Nursing Management Lower Respiratory Problems

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Question 1
Free
Multiple Choice

Following assessment of a client with pneumonia, the nurse identifies a nursing diagnosis of ineffective airway clearance. Which of the following information best supports this diagnosis?

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A

Weak, nonproductive cough effort

B

Large amounts of greenish sputum

C

Respiratory rate of 28 breaths/minute

D

Resting pulse oximetry (SpO2) of 85%

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Question 2
Free
Multiple Choice

The nurse is conducting a chest assessment on a client with pneumococcal pneumonia. Which of the following findings should the nurse expect to assess?

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A

Vesicular breath sounds

B

Increased tactile fremitus

C

Dry, nonproductive cough

D

Hyper-resonance to percussion

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Question 3
Free
Multiple Choice

The nurse is caring for a client with bacterial pneumonia who has pleurisy. Which of the following actions should the nurse implement to promote airway clearance?

Choose correct answer/s
A

Assist the client to splint the chest when coughing.

B

Educate the client about the need for fluid restrictions.

C

Encourage the client to wear the nasal oxygen cannula.

D

Instruct the client on the pursed lip breathing technique.

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Question 4
Free
Multiple Choice

The nurse is providing teaching to a client with pneumonia. Which of the following client statements indicate a good understanding of the discharge instructions given by the nurse?

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A

"I will call the doctor if I still feel tired after a week."

B

"I will need to use home oxygen therapy for 3 months."

C

"I will continue to do the deep-breathing and coughing exercises at home."

D

"I will schedule two appointments for the pneumonia and influenza vaccines."

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Question 5
Free
Multiple Choice

Which of the following nursing actions is most effective in preventing aspiration pneumonia in clients who are at risk?

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A

Turn and reposition immobile clients at least every 2 hours.

B

Place clients with altered consciousness in side-lying positions.

C

Monitor for respiratory symptoms in clients who are immuno-suppressed.

D

Provide for continuous subglottic aspiration in clients receiving enteral feedings.

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Question 6
Multiple Choice

The nurse is caring for a client with right lower-lobe pneumonia who has been treated with intravenous (IV) antibiotics for 2 days. Which of the following assessment data obtained by the nurse indicates that the treatment has been effective?

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A
Bronchial breath sounds are heard at the right base.
B
The client coughs up small amounts of green mucus.
C
The client's white blood cell (WBC) count is 9 * 109/L.
D
Increased tactile fremitus is palpable over the right chest.
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Question 7
Multiple Choice

The health care provider writes a prescription for bacteriological testing for a client who has a positive tuberculosis skin test. Which of the following actions should the nurse take?

Choose correct answer/s
A
Repeat the tuberculin skin testing.
B
Teach about the reason for the blood tests.
C
Obtain consecutive sputum specimens from the client for 3 days.
D
Instruct the client to expectorate three specimens as soon as possible.
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Question 8
Multiple Choice

Which of the following information about a client who has a recent history of

Choose correct answer/s
A
Chest x-ray shows no upper lobe infiltrates.
B
TB medications have been taken for 6 months.
C
Mantoux testing shows an induration of 10 mm.
D
Three sputum smears for acid-fast bacilli are negative.
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Question 9
Multiple Choice

The nurse is providing teaching to a client with pulmonary tuberculosis (TB) regarding the transmission of TB. Which of the following client actions indicate that the teaching has been effective?

Choose correct answer/s
A
Demonstrates correct use of a nebulizer.
B
Washes dishes and personal items after use.
C
Covers the mouth and nose when coughing.
D
Reports daily to the public health department.
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Question 10
Multiple Choice

Which of the following information should the nurse include in the teaching plan for a client who is receiving rifampin for treatment of tuberculosis?

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A
"Your urine, sweat, and tears will be orange coloured."
B
"Read a newspaper daily to check for changes in vision."
C
"Take vitamin B6 daily to prevent peripheral nerve damage."
D
"Call the health care provider if you notice any hearing loss."
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Question 11
Multiple Choice

The nurse is teaching a client who is receiving standard multidrug therapy for tuberculosis (TB) about possible toxic effects of the antitubercular medications. Which of the following findings should the nurse instruct the client to report to the healthcareprovider?

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A
Yellow-tinged skin
B
Changes in hearing
C
Orange-coloured sputum
D
Thickening of the fingernails
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Question 12
Multiple Choice

The nurse is caring for clients with active tuberculosis (TB) who misuse alcohol and/or are homeless. Which of the following interventions by the nurse will be most effective in ensuring adherence with the treatment regimen?

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A
Educating the client about the long-term impact of TB on health
B
Giving the client written instructions about how to take the medications
C
Teaching the client about the high risk for infecting others unless treatment is followed
D
Arranging for a daily noontime meal at a community centre and giving the medication then
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Question 13
Multiple Choice

After 2 months of tuberculosis (TB) treatment with a standard four-drug regimen, a client continues to have positive sputum smears for acid-fast bacilli (AFB). Which of the following actions should the nurse take next?

Choose correct answer/s
A
Ask the client whether medications have been taken as directed.
B
Discuss the need to use some different medications to treat the TB.
C
Schedule the client for directly observed therapy three times weekly.
D
Educate about using a 2-drug regimen for the last 4 months of treatment.
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Question 14
Multiple Choice

A staff nurse has a tuberculosis (TB) skin test of 16-mm induration. A chest radiograph is negative, and the nurse has no symptoms of TB. Which of the following information should the occupational health nurse provide to the staff nurse?

Choose correct answer/s
A
Use and adverse effects of isoniazid (INH)
B
Standard four-drug therapy for TB
C
Need for annual repeat TB skin testing
D
Bacille Calmette-Guérin (BCG) vaccine
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Question 15
Multiple Choice

The nurse is caring for a client who is hospitalized with active tuberculosis (TB) and the nurse observes a family member who is visiting the client. Which of the following actions by the visitor should cause the nurse to intervene?

Choose correct answer/s
A
Washes hands before entering the client's room
B
Hands the client a tissue from the box at the bedside
C
Puts on a surgical face mask before visiting the client
D
Brings food from a "fast-food" restaurant to the client
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Question 16
Multiple Choice

Which of the following actions by the occupational health nurse at a manufacturing plant where there is potential exposure to inhaled dust is most helpful in reducing incidence of lung disease?

Choose correct answer/s
A
Teach about symptoms of lung disease.
B
Treat workers who inhale dust particles.
C
Monitor workers for shortness of breath.
D
Require the use of protective equipment.
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Question 17
Multiple Choice

The nurse is developing a teaching plan for a client with a 42 pack-year history of cigarette smoking. Which of the following information should the nurse include in the plan of care?

Choose correct answer/s
A
Computed tomography (CT) screening for lung cancer
B
Options for smoking cessation
C
Reasons for annual sputum cytology testing
D
Erlotinib therapy to prevent tumour risk
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Question 18
Multiple Choice

The nurse is caring for a client with stage I non-small cell lung cancer who is scheduled for a lobectomy. The client tells the nurse, "I would rather have radiation than surgery." Which of the following responses by the nurse is best?

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A
"Are you afraid that the surgery will be very painful?"
B
"Did you have bad experiences with previous surgeries?"
C
"Surgery is the treatment of choice for stage I lung cancer."
D
"Tell me what you know about the various treatments available."
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Question 19
Multiple Choice

The nurse is caring for a client who had a thoracotomy 1 hour ago and reports incisional pain at a level 7 out of 10 and has decreased left-sided breath sounds. The pleural drainage system has 100 mL of bloody drainage and a large air leak. Which of thefollowing actions is best for the nurse to take next?

Choose correct answer/s
A
Administer the prescribed PRN morphine.
B
Assist the client to deep breathe and cough.
C
Milk the chest tube gently to remove any clots.
D
Tape the area around the insertion site of the chest tube.
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Question 20
Multiple Choice

A client with newly diagnosed lung cancer tells the nurse, "I think I am going to die pretty soon." Which of the following responses by the nurse is best?

Choose correct answer/s
A
"Would you like to talk to the hospital chaplain about your feelings?"
B
"Can you tell me what it is that makes you think you will die so soon?"
C
"Are you afraid that the treatment for your cancer will not be effective?"
D
"Do you think that taking an antidepressant medication would be helpful?"
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