient Assessment- Respiratory System My Nursing Test Banks

 

1.

A patient in the ICU is producing an increased amount of sputum and has a fever. The nurse suspects an infection. Which of the following characteristics of the patients sputum would indicate a bacterial infection, as opposed to a viral infection? Select all that apply.

A)

Yellow

B)

Clear

C)

Blood-streaked

D)

Green

E)

Brown

F)

White

2.

An older patient in the ICU has labored breathing and a history of smoking. The nurse suspects that he has chronic obstructive pulmonary disease (COPD). Which of the following signs would tend to confirm that the patient has COPD? Select all that apply.

A)

Increased anterior-posterior diameter of the chest

B)

The patient lying propped onto one side

C)

Deviation of the trachea from the midline

D)

Inspiration taking just as long as expiration

3.

A patient in the ICU with a history of smoking is having tests performed to assess his respiratory function. Which test would be best for measuring the oxygenation of this patients blood?

A)

SaO2

B)

Pulse oximetry

C)

End-tidal carbon dioxide

D)

pH

4.

A patient has arterial blood gas testing performed. Her PaO2 is 95 mm Hg, SaO2 is 90%, pH is 7.4, and HCO3 is 23 mEq/L. Which of these values should the nurse be most concerned about?

A)

PaO2

B)

HCO3

C)

pH

D)

SaO2

5.

A patient in her first trimester is in the ICU and is displaying signs of metabolic alkalosis. On speaking with the patient, the nurse learns that she has been experiencing much vomiting, diarrhea, and anxiety in the past week. The nurse should recognize that which of the following is the most likely cause of this acid-base imbalance?

A)

Pregnancy

B)

Diarrhea

C)

Vomiting

D)

Anxiety

6.

A patient has arterial blood gas testing performed. His PaO2 is 83 mm Hg, SaO2 is 91%, pH is 7.5, PaCO2 is 24 mm Hg, and HCO3 is 22 mEq/L. Which of the following indicates this patients condition?

A)

Respiratory acidosis with normal saturation (uncompensated)

B)

Metabolic alkalosis with low saturation (uncompensated)

C)

Respiratory alkalosis with low saturation (uncompensated)

D)

Metabolic alkalosis with low saturation (fully compensated)

7.

A patient in the ICU has just undergone arterial blood gas testing. Her results are as follows: PaO2 is 90 mm Hg, pH is 7.43, PaCO2 is 24, and HCO3 is 19 mEq/L. Which of the following indicates this patients condition?

A)

Respiratory alkalosis, fully compensated

B)

Respiratory acidosis, partially compensated

C)

Metabolic alkalosis, fully compensated

D)

Metabolic acidosis, partially compensated

8.

A patient in the ICU with pneumonia and on mechanical ventilation is suspected to have pulmonary embolus. Which diagnostic study would be best for assessing for this condition?

A)

Chest radiography

B)

Ventilation-perfusion scanning

C)

Pulmonary angiography

D)

Bronchoscopy

9.

A patient in the ICU is suspected of having tuberculosis. The nurse understands that which diagnostic test will most likely be performed on this patient to confirm this suspicion?

A)

Sputum culture

B)

Thoracentesis

C)

Ventilation-perfusion scanning

D)

Pulmonary angiography

10.

The nurse is completing a history on a patient with dyspnea. What characteristic of dyspnea is most indicative of pulmonary disease?

A)

Most severe when patient is supine

B)

Awakens patient from sleep at night

C)

Accompanied by anginal chest pain

D)

Most severe with exertion

11.

During the inspection phase of the physical examination, the nurse notices that the patients chest wall is round, and the anterior-to-posterior diameter and the lateral diameter are equal. Based on this information, what disease process does the nurse suspect?

A)

Lobular pneumonia

B)

Chronic obstructive pulmonary disease

C)

Acute respiratory distress syndrome

D)

Respiratory syncytial virus

12.

The nurse is caring for a patient who has undergone thoracic surgery. What assessment information would best support the nurses suspicion of pulmonary consolidation?

A)

Vesicular lung sounds at bases

B)

Bronchial breath sounds over upper airway

C)

Egophony at left posterior base of lung

D)

Basal crackles that clear with cough

13.

A patient is being monitored with continuous pulse oximetry. Under what circumstance would the nurse question the accuracy of the pulse oximetry reading?

A)

The patient is a victim of a fire in an enclosed space.

B)

Cardiac monitor pattern shows normal sinus rhythm.

C)

Extremities are warm and dry with intact pulses.

D)

Respiratory rate and pulse rate are elevated.

14.

The patient is being monitored with an end-tidal CO2 monitor and has values trending upward. What acidbase abnormality should the nurse assess for?

A)

Metabolic acidosis

B)

Metabolic alkalosis

C)

Respiratory acidosis

D)

Respiratory alkalosis

15.

The patient has experienced a significant drop in hemoglobin levels and is slightly tachycardic. The pulse oximetry value is 100% and arterial blood gas values are normal. What is the most important adverse physiologic effect that the nurse would expect?

A)

Polycythemia

B)

Diminished blood pressure

C)

Hyperalertness and hyperreflexia

D)

Diminished tissue oxygenation

16.

The nurse is evaluating the following arterial blood gas values: pH 7.35, PaO2 95 mm Hg, SaO295%, PaCO2 40 mm Hg, and HCO3 24 mEq/L. How does the nurse interpret these results?

A)

Normal

B)

Respiratory acidosis

C)

Metabolic acidosis

D)

Technical error

17.

The patient is experiencing respiratory acidosis. What nursing action is most likely to alleviate this condition?

A)

Suction the endotracheal tube.

B)

Reduce the respiratory rate on the ventilator.

C)

Administer intravenous bicarbonate.

D)

Increase the rate of crystalloid intravenous fluids.

18.

A patient has experienced a cardiopulmonary arrest and is receiving cardiopulmonary resuscitation. As the nurse evaluates the effectiveness of this therapy, what value on arterial blood gases is most indicative of hypoventilation?

A)

Diminished PaO2

B)

Diminished SaO2

C)

Elevated HCO3

D)

Elevated PaCO2

19.

A critically ill patient has arterial blood gas results of pH 7.6, PaCO2 40 mm Hg, and HCO3 30 mEq/L. With what medical situation do these results most clearly correlate?

A)

Excess nasogastric drainage

B)

Severe diarrhea

C)

Diabetic ketoacidosis

D)

Lobular pneumonia

20.

A patient has arterial blood gas results of pH 7.2, PaCO2 55 mm Hg, and HCO3 24 mEq/L. How does the nurse interpret these results?

A)

Metabolic acidosis

B)

Metabolic alkalosis

C)

Respiratory acidosis

D)

Respiratory alkalosis

21.

A critically ill patient has arterial blood gas results of PaO2 60 mm Hg, SaO2 80%, pH 7.35, PaCO2 35 mm Hg, and HCO3 24 mEq/L. How does the nurse interpret these results?

A)

Hypoxemia and respiratory acidosis

B)

Hypoxemia and normal acidbase balance

C)

Normal oxygenation and metabolic acidosis

D)

Normal oxygenation and acidbase balance

22.

A critically ill patient has arterial blood gas results of pH 7.35, PaCO2 55 mm Hg, and HCO3 28 mEq/L. How does the nurse interpret these results?

A)

Respiratory acidosis

B)

Metabolic alkalosis

C)

Partially compensated metabolic alkalosis

D)

Fully compensated respiratory acidosis

23.

A patient who is critically ill is attached to a saturation of mixed venous oxygen monitor (SvO2) and has an SvO2 value that is trending downward and is currently below normal at 55%. What clinical abnormality should the nurse suspect?

A)

Increased cardiac output

B)

Fever and shivering

C)

Fluid volume overload

D)

Oversedation

24.

The nurse is evaluating the chest radiograph of a critically ill patient and notices that the patients trachea has shifted to the left of midline. What additional finding would confirm the presence of a pneumothorax?

A)

Absent or diminished breath sounds on the right

B)

Lung fields generally white on chest radiograph

C)

Lung fields dull to percussion on the right

D)

Blunting of costophrenic angles on chest radiograph

Answer Key

1.

A, D, E

2.

A, B

3.

A

4.

D

5.

C

6.

C

7.

A

8.

C

9.

A

10.

D

11.

B

12.

C

13.

A

14.

C

15.

D

16.

A

17.

A

18.

D

19.

A

20.

C

21.

B

22.

D

23.

B

24.

A

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