Management Of Clients With Acute Pulmonary Disorders

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Question 1
Free
Multiple Choice

In the nursing care of a client recently intubated and placed on mechanical ventilation, the nursing action that would take highest priority is

Choose correct answer/s
A

assessing for pedal pulses regularly.

B

monitoring blood pressure frequently.

C

monitoring temperature every 4 hours.

D

turning the client every 2 hours.

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Question 2
Free
Multiple Choice

A client who was extubated 2 hours ago is becoming increasingly restless. The last vital signs before extubation were pulse 88 beats/min, respirations 18 breaths/min, blood pressure (138/78)mm Hg, and PaCO? 45 mm Hg. Current vital signs include pulse 104 beats/min, respirations 26 breaths/min, blood pressure (140/80) mm Hg, and PaCO? 62 mm Hg. The nurse would

Choose correct answer/s
A

administer a nebulized bronchodilator.

B

assist with reintubation.

C

obtain a complete blood count (CBC).

D

prepare the client for a tracheostomy.

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Question 3
Free
Multiple Choice

The nurse monitoring a client with adult respiratory distress syndrome (ARDS) would closely assess for

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A

atelectasis.

B

cor pulmonale.

C

pneumonia.

D

pulmonary edema.

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Question 4
Free
Multiple Choice

A client admitted to the emergency department (ED) with severe chest injuries and significant hypovolemia caused by hemorrhage would be transfused to replace blood loss initially with

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A

albumin.

B

dextrose 5% in normal saline.

C

type AB-negative blood.

D

type O-negative blood.

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Question 5
Free
Multiple Choice

When a client is admitted to the ED with tension pneumothorax and mediastinal shift following an automobile accident, the nurse would know that the client would exhibit

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A

a sucking chest wound.

B

bradycardia.

C

mediastinal flutter.

D

severe hypotension.

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Question 6
Multiple Choice

The nurse would explain that emergency treatment of a tension pneumothorax requires

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A
a small stab wound with a skin blade made into the pleural space.
B
covering the chest wall wound with gauze.
C
immediate tracheostomy.
D
insertion of an 18-gauge needle into the pleural space.
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Question 7
Multiple Choice

When a client is admitted to the ED with a sucking chest wound, the nurse initially would

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A
cover the wound with whatever is available.
B
leave the wound open.
C
notify the physician.
D
obtain a sterile gauze petroleum dressing to cover the wound.
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Question 8
Multiple Choice

After dressing a sucking chest wound, the nurse notes that the client is developing severe dyspnea, tachypnea, cyanosis, tachycardia, and asymmetrical chest movements. The nurse would

Choose correct answer/s
A
check the chest dressing for any air leakage.
B
insert an 18-gauge needle into the pleural space.
C
notify the physician.
D
remove the chest dressing.
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Question 9
Multiple Choice

When a client developed a hemothorax, the physician inserted a chest catheter connected to a drainage system. In the first 2 hours, 900 ml of blood drainage was collected. The nurse would

Choose correct answer/s
A
clamp the tubing.
B
continue observation of the drainage.
C
monitor the client's vital signs.
D
report this to the physician immediately.
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Question 10
Multiple Choice

Once a near-drowning victim is stabilized, the nurse would continue to assess the client for

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A
bronchospasm.
B
dyspnea.
C
electrolyte imbalances.
D
shock.
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Question 11
Multiple Choice

The nurse would explain that the use of positive end-expiratory pressure (PEEP) assists the client on mechanical ventilation by

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A
gradually increasing the amount of oxygen delivered.
B
increasing the amount of expired carbon dioxide.
C
keeping the alveoli open.
D
using a pressure of 30 cm H2O.
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Question 12
Multiple Choice

As part of the immediate care plan for a client with pulmonary edema and a nursing diagnosis of Impaired Gas Exchange, the nurse would

Choose correct answer/s
A
administer oxygen as ordered using a high-flow rebreather bag.
B
bring a tracheostomy set to the bedside.
C
monitor vital signs every 30 to 45 minutes until stable.
D
position the client's legs above heart level.
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Question 13
Multiple Choice

A client with respiratory failure was intubated with an oral endotracheal (ET) tube 2 hours ago. Suspecting that the tube has changed position slightly since insertion, the nurse would assess the

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A
results of the chest x-ray film taken 2 hours earlier.
B
current oxygen saturation readings.
C
status of the client's breath sounds.
D
position of the numbers on the ET tube at the lip line.
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Question 14
Multiple Choice

A client who sustained a head injury is intubated and receiving volume-cycled mechanical ventilation via the controlled mechanical ventilation (CMV) mode. The nurse would explain that this means

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A
a preset amount of pressure stays in the client's lungs at the end of exhalation.
B
spontaneous inspiratory effort triggers the ventilator to deliver a preset tidal volume.
C
the client's own breaths can become "stacked" with the ventilator breaths.
D
the ventilator delivers the preset volume regardless of the client's efforts.
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Question 15
Multiple Choice

A client who underwent surgery is intubated and receiving mechanical ventilation. The client is receiving a neuromuscular blocking agent to stop spontaneous breathing that is not in synchrony with the ventilator. The appropriate approach by the nurse to the client's postoperative pain control would be

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A
a sedative should be given with an anxiolytic and the neuromuscular blocker to control pain.
B
an analgesic is needed specifically for pain control and must be given as needed along with the neuromuscular blocker and a sedative or anxiolytic.
C
sedatives should be given with the neuromuscular blocking agent, and together these will control pain.
D
the neuromuscular blocking agent will prevent pain impulse transmission, so the prn analgesic order is unnecessary.
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Question 16
Multiple Choice

The nurse would determine that a client is having a dysfunctional ventilatory weaning response if the client's respiratory rate rises to

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A
20 breaths per minute.
B
25 breaths per minute.
C
30 breaths per minute.
D
35 breaths per minute.
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Question 17
Multiple Choice

When the ED nurse receives a radio call from an ambulance transporting a client who sustained chest trauma and has a severe flail chest, the nurse would set up the treatment area with

Choose correct answer/s
A
an intubation tray.
B
petroleum jelly gauze.
C
a pulse oximeter.
D
rib spreaders.
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Question 18
Multiple Choice

The nurse would determine that a client with fractured ribs needs further self-care instructions when the client says

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A
"I can take pain medication every 4 hours if I need it."
B
"I'll be sure to take it really easy for the next several weeks."
C
"I'll strap the ribs snugly so they can't move around."
D
"That heating pad in the closet at home will come in handy now."
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Question 19
Multiple Choice

A client is being transported to the ED after sustaining carbon monoxide (CO) poisoning in a house fire. The nurse would prepare to administer

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A
100% oxygen therapy.
B
intermittent positive-pressure breathing.
C
suctioning.
D
ventilation with 50% oxygen by manual resuscitation bag.
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Question 20
Multiple Choice

When a client with a cuffed ET tube reports shortness of breath, the nurse would

Choose correct answer/s
A
give the ordered pain medication.
B
assess for a cuff leak.
C
increase the level of O2 delivery.
D
elevate the head of the bed.
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