Med Surg Respiratory Exam Practice PDF

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Respiratory Exam Practice (Part 1) 1. A clinic nurse is caring for a patient who has just been diagnosed with chronic obstructive pulmonary disease (COPD). The patient asks the nurse what he could have done to minimize the risk of contracting this disease. What would be the nurse’s best answer? a. “The most important risk factor for COPD is exposure to occupational toxins.” b. “The most important risk factor for COPD is inadequate exercise.” c. “The most important risk factor for COPD is exposure to dust and pollen.” d. “The most important risk factor for COPD is cigarette smoking.” 2. A nurse is creating a health promotion intervention focused on chronic pulmonary obstructive disease (COPD). What should the nurse identify as a complication of COPD? a. Lung cancer b. Cystic fibrosis c. Respiratory failure d. Hemothorax 3. A nurse is caring for a young adult patient whose medical history includes an alpha1antitrypsin deficiency. This deficiency predisposes the patient to what health problem? a. Pulmonary edema b. Lobular emphysema c. Cystic fibrosis (CF) d. Empyema 4. The nurse is assessing a patient whose respiratory disease is characterized by chronic hyperinflation of the lungs. What would the nurse most likely assess in this patient? a. Signs of oxygen toxicity b. Chronic chest pain c. A barrel chest d. Long, thin fingers 5. A patient with emphysema is experiencing shortness of breath. To relieve this patient’s symptoms, the nurse should assist her into what position? a. Sitting upright, leaning forward slightly b. Low Fowler’s, with the neck slightly hyperextended c. Prone d. Trendelenburg 6. A nurse is evaluating the diagnostic study data of a patient with suspected cystic fibrosis (CF). Which of the following test results is associated with diagnosis of cystic fibrosis? a. Elevated sweat chloride concentration b. Presence of protein in the urine c. Positive phenylketonuria d. Malignancy on lung biopsy 7. A school nurse is caring for a 10-year-old girl who is having an asthma attack. What is the preferred intervention to alleviate this client’s airflow obstruction? a. Administer corticosteroids by metered dose inhaler b. Administer inhaled anticholinergics c. Administer an inhaled beta-adrenergic agonist d. Utilize a peak flow monitoring device 8. A student nurse is developing a teaching plan for an adult patient with asthma. Which teaching point should have the highest priority in the plan off care that the student is developing?

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a. Gradually increase levels of physical exertion b. Change filters on heaters and air conditioners frequently c. Take prescribed medications as scheduled d. Avoid goose-down pillows A student nurse is preparing to care for a patient with bronchiectasis. The student nurse should recognize that this patient is likely to experience respiratory difficulties related to what pathophysiologic process? a. Intermittent episodes of acute bronchospasm b. Alveolar distention and impaired diffusion c. Dilation of bronchi and bronchioles d. Excessive gas exchange in the bronchioles A nurse is caring for a 6-year-old patient with cystic fibrosis. In order to enhance the child’s nutritional status, what intervention should most likely be included in the plan of care? a. Pancreatic enzyme supplementation with meals b. Provision of five to six small meals per day rather than three larger meals c. Total parenteral nutrition (TPN) d. Magnesium, thiamine, and iron supplementation A patient arrives in the emergency department with an attack of acute bronchiectasis. Chest auscultation reveals the presence of copious secretions. What intervention should the nurse prioritize in this patient’s care? a. Oral administration of diuretics b. Intravenous fluids to reduce the viscosity of secretions c. Postural chest drainage d. Pulmonary function testing A nurse is completing a focused respiratory assessment of a child with asthma. What assessment finding is most closely associated with the characteristic signs and symptoms of asthma? a. Shallow respirations b. Increased anterior-posterior (A-P) diameter c. Bilateral wheezes d. Bradypnea A nurse is developing the teaching portion of a care plan for a patient with COPD. What would be the most important component for the nurse to emphasize? a. Smoking up to one-half of a pack of cigarettes weekly is allowable b. Chronic inhalation of indoor toxins can cause lung cancer c. Minor respiratory infections are considered to be self-limited and are not treated d. Activities of daily living (ADLs) should be clustered in the early morning hours A nurse is planning the care of a patient with emphysema who will soon be discharges. What teaching should the nurse prioritize in the plan of care? a. Taking prophylactic antibiotics as ordered b. Adhering to the treatment regimen in order to cure the disease c. Avoiding airplanes, buses, and other crowded public places d. Setting realistic short-term and long-range goals A nurse is documenting the results of assessment of a patient with bronchiectasis. What would the nurse most likely include in documentation? a. Sudden onset of pleuritic chest pain b. Wheezes on auscultation c. Increased anterior-posterior (A-P) diameter

d. Clubbing of the fingers 16. A patient is having pulmonary-function studies performed. The patient performs a spirometry test, revealing an FEV1/FVC ratio of 60%. How should the nurse interpret this assessment finding? a. Strong exercise tolerance b. Exhalation volume is normal c. Respiratory infection d. Obstructive lung disease 17. A nurse has been asked to give a workshop on COPD for a local community group. The nurse emphasizes the importance of smoking cessation because smoking has what pathophysiologic effect? a. Increases the amount of mucus production b. Destabilizes haemoglobin c. Shrinks the alveoli in the lungs d. Collapses the alveoli in the lungs 18. A pediatric nurse practitioner is caring for a child who has just been diagnosed with asthma. The nurse has provided the parents with information that includes possible causative agents for an asthmatic reaction. What potential causative agent should the nurse describe? a. Pets b. Lack of sleep c. Psychosocial stress d. Bacteria 19. A nurse is providing discharge teaching for a client with COPD. When teaching the client about breathing exercises, what should the nurse include in the teaching? a. Lie supine to facilitate air entry b. Avoid pursed lip breathing c. Use diaphragmatic breathing d. Use chest breathing 20. A nurse is caring for a patient who has been admitted with an exacerbation of chronic bronchiectasis. The nurse should expect to assess the patient for which of the following clinical manifestations? a. Copious sputum production b. Pain on inspiration c. Pigeon chest d. Dry cough 21. A nurse is reviewing the pathophysiology of cystic fibrosis (CF) in anticipation of a new admission. The nurse should identify what characteristic aspects of CF? a. Alveolar mucus plugging, infection, and eventual bronchiectasis b. Bronchial mucus plugging, inflammation, and eventual bronchiectasis c. Atelectasis, infection, and eventual COPD d. Bronchial mucus plugging, infection, and eventual COPD 22. An older adult patient has been diagnosed with COPD. What characteristic of the patient’s current health status would preclude the safe and effective use of a metered dose inhaler (MDI)? a. The patient has not yet quit smoking b. The patient has severe arthritis in her hands c. The patient requires both corticosteroids and beta2-agonists d. The patient has cataracts

23. A nurse is preparing to perform an admission assessment on a patient with COPD. It is most important for the nurse to review which of the following? a. Social work assessment b. Insurance coverage c. Chloride levels d. Available diagnostic tests 24. An admitting nurse is assessing a patient with COPD. The nurse auscultates diminished breath sounds, which signify changes in the airway. These changes indicate to the nurse to monitor the patient for what? a. Kyphosis and clubbing of the fingers b. Dyspnea and hypoxemia c. Sepsis and pneumothorax d. Bradypnea and pursed lip breathing 25. A nurse is caring for a patient with COPD. The patient’s medication regimen has been recently changed and the nurse is assessing for therapeutic effect of a new bronchodilator. What assessment parameters suggest a consequent improvement in respiratory status? Select all that apply. a. Negative sputum culture b. Increased viscosity of lung secretions c. Increased respiratory rate d. Increased expiratory flow rate e. Relief of dyspnea 26. A nurse’s assessment reveals that a client with COPD may be experiencing bronchospasm. What assessment finding would suggest that the patient is experiencing bronchospasm? a. Fine or coarse crackles on auscultation b. Wheezes or diminished breath sounds on auscultation c. Reduced respiratory rate or lethargy d. Slow, deliberate respirations 27. The case manager for a group of patients with COPD is providing health education. What is the most important for the nurse to assess when providing instructions on self-management to these patients? a. Knowledge of alternative treatment modalities b. Family awareness of functional ability and activities of daily living (ADLs) c. Knowledge of the pathophysiology of the disease process d. Knowledge about self-care and their therapeutic regimen 28. A nurse is developing a teaching plan for a patient with COPD. What should the nurse include as the most important area of teaching? a. Avoiding extremes of heat and cold b. Setting and accepting realtixtic short- and long-range goals c. Adopting a lifestyle of moderate activity d. Avoiding emotional disturbances and stressful situations 29. A nurse is assessing a patient who is suspected of having bronchiectasis. The nurse should consider which of the following potential causes? Select all that apply. a. Pulmonary hypertension b. Airway obstruction c. Pulmonary infections d. Genetic disorders e. Atelectasis

30. A nurse is planning the care of a client with bronchiectasis. What goal of care should the nurse prioritize? a. The patient will successfully mobilize pulmonary secretions b. The patient will maintain an oxygen saturation of greater than or equal to 98% c. The patient’s pulmonary blood pressure will decrease to within reference ranges d. The patient will resume prediagnosis level of function within 72 hours 31. An interdisciplinary team is planning the care of a patient with bronchiectasis. What aspects of care should the nurse anticipate? Select all that apply. a. Occupational therapy b. Antimicrobial therapy c. Positive pressure isolation d. Chest physiotherapy e. Smoking cessation 32. A patient’s severe asthma has ecessitated the use of long-acting beta2-agonist (LABA). Which of the patient’s statements suggest a need for further education? a. “I know that these drugs can sometimes make my heart beat faster.” b. “I’ve heard that this drug is particularly good at preventing asthma attacks during exercise.” c. “I’ll make sure to use this each time I feel an asthma attack coming on.” d. “I’ve heared that this drug sometimes gets less effective over time.” 33. A nurse is providing health education to the family of a patient with bronchiectasis. What should the nuse teach the patient’s family members? a. The correct technique for chest palpation and auscultation b. Techniques for assessing the patient’s fluid balance c. The technique for providing deep nasotracheal suctioning d. The correct technique for providing postural drainage 34. A nurse is working with a child who is undergoing a diagnostic workup for suspected asthma. What are the signs and symptoms that are consistent with a diagnosis of asthma? Select allt hat apply. a. Chest tightness b. Crackles c. Bradypnea d. Wheezing e. Cough 35. A nurse is caring for a patient who has been hospitalized with an acute asthma exacerbation. What drugs should the nurse expect to be ordered for this patient to gain underlying control of persistent asthma? a. Rescue inhalers b. Anti-inflammatory drugs c. Antibiotics d. Antitussives 36. A nurse is teaching a patient with asthma about Azmacort, an inhaled corticosteroid. Which adverse effects should the nurse be sure to address in patient teaching? a. Dyspnea and increased respiratory secretions b. Nausea and vomiting c. Cough and oral thrush d. Fatigue and decreased level of consciousness

37. A nurse is explaining to a patient with asthma what her new presxcription for prednisone is used for. What would be the most accurate explanation that the nurse could give? a. To ensure long-term prevention of asthma exacerbations b. To cure any systemic infection underlying asthma attacks c. To prevent recurrent pulmonary infections d. To gain prompt control of inadequately controlled, persistent asthma 38. An asthma nurse educator is working with a group of adolescent asthma patients. What intervention is most likely to prevent asthma exacerbations among these patients? a. Encouraging patients to carry a corticosteroid inhaler at all times b. Educating patients about recognizing and avoiding asthma triggers c. Teaching patients to utilize alternative therapies in asthma management d. Ensuring that patients keep their immunizations up to date 39. An asthma educator is teaching a patient newly diagnosed with asthma and her family about the use of a peak flow meter. The educator should teach the patient that a peak flow meter measures what value? a. Highest airflow during a forced inspiration b. Highest airflow during a forced expiration c. Airflow during a normal inspiration d. Airflow during a normal expiration 40. A nurse is admitting a new patient who has been admitted with a diagnosis of COPD exacerbation. How can the nurse best help the patient achieve the goal of maintaining effective oxygenation? a. Teach the patient strategies for promoting diaphragmatic breathing b. Administer supplementary oxygen by simple face mask c. Teach the patient to perform airway suctioning d. Assist the patient in developing an appropriate exercise program

Respiratory Answer Key 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40.

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