Medical Surgical Nursing- Respiratory care Test

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| By Frostanity
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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.


Questions and Answers
  • 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 increases
    Explanation
    A barreled-chest is a normal finding in the aging adult due to the decreased elastic recoil of the lungs

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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. Cough
    Explanation
    Cough is the most common symptom in lung diseases

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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. Orthopnea
    Explanation
    Orthopnea is shortness of breath during sleep and is relieved by sitting up or stacking pillows behind the head

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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 embolism
    Explanation
    Pulmonary embolism is life threatening and requires emergent medical intervention

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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. Crackles
    Explanation
    Crackles are popping, discontinuous sounds caused by fluid in the airways

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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. 70
    Explanation
    2 packs/day x 35 years = 70 pack years

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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 status
    Explanation
    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.

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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 return
    Explanation
    The anesthesia from bronchoscopy inhibits swallowing. Therefore, it is important for the nurse to check for the gag reflex as an aspiration precaution

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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 results

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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. Pneumothorax
    Explanation
    A pneumothrorax, or partial or complete lung collapse, can occur within the first 24 hours following a thoracentesis.

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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 acidosis
    Explanation
    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)

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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/min
    Explanation
    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 depression

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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 team
    Explanation
    Tube dislodgement that occurs 72 hours after surgery is an emergency. As such, ventilating the patient first is priority. Remember your ABCs.

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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 suctioning
    Explanation
    Hyperoxygenating before and after prevents hypoxia

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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 meals
    Explanation
    C and D are the only appropriate choices to implement aspiration precautions

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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.

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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.

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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 finding
    Explanation
    Bronchovesicular breath sounds are normally heard over the major bronchi. When heard elsewhere, this would indicate normal aging or an abnormality

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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 facemask
    Explanation
    The Venturi mask offers the most accurate flow rate than the nasal cannula and is therefore preferred for a patient with chronic lung disease

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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 empHysema
    Explanation
    Subcutaenous emphysema occurs when there is an opening in the trachea and air has leaked into the subcutaneous area of the neck

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Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Mar 22, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Mar 31, 2010
    Quiz Created by
    Frostanity
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