RESPIRATORY SYSTEM B

1. Dr. Jones prescribes albuterol sulfate (Proventil) for a patient with newly diagnosed asthma. When
teaching the patient about this drug, the nurse should explain that it may cause:

 A. Nasal congestion

 B. Nervousness

 C. Lethargy

 D. Hyperkalemia

2. Miriam, a college student with acute rhinitis sees the campus nurse because of excessive nasal
drainage. The nurse asks the patient about the color of the drainage. In acute rhinitis, nasal
drainage normally is:

 A. Yellow

 B. Green

 C. Clear

 D. Gray
3. A male adult patient hospitalized for treatment of a pulmonary embolism develops respiratory
alkalosis. Which clinical findings commonly accompany respiratory alkalosis?

 A. Nausea or vomiting

 B. Abdominal pain or diarrhea

 C. Hallucinations or tinnitus

 D. Lightheadedness or paresthesia
4. Before administering ephedrine, Nurse Tony assesses the patient’s history. Because of
ephedrine’s central nervous system (CNS) effects, it is not recommended for:

 A. Patients with an acute asthma attack.

 B. Patients with narcolepsy.

 C. Patients under age

 D. Elderly patients.
5. A female patient suffers acute respiratory distress syndrome as a consequence of shock. The
patient’s condition deteriorates rapidly, and endotracheal intubation and mechanical ventilation
are initiated. When the high-pressure alarm on the mechanical ventilator, alarm sounds, the nurse
starts to check for the cause. Which condition triggers the high-pressure alarm?

 A. Kinking of the ventilator tubing.

 B. A disconnected ventilator tube.

 C. An endotracheal cuff leak.

 D. A change in the oxygen concentration without resetting the oxygen level alarm.
6. A male adult patient on mechanical ventilation is receiving pancuronium bromide (Pavulon), 0.01 mg/kg I.V. as needed.
Which assessment finding indicates that the patient needs another pancuronium dose?

 A. Leg movement
 B. Finger movement

 C. Lip movement

 D. Fighting the ventilator

7. On auscultation, which finding suggests a right pneumothorax?

 A. Bilateral inspiratory and expiratory crackles.

 B. Absence of breaths sound in the right thorax.

 C. Inspiratory wheezes in the right thorax.

 D. Bilateral pleural friction rub.

8. Rhea, confused and short breath, is brought to the emergency department by a family member.
The medical history reveals chronic bronchitis and hypertension. To learn more about the current
respiratory problem, the doctor orders a chest x-ray and arterial blood gas (ABG) analysis. When
reviewing the ABG report, the nurses see many abbreviations. What does a lowercase “a” in ABG
value present?

 A. Acid-base balance

 B. Arterial Blood

 C. Arterial oxygen saturation

 D. Alveoli
9. A male patient is admitted to the healthcare facility for treatment of chronic obstructive
pulmonary disease. Which nursing diagnosis is most important for this patient?

 A. Activity intolerance related to fatigue.

 B. Anxiety related to actual threat to health status.

 C. Risk for infection related to retained secretions.

 D. Impaired gas exchange related to airflow obstruction.

10. Nurse Ruth assessing a patient for tracheal displacement should know that the trachea will
deviate toward the:

 A. Contralateral side in a simple pneumothorax.

 B. Affected side in a hemothorax.

 C. Affected side in a tension pneumothorax.

 D. Contralateral side in hemothorax.

11. After undergoing a left pneumonectomy, a female patient has a chest tube in place for drainage.
When caring for this patient, the nurse must:

 A. Monitor fluctuations in the water-seal chamber.

 B. Clamp the chest tube once every shift.

 C. Encourage coughing and deep breathing.

 D. Milk the chest tube every 2 hours.

12. When caring for a male patient who has just had a total laryngectomy, the nurse should plan to:
 A. Encourage oral feeding as soon as possible.

 B. Develop an alternative communication method.

 C. Keep the tracheostomy cuff fully inflated.

 D. Keep the patient flat in bed.

13. A male patient has a sucking stab wound to the chest. Which action should the nurse take first?

 A. Drawing blood for a hematocrit and hemoglobin level.

 B. Applying a dressing over the wound and taping it on three sides.

 C. Preparing a chest tube insertion tray.

 D. Preparing to start an I.V. line.

14. For a patient with advanced chronic obstructive pulmonary disease (COPD), which nursing action
best promotes adequate gas exchange?

 A. Encouraging the patient to drink three glasses of fluid daily.

 B. Keeping the patient in semi-Fowler's position.

 C. Using a high-flow venturi mask to deliver oxygen as prescribed.

 D. Administering a sedative, as prescribed.

15. A male patient’s X-ray result reveals bilateral white-outs, indicating acute respiratory distress
syndrome (ARDS). This syndrome results from:

 A. Cardiogenic pulmonary edema

 B. Respiratory alkalosis

 C. Increased pulmonary capillary permeability

 D. Renal failure
16. For a female patient with chronic obstructive pulmonary disease, which nursing intervention would
help maintain a patent airway?

 A. Restricting fluid intake to 1,000 ml per day.

 B. Enforcing absolute bed rest.

 C. Teaching the patient how to perform controlled coughing.

 D. Administering prescribed sedatives regularly and in large amounts.

17. Nurse Lei, caring for a client with a pneumothorax and who has had a chest tube inserted,
continues gentle bubbling in the suction control chamber. What action is appropriate?

 A. Do nothing, because this is an expected finding.

 B. Immediately clamp the chest tube and notify the physician.

 C. Check for an air leak because the bubbling should be intermittent.

 D. Increase the suction pressure so that the bubbling becomes vigorous.

18. Nurse Maureen has assisted a physician with the insertion of a chest tube. The nurse monitors the
client and notes fluctuation of the fluid level in the water seal chamber after the tube is inserted.
Based on this assessment, which action would be appropriate?
  A. Inform the physician.

 B. Continue to monitor the client.

 C. Reinforce the occlusive dressing.

 D. Encourage the client to deep breathe.

19. Nurse Reynolds caring for a client with a chest tube turns the client to the side, and the chest tube
accidentally disconnects. The initial nursing action is to:

 A. Call the physician.

 B. Place the tube in a bottle of sterile water.

 C. Immediately replace the chest tube system.

 D. Place a sterile dressing over the disconnection site.

20. A nurse is assisting a physician with the removal of a chest tube. The nurse should instruct the
client to:

 A. Exhale slowly

 B. Stay very still

 C. Inhale and exhale quickly

 D. Perform the Valsalva maneuver

While changing the tapes on a tracheostomy tube, the male client coughs and the tube is dislodged.
The initial nursing action is to:

 A. Call the physician to reinsert the tube.

 B. Grasp the retention sutures to spread the opening.

 C. Call the respiratory therapy department to reinsert the tracheotomy.

 D. Cover the tracheostomy site with a sterile dressing to prevent infection.

21. Nurse Oliver is caring for a client immediately after removal of the endotracheal tube. The nurse
reports which of the following signs immediately if experienced by the client?

 A. Stridor

 B. Occasional pink-tinged sputum

 C. A few basilar lung crackles on the right

 D. Respiratory rate 24 breaths/min

22. An emergency room nurse is assessing a male client who has sustained a blunt injury to the chest
wall. Which of these signs would indicate the presence of a pneumothorax in this client?

 A. A low respiratory rate.

 B. Diminished breath sounds.

 C. The presence of a barrel chest.

 D. A sucking sound at the site of injury.

23. An emergency room nurse is assessing a male client who has sustained a blunt injury to the chest
wall. Which of these signs would indicate the presence of a pneumothorax in this client?
 A. A low respiratory rate.

 B. Diminished breath sounds.

 C. The presence of a barrel chest.

 D. A sucking sound at the site of injury.

24. Nurse Reese is caring for a client hospitalized with acute exacerbation of chronic obstructive
pulmonary disease. Which of the following would the nurse expect to note on assessment of this
client?

 A. Hypocapnia

 B. A hyperinflated chest noted on the chest x-ray.

 C. Increased oxygen saturation with exercise.

 D. A widened diaphragm noted on the chest x-ray.

25. An oxygen delivery system is prescribed for a male client with chronic obstructive pulmonary
disease to deliver a precise oxygen concentration. Which of the following types of oxygen delivery
systems would the nurse anticipate to be prescribed?

 A. Face tent

 B. Venturi mask

 C. Aerosol mask

 D. Tracheostomy collar

26. Blessy, a community health nurse is conducting an educational session with community members
regarding tuberculosis. The nurse tells the group that one of the first symptoms associated with
tuberculosis is:

 A. Dyspnea

 B. Chest pain

 C. A bloody, productive cough.

 D. A cough with the expectoration of mucoid sputum.

27. A nurse performs an admission assessment on a female client with a diagnosis of
tuberculosis. The nurse reviews the result of which diagnosis test that will confirm this
diagnosis?

 A. Bronchoscopy

 B. Sputum culture

 C. Chest x-ray

 D. Tuberculin skin test

28. A nurse is caring for a male client with emphysema who is receiving oxygen. The nurse
assesses the oxygen flow rate to ensure that it does not exceed:

 A. 1 L/min

 B. 2 L/min

 C. 6 L/min

 D. 10 L/min
 29. A nurse instructs a female client to use the pursed-lip method of breathing and 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 to:

 A. Promote oxygen intake.

 B. Strengthen the diaphragm.

 C. Strengthen the intercostal muscles.

 D. Promote carbon dioxide elimination.

 30. A nurse is caring for a male client with acute respiratory distress syndrome. Which of the
following would the nurse expect to note in the client?

 A. Pallor

 B. Low arterial PaO2

 C. Elevated arterial PaO2

 D. Decreased respiratory rate

31. A nurse is preparing to obtain a sputum specimen from a male client. Which of the following
nursing actions will facilitate obtaining the specimen?

 A. Limiting fluid.

 B. Having the client take deep breaths.

 C. Asking the client to spit into the collection container.

 D. Asking the client to obtain the specimen after eating.

32. Nurse Joy is caring for a client after a bronchoscopy and biopsy. Which of the following signs, if
noticed in the client, should be reported immediately to the physician?

 A. Dry cough

 B. Hematuria

 C. Bronchospasm

 D. Blood-streaked sputum
33. A nurse is suctioning fluids from a male client via a tracheostomy tube. When suctioning, the
nurse must limit the suctioning time to a maximum of:

 A. 1 minute

 B. 5 seconds

 C. 10 seconds

 D. 30 second
34. A nurse is suctioning fluids from a female client through an endotracheal tube. During the
suctioning procedure, the nurse notes on the monitor that the heart rate is decreasing. Which if the
following is the appropriate nursing intervention?

 A. Continue to suction.

 B. Notify the physician immediately.

 C. Stop the procedure and reoxygenate the client.

  D. Ensure that the suction is limited to 15 seconds.
35. A male adult client is suspected of having a pulmonary embolism. A nurse assesses the client,
knowing that which of the following is a common clinical manifestation of pulmonary embolism?

 A. Dyspnea

 B. Bradypnea

 C. Bradycardia

 D. Decreased respirations
36. A slightly obese female client with a history of allergy-induced asthma, hypertension, and mitral
valve prolapse is admitted to an acute care facility for elective surgery. The nurse obtains a complete
history and performs a thorough physical examination, paying special attention to the cardiovascular
and respiratory systems. When percussing the client’s chest wall, the nurse expects to elicit:

 A. Resonant sounds.

 B. Hyperresonant sounds.

 C. Dull sounds.

 D. Flat sounds.
37. A male client who weighs 175 lb (79.4 kg) is receiving aminophylline (Aminophylline) (400 mg in
500 ml) at 50 ml/hour. The theophylline level is reported as 6 mcg/ml. The nurse calls the physician
who instructs the nurse to change the dosage to 0.45 mg/kg/hour. The nurse should:

 A. Question the order because it’s too low.

 B. Question the order because it’s too high.

 C. Set the pump at 45 ml/hour.

 D. Stop the infusion and have the laboratory repeat the theophylline measurement.
38.The nurse is teaching a male client with chronic bronchitis about breathing exercises. Which of the following should the nurse
include in the teaching?

 A. Make inhalation longer than exhalation.

 B. Exhale through an open mouth.

 C. Use diaphragmatic breathing.

 D. Use chest breathing.

39.Which phrase is used to describe the volume of air inspired and expired with a normal breath?

 A. Total lung capacity

 B. Forced vital capacity

 C. Tidal volume

 D. Residual volume
40.A male client abruptly sits up in bed, reports having difficulty breathing and has an arterial oxygen
saturation of 88%. Which mode of oxygen delivery would most likely reverse the manifestations?

 A. Simple mask

 B. Non-rebreather mask
 C. Face tent

 D. Nasal cannula
41.A female client must take streptomycin for tuberculosis. Before therapy begins, the nurse should
instruct the client to notify the physician if a health concern occurs?

 A. Impaired color discrimination

 B. Increased urinary frequency

 C. Decreased hearing acuity

 D. Increased appetite
42.A male client is asking the nurse a question regarding the Mantoux test for tuberculosis. The nurse
should base her response on the fact that the:

 A. Area of redness is measured in 3 days and determines whether tuberculosis is present.

 B. Skin test doesn’t differentiate between active and dormant tuberculosis infection.

 C. Presence of a wheal at the injection site in 2 days indicates active tuberculosis.

 D. Test stimulates a reddened response in some clients and requires a second test in 3
months.
43.A female adult client has a tracheostomy but doesn’t require continuous mechanical ventilation.
When weaning the client from the tracheostomy tube, the nurse initially should plug the opening in
the tube for:

 A. 15 to 60 seconds.

 B. 5 to 20 minutes.

 C. 30 to 40 minutes.

 D. 45 to 60 minutes.
44.Nurse Oliver observes constant bubbling in the water-seal chamber of a closed chest drainage
system. What should the nurse conclude?

 A. The system is functioning normally.

 B. The client has a pneumothorax.

 C. The system has an air leak.

 D. The chest tube is obstructed.

45.A black client with asthma seeks emergency care for acute respiratory distress. Because of this
client’s dark skin, the nurse should assess for cyanosis by inspecting the:

 A. Lips

 B. Mucous membranes

 C. Nail beds

 D. Earlobes
46.For a male client with an endotracheal (ET) tube, which nursing action is most essential?

 A. Auscultating the lungs for bilateral breath sounds.

 B. Turning the client from side to side every 2 hours.

  C. Monitoring serial blood gas values every 4 hours.

 D. Providing frequent oral hygiene.

47.The nurse assesses a male client’s respiratory status. Which observation indicates that the client is
experiencing difficulty breathing?

 A. Diaphragmatic breathing

 B. Use of accessory muscles

 C. Pursed-lip breathing

 D. Controlled breathing
48.A female client is undergoing a complete physical examination as a requirement for college. When
checking the client’s respiratory status, the nurse observes respiratory excursion to help assess:

 A. Lung vibrations

 B. Vocal sounds

 C. Breath sounds

 D. Chest movements.
49.A male client comes to the emergency department complaining of sudden onset of diarrhea,
anorexia, malaise, cough, headache, and recurrent chills. Based on the client’s history and physical
findings, the physician suspects Legionnaires’ disease. While awaiting diagnostic test results, the
client is admitted to the facility and started on antibiotic therapy. What is the drug of choice for
treating Legionnaires’ disease?

 A. erythromycin (Erythrocin)

 B. rifampin (Rifadin)

 C. amantadine (Symmetrel)

 D. amphotericin B (Fungizone)
50.A male client with chronic obstructive pulmonary disease (COPD) is recovering from a myocardial
infarction. Because the client is extremely weak and can’t produce an effective cough, the nurse should
monitor closely for:

 A. Pleural effusion

 B. Pulmonary edema

 C. Atelectasis

 D. Oxygen toxicity
Prepared by:
Murada J. Ismael
Source: Nurselabs