Quiz

Lesson 1 (Impaired Gas Exchange) Practice Quiz

Deleted user 100 questions Updated 6 Feb 2019

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Questions in this quiz (100)

1The nurse is assigned a group of patients. Which patient would the nurse identify as being at increased risk for impaired gas exchange? A patient
1. Awith a blood glucose of 350 mg/dL
2. Bwho has been on anticoagulants for 10 days
3. Cwith a hemoglobin of 8.5 g/dL
4. Dwith a heart rate of 100 beats/min and blood pressure of 100/60
2The nurse is reviewing the patient's arterial blood gas results. The Pao2 is 96 mm Hg, pH is 7.20, PaCO2 is 55 mm Hg, and HCO3 is 25 mEq/L. What would the nurse expect to observe on assessment of this patient?
1. ADisorientation and tremors
2. BTachycardia and decreased blood pressure
3. CIncreased anxiety and irritability
4. DHyperventilation and lethargy
3The nurse would identify which patient as having a problem of impaired gas exchange secondary to a perfusion problem? A patient with
1. Aperipheral arterial disease of the lower extremities
2. Bchronic obstructive pulmonary disease (COPD)
3. Cchronic asthma
4. Dsevere anemia secondary to chemotherapy
4The nurse is assessing a patient's differential white blood cell count. What implications would this test have on evaluating the adequacy of a patient's gas exchange?
1. AAn elevation of the total white cell count indicates generalized inflammation.
2. BEosinophil count will assist to identify the presence of a respiratory infection.
3. CWhite cell count will differentiate types of respiratory bacteria.
4. DLevel of neutrophils provides guidelines to monitor a chronic infection.
5Which patient would the nurse identify as being at an increased risk for altered transport of oxygen? A patient with
1. Ahemoglobin level of 8.0
2. Bbronchoconstriction and mucus
3. Cperipheral arterial disease
4. Ddecreased thoracic expansion
6A 3-month-old infant is at increased risk for developing anemia. The nurse would identify which principle contributing to this risk?
1. AThe infant is becoming more active.
2. BThere is an increase in the intake of breast milk or formula.
3. CThe infant is unable to maintain an adequate iron intake.
4. DA depletion of fetal hemoglobin occurs.
7Which clinical management prevention concept would the nurse identify as representative of secondary prevention?
1. ADecreasing venous stasis and risk for pulmonary emboli
2. BImplementation of strict hand washing routines
3. CMaintaining current vaccination schedules
4. DPrevention of pneumonia in patients with chronic lung disease
8The nurse would identify which body systems as directly involved in the process of normal gas exchange? (Select all that apply.)
1. ANeurologic System
2. BEndocrine System
3. CPulmonary System
4. DImmune System
5. ECardiovascular System
6. FHepatic System
9The nurse is assessing a patient for the adequacy of ventilation. What assessment findings would indicate the patient has good ventilation? (Select all that apply.)
1. ARespiratory rate of 24 breaths/min.
2. BOxygen saturation level is 98%.
3. CThe right side of the thorax expands slightly more than the left.
4. DTrachea is just to the left of the sternal notch.
5. ENail beds are pink with a good capillary refill.
6. FThere is the presence of quite, effortless breath sounds at lung base bilaterally.
10The nurse has completed patient teaching about the administration of salmeterol (Serevent) using a metered-dose inhaler (MDI). Which action by the patient indicates a good understanding of the teaching?
1. AThe patient attaches a spacer before using the MDI.
2. BThe patient coughs vigorously after using the inhaler.
3. CThe patient floats the MDI in water to see if it is empty.
4. DThe patient activates the inhaler at the onset of expiration.

11Which information will the nurse include when teaching the patient with asthma about the prescribed medications?
1. AUtilize the inhaled corticosteroid when shortness of breath occurs.
2. BInhale slowly and deeply when using the dry-powder inhaler (DPI)
3. CHold your breath for 5 seconds after using the bronchodilator inhaler.
4. DTremors are an expected side effect of rapidly acting bronchodilators.
12When the nurse is evaluating the effectiveness of therapy for a patient who has received treatment during an asthma attack, which finding is the best indicator that the therapy has been effective?
1. ANo wheezes are audible.
2. BOxygen saturation is >90%.
3. CAccessory muscle use has decreased.
4. DRespiratory rate is 16 breaths/minute.
13A patient seen in the asthma clinic has recorded daily peak flows that are 85% of the baseline. Which action will the nurse plan to take?
1. ATeach the patient about the use of oral corticosteroids.
2. BAdminister a bronchodilator and recheck the peak flow.
3. CInstruct the patient to continue to use current medications.
4. DEvaluate whether the peak flow meter is being used correctly.
14Which information about a newly admitted patient with chronic obstructive pulmonary disease (COPD) indicates that the nurse should consult with the health care provider before administering the prescribed aminophylline?
1. AThe patient has had a recent 10-pound weight gain.
2. BThe patient has a cough productive of green mucus.
3. CThe patient denies any shortness of breath at present.
4. DThe patient takes cimetidine (Tagamet) 150 mg daily.
15A patient with chronic bronchitis has a nursing diagnosis of impaired breathing pattern related to anxiety. Which nursing action is most appropriate to include in the plan of care?
1. ATitrate oxygen to keep saturation at least 90%.
2. BDiscuss a high-protein, high-calorie diet with the patient.
3. CSuggest the use of over-the-counter sedative medications.
4. DTeach the patient how to effectively use pursed lip breathing.
16A patient with chronic obstructive pulmonary disease (COPD) has a nursing diagnosis of imbalanced nutrition: less than body requirements. An appropriate intervention for this problem is to
1. Aincrease the patient’s intake of fruits and fruit juices.
2. Bhave the patient exercise for 10 minutes before meals.
3. Cassist the patient in choosing foods with a lot of texture.
4. Doffer high calorie snacks between meals and at bedtime.
17When the nurse is interviewing a patient with a new diagnosis of chronic obstructive pulmonary disease (COPD), which information will help most in confirming a diagnosis of chronic bronchitis?
1. AThe patient tells the nurse about a family history of bronchitis.
2. BThe patient’s history indicates a 40 pack-year cigarette history.
3. CThe patient denies having any respiratory problems until the last 6 months.
4. DThe patient complains about a productive cough every winter for 3 months.
18After the nurse has finished teaching a patient about pursed-lip breathing, which patient action indicates that more teaching is needed?
1. AThe patient inhales slowly through the nose.
2. BThe patient puffs up the cheeks while exhaling.
3. CThe patient practices by blowing through a straw.
4. DThe patient’s ratio of inhalation to exhalation is 1:3.
19To evaluate the effectiveness of therapy for a patient with cor pulmonale, the nurse will monitor the patient for
1. Aelevated temperature.
2. Bclubbing of the fingers.
3. Cjugular vein distention.
4. Dcomplaints of chest pain.
20When a hospitalized patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen, the best action by the nurse is to
1. Aminimize oxygen use to avoid oxygen dependency.
2. Bmaintain the pulse oximetry level at 90% or greater.
3. Cadminister oxygen according to the patient’s level of dyspnea.
4. Davoid administration of oxygen at a rate of more than 2 L/min.
21Which information will the nurse include in teaching a patient with chronic obstructive pulmonary disease (COPD) who has a new prescription for home oxygen therapy?
1. AStorage of oxygen tanks will require adequate space in the home.
2. BTravel opportunities will be limited because of the use of oxygen.
3. COxygen flow should be increased if the patient has more dyspnea.
4. DOxygen use can improve the patient’s prognosis and quality of life.
22A patient is receiving 35% oxygen via a Venturi mask. To ensure the correct amount of oxygen delivery, it is most important that the nurse
1. Akeep the air entrainment ports clean and unobstructed.
2. Bgive a high enough flow rate to keep the bag from collapsing.
3. Cuse an appropriate adaptor to ensure adequate oxygen delivery.
4. Ddrain moisture condensation from the oxygen tubing every hour.
23When developing a teaching plan to help increase activity tolerance at home for a 70-year-old with severe chronic obstructive pulmonary disease (COPD), the nurse should teach the patient that an appropriate exercise goal is to
1. Awalk until pulse rate exceeds 130.
2. Bwalk for a total of 20 minutes daily.
3. Cexercise until shortness of breath occurs.
4. Dlimit exercise to activities of daily living (ADLs).
24A patient with chronic obstructive pulmonary disease (COPD) is admitted to the hospital. How can the nurse best position the patient to improve gas exchange?
1. AResting in bed with the head elevated to 45 to 60 degrees
2. BSitting up at the bedside in a chair and leaning slightly forward
3. CResting in bed in a high-Fowler’s position with the knees flexed
4. DIn the Trendelenburg position with several pillows behind the head
25When teaching the patient with chronic obstructive pulmonary disease (COPD) about exercise, which information should the nurse include?
1. A“Stop exercising if you start to feel short of breath.”
2. B“Use the bronchodilator before you start to exercise.”
3. C“Breathe in and out through the mouth while you exercise.”
4. D“Upper body exercise should be avoided to prevent dyspnea.”
26Which topic will the nurse include in medication teaching for a patient with newly-diagnosed persistent asthma?
1. AUse of long-acting b-adrenergic medications
2. BSide effects of sustained-release aminophylline
3. CSelf-administration of inhaled corticosteroids
4. DComplications associated with oxygen therapy
27When caring for a patient with a history of asthma, which assessment finding should the nurse communicate immediately to the health care provider?
1. APulse oximetry reading of 91%
2. BRespiratory rate of 26 breaths/minute
3. CUse of accessory muscles in breathing
4. DPeak expiratory flow rate of 240 mL/min
28Which action should the nurse anticipate taking first when a patient who is experiencing an asthma attack develops bradycardia and a decrease in wheezing?
1. AAssist with endotracheal intubation.
2. BDocument changes in respiratory status.
3. CEncourage the patient to cough and deep breathe.
4. DAdminister IV methylprednisolone (SoluMedrol).
29A patient who is experiencing an acute asthma attack is admitted to the emergency department. The nurse’s first action should be to
1. Alisten to the patient’s breath sounds.
2. Bask about inhaled corticosteroid use.
3. Cdetermine when the dyspnea started.
4. Dobtain the forced expiratory volume (FEV) flow rate.
30The nurse in the emergency department receives arterial blood gas results for four recently admitted patients with obstructive pulmonary disease. Which patient will require the most rapid action by the nurse?
1. A20-year-old with ABG results: pH 7.28, PaCO2 60 mm Hg, and PaO2 58 mm Hg
2. B32-year-old with ABG results: pH 7.50, PaCO2 30 mm Hg, and PaO2 65 mm Hg
3. C40-year-old with ABG results: pH 7.34, PaCO2 33 mm Hg, and PaO2 80 mm Hg
4. D64-year-old with ABG results: pH 7.31, PaCO2 58 mm Hg, and PaO2 64 mm Hg
31Which of these nursing actions included in the care plan for a patient with chronic obstructive pulmonary disease (COPD) should the nurse delegate to experienced unlicensed assistive personnel (UAP)?
1. AObtain oxygen saturation using pulse oximetry.
2. BMonitor for increased oxygen need with exercise.
3. CTeach the patient about safe use of oxygen at home.
4. DAdjust oxygen to keep saturation in prescribed parameters.
32The following medications are prescribed by the health care provider for a patient having an acute asthma attack. Which one will the nurse administer first?
1. Asalmeterol (Serevent) 50 mcg per dry-powder inhaler (DPI)
2. Balbuterol (Ventolin) 2.5 mg per nebulizer
3. Cmontelukast 10mg PO
4. Dmethylprednisolone (Solu-Medrol) 60 mg IV
33The nurse has received a change-of-shift report about the following patients with chronic obstructive pulmonary disease (COPD). Which patient should the nurse assess first?
1. AA patient with a respiratory rate of 38
2. BA patient with loud expiratory wheezes
3. CA patient with jugular vein distention and peripheral edema
4. DA patient who has a cough productive of thick, green mucus
34A patient with bacterial pneumonia has rhonchi and thick sputum. Which action will the nurse use to promote airway clearance?
1. AAssist the patient to splint the chest when coughing.
2. BEducate the patient about the need for fluid restrictions.
3. CEncourage the patient to wear the nasal oxygen cannula.
4. DInstruct the patient on the pursed lip breathing technique.
35Which statement by a patient who has been hospitalized for pneumonia indicates a good understanding of the discharge instructions given by the nurse?
1. A“I will call the doctor if I still feel tired after a week.”
2. B“I will need to use home oxygen therapy for 3 months.”
3. C“I will continue to do the deep breathing and coughing exercises at home.”
4. D“I will schedule two appointments for pneumonia and influenza vaccines.”
36Which nursing action will be most effective in preventing aspiration pneumonia in patients who are at risk?
1. ATurn and reposition immobile patients at least every 2 hours.
2. BPlace patients with altered consciousness in side-lying positions.
3. CMonitor for respiratory symptoms in patients who are immunosuppressed.
4. DProvide for continuous subglottic aspiration in patients receiving enteral feedings.
37After a patient with right lower-lobe pneumonia has been treated with intravenous (IV) antibiotics for 2 days, which assessment data obtained by the nurse indicates that the treatment has been effective?
1. ABronchial breath sounds are heard at the right base.
2. BThe patient coughs up small amounts of green mucus.
3. CThe patient’s white blood cell (WBC) count is 9000/µl.
4. DIncreased tactile fremitus is palpable over the right chest.
38When developing a teaching plan for a patient with a 42 pack-year history of cigarette smoking, it will be most important for the nurse to include information about
1. Acomputed tomography (CT) screening for lung cancer.
2. Boptions for smoking cessation.
3. Creasons for annual sputum cytology testing.
4. Derlotinib (Tarceva) therapy to prevent tumor risk.
39The health care provider inserts a chest tube in a patient with a hemopneumothorax. When monitoring the patient after the chest tube placement, the nurse will be most concerned about
1. Aa large air leak in the water-seal chamber.
2. B400 mL of blood in the collection chamber.
3. Ccomplaint of pain with each deep inspiration.
4. Dsubcutaneous emphysema at the insertion site.
40A patient experiences a steering wheel injury as a result of an automobile accident. During the initial assessment, the emergency department nurse would be most concerned about
1. Aparadoxical chest movement.
2. Bthe complaint of chest wall pain.
3. Ca heart rate of 110 beats/minute.
4. Da large bruised area on the chest.
41When assessing a 24-year-old patient who has just arrived after an automobile accident, the emergency department nurse notes that the breath sounds are absent on the right side. The nurse will anticipate the need for
1. Aemergency pericardiocentesis.
2. Bstabilization of the chest wall with tape.
3. Cadministration of an inhaled bronchodilator.
4. Dinsertion of a chest tube with a closed chest drainage system.
42A patient who has a right-sided chest tube following a thoracotomy has continuous bubbling in the suction-control chamber of the collection device. The most appropriate action by the nurse is to
1. Adocument the presence of a large air leak.
2. Bobtain and attach a new collection device.
3. Cnotify the surgeon of a possible pneumothorax.
4. Dtake no further action with the collection device.
43To determine the effectiveness of prescribed therapies for a patient with cor pulmonale and right-sided heart failure, which assessment will the nurse make?
1. ALung sounds
2. BHeart sounds
3. CBlood pressure
4. DPeripheral edema
44Which of these orders will the nurse act on first for a patient who has just been admitted with probable bacterial pneumonia and sepsis?
1. AAdminister aspirin suppository.
2. BSend to radiology for chest x-ray.
3. CGive ciprofloxacin (Cipro) 400 mg IV.
4. DObtain blood cultures from two sites.
45Which assessment information obtained by the nurse when caring for a patient who has just had a thoracentesis is most important to communicate to the health care provider?
1. ABP is 150/90 mm Hg.
2. BOxygen saturation is 89%.
3. CPain level is 5/10 with a deep breath.
4. DRespiratory rate is 24 when lying flat.
46The nurse observes unlicensed assistive personnel (UAP) doing all the following activities when caring for a patient with right lower lobe pneumonia. The nurse will need to intervene when UAP
1. Alower the head of the patient’s bed to 10 degrees.
2. Bsplint the patient’s chest during coughing.
3. Chelp the patient to ambulate to the bathroom.
4. Dassist the patient to a bedside chair for meals.
47A patient who was admitted the previous day with pneumonia complains of a sharp pain “whenever I take a deep breath.” Which action will the nurse take next?
1. AListen to the patient’s lungs.
2. BAdminister the PRN morphine.
3. CHave the patient cough forcefully.
4. DNotify the patient’s health care provider.
48While caring for a patient with respiratory disease, the nurse observes that the patient’s SpO2 drops from 92% to 88% while the patient is ambulating in the hallway. Which action should the nurse take next?
1. ANotify the health care provider.
2. BDocument the response to exercise.
3. CAdminister the PRN supplemental O2.
4. DEncourage the patient to pace activity.
49A patient with chronic hypoxemia (SaO2 levels of 89% to 90%) caused by chronic obstructive pulmonary disease (COPD) has been hospitalized with increasing shortness of breath. In planning for discharge, which of these actions by the nurse will be most effective in improving compliance with discharge teaching?
1. AArrange for the patient’s spouse to be present during the teaching.
2. BStart giving the patient discharge teaching on the day of admission.
3. CAccomplish the patient teaching just before the scheduled discharge.
4. DHave the patient repeat the instructions immediately after the teaching.
50The nurse is admitting a patient who has a diagnosis of an acute asthma attack. Which information obtained by the nurse indicates that the patient may need teaching regarding medication use?
1. AThe patient says there have been no acute asthma attacks during the last year.
2. BThe patient became very short of breath an hour before coming to the hospital.
3. CThe patient has been using the albuterol (Proventil) inhaler more frequently over the last 4 days.
4. DThe patient has been taking acetaminophen (Tylenol) 650 mg every 6 hours for chest-wall pain.
51When the nurse is analyzing the results of a patient’s arterial blood gases (ABGs), which finding indicates the need for most immediate action?
1. AThe arterial oxygen saturation (SaO2) is 92%.
2. BThe partial pressure of oxygen in arterial blood (PaO2) is 59 mm Hg.
3. CThe partial pressure of CO2 in arterial blood (PaCO2) is 31 mm Hg.
4. DThe bicarbonate level (HCO3–) is 29 mEq/L.
52When assessing the respiratory system of a 78-year-old patient, which finding indicates that the nurse should take immediate action?
1. AThe chest appears barrel shaped.
2. BThe patient has a weak cough effort.
3. CCrackles are heard from the lung bases to the midline.
4. DHyperresonance is present across both sides of the chest.
53The nurse has just received arterial blood gas (ABG) results on four patients. Which result is most important to report rapidly to the health care provider?
1. ApH 7.34, PaO2 82 mm Hg, PaCO2 40 mm Hg, and O2 sat 97%
2. BpH 7.35, PaO2 85 mm Hg, PaCO2 45 mm Hg, and O2 sat 95%
3. CpH 7.46, PaO2 90 mm Hg, PaCO2 32 mm Hg, and O2 sat 98%
4. DpH 7.31, PaO2 91 mm Hg, PaCO2 50 mm Hg, and O2 sat 96%
54The nurse obtains this information when assessing a patient with chronic obstructive pulmonary disease (COPD) who has been admitted with increasing dyspnea over the last 3 days. Which finding is most important to report to the health care provider?
1. ARespirations are 36 breaths/minute.
2. BAnterior-posterior chest ratio is 1:1.
3. CLung expansion is decreased bilaterally.
4. DHyperresonance to percussion is present.
55A 10-year-old child with asthma is treated for acute exacerbation in the emergency department. The nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the condition?
1. AWarm, dry skin
2. BDecreased wheezing
3. CPulse rate of 90 beats/minute
4. DRespirations of 18 breaths/minute
56The nurse is caring for an infant with bronchiolitis, and diagnostic tests have confirmed respiratory syncytial virus (RSV). On the basis of this finding, which is the MOST APPROPRIATE nursing action?
1. AInitiate strict enteric precautions.
2. BMove the infant to a room with another child with RSV.
3. CLeave the infant in the present room because RSV is not contagious.
4. DInform the staff that they must wear a mask, gloves, and gown when caring for the child.
57The nurse is preparing for the admission of an infant with a diagnosis of bronchiolitis caused by RSV. Which interventions should the nurse include in the plan of care? (Select all that apply.)
1. APlace the infant in a private room.
2. BEnsure that the infant's head is in a flexed position.
3. CWear a mask at all times when in contact with the infant.
4. DPlace the infant in a tent that delivers warm, humidified air.
5. EPosition the infant on the side, with the head lower than the chest.
6. FEnsure that nurses caring for the infant with RSV do not care for other high-risk children.
58The emergency department nurse is assessing a client who has sustained a blunt injury to the chest wall. Which finding indicates the presence of a pneumothorax in this client?
1. AA low respiratory rate
2. BDiminished breath sounds
3. CThe presence of a barrel chest
4. DA sucking sound at the site of injury.
59The nurse is caring for a client hospitalized with acute exacerbation of chronic obstructive pulmonary disease. Which findings would the nurse expect to note on assessment of this client? (Select all that apply.)
1. AA low arterial PC02 level
2. BA hyperinflated chest noted on the chest x-ray
3. CDecreased oxygen saturation with mild exercise
4. DA widened diaphragm noted on the chest x-ray
5. EPulmonary function tests are demonstrate increased vital capacity.
60The nurse instructs a client to use the pursed-lip breathing method of breathing and evaluates the teaching by asking the client about the purpose of this type of breathing. The nurse determines that the client understands if the client states that the primary purpose of pursed-lip breathing is to promote which outcome?
1. APromote oxygen intake
2. BStrengthen the diaphragm
3. CStrengthen the intercoastal muscles
4. DPromote carbon dioxide elimination
61A client has been admitted with chest trauma after a motor vehicle crash and has undergone subsequent intubation. The nurse checks the client when the high-pressure alarm on the ventilator sounds and notes that the client has an absence of breathing sounds in the right upper lobe of the lung. The nurse immediately assesses for other signs of which condition?
1. ARight pneumothorax
2. BPulmonary embolism
3. CDisplaced endotracheal tube
4. DAcute respiratory distress syndrome
62An oxygen delivery system is prescribed for a client with chronic obstructive pulmonary disease to deliver a precise oxygen concentration. Which oxygen delivery system would the nurse prepare for the client?
1. AFace tent
2. BVenturi mask
3. CAerosol mask
4. DTracheostomy collar
63The nurse is instructing a hospitalized client with a diagnosis of emphysema about measures that will enhance the effectiveness of breathing during dyspneic periods. Which position should the nurse instruct the client to assume?
1. ASitting up in bed
2. BSide-lying in bed
3. CSitting in a recliner chair
4. DSitting up and learning on an overbed table
64The low-pressure alarm sounds on a ventilator. The nurse assesses the client and then attempts to determine the cause of the alarm. If unsuccessful in determining the cause of the alarm, the nurse should take what initial action?
1. AAdminister oxygen
2. BCheck the client's vital signs
3. CVentilate the client manually
4. DStart cardiopulmonary resuscitation
65The client has a prescription to take guaifenesin. The nurse determines that the client understands the proper administration of this medication if the client states that he or she will perform which action?
1. ATake an extra dose if fever develops
2. BTake the medication with meals only
3. CTake the tablet with a full glass of water
4. DDecrease the amount of daily fluid intake
66A client has begun therapy with aminophylline. The nurse should plan to teach the client to limit the intake of which items while taking this medication?
1. ACoffee, cola, and chocolate
2. BOysters, lobster, and shrimp
3. CMelons, oranges, and pineapple
4. DCottage cheese, cream cheese, and dairy creamers
67Your assisting your patient who has asthma to bed. The patient is experiencing a frequent cough and chest tightness. You auscultate the patient's lung fields and note expiratory wheezes. The patient's peak flow rate is 78% less than their best peak flow reading. Which medication will provide the patient with the fastest relief from these signs and symptoms of an asthma attack?
1. AAminophylline
2. BTiotropium
3. CAlbuterol
4. DCromolyn
68You're providing discharge teaching to a patient who was admitted with asthma. You discussed the early warning signs of an asthma attack and ask the patient to list some of them. Select all the correct early warning signs verbalized by the patient:
1. AEasily fatigued with physical activity
2. BReduced peak flow meter reading
3. CChest retractions
4. DCyanosis
5. EWheezing with activity
6. FNighttime coughing
7. GNo relief with short-acting bronchodilator inhaler
69Select all the correct options that represent the pathophysiology of an asthma attack.
1. AThe smooth muscle surrounding the alveoli constricts, limiting oxygenation.
2. BThe mucosa lining experiences severe inflammation.
3. CThe goblet cells within the mucosa lining produce excessive amounts of mucous.
4. DToo much carbon dioxide is exhaled due to hyperventilation and the patient experiences respiratory alkalosis.
70A patient has exercise-induced asthma. Which of the following actions can the patient perform to help prevent an attack during exercise? Select all that apply:
1. AAvoid warming up before exercise.
2. BAdminister a short-acting beta agonist before exercise.
3. CAdminister a short-acting beta agonist after exercise.
4. DAvoid exercising when experiencing a respiratory illness.
71Your patient with asthma is taking aminophylline. Which product below should the patient avoid consuming?
1. ACaffeine
2. BDairy
3. CWheat
4. DShellfish
72A patient received a nebulizer of Albuterol. What is a side effect of this medication?
1. ABradycardia
2. BTachycardia
3. CDrowsiness
4. DFeeling cold
73 A patient is admitted with a chest wound and experiencing extreme dyspnea, tachycardia, and hypoxia. The chest wound is located on the left mid-axillary area of the chest. On assessment, you note there is unequal rise and fall of the chest with absent breath sounds on the left side. You also note a "sucking" sound when the patient inhales and exhales. The patient's chest x-ray shows a pneumothorax. What type of pneumothorax is this known as?
1. AClosed pneumothorax
2. BOpen pneumothorax
3. CTension pneumothorax
4. DSpontaneous pneumothorax
74A client presents to the ER with an opening in the chest wall. The nurse immediately assesses and determines the possibility of an open pneumothorax. What is the nurse's next priority action?
1. APlace the patient in supine position
2. BPlace a non-occlusive dressing over the chest wound
3. CPlace a sterile occlusive dressing over the chest wound and tape it on three sides
4. DPrepare the patient for a thoracentesis
75A patient is diagnosed with a primary spontaneous pneumothorax. Which of the following is NOT a correct statement about this type of pneumothorax?
1. AIt can be caused by the rupture of a pulmonary bleb.
2. BIt can occur in patients who are young, tall and thin without a history of lung disease.
3. CSmoking increases the chances of a patient developing a spontaneous pneumothorax.
4. DIt is most likely to occur in patients with COPD, asthma, and cystic fibrosis.
76Which of the following is a LATE sign of the development of a tension pneumothorax?
1. AHypotension
2. BTachycardia
3. CTracheal deviation
4. DDyspnea
77While caring for a patient with a suspected pneumothorax, you note there are several areas on the patient’s skin that appear to be “bulging” out. These “bulging” areas are located on the patient’s neck, face, and abdomen. On palpation on these areas, you note they feel "crunchy". When charting your findings you would refer to this finding as?
1. ASubcutaneous paresthesia
2. BPigment molle
3. CSubcutaneous emphysema
4. DVeisalgia
78You're providing care to a patient with a pneumothorax who has a chest tube. On assessment of the chest tube system, you note there is no fluctuation of water in the water seal chamber as the patient inhales and exhales. You check the system for kinks and find none. What is your next nursing action?
1. AKeep monitoring the patient because this is a normal finding.
2. BIncrease wall suction to the system until the water fluctuates in the water seal chamber.
3. CAssess patient's lung sounds to assess if the affected lung has re-expanded.
4. DNotify the physician.
79A patient has a chest tube for treatment of a pneumothorax in the left lung. Which finding during your assessment requires immediate nursing intervention?
1. AThe water seal chamber has intermittent bubbling.
2. BThe patient has slight tracheal deviation to the right side.
3. CThe water seal chamber fluctuates while the patient inhales and exhales.
4. DThe patient complains of tenderness at the chest tube insertion site.
80Which statement is CORRECT about a tension pneumothorax?
1. AThis condition happens when an opening to the intrapleural space creates a two-way valve which causes pressure to build up in the space leading to shifting of the mediastinum.
2. BA tension pneumothorax is a medical emergency and is treated with needle decompression.
3. CTracheal deviation is an early sign of a tension pneumothorax
4. DAn open pneumothorax is the only cause of a tension pneumothorax
81A patient receiving treatment for a pneumothorax calls on the call light to tell you something is wrong with their chest tube. When you arrive to the room you note that the drainage system has fallen on its side, and there is a large crack in the system. What is your next PRIORITY?
1. APlace the patient in supine position and clamp the tubing.
2. BNotify the physician immediately.
3. CDisconnect the drainage system and get a new one.
4. DDisconnect the tubing from the drainage system and insert the tubing 1 inch into a bottle of sterile water and obtain a new system.
82What is the most significant modifiable risk factor for the development of impaired gas exchange?
1. AAge
2. BTobacco Use
3. CDrug overdose
4. DProlonged immobility
83A patient is having the arterial blood gas (ABG) measured. What would the nurse identify as the parameters to be evaluated by this test?
1. ARatio of hemoglobin and hematocrit
2. BStatus of acid–base balance in arterial blood
3. CAdequacy of oxygen transport
4. DPresence of a pulmonary embolus
84The nurse would anticipate that which of the following patients will need to be treated with insertion of a chest tube?
1. AA patient with asthma and severe shortness of breath
2. BA patient undergoing a bronchoscopy for a biopsy
3. CA patient with a pleural effusion requiring fluid removal
4. DA patient experiencing a problem with a pneumothorax
85When evaluating the concept of gas exchange, how would the nurse best describe the movement of oxygen and carbon dioxide?
1. AOxygen and carbon dioxide are exchanged across the capillary membrane to provide oxygen to hemoglobin.
2. BGas moves from an area of high pressure to an area of low pressure across the alveolar membrane.
3. CThe level of inspired oxygen must be sufficient to displace the carbon dioxide molecules in the alveoli.
4. DGases are exchanged between the atmosphere and the blood based on the oxygen-carrying capacity of the hemoglobin.
86The nurse is administering oral glucocorticoids to a patient with asthma. What assessment finding would the nurse identify as a therapeutic response to this medication?
1. ANo observable respiratory difficulty or shortness of breath over the last 24 hours
2. BA decrease in the amount of nasal drainage and sneezing
3. CNo sputum production, and a decrease in coughing episodes
4. DRelief of an acute asthmatic attack
87The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD). The patient tells the nurse he is having a “hard time breathing.” His respiratory rate is 32 breaths per minute, his pulse is 120 beats per minute, and the oxygen saturation is 90%. What would be the best nursing intervention for this patient?
1. ABegin oxygen via a face mask at 60% FiO2 (fraction of inspired oxygen).
2. BAdminister a PRN (as necessary) dose of an intranasal glucocorticoid.
3. CEncourage coughing and deep breathing to clear the airway.
4. DInitiate oxygen via a nasal cannula, and begin at a flow rate of 3 L/min.
88The nurse is assigned to care for a patient who has anxiety and an exacerbation of asthma. What is the primary reason for the nurse to carefully inspect the chest wall of this patient?
1. AAllow time to calm the patient.
2. BObserve for signs of diaphoresis.
3. CEvaluate the use of intercostal muscles.
4. DMonitor the patient for bilateral chest expansion.
89Which test result identifies that a patient with asthma is responding to treatment?
1. AAn increase in CO2 levels
2. BA decreased exhaled nitric oxide
3. CA decrease in white blood cell count
4. DAn increase in serum bicarbonate levels
90The patient has an order for albuterol 5 mg via nebulizer. Available is a solution containing 2 mg/mL. Calculate how many milliliters the nurse should use to prepare the patient’s dose
1. A4.5 mL
2. B5 mL
3. C2.5 mL
4. D3 mL
91The nurse is evaluating if a patient understands how to safely determine whether a metered-dose inhaler (MDI) is empty. The nurse interprets that the patient understands this important information to prevent medication underdosing when the patient describes which method to check the inhaler?
1. APlace it in water to see if it floats.
2. BKeep track of the number of inhalations used.
3. CShake the canister while holding it next to the ear.
4. DCheck the indicator line on the side of the canister.
92The nurse identifies the nursing diagnosis of activity intolerance for a patient with asthma. In patients with asthma, the nurse assesses for which etiologic factor for this nursing diagnosis?
1. AWork of breathing
2. BFear of suffocation
3. CEffects of medications
4. DAnxiety and restlessness
93When admitting a patient with a diagnosis of asthma exacerbation, the nurse will assess for what potential triggers (select all that apply.)?
1. AExercise
2. BAllergies
3. CEmotional stress
4. DDecreased humidity
5. EUpper respiratory infections
94A patient has been receiving oxygen per nasal cannula while hospitalized for chronic obstructive pulmonary disease (COPD). The patient asks the nurse whether oxygen use will be needed at home. What is the most appropriate response by the nurse?
1. A“Long-term home oxygen therapy should be used to prevent respiratory failure.”
2. B“Oxygen will not be needed until or unless you are in the terminal stages of this disease.”
3. C“Long-term home oxygen therapy should be used to prevent heart problems related to COPD.”
4. D“You will not need oxygen until your oxygen saturation drops to 88% and you have symptoms of hypoxia.”
95Before discharge, the nurse discusses activity levels with a 61-yr-old patient with chronic obstructive pulmonary disease (COPD) and pneumonia. Which exercise goal is most appropriate once the patient is fully recovered from this episode of illness?
1. ASlightly increase activity over the current level.
2. BSwim for 10 min/day, gradually increasing to 30 min/day.
3. CLimit exercise to activities of daily living to conserve energy.
4. DWalk for 20 min/day, keeping the pulse rate less than 130 beats/min.
96The nurse is teaching a patient how to self-administer ipratropium via a metered-dose inhaler (MDI). Which instruction given by the nurse is most appropriate to help the patient learn the proper inhalation technique?
1. A“Avoid shaking the inhaler before use.”
2. B“Breathe out slowly before positioning the inhaler.”
3. C“Using a spacer should be avoided for this type of medication.”
4. D“After taking a puff, hold the breath for 30 seconds before exhaling.”
97The physician has prescribed salmeterol (Serevent) for a patient with asthma. In reviewing the use of dry powder inhalers (DPIs) with the patient, what instructions should the nurse provide?
1. A“Close lips tightly around the mouthpiece and breathe in deeply and quickly.”
2. B“To administer a DPI, you must use a spacer that holds the medicine so that you can inhale it.”
3. C“You will know you have correctly used the DPI when you taste or sense the medicine going into your lungs.”
4. D“Hold the inhaler several inches in front of your mouth and breathe in slowly, holding the medicine as long as possible.”
98Nursing assessment findings of jugular venous distention and pedal edema would be indicative of what complication of chronic obstructive pulmonary disease (COPD)?
1. AAcute respiratory failure
2. BSecondary respiratory infection
3. CFluid volume excess resulting from cor pulmonale
4. DPulmonary edema caused by left-sided heart failure
99You are providing diet teaching to a patient with low iron levels. Which foods would you encourage the patient to eat regularly?
1. AHerbal tea, apples, and watermelon
2. BSweet potatoes, artichokes, and packaged meat
3. CEgg yolks, beef, and legumes
4. DChocolate, cornbread, and cabbage
100A patient is admitted with iron- deficiency anemia and has been receiving iron supplementation. The patient voices concern about how their stool is dark black. As the nurse, you would?
1. ANotify the doctor
2. BHold the next dose of iron
3. CReassure the patient this is a normal side effect of iron supplementation
4. DNone of the options are correct

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Description: Lesson 1, NURS 219 EXAM
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Lesson 1 (Impaired Gas Exchange) Practice Quiz

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