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- 1. Open EndedA nurse is collecting data on a client following a bronchoscopy. Which of the following findings should the nurse report to the provider? A: Blood-tinged sputum B: Dry, nonproductive cough C: sore throat D: Laryngospasm
- 2. Open EndedA nurse is caring for a client who is scheduled for thoracentesis. which of the following supplies should the nurse ensure are in the clients room? ( select all that apply.) A: oxygen equipment B: Incentive spirometer C: Pulse oximeter D: Sterile dressing E: Suture removal kit
- 3. Open EndedA nurse is caring for a client following a thracentesis. Which of the following manifestations should the nurse recognize as risks for complications? ( select all that apply) A: Dyspnea B: Localized bloody drainage on the dressing C: Fever D: Hypotension E: Report of pain at the puncture site
- 4. Open EndedA nurse is collecting data from a client who has a chest tube and drainage system in place. Which of the following findings should the nurse expect? ( select all that apply) A: Continuous bubbling in the water seal chamber B: Gentle constant bubbling in the suction control chamber C: Rise and fall in the level of water in the water seal chamber with inspiration and expiration D: Exposed sutures without dressing E: Drainage system upright at chest level
- 5. Open EndedA nurse is assisting a provider with the removal of chest tube. Which of the following actions should the nurse instruct the client to do? A: Lie on his left side B: Use the incentive spirometer C: Cough at regular intervals D: Perform the valsalva maneuver
- 6. Open EndedA nurse is caring for a client who is experiencing respiratory distress. Which of the following manifestations of hypoxemia should the nurse recognize? ( Select all that apply.) A: Confusion B: Pale skin C: Bradycardia D: Hypotension E: Elevated blood pressure
- 7. Open EndedThe nurse is caring for a client who has dyspena and will receive oxygen continuously. Which of the following oxygen devices should the nurse use to deliver a precise amount of oxygen to the client? A: Nonrebreather mask B: Venturi mask C: Nasal cannula D: Simple face mask
- 8. Open EndedA nurse is caring for a client who has a new prescription for oxygen therapy of 4 L/min using a nasal cannula. Which of the following actions should the nurse take? A: provide humidification B: Remove the cannula during meal times C: Establish an alternative means of communication D: Lubricate the nares with 0.9 % sodium chloride
- 9. Open EndedA nurse is assisting with the plan of care for a client who has respiratory distress. Which of the following interventions should the nurse include in the plan ( Select all that apply) A: Position the client on his left side B: Provide emotional support to the client C: Encourage the client to cough D: Preform oral suctioning as needed E: Have the client take short, shallow breaths
- 10. Open EndedA nurse is collecting data from a client who receiving mechanical ventilation. which of the following findings indicates that the client might have developed an infection? A: Decrease in blood pressure B: Increase in abdominal girth C: Change in sputum color D: Absent breath sounds over one lung area
- 11. Open EndedA nurse is monitoring a group of clients for increased risk for developing pneumonia. Which of the following clients should the expect to be at risk? ( select all that apply) A: Client who has dysphagia B: Client who has AIDS C: Client who received vaccines for pneumococcus and influenza 6 months ago D: Client who is ambulatory after receiving a local anesthesia E: Client who has closed head injury and receiving ventilation F: Client who has myasthenia gravis
- 12. Open EndedA nurse in a clinic is caring for a client whose partner states the client woke up this morning, did not recognize him, and did not know where she was. The client reports chills and chest pain that is worse upon inspiration. Which of the following actions is the nursing priority? A: Obtain baseline vital signs and oxygen saturation B: Obtain a sputum culture C: Obtain a complete history from the client D: Provide a pneumococcal vacccine
- 13. Open EndedA nurse is caring for a client who has pneumonia. Data collection findings include temperature 37.8 (100 F), respiration 30/min. blood pressure 130/76 mm Hg, heart rate 100/min, and SaO2 91 % on room air. Which of the following actions is the nurse priority? A: Administer antibiotics B: Administer oxygen therapy C: Perform a sputum culture D: Administer an antipyretic medication to promote client comfort
- 14. Open EndedA nurse in a clinic is collecting data on a client who has sinusitis. Which of the following techniques should the nurse use identify manifestations of this disorder? A: Percussion of posterior lobes of lungs B: Auscultation of the trachea C: Inspection of the conjunctiva D: Palpation of the orbital areas
- 15. Open EndedA nurse is reinforcing teaching with a client about influenza. Which of the following clients statements indicates an understanding of the teaching A. " I should wash my hands after blowing my nose to prevent spreading the virus." B: " I need to avoid drinking fluids if develop symptoms." C: " I need a flu shot every 2 years because of the different flu strains." D: " I should cover my mouth with my hand when I sneeze."
- 16. Open EndedA nurse is collecting data from a client who is having an acute asthma attack. which of the following findings should indicate to the nurse that the client's respiratory status is declining? ( select all that apply.) A: SaO2 95% B: Wheezing C: Retraction of sternal muscles D: Pink mucous membranes E: Premature ventricular complexes (PVC's)
- 17. Open EndedA nurse is collecting data from a client who is being admitted to an acute care facility. The client has an SaO2 of 91 % exhibits audible wheezes, and is using accessory muscles when breathing. Which of the following classes of medications should the nurse expected to administered? A: Antibiotic B: Beta blocker C: Antiviral D: Beta2 agonist
- 18. Open EndedA nurse is reinforcing discharge teaching with a client who has a new prescription for prednisone to treat asthma. Which of the following client statements indicates an understanding of the teaching? A: " I will decrease my fluid intake while taking this medication." B: " I will expect to have black, tarry stools." C: " I will take my medication with meals." D: " I will monitor for weight loss while on this medication."
- 19. Open EndedA nurse is collecting data from a client who has history of asthma. Which of the following factors should the nurse identify as a risk for asthma? A: Gender B: Environmental allergies C: Alcohol use D: Race
- 20. Open EndedA nurse is reinforcing teaching with a client on the purpose of taking inhaled albuterol. Which of the following client statements indicates an understanding of the teaching? A: " This medication can decrease my immune response." B: " I take this medication to stop an asthma attack." C: " I need to take this medication with food." D: " This medication has a slow onset to treat my symptoms."
- 21. Open EndedA nurse is reinforcing discharge teaching with a client who has COPD and a new prescription for albuterol. Which of the following client statements indicates understanding of the teaching? A. " This medication can increase my blood sugar levels." B: " This medication can decrease my immune response." C. " I can have an increase in my heart rate while taking this medication." D: " I can have mouth sores while taking this medication."
- 22. Open EndedA nurse is preparing to administer a dose pf prednisone to a client who has COPD. The nurse should monitor for which of the following adverse effects of this medication? ( select all that apply.) A: Hypokalemia B: Tachycardia C: Fluid retention D: Nausea E: Black, tarry stools
- 23. Open EndedA nurse is assisting with the discharge of a client who has COPD. Upon discharge, the client is concerned that he will never be able to leave his house now that he is on continuous oxygen. Which of the following is an appropraite response by the nurse? A. " There is portable oxygen delivery systems that you can take with you." B: " When you go out, you can remove the oxygen and then reapply it when you get home." C: " You probably will not be able to go out as much as you need to." D: " Home health services will come to you so you will not need to get out."
- 24. Open EndedA nurse is reinforcing teaching with a client about use of an incentive spirometer. Which of the following client statements indicates understanding of the teaching? A: " I will place the adapter on my finger to read my blood oxygen saturated level." B: " I will lie on my back with my kneees bent." C: " I will rest my hand over my abdomen to create resistance." D: " I will take in a deep breath and hold it before exhaling."
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