Pre-test Respiratory Assessment
This pre-test evaluates nursing interventions and assessments for respiratory conditions, focusing on COPD, asthma, and pneumonia symptoms management.
Questions and Answers
- 1.
A nurse is assessing a client whi is experiencing shortness of breath. The client exhibits nasal flaring, use of accesory muscles, a respiratory rate of 36 breaths per minute, and an oxygen saturation of 89% on 2 Liters of oxygen via nasal cannula. After listening to the client's breath sounds, which of these interventions is appropriate based on the assessment data?
- A.
Get the client back to bed
- B.
Notify the client's Physician
- C.
Ask the respiratory therapist to give a breathing treatment
- D.
Check th position of the nasal cannula
Correct Answer
B. Notify the client's PhysicianExplanation
Based on the assessment data provided, the client is experiencing significant respiratory distress with symptoms such as nasal flaring, use of accessory muscles, a high respiratory rate, and low oxygen saturation. These symptoms indicate that the client's condition is deteriorating and requires immediate medical attention. Notifying the client's physician is the most appropriate intervention in this situation to ensure prompt medical assessment and intervention.Rate this question:
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- 2.
When ausculatating the lungs of a client with asthma, the nurse hears high pitched, shrill breath sounds on expiration. Which of these nursing interventions is appropriate based on the assessment data.
- A.
Chest physiotherapy
- B.
Postural drainage
- C.
A nebulizer treatment
- D.
Increase the oxygen
Correct Answer
C. A nebulizer treatmentExplanation
A nebulizer treatment is appropriate based on the assessment data because it helps deliver medication directly to the lungs, which can help relieve symptoms of asthma such as high pitched, shrill breath sounds on expiration. Nebulizer treatments can help open up the airways and reduce inflammation, making it easier for the client to breathe. Chest physiotherapy and postural drainage may be helpful in other respiratory conditions but may not be as effective in treating asthma. Increasing the oxygen may not directly address the underlying cause of the high pitched, shrill breath sounds.Rate this question:
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- 3.
A client who has COPD is receiving oxygen via a Bipap mask with external positive pressure ventilation. The nurse determines f the theapy is effective if which of these values decreases on an arteial blood gas?
- A.
PaO2
- B.
Hco3
- C.
Paco2
- D.
PH
Correct Answer
C. Paco2Explanation
The correct answer is Paco2. In a client with COPD receiving oxygen via a Bipap mask with external positive pressure ventilation, the therapy is effective if the Paco2 (partial pressure of carbon dioxide) decreases on an arterial blood gas. This is because the positive pressure ventilation helps to improve ventilation and remove excess carbon dioxide from the lungs, leading to a decrease in Paco2 levels.Rate this question:
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- 4.
A client states " I never feel as though I'm getting enough air" The client has a 20 yea history of COPD and is hospitalized with pneumonia. His respiratory rate is 40 breaths per minute and shallow. Bilateral course crackles in the upper lung lobes are auscultated by the nurse. The client has a dry cough and is restless. Which of these nursing diagnoses would the nurse choose to plan care for the client?
- A.
Impaired gas exchange
- B.
Insufficient airway clearance
- C.
Ineffective breathing pattern
- D.
Risk for aspiration
Correct Answer
B. Insufficient airway clearanceExplanation
The client's statement of never feeling like they're getting enough air, along with their history of COPD, hospitalized with pneumonia, and shallow respiratory rate of 40 breaths per minute, indicates that they are experiencing difficulty in clearing their airway. The presence of bilateral coarse crackles in the upper lung lobes, dry cough, and restlessness further support the diagnosis of insufficient airway clearance. This nursing diagnosis would be chosen to plan care for the client, as it addresses the specific issue of inadequate airway clearance, which is essential for effective breathing and gas exchange.Rate this question:
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- 5.
A client presents to the emergency room with fever, malaise and a productive cough. During the physical examination, the nurse papates the chest from one side to other while the client says "99". This technique will assist in detecting which of these physical findings?
- A.
Ecophony
- B.
Bronchophony
- C.
Pectoriloquy
- D.
Fremitis
Correct Answer
D. FremitisExplanation
During the physical examination, the nurse palpates the chest from one side to the other while the client says "99." This technique is known as fremitis. Fremitis refers to the vibration felt on the chest wall when the patient speaks. Increased fremitis can indicate underlying lung consolidation or fluid in the lungs. Therefore, by palpating the chest and assessing for fremitis, the nurse can detect abnormal physical findings that may suggest a respiratory condition such as pneumonia.Rate this question:
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Current Version
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Mar 22, 2022Quiz Edited by
ProProfs Editorial Team -
Aug 05, 2009Quiz Created by
Bryantj1