Resp. Stuff

This is a collection of a bunch of resp. questions from a friend of mine in 7. Some of them look familiar but she told me to know these questions inside and out.


NCLEX Examination Review Questions Chapter 17
1.
The majority of the body’s water is contained in which of the following fluid compartments?

A.
interstitial
B.
intracellular
C.
extracellular
D.
intravascular




3.
An elderly woman was admitted to the medical unit with dehydration. A clinical indication of this problem is

A.
weight loss.
B.
full bounding pulse.
C.
engorged neck veins.
D.
Kussmaul respiration.



4.
Implementation of nursing care for the patient with hyponatremia includes

A.
fluid restriction.
B.
administration of hypotonic IV fluids.
C.
administration of a cation exchange resin.
D.
increased water intake for patients on nasogastric suction.



5.
A patient is receiving a loop diuretic. The nurse should be alert to which of the following symptoms?

A.
restlessness and agitation
B.
paresthesias and irritability
C.
weak, irregular pulse and poor muscle tone
D.
increased blood pressure and muscle spasms



6.
Which of the following patients would be at greatest risk for the potential development of hypermagnesemia?

A.
83-year-old man with lung cancer and hypertension
B.
65-year-old woman with hypertension taking β-adrenergic blockers
C.
42-year-old woman with systemic lupus erythematosus and renal failure
D.
50-year-old man with benign prostatic hyperplasia and a urinary tract infection



7.
It is especially important for the nurse to assess for which of the following in a patient who has just undergone a total thyroidectomy?

A.
weight gain
B.
depressed reflexes
C.
positive Chvostek’s sign
D.
confusion and personality changes



8.
The nurse anticipates that the patient with hyperphosphatemia secondary to renal failure will require

A.
calcium supplements.
B.
potassium supplements.
C.
magnesium supplements.
D.
fluid replacement therapy.



9.
The lungs act as an acid-base buffer by

A.
increasing respiratory rate and depth when CO2 levels in the blood are high, reducing acid load.
B.
increasing respiratory rate and depth when CO2 levels in the blood are low, reducing base load.
C.
decreasing respiratory rate and depth when CO2 levels in the blood are high, reducing acid load.
D.
decreasing respiratory rate and depth when CO2 levels in the blood are low, increasing acid load.



10.
A patient has the following arterial blood gas results: pH 7.52; PaCO2 30 mm Hg; HCO3– 24 mEq/L. The nurse determines that these results indicate

A.
metabolic acidosis.
B.
metabolic alkalosis.
C.
respiratory acidosis.
D.
respiratory alkalosis.



11.
The typical fluid replacement for the patient with an ICF fluid volume deficit is

A.
isotonic.
B.
hypotonic.
C.
hypertonic.
D.
a plasma expander.


NCLEX Examination Review Questions Chapter 26
1.
The mechanism that stimulates the release of surfactant is

A.
fluid accumulation in the alveoli.
B.
alveolar collapse from atelectasis.
C.
alveolar stretch from deep breathing.
D.
air movement through the alveolar pores of Kohn.



2.
During inspiration, air enters the thoracic cavity as a result of

A.
contraction of the accessory abdominal muscles.
B.
increased carbon dioxide and decreased oxygen in the blood.
C.
stimulation of the respiratory muscles by the chemoreceptors.
D.
decreased intrathoracic pressure relative to pressure at the airway.



3.
The ability of the lungs to adequately oxygenate the arterial blood is determined by examination of the

A.
arterial oxygen tension.
B.
carboxyhemoglobin level.
C.
arterial carbon dioxide tension.
D.
venous carbon dioxide tension.



4.
The most important respiratory defense mechanism distal to the respiratory bronchioles is the

A.
alveolar macrophage.
B.
impaction of particles.
C.
reflex bronchoconstriction.
D.
mucociliary clearance mechanism.



5.
A rightward shift of the oxygen-hemoglobin dissociation curve

A.
is caused by metabolic alkalosis.
B.
is seen in postoperative hypothermia.
C.
facilitates release of oxygen at the tissue level.
D.
causes oxygen to have a greater affinity for hemoglobin.




6.
Very early signs or symptoms of inadequate oxygenation include

A.
dyspnea and hypotension.
B.
apprehension and restlessness.
C.
cyanosis and cool, clammy skin.
D.
increased urine output and diaphoresis.



7.
During the respiratory assessment of the older adult, the nurse would expect to find

A.
hypercapnia while at rest.
B.
increased breath sounds in the lung apices.
C.
decreased pH and increased PaCO2 levels.
D.
increased anteroposterior chest diameter.



8.
When assessing activity-exercise patterns related to respiratory health, the nurse inquires about

A.
dyspnea during rest or exercise.
B.
recent weight loss or weight gain.
C.
willingness to wear oxygen in public.
D.
ability to sleep through the entire night.



9.
The vibration of tactile fremitus is best assessed using the nurse’s

A.
palms.
B.
fingertips.
C.
stethoscope.
D.
index fingers.

10.
Which of the following is an abnormal assessment finding of the respiratory system?

A.
presence of rhonchial fremitus
B.
inspiratory chest expansion of 1 inch
C.
percussion resonance over the lung bases
D.
symmetric chest expansion and contraction


11.
A diagnostic procedure done to remove pleural fluid for analysis is

A.
thoracentesis.
B.
bronchoscopy.
C.
pulmonary angiography.
D.
sputum culture and sensitivity.


NCLEX Examination Review Questions Chapter 27
1.
In assessing a patient with pneumococcal pneumonia, the nurse recognizes that clinical manifestations of this condition include

A.
fever, chills, and a productive cough with rust-colored sputum.
B.
a nonproductive cough and night sweats that are usually self-limiting.
C.
a gradual onset of nasal stuffiness, sore throat, and purulent productive cough.
D.
an abrupt onset of fever, nonproductive cough, and formation of lung abscesses.



2.
An appropriate nursing intervention for a patient with pneumonia with the nursing diagnosis of ineffective airway clearance related to thick secretions and fatigue would be to

A.
perform postural drainage every hour.
B.
provide analgesics as ordered to promote patient comfort.
C.
administer oxygen as prescribed to maintain optimal oxygen levels.
D.
teach the patient how to cough effectively to bring secretions to the mouth.



3.
A patient with TB has a nursing diagnosis of noncompliance. The nurse recognizes that the most common etiologic factor for this diagnosis in patients with TB is

A.
fatigue and lack of energy to manage self-care.
B.
lack of knowledge about how the disease is transmitted.
C.
little or no motivation to adhere to a long-term drug regimen.
D.
feelings of shame and the response to the social stigma associated with TB.



4.
A patient has been receiving high-dose corticosteroids and broad-spectrum antibiotics for treatment of serious trauma and infection. The nurse plans care for the patient knowing that the patient is most susceptible to

A.
candidiasis.
B.
aspergillosis.
C.
histoplasmosis.
D.
coccidioidomycosis.



7.
The type of lung cancer generally associated with the best prognosis because it is potentially surgically resectable is

A.
adenocarcinoma.
B.
small cell carcinoma.
C.
squamous cell carcinoma.
D.
undifferentiated large cell carcinoma.



8.
The nurse identifies a flail chest in a trauma patient when

A.
multiple rib fractures are determined by x-ray.
B.
a tracheal deviation to the unaffected side is present.
C.
paradoxic chest movement occurs during respiration.
D.
there is decreased movement of the involved chest wall.



9.
The nurse notes tidaling of the water level in the tube submerged in the water-seal chamber in a patient with closed chest-tube drainage. The nurse should

A.
continue to monitor this normal finding.
B.
check all connections for a leak in the system.
C.
lower the drainage collector further from the chest.
D.
clamp the tubing at progressively distal points away from the patient until the tidaling stops.



10.
A nursing measure that should be instituted after a pneumonectomy is

A.
monitoring chest-tube drainage and functioning.
B.
positioning the patient on the unaffected side or back.
C.
range-of-motion exercises on the affected upper extremity.
D.
auscultating frequently for lung sounds on the affected side.



11.
Guillain-Barré syndrome causes respiratory problems primarily by

A.
depressing the CNS.
B.
deforming chest-wall muscles.
C.
paralyzing the diaphragm secondary to trauma.
D.
interrupting nerve transmission to respiratory muscles.



12.
A patient with COPD asks why the heart is affected by the respiratory disease. The nurse’s response to the patient is based on the knowledge that cor pulmonale is characterized by

A.
pulmonary congestion secondary to left ventricular failure.
B.
excess serous fluid collection in the alveoli caused by retained respiratory secretions.
C.
right ventricular hypertrophy secondary to increased pulmonary vascular resistance.
D.
right ventricular failure secondary to compression of the heart by hyperinflated lungs.



13.
In responding to a patient with emphysema who asks about the possibility of a lung transplant, the nurse knows that lung transplantation is contraindicated in patients

A.
with cor pulmonale.
B.
who currently smoke.
C.
older than 50 years of age.
D.
with end-stage lung disease.


NCLEX Examination Review Questions Chapter 28
1.
Asthma is best characterized as

A.
an inflammatory disease.
B.
a steady progression of bronchoconstriction.
C.
an obstructive disease with loss of alveolar walls.
D.
a chronic obstructive disorder characterized by mucus production.



2.
In evaluating the asthmatic patient’s knowledge of self-care, the nurse recognizes that additional instruction is needed when the patient says,

A.
"I use my corticosteroid inhaler when I feel short of breath."
B.
"I get a flu shot every year and see my health care provider if I have an upper respiratory infection."
C.
"I use my bronchodilator inhaler before I visit my aunt who has a cat, but I only visit for a few minutes because of my allergies."
D.
"I walk 30 minutes every day but sometimes I have to use my bronchodilator inhaler before walking to prevent me from getting short of breath."





3.
A plan of care for the patient with COPD would include

A.
chronic corticosteroid therapy.
B.
reduction of risk factors for infection.
C.
high flow rate O2 administration.
D.
lung exercises that involve inhaling longer than exhaling.



4.
The effects of cigarette smoking on the respiratory system include

A.
increased proliferation of ciliated cells.
B.
hypertrophy of the alveolar membrane.
C.
destruction of all alveolar macrophages.
D.
hyperplasia of goblet cells and increased production of mucus.



5.
One of the most important things that a nurse can teach a patient with emphysema is to

A.
move to a hot, dry climate.
B.
perform chest physiotherapy.
C.
obtain adequate rest in the supine position.
D.
know the early signs of respiratory infection.



6.
The major advantage of a Venturi mask is that it can

A.
deliver up to 80% O2
B.
provide continuous 100% humidity.
C.
deliver a precise concentration of O2
D.
be used while a patient eats and sleeps.



7.
Diagnostic studies that the nurse would expect to be abnormal in a person with CF are

A.
insulin tolerance and blood glucose.
B.
pancreatic enzymes and hormones.
C.
sweat test and vitamin B tolerance test.
D.
pulmonary function test and sweat test.

Questions from lecture

Lung stiffness or decreased lung compliance is the pathophysiology of which condition?
○ emphysema ("floppy, old balloon," too much air, does not come out)
○ bronchitis (obstructive disease)
○ cystic fibrosis (too much abnormal mucus production)
● pleural effusion (fluid in the pleural space which makes the lungs stiff)
○ administer humidified oxygen (2)
○ place in semi-Fowler’s position (1)
○ provide nebulizer treatment with bronchodilator (3)
○ discuss factors that precipitate attacks (4)

Which condition is an example of ventilation in excess of perfusion?
○ bronchitis
○ hypoventilation
○ hypopnea
● pulmonary embolus

When assessing respiratory system of 80-year-old man, the nurse will expect to find:
○ decreased anteroposterior diameter
● decreased chest wall compliance
○ bronchovesicular sounds at the apex of the lungs
○ increased respiratory excursions

The nurse is caring for a 45-pack year history of smoking patient. The nurse recognizes that the patient will most likely have decreased respiratory defenses due to impaired:
● mucociliary clearance
○ cough reflex
○ ability to filter particles from the air

Upon assessment of a patient with pneumonia, the nurse knows:
○ typical pneumonia symptoms are caused by Mycoplasma pneumoniae
● manifestations of pneumonia varies, depending on the causative organ
○ variety of microorganisms, but the pathophysiology is the same, regardless of cause
○ all patients with pneumonia will have a productive cough

To prevent aspiration pneumonia with patient on continuous nasogastric feeding, the appropriate nursing action would be:
○ keep patient turned to their side to allow secretions to drain out
○ administer bolus feeding rather than continuous
● check for stomach residual frequently
○ administer feeding at lowest and acceptable rate

Child’s mother and father are both carriers of CF gene. What is the genetic basis for this child to have CF?
● 25% of each pregnancy

Planning care for patient with cystic fibrosis, the nurse understands that the most important therapeutic approach to promote pulmonary function in the patient is:
● chest physiotherapy

Patient with COPD usually receive low oxygen doses via nasal cannula. The nurse understands that what problem may occur if the patient receives too much oxygen.
○ hyperventilation
○ tachypnea
● hypoventilation
○ increased snoring

For patient with COPD, what is the main risk factor for pulmonary infections?
○ fluid imbalance with pitting edema
○ decreased fluid intake and loss of body weight
● pooling with respiratory secretions
○ decreased anteroposterior diameter of chest

The nurse if monitoring a patient who is experiencing an acute asthma attack. What observation would indicate an improvement in condition.
○ pulse oximetry of 88%
○ pulse rate of 110 bpm
○ productive cough with rapid breathing
● respiratory rate of 18 breaths/min

When receiving an adrenergic beta2 agonist for asthma, complaints of palpitations, chest pain, and headaches, what should the nurse do:
● withhold drug until additional orders are obtained from the physician
○ tell patient not to worry, these are expected side effects from drug
○ ask patient to relax, breathe slowly, and deeply for several minutes
○ reassure the patient that these effects are temporary and will subside as the body becomes accustomed to the drug

Loss of surface area for gas exchange is an example of which condition?
● emphysema
○ bonchitis
○ cystic fibrosis
○ pleural effusion