NCLEX Practice Nursing Questions On Respiratory System

1. Aminophylline (theophylline) is prescribed for a client with acute bronchitis. A nurse administers the medication. knowing that the primary action of this medication is to:

Promote expectoration

Suppress the cough

Relax smooth muscles of the bronchial airway

Prevent infection

Aminophylline is a bronchodilator that directly relaxes the smooth muscles of the bronchial airway.

Explanation

Aminophylline is a bronchodilator that directly relaxes the smooth muscles of the bronchial airway.

2. A client has just returned to a nursing unit following bronchoscopy. A nurse would implement which of the following nursing interventions for this client?

Encouraging additional fluids for the next 24 hours

Ensuring the return of the gag reflex before offering foods or fluids

Administering atropine intravenously

Administering small doses of midazolam (Versed).

After bronchoscopy. the nurse keeps the client on NPO status until the gag reflex returns because the preoperative sedation and the local anesthesia impair swallowing and the protective laryngeal reflexes for a number of hours. Additional fluids is unnecessary because no contrast dye is used that would need to be flushed from the system. Atropine and Versed would be administered before the procedure. not after.

Explanation

After bronchoscopy. the nurse keeps the client on NPO status until the gag reflex returns because the preoperative sedation and the local anesthesia impair swallowing and the protective laryngeal reflexes for a number of hours. Additional fluids is unnecessary because no contrast dye is used that would need to be flushed from the system. Atropine and Versed would be administered before the procedure. not after.

3. A female client is scheduled to have a chest radiograph. Which of the following questions is of most importance to the nurse assessing this client?

“Is there any possibility that you could be pregnant?”

“Are you wearing any metal chains or jewelry?”

“Can you hold your breath easily?”

“Are you able to hold your arms above your head?”

The most important item to ask about is the client’s pregnancy status because pregnant women should not be exposed to radiation. Clients are also asked to remove any chains or metal objects that could interfere with obtaining an adequate film. A chest radiograph most often is done at full inspiration. which gives optimal lung expansion. If a lateral view of the chest is ordered. the client is asked to raise the arms above the head. Most films are done in posterior-anterior view.

Explanation

The most important item to ask about is the client’s pregnancy status because pregnant women should not be exposed to radiation. Clients are also asked to remove any chains or metal objects that could interfere with obtaining an adequate film. A chest radiograph most often is done at full inspiration. which gives optimal lung expansion. If a lateral view of the chest is ordered. the client is asked to raise the arms above the head. Most films are done in posterior-anterior view.

4. A client is receiving isoetharine hydrochloride (Bronkosol) via a nebulizer. The nurse monitors the client for which side effect of this medication?

Constipation

Diarrhea

Bradycardia

Tachycardia

Side effects that can occur from a beta 2 agonist include tremors. nausea. nervousness. palpitations. tachycardia. peripheral vasodilation. and dryness of the mouth or throat.

Explanation

Side effects that can occur from a beta 2 agonist include tremors. nausea. nervousness. palpitations. tachycardia. peripheral vasodilation. and dryness of the mouth or throat.

5. A nurse teaches a client about the use of a respiratory inhaler. Which action by the client indicated a need for further teaching?

Removes the cap and shakes the inhaler well before use.

Presses the canister down with finger as he breathes in.

Inhales the mist and quickly exhales.

Waits 1 to 2 minutes between puffs if more than one puff has been prescribed.

The client should be instructed to hold his or her breath at least 10 to 15 seconds before exhaling the mist.

Explanation

The client should be instructed to hold his or her breath at least 10 to 15 seconds before exhaling the mist.

6. A client has been taking benzonatate (Tessalon Perles) as prescribed. A nurse concludes that the medication is having the intended effect if the client experiences:

Decreased anxiety level

Increased comfort level

Reduction of N/V

Decreased frequency and intensity of cough

Benzonatate is a locally acting antitussive the effectiveness of which is measured by the degree to which it decreases the intensity and frequency of cough without eliminating the cough reflex.

Explanation

Benzonatate is a locally acting antitussive the effectiveness of which is measured by the degree to which it decreases the intensity and frequency of cough without eliminating the cough reflex.

7. A nurse is assessing a client with chronic airflow limitation and notes that the client has a "barrel chest." The nurse interprets that this client has which of the following forms of chronic airflow limitation?

Chronic obstructive bronchitis

Emphysema

Bronchial asthma

Bronchial asthma and bronchitis

The client with emphysema has hyperinflation of the alveoli and flattening of the diaphragm. These lead to increased anteroposterior diameter. which is referred to as “barrel chest.” The client also has dyspnea with prolonged expiration and has hyperresonant lungs to percussion.

Explanation

The client with emphysema has hyperinflation of the alveoli and flattening of the diaphragm. These lead to increased anteroposterior diameter. which is referred to as “barrel chest.” The client also has dyspnea with prolonged expiration and has hyperresonant lungs to percussion.

8. A client has an order to have radial ABG drawn. Before drawing the sample. a nurse occludes the:

Brachial and radial arteries. and then releases them and observes the circulation of the hand.

Radial and ulnar arteries. releases one. evaluates the color of the hand. and repeats the process with the other artery.

Radial artery and observes for color changes in the affected hand.

Ulnar artery and observes for color changes in the affected hand.

Before drawing an ABG. the nurse assesses the collateral circulation to the hand with Allen’s test. This involves compressing the radial and ulnar arteries and asking the client to close and open the fist. This should cause the hand to become pale. The nurse then releases pressure on one artery and observes whether circulation is restored quickly. The nurse repeats the process. releasing the other artery. The blood sample may be taken safely if collateral circulation is adequate.

Explanation

Before drawing an ABG. the nurse assesses the collateral circulation to the hand with Allen’s test. This involves compressing the radial and ulnar arteries and asking the client to close and open the fist. This should cause the hand to become pale. The nurse then releases pressure on one artery and observes whether circulation is restored quickly. The nurse repeats the process. releasing the other artery. The blood sample may be taken safely if collateral circulation is adequate.

9. Which of the following would be an expected outcome for a client recovering from an upper respiratory tract infection? The client will:

Maintain a fluid intake of 800 ml every 24 hours.

Experience chills only once a day

Cough productively without chest discomfort.

Experience less nasal obstruction and discharge.

A client recovering from an URI should report decreasing or no nasal discharge and obstruction. Daily fluid intake should be increased to more than 1 L every 24 hours to liquefy secretions. The temperature should be below 100*F (37.8*C) with no chills or diaphoresis. A productive cough with chest pain indicated pulmonary infection. not an URI.

Explanation

A client recovering from an URI should report decreasing or no nasal discharge and obstruction. Daily fluid intake should be increased to more than 1 L every 24 hours to liquefy secretions. The temperature should be below 100*F (37.8*C) with no chills or diaphoresis. A productive cough with chest pain indicated pulmonary infection. not an URI.

10. Which of the following individuals would the nurse consider to have the highest priority for receiving an influenza vaccination?

A 60-year-old man with a hiatal hernia

A 36-year-old woman with 3 children

A 50-year-old woman caring for a spouse with cancer

A 60-year-old woman with osteoarthritis

Individuals who are household members or home care providers for high-risk individuals are high-priority targeted groups for immunization against influenza to prevent transmission to those who have a decreased capacity to deal with the disease. The wife who is caring for a husband with cancer has the highest priority of the clients described.

Explanation

Individuals who are household members or home care providers for high-risk individuals are high-priority targeted groups for immunization against influenza to prevent transmission to those who have a decreased capacity to deal with the disease. The wife who is caring for a husband with cancer has the highest priority of the clients described.