Medical Surgical Nursing- Respiratory care Test
(232).jpg "Medical Surgical Nursing- Respiratory care Test - Quiz")
The respiratory system is responsible for taking in oxygen and expelling carbon dioxide. The main organ for this system is the lungs, which carry out the exchange of gases. People with respiratory-related problems need special care, especially when they get out of surgery. Test your cognitive nursing skills in med-surge respiratory care for the adult patient. Please note that this quiz does not cover respiratory disorders.
- 1.
Which of the following is a normal finding in the aging adult?
- A.
Anteroposterior diameter increases
- B.
Residual volume decreases
- C.
Airways close late
- D.
Ability to cough increases
Correct Answer
A. Anteroposterior diameter increasesExplanation
A barreled-chest is a normal finding in the aging adult due to the decreased elastic recoil of the lungsRate this question:
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- 2.
Which clinical manifestation is the main sign of lung disease?
- A.
Dyspnea
- B.
Hemoptysis
- C.
Cough
- D.
Hoarseness
Correct Answer
C. CoughExplanation
Cough is the most common symptom in lung diseasesRate this question:
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- 3.
While the nurse interviews a patient, he verbalizes that he has difficulty breathing during sleep and uses three pillows for relief. The nurse notes that he may be experiencing :
- A.
Paroxysmal nocturnal dyspnea
- B.
Orthopnea
- C.
Hyperventilation
- D.
Claudication
Correct Answer
B. OrthopneaExplanation
Orthopnea is shortness of breath during sleep and is relieved by sitting up or stacking pillows behind the headRate this question:
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- 4.
A 37-year-old patient is admitted to the ED with dyspnea, tachypnea and pink, frothy sputum. The nurse determines that the patient is experiencing:
- A.
Lung abscess
- B.
Neck trauma
- C.
Cor pulmonale
- D.
Pulmonary embolism
Correct Answer
D. Pulmonary embolismExplanation
Pulmonary embolism is life threatening and requires emergent medical interventionRate this question:
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- 5.
As the nurse auscultates the patient, she hears a popping, discontinuous sound over the lung fields. This type of adventitious sound is known as:
- A.
Wheezes
- B.
Crackles
- C.
Resonance
- D.
Pleural friction rub
Correct Answer
B. CracklesExplanation
Crackles are popping, discontinuous sounds caused by fluid in the airwaysRate this question:
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- 6.
A 53-year-old patient reports smoking two packs of cigarettes per day for the past 35 years. Calculate the pack-years for this patient.
- A.
17.5
- B.
35
- C.
70
- D.
106
Correct Answer
C. 70Explanation
2 packs/day x 35 years = 70 pack yearsRate this question:
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- 7.
The nurse comes into the patient's room and discovers that the patient's pulse oximetry reading is 91%. The nurse should first:
- A.
Notify the Rapid Response Team
- B.
Assess the patient's respiratory status
- C.
Apply supplemental oxygen
- D.
Place patient in high-Fowler's position
Correct Answer
B. Assess the patient's respiratory statusExplanation
A reading between 95%-100% is WNL, while a reading less than 85% is life-threatening. Since this question asks what the nurse will do FIRST, the nurse should assess before implementing an appropriate intervention. Remember ADPIE.Rate this question:
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- 8.
A postop patient who had a bronchoscopy two hours ago is NPO and states that he is hungry. What should the nurse do?
- A.
Notify the physician
- B.
Calmly tell the patient that he must remain NPO until another four hours
- C.
Order food since the patient is A&O
- D.
Check for a gag reflex return
Correct Answer
D. Check for a gag reflex returnExplanation
The anesthesia from bronchoscopy inhibits swallowing. Therefore, it is important for the nurse to check for the gag reflex as an aspiration precautionRate this question:
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- 9.
The patient is scheduled to have a pulmonary function test. Further instruction is needed when she states:
- A.
" I should use my atenolol right away before the test."
- B.
"I shouldn't smoke 6 hours beforehand."
- C.
"I should only breathe through my mouth."
- D.
"This test will help identify the cause of my shortness of breath."
Correct Answer
A. " I should use my atenolol right away before the test."Explanation
Atenolol is a bronchodilator that must be withheld 4-6 hours before the procedure as to not skew the resultsRate this question:
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- 10.
A nurse is caring for a patient who had a thoracentesis eight hours ago. While assessing the patient, the nurse observes that the patient has a rapid heart rate, rapid, shallow respirations, and has absent breath sounds to the left upper lobe of the lung. The nurse interprets this complication as:
- A.
Pulmonary embolism
- B.
Pneumothorax
- C.
Respiratory distress
- D.
Flail chest
Correct Answer
B. PneumothoraxExplanation
A pneumothrorax, or partial or complete lung collapse, can occur within the first 24 hours following a thoracentesis.Rate this question:
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- 11.
A nurse is reviewing the ABG values and notes a pH of 7.42, a PCO2 of 55 mm Hg, and a HCO3 of 24 mEq/L. What does the nurse interpret these values as?
- A.
Uncompensated respiratory alkalosis
- B.
Compensated respiratory alkalosis
- C.
Compensated respiratory acidosis
- D.
Uncompensated respiratory acidosis
Correct Answer
C. Compensated respiratory acidosisExplanation
The pH is WNL (7.35-7.45) which suggests that compensation has occurred. The PCO2 is higher than normal limits (35-45 mm Hg) which indicates respiratory acidosis. Since HCO3 is WNL (22-26 mEq/L) alkalosis has not taken place. Remember ROME (Respiratory Opposite Metabolic Equal)Rate this question:
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- 12.
A nurse is administering oxygen to a patient who has hypoxemia and hypercarbia. Which oxygen delivery system is appropriate for this patient?
- A.
Nonrebreather mask
- B.
Nasal cannula at 2L/min
- C.
Nasal cannula at 4L/min
- D.
Simple facemask at 5L/min
Correct Answer
B. Nasal cannula at 2L/minExplanation
A nasal cannula at 2L/min is given since increased oxygen levels will disrupt the hypoxic drive to breathe causing the patient to have a respiratory depressionRate this question:
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- 13.
A nurse is caring for a patient who had a surgical placement of a tracheostomy 48 hours ago. What should the nurse's initial action be if tube dislodgement occurs?
- A.
Re-insert the tube and notify the physician
- B.
Place a 4x4 sterile gauze over the stoma to prevent infection
- C.
Obtain the patient's vital signs
- D.
Ventilate the patient using a manual resuscitation bag as another nurse notifies for help from the resuscitation team
Correct Answer
D. Ventilate the patient using a manual resuscitation bag as another nurse notifies for help from the resuscitation teamExplanation
Tube dislodgement that occurs 72 hours after surgery is an emergency. As such, ventilating the patient first is priority. Remember your ABCs.Rate this question:
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- 14.
The nurse is suctioning a patient with an endotracheal tube. Which of the following is a correct technique for this procedure?
- A.
Suction for 5 seconds
- B.
Apply suction during insertion
- C.
Suction the mouth before suctioning the airway
- D.
Hyperoxygenate before and after suctioning
Correct Answer
D. Hyperoxygenate before and after suctioningExplanation
Hyperoxygenating before and after prevents hypoxiaRate this question:
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- 15.
What aspiration precaution measures should the nurse implement to the 78-year-old patient with a tracheostomy? (Select all that apply.)
- A.
Instruct patient to drink water, especially while chewing
- B.
Keep patient at low-Fowler's position
- C.
Do not rush patient
- D.
Deflate cuff during meals
- E.
Provide large meals
Correct Answer(s)
C. Do not rush patient
D. Deflate cuff during mealsExplanation
C and D are the only appropriate choices to implement aspiration precautionsRate this question:
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- 16.
A nurse is providing discharge instructions for a tracheostomy patient. Which statement indicates that the patient understands tracheostomy care?
- A.
"I will increase the humidity in my home."
- B.
"I can no longer have showers anymore."
- C.
"Before suctioning, I should wash my hands."
- D.
"If I stick a large cottonball in the airway, I won't be able to breathe."
Correct Answer
A. "I will increase the humidity in my home."Explanation
Increasing humidity in the home helps thin secretions.Rate this question:
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- 17.
A nurse is monitoring a patient who has a chest tube drainage system and notices that there is gentle bubbling in the suction control chamber. What is the appropriate nursing action for this scenario?
- A.
Document this finding.
- B.
Check to see if the chest tube is blocked or kinked
- C.
Check for an air leak
- D.
Notify the physician immediately
Correct Answer
A. Document this finding.Explanation
Gentle bubbling indicates there is suctioning and is normal. Vigorous bubbling indicates an air leak in the chest tube system, while a blocked or kinked tube can cause bubbling to stop.Rate this question:
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- 18.
While auscultating a 65-year-old patient, the nurse hears bronchovesicular breath sounds over the lung fields. How does this nurse interpret this finding?
- A.
Pulmonary consolidation
- B.
This is a normal finding
- C.
Bronchitis
- D.
Pleural effusion
Correct Answer
B. This is a normal findingExplanation
Bronchovesicular breath sounds are normally heard over the major bronchi. When heard elsewhere, this would indicate normal aging or an abnormalityRate this question:
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- 19.
A patient with a chronic lung disease arrives on the med-surg unit. Which delivery system would offer the most precise oxygen concentration for this patient?
- A.
Nonrebreather
- B.
Venturi facemask
- C.
Nasal cannula
- D.
Face tent
Correct Answer
B. Venturi facemaskExplanation
The Venturi mask offers the most accurate flow rate than the nasal cannula and is therefore preferred for a patient with chronic lung diseaseRate this question:
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- 20.
While assessing a trachostomy patient, the nurse notices that there is a crackling sensation around the neck. The nurse suspects this complication as:
- A.
Pneumothorax
- B.
Tracheomalacia
- C.
Subcutaneous emphysema
- D.
Trachea-innominate artery fistula
Correct Answer
C. Subcutaneous emphysemaExplanation
Subcutaenous emphysema occurs when there is an opening in the trachea and air has leaked into the subcutaneous area of the neckRate this question:
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Current Version
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Mar 22, 2023Quiz Edited by
ProProfs Editorial Team -
Mar 31, 2010Quiz Created by
Frostanity
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