1.
Which of the following is a normal finding in the aging adult?
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.
2.
Which clinical manifestation is the main sign of lung disease?
Correct Answer
C. Cough
Explanation
Cough is the most common symptom in lung diseases.
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:
Correct Answer
B. Orthopnea
Explanation
Orthopnea is shortness of breath during sleep and is relieved by sitting up or stacking pillows behind the head.
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:
Correct Answer
D. Pulmonary embolism
Explanation
Pulmonary embolism is life-threatening and requires emergent medical intervention.
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:
Correct Answer
B. Crackles
Explanation
Crackles are popping, discontinuous sounds caused by fluid in the airways
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.
Correct Answer
C. 70
Explanation
2 packs/day x 35 years = 70 pack years
7.
The nurse comes into the patient's room and discovers that the patient's pulse oximetry reading is 91%. The nurse should first:
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.
8.
A postop patient who had a bronchoscopy two hours ago is NPO and states that he is hungry. What should the nurse do?
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
9.
The patient is scheduled to have a pulmonary function test. Further instruction is needed when she states:
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
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:
Correct Answer
B. Pneumothorax
Explanation
A pneumothrorax, or partial or complete lung collapse, can occur within the first 24 hours following a thoracentesis.
11.
A nurse is reviewing the ABG values and notes a pH of 7.42, a PCO2 of 55 mm Hg, and an HCO3 of 24 mEq/L. What does the nurse interpret these values as?
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)
12.
A nurse is administering oxygen to a patient who has hypoxemia and hypercarbia. Which oxygen delivery system is appropriate for this patient?
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 respiratory depression.
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?
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.
14.
The nurse is suctioning a patient with an endotracheal tube. Which of the following is a correct technique for this procedure?
Correct Answer
D. Hyperoxygenate before and after suctioning
Explanation
Hyperoxygenating before and after prevents hypoxia.
15.
What aspiration precaution measures should the nurse implement to the 78-year-old patient with a tracheostomy?
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.
16.
A nurse is providing discharge instructions for a tracheostomy patient. Which statement indicates that the patient understands tracheostomy care?
Correct Answer
A. "I will increase the humidity in my home."
Explanation
Increasing humidity in the home helps thin secretions.
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?
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.
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?
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
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?
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.
20.
While assessing a trachostomy patient, the nurse notices that there is a crackling sensation around the neck. The nurse suspects this complication as:
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