Question 1

An older adult patient who reports difficulty breathing and a productive cough and has a low-grade fever is admitted to the hospital for diagnosis and treatment.Which new-onset symptom should take priority?

Accepted Answer

A)   Fatigue
B)   Confusion
C)   Blood-tinged sputum
D)   Crackles on lung auscultationE) C) and D)
F) B) and D) B

Question 2

The nurse is reviewing the health histories for an assigned group of patients.Which patient should the nurse identify as being the most at risk for TB?

Accepted Answer

A)   The patient with lung cancer
B)   The patient with a history of alcohol abuse
C)   The patient with chronic airflow limitation
D)   The patient with acquired immunodeficiency syndromeE) A) and D)
F) B) and C)

Question 3

The nurse is providing care for a patient prescribed tiotropium (Spiriva) .Which statement should be included in the patient education?

Accepted Answer

A)   "Do not swallow the capsules."
B)   "This medication can cause blurred vision and anorexia."
C)   "It is important to alert the doctor to any abdominal pain or bloating."
D)   "You may experience a headache and sensitivity to light while taking this medication."E) All of the above
F) B) and D)

Question 4

A patient is diagnosed with respiratory failure.Which acid-base abnormality should the nurse expect the patient to demonstrate?

Accepted Answer

A)   Metabolic acidosis
B)   Metabolic alkalosis
C)   Respiratory acidosis
D)   Respiratory alkalosisE) A) and D)
F) C) and D)

Question 5

The nurse is concerned that a patient with a chronic low oxygen saturation level should be wearing home oxygen.Which oxygenation level should be used to make this decision?

Accepted Answer

A)   95%
B)   90%
C)   88%
D)   72%E) B) and C)
F) None of the above

Question 6

A patient with suspected TB is prescribed a Candida skin test.What should the nurse explain as the purpose of this test?

Accepted Answer

A)   Provides a control test
B)   Tests for skin superinfection
C)   Potentiates the purified protein derivative (PP
D)   test
D)   Determines if the patient has a Candida albicans infectionE) None of the above
F) A) and D)

Question 7

A patient with cystic fibrosis has ineffective airway clearance.What intervention would worsen this problem?

Accepted Answer

A)   Fluids
B)   Bedrest
C)   Mucolytics
D)   Percussion and postural drainageE) A) and B)
F) C) and D)

Question 8

A nurse performs purified protein derivative and Candida skin tests on a patient suspected of TB.After 48 hours,what finding at the injection sites should the nurse document as a positive result?

Accepted Answer

A)   Warmth
B)   Redness
C)   Induration
D)   Purulent dischargeE) A) and C)
F) A) and D)

Question 9

A patient with TB takes the prescribed drugs until the bottle runs out and then feels better and does not refill the prescription.The home health nurse explains that continuing the drugs is important for which reason?

Accepted Answer

A)   "If taken consistently, your drugs will prevent hemoptysis."
B)   "If you don't take all your drugs you can develop a superinfection."
C)   "The drugs will keep you pain free so you can cough more effectively."
D)   "You must take all the drugs to prevent development of resistant bacteria."E) None of the above
F) B) and D) D

Question 10

The nurse is providing routine follow-up care for a young adult with asthma who has been on a 3-month course of maintenance therapy.Which activity would best help the nurse to determine if the patient's treatment plan was effective?

Accepted Answer

A)   Obtain an ABG analysis.
B)   Determine the patient's pulse oximeter reading.
C)   Evaluate the patient's use of an incentive spirometer.
D)   Examine daily tracking records of the peak expiratory flow rate.E) B) and C)
F) B) and D)

Question 11

While reinforcing discharge teaching for a patient with emphysema,which patient statement indicates that teaching was effective?

Accepted Answer

A)   "There are bacteria in my lungs so my body is trying to wall off the infection."
B)   "My disease is caused by spasm of the smooth muscles in my breathing pipes."
C)   "Emphysema causes swelling in the airways and an increase in mucus production."
D)   "Air gets trapped when damage to the air sacs makes it hard for air to move in and out."E) A) and B)
F) A) and D)

Question 12

The nurse is reviewing the health statuses for assigned patients to determine the risk for pneumonia.Which type of pneumonia occurs most often as a nosocomial infection in hospitalized patients,very young patients,and older patients?

Accepted Answer

A)   Viral pneumonia
B)   Lobar pneumonia
C)   Fungal pneumonia
D)   BronchopneumoniaE) A) and D)
F) A) and C)

Question 13

A patient is prescribed long-term anticoagulant therapy as treatment for pulmonary emboli.What should the nurse ensure the patient is instructed before being discharged home? (Select all that apply.)

Accepted Answer

A)   Wear shoes at home.
B)   Use an electric razor.
C)   Use a soft toothbrush.
D)   Expect bruising to occur.
E)   Restrict the intake of citrus fruits.F) B) and D)
G) All of the above

Question 14

The nurse develops a plan for impaired gas exchange for a patient with end-stage chronic obstructive pulmonary disease (COPD) .Which finding best helps the nurse to know when the goal has been reached?

Accepted Answer

A)   The patient is alert and oriented.
B)   The patient's oxygen saturation is 92%.
C)   The patient is able to clear the airway with coughing.
D)   The patient correctly demonstrates pursed lip breathing.E) B) and C)
F) A) and B)

Question 15

A patient prescribed theophylline for asthma has a theophylline level of 3 mcg/dL.What should the nurse do?

Accepted Answer

A)   Notify the physician.
B)   Double the next dose of theophylline.
C)   No action is necessary; this is a therapeutic level.
D)   Hold the next dose of theophylline until further orders are given.E) A) and B)
F) B) and D)

Question 16

A patient with chronic obstructive pulmonary disease is prescribed methylprednisolone (Solu-Medrol) .For what reason should the nurse realize that corticosteroids are used in the treatment of this health problem?

Accepted Answer

A)   Dry secretions
B)   Treat infection
C)   Improve the oxygen-carrying capacity of hemoglobin
D)   Reduce airway inflammationE) All of the above
F) C) and D)

Question 17

The nurse is caring for a patient with pneumonia.Which laboratory test would best help the nurse to monitor the condition of this patient?

Accepted Answer

A)   Electrolytes, serum creatinine
B)   Complete blood count (CB
C)  , urinalysis
C)   Partial thromboplastin time (PTT) , serum potassium
D)   White blood cell (WB
C)   count, arterial blood gases (ABGs) E) A) and D)
F) B) and C)

Question 18

The nurse is reviewing data collected on a patient with a respiratory disorder.Which factor should the nurse identify that places the patient at risk for lung cancer?

Accepted Answer

A)   Smoking and exposure to radon gas
B)   Living in a cold climate and having pets
C)   Eating foods high in beta carotene and fiber
D)   Living in crowded conditions and lack of sunlightE) A) and C)
F) A) and D)

Question 19

The nurse teaches a patient with TB about drug therapy.Which patient statement indicates that teaching has been effective?

Accepted Answer

A)   "I will have to take the antibiotics for 10 days."
B)   "I will get a prescription for 2 weeks of antibiotics."
C)   "I will have to take antibiotics for the rest of my life."
D)   "I will probably need to be on antibiotic therapy for 6 months to 2 years."E) B) and D)
F) All of the above D

Question 20

A patient has difficulty raising pulmonary secretions,and the nurse writes a nursing diagnosis of "Ineffective Airway Clearance related to weak cough and fatigue." What would best help the patient maintain a clear airway?

Accepted Answer

A)   Teach relaxation exercises.
B)   Allow rest periods between activities.
C)   Encourage fluids; suction prn as ordered.
D)   Instruct in abdominal and pursed-lip breathing.E) A) and B)
F) None of the above

Exam 31: Nursing Care of Patients With Lower Respiratory Tract Disorders

An older adult patient who reports difficulty breathing and a productive cough and has a low-grade fever is admitted to the hospital for diagnosis and treatment.Which new-onset symptom should take priority?

Correct AnswerverifiedB

The nurse is reviewing the health histories for an assigned group of patients.Which patient should the nurse identify as being the most at risk for TB?

Correct AnswerverifiedShow Answer

The nurse is providing care for a patient prescribed tiotropium (Spiriva) .Which statement should be included in the patient education?

Correct AnswerverifiedShow Answer

A patient is diagnosed with respiratory failure.Which acid-base abnormality should the nurse expect the patient to demonstrate?

Correct AnswerverifiedShow Answer

The nurse is concerned that a patient with a chronic low oxygen saturation level should be wearing home oxygen.Which oxygenation level should be used to make this decision?

Correct AnswerverifiedShow Answer

A patient with suspected TB is prescribed a Candida skin test.What should the nurse explain as the purpose of this test?

Correct AnswerverifiedShow Answer

A patient with cystic fibrosis has ineffective airway clearance.What intervention would worsen this problem?

Correct AnswerverifiedShow Answer

A nurse performs purified protein derivative and Candida skin tests on a patient suspected of TB.After 48 hours,what finding at the injection sites should the nurse document as a positive result?

Correct AnswerverifiedShow Answer

A patient with TB takes the prescribed drugs until the bottle runs out and then feels better and does not refill the prescription.The home health nurse explains that continuing the drugs is important for which reason?

Correct AnswerverifiedD

The nurse is providing routine follow-up care for a young adult with asthma who has been on a 3-month course of maintenance therapy.Which activity would best help the nurse to determine if the patient's treatment plan was effective?

Correct AnswerverifiedShow Answer

While reinforcing discharge teaching for a patient with emphysema,which patient statement indicates that teaching was effective?

Correct AnswerverifiedShow Answer

The nurse is reviewing the health statuses for assigned patients to determine the risk for pneumonia.Which type of pneumonia occurs most often as a nosocomial infection in hospitalized patients,very young patients,and older patients?

Correct AnswerverifiedShow Answer

A patient is prescribed long-term anticoagulant therapy as treatment for pulmonary emboli.What should the nurse ensure the patient is instructed before being discharged home? (Select all that apply.)

Correct AnswerverifiedShow Answer

The nurse develops a plan for impaired gas exchange for a patient with end-stage chronic obstructive pulmonary disease (COPD) .Which finding best helps the nurse to know when the goal has been reached?

Correct AnswerverifiedShow Answer

A patient prescribed theophylline for asthma has a theophylline level of 3 mcg/dL.What should the nurse do?

Correct AnswerverifiedShow Answer

A patient with chronic obstructive pulmonary disease is prescribed methylprednisolone (Solu-Medrol) .For what reason should the nurse realize that corticosteroids are used in the treatment of this health problem?

Correct AnswerverifiedShow Answer

The nurse is caring for a patient with pneumonia.Which laboratory test would best help the nurse to monitor the condition of this patient?

Correct AnswerverifiedShow Answer

The nurse is reviewing data collected on a patient with a respiratory disorder.Which factor should the nurse identify that places the patient at risk for lung cancer?

Correct AnswerverifiedShow Answer

The nurse teaches a patient with TB about drug therapy.Which patient statement indicates that teaching has been effective?

Correct AnswerverifiedD

A patient has difficulty raising pulmonary secretions,and the nurse writes a nursing diagnosis of "Ineffective Airway Clearance related to weak cough and fatigue." What would best help the patient maintain a clear airway?

Correct AnswerverifiedShow Answer

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D

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D

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