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Question 1
Free
Multiple Choice

To evaluate the effectiveness of prescribed therapies for a client with ventilatory failure, which of the following diagnostic tests will be most useful to the nurse?

Choose correct answer/s
A

Chest x-rays

B

Pulse oximetry

C

Arterial blood gas (ABG) analysis

D

Pulmonary artery pressure monitoring

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Question 2
Free
Multiple Choice

The nurse is caring for a client who has been admitted with a pulmonary embolism and notes a change in the client's oxygen saturation (SpO2) from 94% to 88%. Which of the following actions should the nurse implement?

Choose correct answer/s
A

Increase the oxygen flow rate.

B

Suction the client's oropharynx.

C

Assist the client to cough and deep breathe.

D

Help the client to sit in a more upright position.

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Question 3
Free
Multiple Choice

The nurse is caring for a client with respiratory failure who has a respiratory rate of 8/min and a SpO2 of 89%. The client is increasingly lethargic. Which of the following actions should the nurse anticipate?

Choose correct answer/s
A

Administration of 100% oxygen by non-rebreather mask

B

Endotracheal intubation and positive pressure ventilation

C

Insertion of a mini-tracheostomy with frequent suctioning

D

Initiation of bilevel positive pressure ventilation (BiPAP)

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Question 4
Free
Multiple Choice

The pulse oximetry for a client with right lower lobe pneumonia indicates an oxygen saturation of 90%. The client has rhonchi, a weak cough effort, and complains of fatigue. Which of the following actions is best for the nurse to take?

Choose correct answer/s
A

Position the client on the right side.

B

Place a humidifier in the client's room.

C

Assist the client with staged coughing.

D

Schedule a 2-hour rest period for the client.

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Question 5
Free
Multiple Choice

The nurse is caring for an obese client with left lower lobe pneumonia. Which of the following positions should the nurse place the client in for optimal gas exchange?

Choose correct answer/s
A

Left lateral

B

Right lateral

C

Tripod position.

D

High Fowler's position

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Question 6
Multiple Choice

The nurse is admitting a client who is in possible respiratory failure with a high PaCO2. Which of the following assessment information will be of most concern to the nurse?

Choose correct answer/s
A
The client is somnolent.
B
The client's SpO2 is 90%.
C
The client complains of weakness.
D
The client's blood pressure is 162/94 mmHg.
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Question 7
Multiple Choice

Chest physiotherapy is indicated for which of the following clients?

Choose correct answer/s
A
Takes a bronchodilator
B
Produces 40 mL of sputum per 24 hours
C
Has an increased PCO2 level
D
Is taking vancomycin
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Question 8
Multiple Choice

The nurse is caring for a client who develops increasing dyspnea and hypoxemia 2 days after having cardiac surgery. To determine whether the client has acute respiratory distress syndrome (ARDS) or pulmonary edema caused by left ventricular failure, thenursewill anticipate assisting with which of the following actions?

Choose correct answer/s
A
Inserting a pulmonary artery catheter
B
Obtaining a ventilation-perfusion scan
C
Drawing blood for arterial blood gases
D
Positioning the client for a chest radiograph
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Question 9
Multiple Choice

Which of the following assessment findings by the nurse when caring for a client with ARDS who is being treated with mechanical ventilation and high levels of positive end-expiratory pressure (PEEP) indicates that the PEEP may need to be decreased?

Choose correct answer/s
A
The client has subcutaneous emphysema.
B
The client has a sinus bradycardia with a rate of 52.
C
The client's PaO2 is 50 mm Hg and the SaO2 is 88%.
D
The client has bronchial breath sounds in both the lung fields.
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Question 10
Multiple Choice

Which of the following statements by the nurse when explaining the purpose of positive end-expiratory pressure (PEEP) to the family members of a client with ARDS is correct?

Choose correct answer/s
A
"PEEP will prevent fibrosis of the lung from occurring."
B
"PEEP will push more air into the lungs during inhalation."
C
"PEEP allows the ventilator to deliver 100% oxygen to the lungs."
D
"PEEP prevents the lung air sacs from collapsing during exhalation."
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Question 11
Multiple Choice

When prone positioning is used in the care of a client with acute respiratory distress syndrome (ARDS), which of the following information obtained by the nurse indicates that the positioning is effective?

Choose correct answer/s
A
The client's PaO2 is 90 mm Hg, and the SaO2 is 92%.
B
Endotracheal suctioning results in minimal mucous return.
C
Sputum and blood cultures show no growth after 24 hours.
D
The skin on the client's back is intact and without redness.
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Question 12
Multiple Choice

The nurse obtains the vital signs for a client admitted 2 days ago with gram-negative sepsis: temperature 38.4°C (101.1°F), blood pressure 90/56 mm Hg, pulse 92 beats/minute, respirations 34/minute. Which of the following actions should the nurse take next?

Choose correct answer/s
A
Administer the scheduled IV antibiotic.
B
Give the PRN acetaminophen 650 mg.
C
Obtain oxygen saturation using pulse oximetry.
D
Notify the health care provider of the client's vital signs.
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Question 13
Multiple Choice

To decrease the risk for ventilator-associated pneumonia, which of the following actions should the nurse include in the plan of care for a client who requires intubation and mechanical ventilation?

Choose correct answer/s
A
Avoid use of positive end-expiratory pressure (PEEP).
B
Suction every 2 hours.
C
Elevate head of bed to 45 degrees.
D
Give enteral feedings at no more than 10 mL/hour.
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Question 14
Multiple Choice

The nurse is caring for a client who has a nursing diagnosis of ineffective airway clearance related to thick, secretions. Which of the following actions should the nurse include in the plan of care?

Choose correct answer/s
A
Encourage use of the incentive spirometer.
B
Offer the client fluids at frequent intervals.
C
Teach the client the importance of coughing.
D
Increase oxygen level to keep O2 saturation >95%.
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Question 15
Multiple Choice

The nurse is caring for a client with acute respiratory distress syndrome (ARDS) who is intubated, receiving mechanical ventilation and has developed a pneumothorax. Which of the following actions will the nurse anticipate taking?

Choose correct answer/s
A
Lower the positive end-expiratory pressure (PEEP).
B
Increase the fraction of inspired oxygen (FIO2).
C
Suction more frequently.
D
Increase the tidal volume.
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Question 16
Multiple Choice

After receiving change-of-shift report, which of the following clients should the nurse assess first?

Choose correct answer/s
A
A client with cystic fibrosis who has thick, green-coloured sputum
B
A client with pneumonia who has coarse crackles in both lung bases
C
A client with emphysema who has an oxygen saturation of 91% to 92%
D
A client with septicemia who has intercostal and suprasternal retractions
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Question 17
Multiple Choice

The nurse is admitting a client with chronic obstructive pulmonary disease (COPD) who has shortness of breath and dyspnea. Which of the following assessment findings is most important to report to the health care provider?

Choose correct answer/s
A
The client has bibasilar lung crackles.
B
The client is sitting in the tripod position.
C
The client's respiratory rate has decreased from 30 to 10 breaths/minute.
D
The client's pulse oximetry indicates an O2 saturation of 91%.
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Question 18
Multiple Choice

The nurse is assessing a client with chronic lung disease and finds a sudden onset of agitation and confusion. Which of the following actions should the nurse take first?

Choose correct answer/s
A
Check pupil reaction to light.
B
Notify the health care provider.
C
Attempt to calm and reassure the client.
D
Assess oxygenation using pulse oximetry.
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Question 19
Multiple Choice

The nurse is caring for a client who came to the emergency department with acute respiratory distress. Which of the following information requires the most rapid action by the nurse?

Choose correct answer/s
A
Respiratory rate is 32 breaths/minute.
B
Pattern of breathing is shallow.
C
The client's PaO2 is 45 mm Hg.
D
The client's PaCO2 is 34 mm Hg.
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Question 20
Multiple Choice

The nurse is caring for a client who was hospitalized 2 days earlier with aspiration pneumonia. Which of the following assessment information is most important to communicate to the health care provider?

Choose correct answer/s
A
Cough that is productive of blood-tinged sputum
B
Scattered crackles throughout the posterior lung bases
C
Temperature of 38.6°C (101.5°C) after 2 days of IV antibiotic therapy
D
Oxygen saturation (SpO2) has dropped to 90% with administration of 100% O2 by non-rebreather mask
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