Chapter 26- Common Respiratory Disorders My Nursing Test Banks

 

1.

A patient in the ICU presents with a fever, headache, malaise, and myalgia. The nurse suspects that the patient has a SARS infection. Which other finding or findings would tend to confirm this suspicion? Select all that apply.

A)

Mucus-producing cough

B)

Dyspnea

C)

Positive for human cytomegalovirus

D)

Lymphopenia

2.

A patient in the ICU with congestive heart failure demonstrates shortness of breath and complains of pleuritic chest pain. Which of the following conditions, associated with heart failure, should the nurse most suspect in this patient?

A)

Transudative pleural effusion

B)

Exudative pleural effusion

C)

Acute asthma

D)

Emphysema

3.

It has been determined that a patient in the ICU has pleural effusion. Which intervention is needed at this point to distinguish between transudative and exudative pleural effusion?

A)

Chest x-ray

B)

CT scan

C)

Ultrasound

D)

Assessment of pleural fluid

4.

A tall, thin patient in his mid-twenties presents to the ICU with dyspnea, pleuritic chest pain, and a heart rate of 120 bpm. A chest radiograph shows a contralateral mediastinal shift. Which condition does this patient most likely have?

A)

Primary spontaneous pneumothorax

B)

Secondary spontaneous pneumothorax

C)

Traumatic pneumothorax

D)

Transudative pleural effusion

5.

A young man with spontaneous primary pneumothorax is given supplemental oxygen. What is the primary purpose for giving this patient supplemental oxygen?

A)

Oxygen reverses the formation of excess pleural fluid.

B)

Oxygen accelerates the rate of air resorption from the pleural space.

C)

Oxygen counteracts the hypoxemia associated with pneumothorax.

D)

Oxygen calms the patient.

6.

A patient on renal dialysis in the ICU begins to develop worsening dyspnea, pleuritic chest pain, cough, apprehension, and pain. Moreover, the nurse observes that his right leg is swelling significantly. Which diagnostic study would be most appropriate for confirming a diagnosis of pulmonary embolus?

A)

Computed tomography (CT) angiogram

B)

Thoracentesis

C)

Ventilation-perfusion scan

D)

Arterial blood gas test

7.

An elderly woman in the ICU has chronic obstructive pulmonary disease (COPD), with FEV1 of 20%, and is worried about developing a serious illness that would cause complications with her COPD. Which of the following should the nurse recommend to the patient that could reduce her risk for serious illness or death by about 50%?

A)

Influenza vaccine

B)

Lung transplantation

C)

Heparin

D)

Lung volume reduction surgery

8.

The nurse is working with a 50-year-old patient with emphysema who smokes and eats poorly. Which of the following should she mention to the patient regarding her disease? Select all that apply.

A)

The disease may be reversible if the irritant causing inflammation can be identified.

B)

Lung volume reduction surgery may increase her respiratory function.

C)

Smoking cessation can slow the progress of COPD.

D)

Improving her nutritional state could increase her respiratory muscle strength.

9.

A patient in the ICU is experiencing an asthma attack. The room temperature is approximately 72F. The patient has recently had symptoms of a cold. Which of the following is the most likely trigger for the womans asthma attack?

A)

Upper respiratory infection

B)

Latex allergy

C)

Room temperature

D)

Pollen

10.

A patient in the ICU with acute respiratory failure demonstrates dyspnea, headache, tachypnea, and tachycardia. Which of these symptoms distinguishes this patients condition as acute hypercapnic respiratory failure, as opposed to acute hypoxemic respiratory failure?

A)

Dyspnea

B)

Headache

C)

Tachycardia

D)

Tachypnea

11.

An elderly resident of a long-term care facility is admitted to the CCU with acute pneumonia. What might be a factor increasing the risk of pneumonia for this patient?

A)

Takes a histamine-2 antagonist medication daily

B)

Has never smoked or lived with anyone who smoked

C)

Usually has a good appetite without swallowing difficulty

D)

Has his teeth cleaned every 6 months and brushes often

12.

An elderly patient with community-acquired pneumonia has been admitted to the CCU. What nursing action will improve the patients chances of survival?

A)

Obtain blood and sputum cultures on admission and 2 days after admission.

B)

Initiate intravenous antibiotic therapy within 8 hours after admission.

C)

Administer intravenous antibiotics for 7 full days.

D)

Initiate antibiotics only after culture results are known.

13.

What nursing strategy implemented after a patient is admitted to the CCU will decrease the risk that he or she will develop hospital-acquired pneumonia?

A)

Verify that patients received a pneumococcal pneumonia vaccine before admission.

B)

Ensure that all members of the health care team follow hand hygiene protocols strictly.

C)

For patients who cannot eat normally, maintain NPO status.

D)

Maintain bed rest in supine position for all mechanically intubated patients.

14.

A patient has been admitted to the CCU in respiratory failure from probable SARS pneumonia. Knowing that SARS is very contagious, in addition to ensuring strict hand hygiene by everyone, what is the most important nursing action?

A)

Provide adequate nutrition.

B)

Obtain blood and sputum cultures.

C)

Place patient in full isolation.

D)

Ensure adequate fluid balance.

15.

A patient has been admitted with severe dyspnea, orthopnea, and pleuritic chest pain. A chest x-ray shows a pleural effusion. In planning care for this patient, what action is most appropriate?

A)

Thoracentesis for all patients

B)

Diuretics and positive inotropes

C)

Low-fat, high-carbohydrate diet

D)

Oxygen therapy assessed by arterial blood gases

16.

A patient being mechanically ventilated with positive end-expiratory pressure and pressure support totaling 30 mm Hg has developed unequal chest expansion, absent breath sounds on the right, and tracheal deviation to the right. The patient is increasingly tachycardic, anxious, and agitated, and his pulmonary compliance is rapidly decreasing. What is the most appropriate nursing action?

A)

Obtain a chest x-ray to rule out pneumothorax.

B)

Inititate needle thoracotomy or chest tube insertion.

C)

Sedate the patient and evaluate ventilator settings.

D)

Obtain arterial blood gases to evaluate gas exchange.

17.

Which of the following patients would be at highest risk for the development of deep vein thrombosis progressing to pulmonary embolus?

A)

Age 45, exercises daily, underwent elective knee repair surgery, high normal platelets

B)

Age 85, sedentary, somewhat dehydrated, underwent repair of a pelvic fracture, high normal platelets

C)

Age 26, athletic, underwent repair of a football injury, normal platelets

D)

Age 50, on aspirin and beta blockers, underwent open heart surgery, borderline low platelets

18.

A patient is being evaluated for development of chronic obstructive pulmonary disease. Which symptom is most likely to indicate this disease process?

A)

Clubbing of fingernails

B)

Chronically elevated carbon dioxide level

C)

Development of barrel chest

D)

Impaired expiratory air volume

19.

A patient with chronic obstructive pulmonary disease is receiving supplemental oxygen at 2 L/min by nasal cannula. What should the nurse particularly watch for in this patient?

A)

Somnolence, cherry color of mucous membranes, bradypnea

B)

Tachypnea, dyspnea, pleuritic chest pain with cough

C)

Increased frequency of cough and elevated temperature

D)

Change in quality and color of sputum and general malaise

20.

What symptom or factor would the nurse find in emphysema but not in chronic bronchitis?

A)

Cough, thick sputum

B)

Dyspnea with exertion

C)

History of smoking

D)

Hyperinflation of lungs

21.

A patient has severe wheezing, air hunger, cyanosis, and anxiety and is given an inhaled bronchodilator. If the bronchodilator is effective, the nurse will find what direct effect after administration?

A)

Increased respiratory rate

B)

Increased heart rate

C)

Unchanged cough frequency

D)

Reduction of audible wheeze

22.

A patient has been admitted to the CCU in severe distress with acute respiratory failure. Initial arterial blood gases are pH 7.33, PaCO2 65, HCO3 30, PaO2 65, SaO2 90. What is the most important nursing action?

A)

Administer oxygen at 100%.

B)

Prepare for intubation.

C)

Obtain arterial blood gases.

D)

Measure functional expiratory volume.

Answer Key

1.

B, D

2.

A

3.

D

4.

A

5.

B

6.

C

7.

A

8.

B, C, D

9.

A

10.

B

11.

A

12.

B

13.

B

14.

C

15.

D

16.

B

17.

B

18.

D

19.

A

20.

D

21.

D

22.

B

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