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    Exam Review

    1. A nurse is assisting with the assessment of a client who has flail chest. Which of the following findings should the nurse expect?
      A)
      Only the flail segment pulling inward during inspiration
      B)
      Only the flail segment pulling inward during expiration
      C)
      The entire chest pulling inward during expiration
      D)
      The entire chest pushing outward during inspiration
    2. A nurse is collecting data from a client who has pulmonary tuberculosis. Which of the following findings should the nurse expect?
      A)
      High fever in the early morning
      B)
      Increased appetite
      C)
      Edema
      D)
      Fatigue
    3. What is albuterol (Proventil) used to treat?
      A)
      Nasal congestion
      B)
      Acute bronchospasm
      C)
      Dyspnea on exertion
      D)
      Acute allergies
    4. A nurse is collecting data from a client who is having an acute asthma exacerbation. When auscultating the client's chest, the nurse should expect to hear which of the following sounds?
      A)
      Expiratory wheeze
      B)
      Pleural friction rub
      C)
      Fine rales
      D)
      Rhonchi
    Page 1 of 13

    Exam Review

    1. A nurse is caring for a client who has been admitted with asthma exacerbation and is experiencing increased wheezing and has an oxygen saturation of 91%. The client is scheduled for his next breathing treatment in 1hr. Which of the following actions should the nurse take?
      A)
      Requesting the pharmacy to dispense 10 mL of dextromethorphan PO
      B)
      Increasing oxygen to maintain an oxygen saturation of 95% or greater in the client
      C)
      Instructing respiratory therapy to administer a PRN albuterol aerosol
      D)
      Asking the provider to repeat another radiograph of the chest
    2. Which principle(s) would be important to teach a patient about the use of a steroid inhaler? (SELECT ALL THAT APPLY)
      (SATA)
      A)
      When taking a steroid drug as well as a bronchodilator, the bronchodilator should be administered first
      B)
      Frequent oral hygiene is necessary
      C)
      Hold your breath for 10 seconds during inhalation of the medication
      D)
      Rinse and spit after inhalation of the medication
      E)
      The inhaler should be used on a PRN basis only
    3. A nurse is reinforcing teaching to a client who has a pulmonary embolism. Which of the following should the nurse include in the teaching?
      A)
      Any size of a pulmonary embolism is fatal.
      B)
      There is an increased risk of bleeding.
      C)
      Rest when experiencing symptoms of a pulmonary embolism.
      D)
      Follow-up is not needed.
    4. A nurse at a long-term care facility is reinforcing teaching with a newly hired nurse about care of clients who are receiving mechanical ventilation. Which of the following information should the nurse include?
      A)
      Turn off the ventilator alarms before suctioning the client's airway.
      B)
      Place the head of the client's bed at 40° when supine.
      C)
      Reposition the client every 4 hr.
      D)
      Provide mouth care every 10 to 12 hr with hydrogen peroxide.
    Page 2 of 13

    Exam Review

    1. A nurse is collecting data on a client who has COPD. Which of the following findings should the nurse expect?
      A)
      Pleural friction rub
      B)
      Spoon nails
      C)
      Peripheral edema
      D)
      Barrel chest
    2. A nurse is assisting with the care of a client who has multiple injuries following a motor vehicle crash. The nurse should monitor for which of the following manifestations of a pneumothorax?
      A)
      Inspiratory stridor
      B)
      Expiratory wheeze
      C)
      Coarse crackles
      D)
      Absence of breath sounds
    3. Which of the following could the nurse expect to observe in an older adult client who has a pneumothorax?
      A)
      Lower energy expenditure
      B)
      Increased lung capacity
      C)
      Higher oxygen saturations of 98% to 99%
      D)
      Lower oxygen saturations of 93% to 94%
    4. A nurse is caring for a client who is immobile. Which of the following actions is the priority for the nurse to contribute to the client's plan of care?
      A)
      Auscultate breath sounds at least every 2 hr.
      B)
      Perform range-of-motion exercises at least two to three times daily.
      C)
      Apply antiembolic stockings.
      D)
      Make sure the client has an intake of 2,000 to 3,000 mL of fluid per day.
    Page 3 of 13

    Exam Review

    1. A nurse is reinforcing discharge teaching on actions that improve gas exchange to a client diagnosed with emphysema. Which of the following instructions should be included in the teaching?
      A)
      Rest in a supine position.
      B)
      Limit fluid intake throughout the day.
      C)
      Breathe in through her nose and out through pursed lips.
      D)
      Consume a low-protein diet.
    2. What nursing intervention enhances the nutritional status of a patient with COPD?
      A)
      Offer small frequent meals
      B)
      Encourage extra liquids with meals
      C)
      Supply information about nutrition
      D)
      Assist the patient to exercise before meals
    3. A nurse is reinforcing teaching about use of a metered-dose inhaler (MD) with a client who has a new diagnosis of asthma. Identify the sequence the client should follow. (Move the steps into the box on the right, placing them in the selected order of performance. Use all steps.)
      A)
      Exhale slowly through pursed lips.
      B)
      Hold her breath for 10 seconds.
      C)
      Place her lips firmly around the mouthpiece.
      D)
      Shake the canister 3 to 5 seconds vigorously.
      E)
      Inhale slowly over 3 to 5 seconds while pushing down on the canister.
    4. A nurse is caring for a client who has COPD. Which of the following actions should the nurse take?
      A)
      Instruct the client to cough every 4 hr.
      B)
      Advise the client to lie down after eating.
      C)
      Provide the client with a low protein diet.
      D)
      Encourage the client to drink 8 glasses of water a day.
    Page 4 of 13

    Exam Review

    1. A nurse is preparing to review discharge instructions with a client who has pulmonary tuberculosis. Which of the following information should the nurse include?
      A)
      Consume alcohol in moderation while taking antituberculosis medications.
      B)
      Place tissue soiled with respiratory secretions in a paper bag for later disposal.
      C)
      Provide samples for sputum cultures every 6 weeks.
      D)
      Wear a mask while out or around crowds of people.
    2. A nurse is reinforcing teaching with a client who has COPD about purse-lipped breathing. Which of the following statements should the nurse make?
      A)
      "You should inhale through your nose and exhale through your mouth during purse-lipped breathing."
      B)
      "You should cough forcefully during exhalation when you are purse-lipped breathing."
      C)
      "Your inspiration should be longer than expiration during purse-lipped breathing."
      D)
      "You should be flat on your back when you perform purse-lipped breathing."
    3. A nurse is reinforcing teaching with a client who is to start taking montelukast to treat asthma. Which of the following statements by the client indicates an understanding of the teaching?
      A)
      "I'll use this medication when I get an asthma attack."
      B)
      "I'll take this medication once a day in the evening."
      C)
      "I'll decrease my sodium intake while I'm taking this medication."
      D)
      "I'll rinse my mouth after taking this medication."
    4. The nurse is caring for a client who has a pneumothorax and a water-seal chest tube drainage system to suction. Which of the following actions should the nurse take?
      A)
      Clamp the chest tubes if it becomes disconnected
      B)
      Add tap water as needed to the suction control chamber.
      C)
      Maintain the drainage container below the level of the client's chest.
      D)
      Empty the collection container every shift.
    Page 5 of 13

    Exam Review

    1. A nurse is collecting data from a client who has emphysema. Which of the following findings should the nurse expect? (Select all that apply.)
      A)
      Clubbing of the fingers
      B)
      Bradycardia
      C)
      Barrel chest
      D)
      Dyspnea
      E)
      Shallow respirations
    2. A nurse is reinforcing teaching with the parents of a child who is starting to use a spacer with a metered-dose inhaler (MDI) to treat asthma. Which of the following information should the nurse include in the teaching?
      A)
      The spacer increases the amount of medication delivered to the oropharynx.
      B)
      Cover exhalation slots of the spacer with lips when inhaling.
      C)
      Inhale rapidly when using the spacer with the MDI.
      D)
      The spacer increases the amount of medication delivered to the lungs.
    3. A nurse is reinforcing teaching to a client who has a spinal cord injury about prevention of atelectasis. Which of the following statements should the nurse include in the teaching?
      A)
      "Do panting breaths several times a day."
      B)
      "Strengthen your chest muscles by performing therapy exercises."
      C)
      "Perform deep coughing twice a day."
      D)
      "Get plenty of rest throughout the day."
    4. A nurse is assisting with the care of a client who is postoperative following a pneumonectomy. Which of the following actions should the nurse take?
      A)
      Monitor respiratory status every 8 hr.
      B)
      Elevate the head of the bed to a 15° angle.
      C)
      Position the client on the nonoperative side.
      D)
      Encourage the client to splint the incision when coughing.
    Page 6 of 13