Nclex-Rn Practice Questions-Care Of The Adult - Respiratory Disorders Part 4
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Question 1 |
A client has been diagnosed with a benign lung tumor and asks the nurse how it will be treated. What is the best response by the nurse?
A | The tumor is treated with radiation only. |
B | The tumor is treated with chemotherapy only. |
C | The tumor is left alone unless symptoms are present. |
D | The tumor is removed, involving the least possible amount of tissue. |
Question 2 |
A client is admitted to the hospital with shortness of breath. The physician orders a stat hemoglobin and hematocrit level to be drawn. The client is questioning why he needs to have blood drawn when he is having trouble breathing. What is the best response by the nurse?
A | “Hemoglobin has no effect on oxygenation.” |
B | “More hemoglobin reduces the client’s respiratory rate.” |
C | “Low hemoglobin levels cause reduced oxygen-carrying capacity.” |
D | “Low hemoglobin levels cause increased oxygen-carrying capacity.” |
Question 3 |
A client has been intubated and placed on a ventilator with positive endexpiratory pressure (PEEP). The nurse anticipates that the primary function of PEEP will be to:
A | provide more oxygen to the client. |
B | open up bronchioles and allow oxygen to get in the lungs. |
C | open up collapsed alveoli and help keep them open. |
D | add pressure to the lung tissue, which improves gaseous exchange. |
Question 4 |
The nurse is reviewing a client’s chest X-ray report that states that there are bilateral areas of collapsed alveoli in the bases. The nurse initiated coughing and deep breathing exercises, reinforced the use of the incentive spirometer, and encouraged the client to ambulate in the halls at least twice a day. The nurse implemented these interventions into the plan of care based on what knowledge?
A | Alveoli need oxygen to live. |
B | Alveoli have no effect on oxygenation. |
C | Collapsed alveoli increase oxygen demand. |
D | Gaseous exchange occurs in the alveolar membrane. |
Question 5 |
The nurse is caring for a client with a pleural effusion. The client asks, “What is a pleural effusion?” What is the most appropriate response from the nurse?
A | “It is the collapse of alveoli.” |
B | “It is the collapse of a bronchiole.” |
C | “It is the fluid in the alveolar space.” |
D | “It is the accumulation of fluid between the linings of the pleural space.” |
Question 6 |
The client has developed a pleural effusion. The nurse anticipates that the most appropriate intervention would be?
A | Inserting a chest tube |
B | Performing thoracentesis |
C | Performing paracentesis |
D | Allowing the pleural effusion to drain by itself |
Question 7 |
A comatose client requires a nasopharyngeal airway for suctioning. After the airway is inserted, he gags and coughs. The priority intervention by the nurse would be?
A | Remove the airway and insert a shorter one. |
B | Reposition the airway. |
C | Leave the airway in place until the client gets used to it. |
D | Remove the airway and attempt suctioning without it. |
Question 8 |
Nursing management of a client with a pulmonary embolism will primarily focus on which action?
A | Assessing oxygenation status |
B | Monitoring the oxygen delivery device |
C | Monitoring for other sources of clots |
D | Determining whether the client requires another ventilation-perfusion (V/Q) scan |
Question 9 |
The nurse is obtaining a pulse oximetry reading on a client. The nurse is aware that analysis of the results will provide information regarding:
A | amount of carbon dioxide in the blood. |
B | amount of oxygen in the blood. |
C | percentage of hemoglobin carrying oxygen. |
D | respiratory rate. |
Question 10 |
A client with a pulmonary embolism is scheduled to have an umbrella filter placed in the vena cava. The nurse determines that teaching has been effective when the client states:
A | “The filter prevents further clot formation.” |
B | “The filter collects clots so they don’t go to the lung.” |
C | “The filter breaks up clots into insignificantly small pieces.” |
D | “The filter contains anticoagulants that are slowly released, dissolving any clots.” |
Question 11 |
The nurse is caring for a client with terminal lung cancer. What is the priority nursing intervention for this client?
A | Provide emotional support. |
B | Provide nutritional support. |
C | Provide pain control. |
D | Prepare the client’s will. |
Question 12 |
The nurse is conducting a preoperative class for clients scheduled for gastric bypass surgery. One of the clients asks the nurse what the most common source of pulmonary embolism is. The most appropriate response by the nurse is:
A | amniotic fluid. |
B | bone marrow. |
C | septic thrombi. |
D | venous thrombi. |
Question 13 |
The nurse is planning care for a client who has undergone a total knee replacement. The most important intervention to prevent the development of a pulmonary embolism would be?
A | Early ambulation |
B | Frequent chest X-rays to find a pulmonary embolism |
C | Frequent lower extremity scans |
D | Intubation of the client |
Question 14 |
Which physiologic effect of a pulmonary embolism would initially affect oxygenation?
A | A blood clot blocks ventilation; perfusion is unaffected. |
B | A blood clot blocks ventilation, producing hypoxia despite normal perfusion. |
C | A blood clot blocks perfusion and ventilation, producing profound hypoxia. |
D | A blood clot blocks perfusion, producing hypoxia despite normal or supernormal ventilation. |
Question 15 |
The nurse is teaching the client about his diagnosis of a pulmonary embolism. The client tells the nurse that the doctor told him that he has a ventilation-perfusion mismatch. Which statement by the client best conveys an understanding of the diagnosis?
A | The area of the lung being ventilated isn’t being perfused. |
B | The area of the lung being perfused isn’t being ventilated. |
C | The area of the lung being ventilated is also being perfused. |
D | The amount of ventilation occurring doesn’t equal perfusion. |
Question 16 |
A client has been diagnosed with a pulmonary embolism and begins to experience chest pain. The client asks the nurse what is causing the pain. The most appropriate response by the nurse is:
A | costochondritis. |
B | myocardial infarction (MI). |
C | inflammatory reaction. |
D | referred pain from the pelvis to the chest. |
Question 17 |
A client with a pulmonary embolism tells the nurse that he feels a sense of “impending doom.” The nurse recognizes that this manifestation is caused by what?
A | Inflammatory reaction in the lung parenchyma |
B | Loss of chest expansion |
C | Loss of lung tissue |
D | Sudden reduction in adequate oxygenation |
Question 18 |
The nurse is providing preoperative teaching for a client with a pulmonary embolism scheduled for an embolectomy. The most appropriate information for the nurse to give the patient is:
A | “It is done to remove an embolism in the lower extremity.” |
B | “It sucks an embolism out of the lung by bronchoscopy.” |
C | “It surgically removes the embolism source in the pelvis.” |
D | “It surgically removes the embolism in the pulmonary vasculature.” |
Question 19 |
A client with pulmonary embolism has developed hemoptysis. The nurse determines that this is most likely related to:
A | alveolar damage in the infarcted area. |
B | involvement of major blood vessels where the clot formed. |
C | loss of lung parenchyma. |
D | loss of lung tissue. |
Question 20 |
A definitive diagnosis of pulmonary embolism has been made for a client. The nurse anticipates which medication will be ordered?
A | Warfarin (Coumadin) |
B | Heparin |
C | Streptokinase (Streptase) |
D | Acyclovir (Zovirax) |
Question 21 |
The nurse is teaching a client diagnosed with a pulmonary embolism about the prescribed heparin therapy. The nurse determines that teaching has been effective when the client states heparin is given to:
A | dissolve the clot. |
B | break up the pulmonary embolism. |
C | slow the development of other clots. |
D | prevent clots from breaking off and embolizing to the lung. |
Question 22 |
A client who was hospitalized for pulmonary embolism is being discharged on warfarin (Coumadin) therapy. The client asks the nurse to explain how warfarin works. The best response by the nurse is:
A | “It inhibits the formation of blood clots.” |
B | “It will reduce the size of the pulmonary embolism.” |
C | “It will reduce blood pressure and prevent venous stasis.” |
D | “It will dissolve an existing clot.” |
Question 23 |
A client hospitalized with a pulmonary embolism develops hypotension. The nurse determines that the hypotension was the result of which of the following?
A | Pressure on the heart and reduced cardiac output |
B | Reduced blood flow to the lung, which causes hypotension |
C | Reduced blood return to the right side of the heart leading to lower blood pressure |
D | Increased pulmonary vascular resistance and reduced blood delivery to the left side of the heart |
Question 24 |
A client with a pulmonary embolism is experiencing chest pain and apprehension. What is the priority intervention by the nurse?
A | Administering analgesics |
B | Using guided imagery |
C | Positioning the client on his left side |
D | Providing emotional support |
Question 25 |
A client with a massive pulmonary embolism is scheduled to have arterial blood gas analysis performed. The nurse expects the analysis will identify:
A | metabolic acidosis. |
B | metabolic alkalosis. |
C | respiratory acidosis. |
D | respiratory alkalosis. |
Question 26 |
Which client is at highest risk for developing a pulmonary embolism?
A | An ambulatory client with an inflammatory joint disease |
B | An ambulatory client who has type 1 diabetes |
C | A healthy client who’s 6 months pregnant |
D | A client who has fractures of his pelvis and right femur |
Question 27 |
An 18-year-old client who was involved in a motor vehicle accident is admitted to the hospital with a diagnosis of pneumothorax. A chest tube was inserted and attached to a chest drainage system. The nurse notes bubbling in the water seal chamber and determines further assessment is required. The nurse is aware the bubbling is most likely the result of:
A | air leaks. |
B | adequate suction. |
C | inadequate suction. |
D | kinked chest tubes. |
Question 28 |
A client is being treated with bilevel positive airway pressure (BiPAP). The nurse anticipates that the use of BiPAP will:
A | provide 100% oxygen at both inspiration and expiration. |
B | provide pressurized oxygen so the client can breathe more easily. |
C | provide pressurized oxygen at the end of expiration to open collapsed alveoli. |
D | provide both continuous positive airway pressure (CPAP) and positive end-expiratory pressure (PEEP) to provide optimal oxygenation and ventilation. |
Question 29 |
A hospitalized client is experiencing hypoxia. The physician orders continuous positive airway pressure (CPAP) per face mask. The family is concerned and questions the nurse as to why the client needs the mask. What is the most appropriate response by the nurse?
A | “The mask is providing 100% oxygen to the client.” |
B | “The mask is providing continuous air that the client can breathe.” |
C | “The mask is providing pressurized oxygen so the client can breathe more easily.” |
D | “The mask is providing pressurized oxygen at the end of expiration to open collapsed alveoli.” |
Question 30 |
A 165-lb client with a pulmonary embolus is ordered to receive heparin 20 units/kg/hour by I.V. infusion. How many units of heparin should he receive each hour?
A | 1,000 |
B | 1,200 |
C | 1,500 |
D | 1,700 |
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