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- 1. Multiple Choice
Under normal circumstances, what is the strongest stimulus to breathe?
hypercapnia
hypoxemia
consolidation
dyspnea
- 2. Multiple Choice
The nurse is preparing to auscultate a client's lungs after completing thoracic inspection, palpation, and percussion. How should the nurse best prepare for this assessment technique?
Keep the client's shirt or gown in place to maintain privacy.
Begin with the bell of the stethoscope on the client's anterior chest.
Tell the client that you will be asking them to breathe as quickly and deeply as possible.
Place the diaphragm on the client's posterior chest wall.
- 3. Multiple Choice
The nurse's auscultation of a client's lung fields reveals the presence of a wheeze. The nurse should recognize that this adventitious sound results from what pathophysiologic process?
Air leaking from the alveoli into the pleural space
Air being diverted from the trachea to the bronchi
Air increasing in turbulence in a wide passage
Air passing through constricted passageways
- 4. Multiple Choice
The nurse is assessing a client's respiratory rate and rhythm during the beginning of a shift. The client's rate is 29 breaths/min. How should the nurse respond to this assessment finding?
Ask the client if she has recently exerted herself.
Report the finding to the client's primary care provider.
Ask the client if she has smoked recently.
Palpate the client's anterior and posterior thorax.
- 5. Multiple Choice
While assessing the health of a client's respiratory system, the nurse is palpating for fremitus. What instruction should the nurse provide to the client during this component of assessment?
When I say so, please exhale forcefully and hold the breath.
Say the letter e and keep saying it until I tell you to stop.
Breathe in as deeply as you can and hold your breath until I say to stop.
Please say the number ninety-nine for me.
- 6. Multiple Choice
The nurse is performing a respiratory assessment of a client who is receiving palliative care only due to severe, uncompensated heart failure. What type of respiratory pattern should the nurse anticipate?
Biot
CheyneStoke
Bradypnea
Kussmaul
- 7. Multiple Choice
The nurse assesses chest expansion in a 30-year-old man and finds it to be 8 cm. How would the nurse document this finding?
Limited expansion
Normal expansion
hypoexpansion
Hyperexpansion
- 8. Multiple Choice
The nurse is assessing a 69-year-old woman's risks for lung disease. The woman states, It shouldn't be a problem for me. My husband smokes quite heavily but I've been a lifelong nonsmoker. The nurse should recognize the need to teach the client about what topic?
Strategies for making her husband quit smoking
Genetic causes of lung cancer
Age-related changes to respiratory function
Health risks of secondhand smoke
- 9. Multiple Choice
The nurse is assessing a 79-year-old client's posterior thorax during a focused respiratory assessment. The nurse should attribute what assessment finding to age-related changes?
Slight kyphosis
Inaudible posterior lung sounds
Audible wheeze
Asymmetrical chest expansion
- 10. Multiple Choice
A nursing instructor is discussing cultural variations in the size of the thorax and impact on lung capacity. Which group would the instructor identify as typically having a larger thorax?
African Americans
Native Americans
Asian Americans
Caucasians
- 11. Multiple Choice
During a health-screening event, the nurse is assessing a client's risk factors for lung cancer. When addressing the most significant risk factor for lung cancer, the nurse should question the client about which of the following?
Childhood exposure to air pollution
History of tobacco use
History of working in a factory or smelter
History of recurrent lung infections
- 12. Multiple Choice
The nurse is preparing to perform a focused respiratory assessment on a client. The nurse should be cognizant of what anatomical characteristic of the lungs?
The right lung has three lobes, while the left lung has two lobes.
The lungs are structurally symmetrical but functionally different.
The right lung is approximately one third larger than the left lung.
The lower lobes of both lungs are primarily located toward the anterior chest wall.
- 13. Multiple Choice
During the health interview, a client tells the nurse that he can't breathe all that well at night when he is lying down and that this significantly disrupts his sleep. The nurse should assess this client further for what health problem?
Pneumonia
Tuberculosis
Heart failure
Bronchitis
- 14. Multiple Choice
The nurse is assessing a client who has been admitted for the treatment of severe dehydration. What would the nurse expect to hear when auscultating the lungs of this client?
Stridor
Friction Rub
Sibilant wheeze
Decreased breath sounds
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