Exam Review

Which of the following are cues for Acute Poststreptococcal Glomerulonephritis (APSGN)?
(SATA)
A)
Persistent cough.
B)
Peripheral edema.
C)
Dry, itchy skin.
D)
Presence of hematuria.
E)
Elevated blood pressure.
F)
Recent history of streptococcal infection.
A nurse is caring for a client who has asthma and developed viral pharyngitis and has a WBC of 16,000/mm. Which of the following findings should the nurse expect?
(SATA)
A)
Negative throat culture.
B)
Severe hyperemia of pharyngeal mucosa.
C)
Petechiae on the chest and the abdomen.
D)
Elevated serum glucose levels.
A nurse is teaching a client who is obese and has obstructive sleep apnea how to decrease the number of nightly apneic episodes. Which of the following client statements indicates an understanding of the teaching?
A)
I will get a humidifier to run at my bedside at night.
B)
If I could lose about 50 pounds, I might stop having so many apneic episodes.
C)
I will sleep better if I take a sleeping pill at night.
D)
It might help if I tried sleeping only on my back.
A nurse is working on a medical/surgical unit and is giving an in-service on patients at risk for Atelectasis. Identify which of the following patients are at risk for Atelectasis.
(SATA)
A)
A patient who is admitted for a COPD exacerbation and smokes 1 pack of cigarettes a day.
B)
A patient who is 1 day post op from abdominal surgery.
C)
A patient who has been having coughing fits from viral rhinitis.
D)
A patient with gangrene of the toe.
E)
An obese patient who is admitted for kidney failure.

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Exam Review

A nurse is assessing a client for hypoxemia during an asthma attack. Which of the following manifestations should the nurse expect?
A)
Agitation.
B)
Nausea.
C)
Hypotension.
D)
Dysphagia.
A nurse in a provider's office is assessing a client. The nurse should identify that which of the following findings are manifestations of pulmonary tuberculosis?
(SATA)
A)
Weight gain.
B)
Low-grade fever.
C)
Blood in the sputum.
D)
Night sweats.
E)
Flushed cheeks.
A nurse is planning to perform nasotracheal suction for a client who has an artificial airway. Which of the following actions should the nurse take?
A)
Perform suctioning for up to four passes.
B)
Limit each suction pass to 25 seconds.
C)
Apply suction to the catheter when advancing it into the trachea.
D)
Preoxygenate the client with 100
The clinic nurse is caring for a patient who has been diagnosed with emphysema and who has just had a pulmonary function test (PFT) ordered. The patient asks, "What exactly is this test for?" What would be the nurse's best response?
A)
A PFT measures how much air moves in and out of your lungs when you breathe.
B)
A PFT measures your oxygen saturation.
C)
A PFT measures whether oxygen and carbon dioxide is balanced with an appropriate pH.
D)
A PFT measures whether oxygen and carbon dioxide move between your lungs and your blood.

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Exam Review

A nurse is caring for a client who has an NG tube set to low intermittent suction. The nurse irrigates the NG tube twice with 30 mL of 0.9 At the end of the shift, the NG canister contains 475 mL. What amount of NG drainage should the nurse record?
Correct Answer:415 mL
A nurse on a medical-surgical unit is performing an admission assessment of a client who has COPD with emphysema. The client reports that he has a frequent productive cough and is short of breath. The nurse should anticipate which of the following assessment findings for this client?
A)
Respiratory alkalosis.
B)
Increased anteroposterior diameter of the chest.
C)
Oxygen saturation level 96
D)
Petechiae on chest.
A nurse is developing a plan of care for a client who has COPD. The nurse should include which of the following interventions in the plan?
A)
Instruct the client to use pursed-lip breathing.
B)
Provide the client with a low-protein diet.
C)
Restrict the client's fluid intake to less than 2 L/day.
D)
Have the client use the early-morning hours for exercise and activity.
A nurse is auscultating the breath sounds of a client who has asthma. When the client exhales, the nurse hears high-pitched squeaking sounds. The nurse should document this as which of the following adventitious breath sounds?
A)
Crackles.
B)
Wheezes.
C)
Stridor.
D)
Rhonchi.

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Exam Review

A nurse is teaching a client who has chronic obstructive pulmonary disease and is to start using Budesonide (Pulmicort) by MDI twice daily. Which of the following instructions should the nurse include?
A)
Skip the morning dose if you do not have any symptoms.
B)
Use this medication to relieve an acute attack.
C)
Check your heart rate before each dose.
D)
Inspect your mouth for lesions daily.
A nurse is monitoring an older adult client immediately following a bronchoscopy. The nurse's priority is to monitor the client for which of the following?
A)
Observing for confusion.
B)
Auscultating breath sounds.
C)
Measuring blood pressure.
D)
Confirming the gag reflex.
A nurse is performing a respiratory assessment. During the exam, the nurse palpates subcutaneous air under the client's skin. Which term would the nurse use when documenting this finding?
A)
Resonance.
B)
Crackles.
C)
Wheeze.
D)
Crepitus.
A nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) who has been prescribed Methylprednisolone (Solu-Medrol) as part of their treatment plan. The nurse educates the patient about the potential side effects of this medication. Which of the following potential effects should the nurse emphasize as most important to monitor while the patient is on this medication?
A)
Decreased appetite and weight loss.
B)
Hypotension and fluid retention.
C)
Muscle weakness and skin rash.
D)
Increased risk of infection and elevated blood sugar.

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Exam Review

What is the primary purpose of Directly Observed Therapy (DOT) in the treatment of tuberculosis (TB)?
A)
To diagnose TB more accurately in patients.
B)
To reduce the cost of TB medications for patients.
C)
To ensure that patients adhere to their medication regimen and complete their treatment course.
D)
To provide a social support network for patients with TB.
A nurse is caring for a client who has pneumonia. Which of the following actions should the nurse take to promote thinning of respiratory secretions?
A)
Encourage the client to ambulate frequently.
B)
Encourage coughing and deep breathing.
C)
Encourage the client to increase fluid intake.
D)
Encourage regular use of the incentive spirometer.
A nurse is caring for a client who has a tracheostomy. The nurse completes an assessment and finds that the client's oxygen saturation is 96
A)
Increased respiratory rate.
B)
Oxygen Saturation of 96
C)
Brisk capillary refill.
D)
Clear breath sounds.
A nurse is monitoring a client following a thoracentesis. The nurse should identify which of the following manifestations as a complication and contact the provider immediately?
A)
Serosanguineous drainage from the puncture site.
B)
Increased heart rate.
C)
Decreased temperature.
D)
Discomfort at the puncture site.

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Exam Review

A nurse is teaching a client who has obstructive sleep apnea (OSA) about continuous positive airway pressure (CPAP). Which of the following instructions should the nurse include?
A)
The CPAP device delivers less pressure during exhalation than inhalation.
B)
The CPAP device should be placed over the nose.
C)
The CPAP device should fit loosely on the face.
D)
The CPAP device requires an invasive ventilation tube.
A nurse is caring for a client who has a history of exposure to TB and symptoms of night sweats and hemoptysis. Which of the following tests should the nurse realize is the most reliable to confirm the diagnosis of active pulmonary TB?
A)
Mantoux test.
B)
Sputum smear.
C)
Sputum culture for acid-fast bacillus.
D)
Chest x-ray.
A nurse is caring for a client following a total laryngectomy. Which of the following is the priority observation in the client's care?
A)
The client's airway.
B)
Level of pain.
C)
Patency of the intravenous line.
D)
Integrity of the dressing.
A nurse is auscultating the lungs of a client who has pleurisy. Which of the following adventitious breath sounds should the nurse expect to hear?
A)
Rhonchi (Snoring sounds).
B)
Pleural Friction Rub (Loud, scratchy, rubbing sounds).
C)
Wheezing (Squeaky, musical sounds).
D)
Crackles (Popping sounds).

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