NURS 301 Respiratory Practice questions with answers at the bottom

1. An elderly client with pneumonia may appear with which of the following symptoms first? 1. Altered mental status and dehydration 2. fever and chills 3. Hemoptysis and dyspnea 4. Pleuritic chest pain and cough 2. Which of the following pathophysiological mechanisms that occur in the lung parenchyma allows pneumonia to develop? 1. Atelectasis 2. Bronchiectasis 3. Effusion 4. Inflammation 3. A 7-year-old client is brought to the E.R. He’s tachypneic and afebrile and has a respiratory rate of 36 breaths/minute and a nonproductive cough. He recently had a cold. From his history, the client may have which of the following? 1. Acute asthma 2. Bronchial pneumonia 3. Chronic obstructive pulmonary disease (COPD) 4. Emphysema 4. Which of the following assessment findings would help confirm a diagnosis of asthma in a client suspected of having the disorder? 1. Circumoral cyanosis 2. Increased forced expiratory volume 3. Inspiratory and expiratory wheezing 4. Normal breath sounds 5. Which of the following types of asthma involves an acute asthma attack brought on by an upper respiratory infection? 1. Emotional 2. Extrinsic 3. Intrinsic 4. Mediated 6. A client with acute asthma showing inspiratory and expiratory wheezes and a decreased expiratory volume should be treated with which of the following classes of medication right away? 1. Beta-adrenergic blockers 2. Bronchodilators 3. Inhaled steroids 4. Oral steroids 7. A 19-year-old comes into the emergency department with acute asthma. His respiratory rate is 44 breaths/minute, and he appears to be in acute respiratory distress. Which of the following actions should be taken first? 1. Take a full medication history 2. Give a bronchodilator by nebulizer 3. Apply a cardiac monitor to the client 4. Provide emotional support to the client. 8. A 58-year-old client with a 40-year history of smoking one to two packs of cigarettes a day has a chronic cough producing thick sputum, peripheral edema, and cyanotic nail beds. Based on this information, he most likely has which of the following conditions? 1. Adult respiratory distress syndrome (ARDS) 2. Asthma 3. Chronic obstructive bronchitis 4. Emphysema 9. The term “blue bloater” refers to which of the following conditions? 1. Adult respiratory distress syndrome (ARDS) 2. Asthma 3. Chronic obstructive bronchitis 4. Emphysema 10. The term “pink puffer” refers to the client with which of the following conditions? 1. ARDS 2. Asthma 3. Chronic obstructive bronchitis 4. Emphysema 11. A 66-year-old client has marked dyspnea at rest, is thin, and uses accessory muscles to breathe. He’s tachypneic, with a prolonged expiratory phase. He has no cough. He leans forward with his arms braced on his knees to support his chest and shoulders for breathing. This client has symptoms of which of the following respiratory disorders? 1. ARDS 2. Asthma 3. Chronic obstructive bronchitis 4. Emphysema 12. It’s highly recommended that clients with asthma, chronic bronchitis, and emphysema have Pneumovax and flu vaccinations for which of the following reasons? 1. All clients are recommended to have these vaccines 2. These vaccines produce bronchodilation and improve oxygenation. 3. These vaccines help reduce the tachypnea these clients experience. 4. Respiratory infections can cause severe hypoxia and possibly death in these clients. 13. Exercise has which of the following effects on clients with asthma, chronic bronchitis, and emphysema? 1. It enhances cardiovascular fitness. 2. It improves respiratory muscle strength. 3. It reduces the number of acute attacks. 4. It worsens respiratory function and is discouraged. 14. Clients with chronic obstructive bronchitis are given diuretic therapy. Which of the following reasons best explains why? 1. Reducing fluid volume reduces oxygen demand. 2. Reducing fluid volume improves clients’ mobility. 3. Restricting fluid volume reduces sputum production. 4. Reducing fluid volume improves respiratory function. 15. A 69-year-old client appears thin and cachectic. He’s short of breath at rest and his dyspnea increases with the slightest exertion. His breath sounds are diminished even with deep inspiration. These signs and symptoms fit which of the following conditions? 1. ARDS 2. Asthma 3. Chronic obstructive bronchitis 4. Emphysema 16. A client with emphysema should receive only 1 to 3 L/minute of oxygen, if needed, or he may lose his hypoxic drive. Which of the following statements is correct about hypoxic drive? 1. The client doesn’t notice he needs to breathe. 2. The client breathes only when his oxygen levels climb above a certain point. 3. The client breathes only when his oxygen levels dip below a certain point. 4. The client breathes only when his carbon dioxide level dips below a certain point. 17. Teaching for a client with chronic obstructive pulmonary disease (COPD) should include which of the following topics? 1. How to have his wife learn to listen to his lungs with a stethoscope from Wal-Mart. 2. How to increase his oxygen therapy. 3. How to treat respiratory infections without going to the physician. 4. How to recognize the signs of an impending respiratory infection. 18. Which of the following respiratory disorders is most common in the first 24 to 48 hours after surgery? 1. Atelectasis 2. Bronchitis 3. Pneumonia 4. Pneumothorax 19. Which of the following measures can reduce or prevent the incidence of atelectasis in a postoperative client? 1. Chest physiotherapy 2. Mechanical ventilation 3. Reducing oxygen requirements 4. Use of an incentive spirometer 20. Emergency treatment of a client in status asthmaticus includes which of the following medications? 1. Inhaled beta-adrenergic agents 2. Inhaled corticosteroids 3. I.V. beta-adrenergic agents 4. Oral corticosteroids 21. Which of the following treatment goals is best for the client with status asthmaticus? 1. Avoiding intubation 2. Determining the cause of the attack 3. Improving exercise tolerance 4. Reducing secretions 22. Dani was given dilaudid for pain. She’s sleeping and her respiratory rate is 4 breaths/minute. If action isn’t taken quickly, she might have which of the following reactions? 1. Asthma attack 2. Respiratory arrest 3. Be pissed about receiving Narcan 4. Wake up on her own 23. Which of the following additional assessment data should immediately be gathered to determine the status of a client with a respiratory rate of 4 breaths/minute? 1. Arterial blood gas (ABG) and breath sounds 2. Level of consciousness and a pulse oximetry value. 3. Breath sounds and reflexes 4. Pulse oximetry value and heart sounds 24. A client is in danger of respiratory arrest following the administration of a narcotic analgesic. An arterial blood gas value is obtained. The nurse would expect to PaCO2 to be which of the following values? 1. 15 mm Hg 2. 30 mm Hg 3. 40 mm Hg 4. 80 mm Hg 25. A client has started a new drug for hypertension. Thirty minutes after he takes the drug, he develops chest tightness and becomes short of breath and tachypneic. He has a decreased level of consciousness. These signs indicate which of the following conditions? 1. Asthma attack 2. Pulmonary embolism 3. respiratory failure 4. Rheumatoid arthritis 26. Emergency treatment for a client with impending anaphylaxis secondary to hypersensitivity to a drug should include which of the following actions first? 1. Administering oxygen 2. Inserting an I.V. catheter 3. Obtaining a complete blood count (CBC) 4. Taking vital signs 27. Following the initial care of a client with asthma and impending anaphylaxis from hypersensitivity to a drug, the nurse should take which of the following steps next? 1. Administer beta-adrenergic blockers 2. Administer bronchodilators 3. Obtain serum electrolyte levels 4. Have the client lie flat in the bed. 28. A client’s ABG results are as follows: pH: 7.16; PaCO2 80 mm Hg; PaO2 46 mm Hg; HCO3- 24 mEq/L; SaO2 81%. This ABG result represents which of the following conditions? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis 29. A nurse plans care for a client with chronic obstructive pulmonary disease, knowing that the client is most likely to experience what type of acid-base imbalance? 1. Respiratory acidosis 2. Respiratory alkalosis 3. Metabolic acidosis 4. Metabolic alkalosis 30. A nurse is caring for a client who is on a mechanical ventilator. Blood gas results indicate a pH of 7.50 and a PCO2 of 30 mm Hg. The nurse has determined that the client is experiencing respiratory alkalosis. Which laboratory value would most likely be noted in this condition? 1. Sodium level of 145 mEq/L 2. Potassium level of 3.0 mEq/L 3. Magnesium level of 2.0 mg/L 4. Phosphorus level of 4.0 mg/dl 31. A nurse reviews the arterial blood gas results of a patient and notes the following: pH 7.45; PCO2 30 mm Hg; and bicarbonate concentration of 22 mEq/L. The nurse analyzes these results as indicating: 1. Metabolic acidosis, compensated. 2. Metabolic alkalosis, uncompensated. 3. Respiratory alkalosis, compensated. 4. Respiratory acidosis, compensated. 32. A client is scheduled for blood to be drawn from the radial artery for an ABG determination. Before the blood is drawn, an Allen’s test is performed to determine the adequacy of the: 1. Popliteal circulation 2. Ulnar circulation 3. Femoral circulation 4. Carotid circulation 33. A nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client, knowing that the client is at risk for which acid-base disorder? 1. Respiratory acidosis 2. Respiratory alkalosis 3. Metabolic acidosis 4. Metabolic alkalosis 34. A nurse is caring for a client with an ileostomy understands that the client is most at risk for developing which acid-base disorder? 1. Respiratory acidosis 2. Respiratory alkalosis 3. Metabolic acidosis 4. Metabolic alkalosis 35. A nurse is caring for a client with diabetic ketoacidosis and documents that the client is experiencing Kussmaul’s respirations. Based on this documentation, which of the following did the nurse observe? 1. Respirations that are abnormally deep, regular, and increased in rate. 2. Respirations that are regular but abnormally slow. 3. Respirations that are labored and increased in depth and rate 4. Respirations that cease for several seconds. 36. A nurse understands that the excessive use of oral antacids containing bicarbonate can result in which acid-base disturbance? 1. Respiratory alkalosis 2. Respiratory acidosis 3. Metabolic acidosis 4. Metabolic alkalosis 37. A nurse is caring for a client with renal failure. Blood gas results indicate a pH of 7.30; a PCO2 of 32 mm Hg, and a bicarbonate concentration of 20 mEq/L. The nurse has determined that the client is experiencing metabolic acidosis. Which of the following laboratory values would the nurse expect to note? 1. Sodium level of 145 mEq/L 2. Magnesium level of 2.0 mg/dL 3. Potassium level of 5.2 mEq/L 4. Phosphorus level of 4.0 mg/dL 38. A nurse is preparing to obtain an arterial blood gas specimen from a client and plans to perform the Allen’s test on the client. Number in order of priority the steps for performing the Allen’s test (#1 is first step). 1. Ask the client to open and close the hand repeatedly. 2. Apply pressure over the ulnar and radial arteries. 3. Assess the color of the extremity distal to the pressure point 4. Release pressure from the ulnar artery 5. Explain the procedure to the client. 39. A nurse is preparing to obtain a sputum specimen from a client. Which of the following nursing actions will facilitate obtaining the specimen? 1. Limiting fluids 2. Having the client take 3 deep breaths. 3. Asking the client to spit into the collection container. 4. Asking the client to obtain the specimen after eating. 40. A nurse is caring for a client after a bronchoscopy and biopsy. Which of the following signs if noted in the client should be reported immediately to the physician? 1. Blood-streaked sputum 2. Dry cough 3. Hematuria 4. Bronchospasm 41. A nurse is suctioning fluids from a client via a tracheostomy tube. When suctioning, the nurse must limit the suctioning to a maximum of: 1. 5 seconds 2. 10 seconds 3. 30 seconds 4. 1 minute 42. A nurse is suctioning fluids from a client through an endotracheal tube. During the suctioning procedure, the nurse notes on the monitor that the heart rate decreases. Which of the following is the most appropriate nursing intervention? 1. Continue to suction 2. Ensure that the suction is limited to 15 seconds 3. Stop the procedure and reoxygenated the client 4. Notify the physician immediately. 43. An unconscious client is admitted to an emergency room. Arterial blood gas measurements reveal a pH of 7.30, a low bicarbonate level, a normal carbon dioxide level, and a normal oxygen level. An elevated potassium level is also present. These results indicate the presence of: 1. Metabolic acidosis 2. Respiratory acidosis 3. Combined respiratory and metabolic acidosis 4. over compensated respiratory acidosis 44. A nurse is caring for a client hospitalized with acute exacerbation of COPD. Which of the following would the nurse expect to note on assessment of this client? 1. Increased oxygen saturation with exercise 2. Hypocapnia 3. A hyperinflated chest on x-ray film 4. A widened diaphragm noted on chest x-ray film 45. An oxygenated delivery system is prescribed for a client with COPD to deliver a precise oxygen concentration. Which of the following types of oxygen delivery systems would the nurse anticipate to be prescribed? 1. Venturi mask 2. Aerosol mask 3. Face tent 4. Tracheostomy collar 46. Theophylline (Theo-Dur) tablets are prescribed for a client with chronic airflow limitation, and the nurse instructs the client about the medication. Which statement by the client indicates a need for further teaching? 1. “I will take the medication on an empty stomach.” 2. “I will take the medication with food.” 3. “I will continue to take the medication even if I am feeling better.” 4. “Periodic blood levels will need to be obtained.” 47. A nurse is caring for a client with emphysema. The client is receiving oxygen. The nurse assesses the oxygen flow rate to ensure that it does not exceed 1. 1 L/min 2. 2 L/min 3. 6 L/min 4. 10 L/min 48. The nurse reviews the ABG values of a client. The results indicate respiratory acidosis. Which of the following values would indicate that this acid-base imbalance exists? 1. pH of 7.48 2. PCO2 of 32 mm Hg 3. pH of 7.30 4. HCO3- of 20 mEq/L 49. A nurse instructs a client to use the pursed lip method of breathing. The client asks the nurse about the purpose of this type of breathing. The nurse responds, knowing that the primary purpose of pursed lip breathing is: 1. Promote oxygen intake 2. Strengthen the diaphragm 3. Strengthen the intercostal muscles 4. Promote carbon dioxide elimination 50. A nurse reviews the ABG values and notes a pH of 7.50, a PCO2 of 30 mm Hg, and an HCO3 of 25 mEq/L. The nurse interprets these values as indicating: 1. Respiratory acidosis uncompensated 2. Respiratory alkalosis uncompensated 3. Metabolic acidosis uncompensated 4. Metabolic acidosis partially compensated.