QUIZ 5 respiratory med surg class PDF

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notes for chapter 21 of timbys book med surg...

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Question 1

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A nurse is caring for a client with COPD who needs teaching on pursed-lip breathing. Place the steps in order in which the nurse will instruct the client. You Selected:  

“Inhale through your nose.” “Slowly count to 3.”



“Exhale slowly through pursed lips.”



“Slowly count to 7.”

Correct response:  

“Inhale through your nose.” “Slowly count to 3.”



“Exhale slowly through pursed lips.”



“Slowly count to 7.”

Explanation: Reference: 

Timby, B.K., & Smith, N.E., Introductory Medical-Surgical Nursing, 12th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 19: Introduction to the Respiratory System, p. 310. Chapter 19: Introduction to the Respiratory System - Page 310

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Question 2

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The clinic nurse is caring for a client who has been diagnosed with emphysema and who has just had a pulmonary function test (PFT) ordered. The client asks, “What exactly is this test for?” What would be the nurse’s best response? You Selected:

“A PFT measures how much air moves in and out of your lungs when you breathe.”



Correct response:

“A PFT measures how much air moves in and out of your lungs when you breathe.”

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Explanation: Reference:

Timby, B.K., & Smith, N.E., Introductory Medical-Surgical Nursing, 12th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 19: Introduction to the Respiratory System, Pulmonary Function Studies, pp. 289-290.

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Question 3

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The nurse should convey which information to a client prior to a pulmonary function test? Select all that apply. You Selected:  

The client should wear loose-fitting clothing. The client should not eat 2 hours prior to the test.



The client may be tired after the test.

Correct response:

 

The client should not eat 2 hours prior to the test. The client should wear loose-fitting clothing.



The client may be tired after the test.

Explanation: Reference:

Timby, B.K., & Smith, N.E. Introductory Medical-Surgical Nursing, 12th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2018, Chapter 19: Introduction to the Respiratory System, p. 289.

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Question 4

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A nurse is preparing a client for bronchoscopy. Which instruction should the nurse give to the client? You Selected:

Do not eat or drink for 6 hours before the procedure.



Correct response:

Do not eat or drink for 6 hours before the procedure.

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Explanation: Reference:

Timby, B.K., & Smith, N.E., Introductory Medical-Surgical Nursing, 12th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 19: Introduction to the Respiratory System, Nursing Care Plan 19-1, p. 292.

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Question 5 29s

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The nurse is admitting a client who just had a bronchoscopy. Which assessment should be the nurse's priority? You Selected:

Swallow reflex



Correct response:

Swallow reflex



Explanation: Reference:

Timby, B.K., & Smith, N.E., Introductory Medical-Surgical Nursing, 12th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 19: Introduction to the Respiratory System, Bronchoscopy, p. 291.

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Question 6

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In which position should the client be placed for a thoracentesis? You Selected: 

Sitting on the edge of the bed

Correct response: 

Sitting on the edge of the bed

Explanation: Reference: 

Timby, B.K., & Smith, N.E., Introductory Medical-Surgical Nursing, 12th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 19: Introduction to the Respiratory System, p. 293. Chapter 19: Introduction to the Respiratory System - Page 293

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Question 7

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A nurse is educating a client in anticipation of a procedure that will require a watersealed chest drainage system. What should the nurse tell the client and the family that this drainage system is used for? You Selected: 

Removing excess air and fluid

Correct response: 

Removing excess air and fluid

Explanation: Reference: 

Timby, B.K., & Smith, N.E., Introductory Medical-Surgical Nursing, 12th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 19: Introduction to the Respiratory System, Postoperative Nursing Management, pp. 355-356. Chapter 19: Introduction to the Respiratory System - Page 355-356

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Question 8

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A nurse is suctioning the client with a tracheostomy. Place in the correct order the steps will follow to deliver care. You Selected:  

Place client in Fowler’s position. Preoxygenate client for at least 1 to 2 minutes, checking that suction pressure is low.



Open the suction kit, don gloves, and lubricate a sterile, 10- to 14- French disposable catheter with sterile saline.

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Insert catheter into the lumen of the tube.

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Begin intermittent suctioning while slowly withdrawing and rotating the catheter.

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Discard the suction catheter after use.

Correct response:  

Place client in Fowler’s position. Preoxygenate client for at least 1 to 2 minutes, checking that suction pressure is low.



Open the suction kit, don gloves, and lubricate a sterile, 10- to 14- French disposable catheter with sterile saline.



Insert catheter into the lumen of the tube.



Begin intermittent suctioning while slowly withdrawing and rotating the catheter.



Discard the suction catheter after use.

Explanation: Reference:

Timby, B.K., & Smith, N.E., Introductory Medical-Surgical Nursing, 12th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 20: Caring for Clients with Upper Respiratory Disorders, p. 313.

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Question 9

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The nurse is taking a respiratory history for a patient who has come into the clinic with a chronic cough. What information should the nurse obtain from this patient? (Select all that apply.) You Selected:  

Previous history of lung disease in the patient or family Previous history of smoking



Occupational and environmental influences

Correct response:

 

Previous history of lung disease in the patient or family Occupational and environmental influences



Previous history of smoking

Explanation: Reference:

Timby, B.K., & Smith, N.E., Introductory Medical-Surgical Nursing, 12th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 19: Introduction to the Respiratory System, History, p. 287.

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Question 10

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A client is brought to the ED by ambulance after a motor vehicle accident in which the client received blunt trauma to the chest. The client is in acute respiratory failure, is intubated, and is transferred to the ICU. What assessment parameters should the nurse monitor most closely? Select all that apply. You Selected:  

Vital signs Level of consciousness



Arterial blood gases

Correct response:  

Level of consciousness Arterial blood gases



Vital signs

Explanation: Reference: 

Timby, B.K., & Smith, N.E., Introductory Medical-Surgical Nursing, 12th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 21: Caring for Clients with Lower Respiratory Disorders, Nursing Management, p. 348. Chapter 21: Caring for Clients with Lower Respiratory Disorders - Page 348

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Question 11

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What are the primary functions of the lungs? Select all that apply. You Selected:

gas exchange ventilation

 

Correct response:

ventilation gas exchange

 

Explanation: Reference:

Timby, B.K., & Smith, N.E. Introductory Medical-Surgical Nursing, 12th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2018, Chapter 19: Introduction to the Respiratory System, p. 283.

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Question 12

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The nurse is performing a nutritional assessment on a client who has been diagnosed with cancer of the larynx. Which laboratory values would be assessed when determining the nutritional status of the client? Select all that apply. You Selected:  

Glucose level Albumin level



Protein level

Correct response:  

Protein level Albumin level



Glucose level

Explanation: Reference:

Timby, B.K., & Smith, N.E., Introductory Medical-Surgical Nursing, 12th ed., Philadelphia, Wolters Kluwer, 2018.

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Question 13

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Not every structure in the upper airway has a purpose in respiration. There are some structures whose role is immunological. Which structures protect against infection? Select all that apply. You Selected:  

palantine tonsils pharyngeal tonsils

Correct response:  

palantine tonsils pharyngeal tonsils

Explanation: Reference: 

Timby, B.K., & Smith, N.E. Introductory Medical-Surgical Nursing, 12th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2018, Chapter 19: Introduction to the Respiratory System, p. 283. Chapter 19: Introduction to the Respiratory System - Page 283

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Question 14

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Following thoracic surgery, what should the nurse include in the care plan for a client at risk for impaired gas exchange? Select all that apply. You Selected:  

Elevate head of bed 30 to 40 degrees as tolerated. Monitor vital signs frequently.



Reinforce preoperative breathing exercises.

Correct response:  

Monitor vital signs frequently. Reinforce preoperative breathing exercises.



Elevate head of bed 30 to 40 degrees as tolerated.



Administer pain medications.

Explanation: Reference:

Timby, B.K., & Smith, N.E. Introductory Medical-Surgical Nursing, 12th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2018, Chapter 21: Caring for Clients with Lower Respiratory Disorders, p. 356.

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Question 15

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A 22-year-old college student recently returned from a backpacking trip to Southeast Asia and has been experiencing increasing malaise over the past 2 weeks. Today, he is seeking care because he reports that he coughed up blood during a particularly heavy coughing fit this morning. The nurse would document the presence of: You Selected: 

Hemoptysis

Correct response:

Hemoptysis



Explanation: Reference:

Timby, B.K., & Smith, N.E., Introductory Medical-Surgical Nursing, 12th ed., Philadelphia, Wolters Kluwer, 2018.

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Question 16

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A client is having a pulmonary angiography. Which sign would indicate an allergic reaction to the contrast medium? You Selected:

difficulty breathing



Correct response:

difficulty breathing



Explanation: Reference:

Timby, B.K., & Smith, N.E. Introductory Medical-Surgical Nursing, 12th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2018, Chapter 19: Introduction to the Respiratory System, p. 290.

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Question 17

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An older male client with a history of chronic laryngitis reports a persistent hoarseness. What condition is the client at risk to develop? You Selected: 

laryngeal cancer

Correct response: 

laryngeal cancer

Explanation: Reference: 

Timby, B.K., & Smith, N.E. Introductory Medical-Surgical Nursing, 12th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2018, Chapter 20: Caring for Clients with Upper Respiratory Disorders, p. 308. Chapter 20: Caring for Clients with Upper Respiratory Disorders - Page 308

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Question 18

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A client is recovering in the hospital from a bout with empyema. What intervention would the nurse implement to promote healing and oxygenation? You Selected: 

Encourage breathing exercises.

Correct response: 

Encourage breathing exercises.

Explanation: Reference: 

Timby, B.K., & Smith, N.E. Introductory Medical-Surgical Nursing, 12th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2018, Chapter 21: Caring for Clients with Lower Respiratory Disorders, p. 325. Chapter 21: Caring for Clients with Lower Respiratory Disorders - Page 325

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Question 19

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Which term will the nurse use to document the inability of a client to breathe easily unless positioned upright? You Selected:

Orthopnea



Correct response:

Orthopnea



Explanation: Reference:

Timby, B.K., & Smith, N.E., Introductory Medical-Surgical Nursing, 12th ed., Philadelphia, Wolters Kluwer, 2018.

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Question 20

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The nurse is caring for a client at risk for atelectasis. The nurse implements a first-line measure to prevent atelectasis development in the client. What is an example of a firstline measure to minimize atelectasis? You Selected: 

Incentive spirometry

Correct response: 

Incentive spirometry

Explanation: Reference:

Timby, B.K., & Smith, N.E., Introductory Medical-Surgical Nursing, 12th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 21: Caring for Clients with Lower Respiratory Disorders, Nursing Management, p. 332.

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Question 21

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A client who underwent surgery 12 hours ago has difficulty breathing. He has petechiae over his chest and complains of acute chest pain. What action should the nurse take first? You Selected: 

Initiate oxygen therapy.

Correct response: 

Initiate oxygen therapy.

Explanation: Reference: 

Timby, B. K., Smith, N. E. Introductory Medical–Surgical Nursing , 12th ed., Philadelphia: Wolters Assessment Kluwer Health/Lippincott Williams & Wilkins, 2018, Chapter 21: Caring for Clients With Lower Respiratory Disorders , p. 347. Chapter 21: Caring for Clients with Lower Respiratory Disorders - Page 347

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Question 22

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A client hospitalized with pneumonia has thick, tenacious secretions. Which intervention should the nurse include when planning this client's care? You Selected:

Encouraging increased fluid intake



Correct response:

Encouraging increased fluid intake



Explanation: Reference:

Timby, B. K., Smith, N. E. Introductory Medical–Surgical Nursing , 12th ed., Philadelphia: Wolters Assessment Kluwer Health/Lippincott Williams & Wilkins, 2018, Chapter 21: Caring for Clients With Lower Respiratory Disorders , p. 323.

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Question 23

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The home care nurse is planning to begin breathing retraining exercises with a client newly admitted to the home h...