Pulmonary Disorders
1.
Upon auscultation of the lungs, the nurse assesses a sound described as a grating, not decreased or
increased after coughing” This adventitious sound is:
A. Friction rub
B. Crackling
C. Rhonchi
D. Wheezing
2.
The description that should be used for the soft swishing sounds of normal breathing heard when the nurse
auscultates a client’s chest would be:
A. Fine crackles
B. Adventitious sounds
C. Vesicular sounds
D. Diminished breath sounds
3.
Tuberculosis is a communicable disease transmitted by which of the following methods?
A. Sexual contact
B. Using dirty needles
C. Using an infected person’s eating utensils
D. Inhalation droplets exhaled from an infected person
4.
An adult client is being screened in the clinic today for tuberculosis. He reports having negative purified
protein derivative (PPD) test results in the past. The nurse performs a PPD test on his right forearm today.
When should he return to have the test read?
A. Right after performing the test
B. 24 hours after performing the test
C. 48 hours after performing the test
D. 1 week after performing the test
5.
The client had active tuberculosis. Which of the following symptoms will exhibit?
A. Chest and lower back pain
B. Chills, fever, night sweats, hemoptysis, and weight loss
C. Fever of more than 104 F and nausea
D. Headache and photophobia
6.
To make a definitive diagnosis of tuberculosis, the nurse understands that the physician must order a:
A. Chest x-ray film
B. Tuberculin skin test
C. Pulmonary function test
D. Sputum for acid-fast testing
7.
The most common risk for chronic obstructive pulmonary disease is:
A. Cigarette smoking
B. Allergies
C. Familial and hereditary
D. Recurrent infection
8.
The diet
A.
B.
C.
D.
9.
A client with chronic obstructive pulmonary disease complains of a weight gain of 5 pounds in 1 week. The
complication that may have precipitated this weight gain is:
A. Polycythemia
B. Cor pulmonale
C. Left ventricular failure
D. Compensated acidosis
modification for patients with COPD includes:
Three large meals and 2 liters of water everyday
Frequent small meals and 2-3 liters of water
Use laxatives to soften stools.
Force fluids and drink lots of fruit juices.
10. A client with a history of chronic obstructive pulmonary disease develops cor pulmonale. When teaching
about nutrition, the nurse should encourage this client to:
A. Eat small meals 6 times a day to limit oxygen needs
B. Lie down after eating to permit energy to be used for digestion
C. Drink large amounts of fluid to help liquefy respiratory secretions
D. Increase protein intake to decrease intravascular hydrostatic pressure
11. A client
expect:
A.
B.
C.
D.
is admitted and the physician suspects atelectasis. When assessing this individual the nurse would
Slow, deep respirations
A normal oral temperature
A dry, unproductive cough
Diminished breath sounds
12. A 20-year old client is being treated for pneumonia. He has a persistent cough and complains of severe pain
on coughing. What type of instruction could be given to help the client reduce the discomfort he is having?
A. Hold in your cough as much as possible
B. Place the head of your bed flat to help with coughing.
C. Restrict fluids to help decrease the amount of sputum
D. Splint your chest wall with a pillow for comfort.
13. Asthma
A.
B.
C.
D.
is a chronic, reactive airway disorder characterized by, except:
Irreversible airway obstruction
Increased mucus secretion
Mucosal edema
Bronchospasm
14. A client with acute asthma showing inspiratory and expiratory wheezes and a decreased forced expiratory
volume should be treated with which of the following classes of medication right away?
A. Beta blockers
B. Bronchodilators
C. Inhaled steroids
D. Oral steroids
15. A nurse
A.
B.
C.
D.
is correct to state that the best treatment for asthma is:
Corticosteroids, epinephrine and IV aminophyline
Albuterol and terbutalline
Identifying and avoiding precipitating factors
Desensitization
16. To help
A.
B.
C.
D.
alleviate the distress of a client with asthma and pulmonary edema the nurse should:
Prepare modified postural drainage
Place the client in an orthopneic position
Elevate the lower extremities
Encourage frequent coughing
17. To prevent recurrent asthma attacks for a patient ready for discharge, the nurse should teach:
A. Breathing techniques to loosen secretions
B. Avoiding allergens and stress management
C. Drinking 2-3 liters of water everyday
D. All of these.
18. Which of the
A. The
B. The
C. The
D. The
following states best describes pleural effusion?
collapse of the alveoli
collapse of a bronchiole
fluid in the alveolar space
accumulation of fluid between the linings of the pleural space
19. If a pleural effusion develops, which of the following actions best describes how the fluid can be removed
from the pleural space and proper lung status restored?
A. Insert a chest tube
B. Perform thoracentesis
C. Perform paracentesis
D. Allow the pleural effusion to drain by itself
20. Mr. Freddie is confined in the medical ward and is suffering from pneumonia. After performing your physical
assessment to MR. Fernandez, which of the following signifies that he is having pneumonia?
A. Chest auscultation reveals that he is having bronchial breath sounds
B. Equal chest wall expansion occurring during inspiration
C. Tactile fremitus is decreased over the affected area
D. Percussion is clear over areas of pneumonia
21. Captain Ramon, 52, is admitted to the hospital with diagnosis of chronic obstructive lung disease. He admits
of smoking a pack of cigarettes a day for the past 20 years. Capt. Ramon’s doctor orders, “do not give
oxygen”. The basis for this order is that the administration of oxygen at this point of time may produce:
A. Over-distention of emphysematous alveoli
B. Respiratory arrest
C. Bronchial spasm
D. Pulmonary hypertension
22. Which of the following tissue changes is characteristic of emphysema?
A. Over-distention, inelastic and rupture of alveoli
B. Accumulation of pus in the pleural space
C. Filling of air passage by inflammation of the alveoli
D. Accumulation of fluids on the pleural sac
23. Mrs. Zamora has a chronic dyspnea. Her physician made a diagnosis of the pulmonary emphysema. She
has dyspnea with mild exertion. What is the probable cause of this?
A. Impaired diffusion between the alveolar air and blood
B. Decrease tone of the diaphragm
C. Thrombin obstruction of pulmonary arterioles
D. Lowered oxygen carrying capacity of the RBC
24. Which exercise would you expect a patient with emphysema to perform?
A. Blowing candles
B. Abdominal exercise to increase inspiration
C. Blowing rapidly into a paper bag
D. Panting exercise
25. The care plan instructs the nurse to monitor a patient suffering ARDS following massive body trauma. The
first signs of ARDS are:
A.
B.
C.
D.
Tachypnea & restlessness
Agitation & anger
Cyanosis and diaphoresis
Confusion and seizures
26. A nurse is caring for a client with acute respiratory distress syndrome (ARDS). Which of the following would
the nurse expect to note in the client?
A. Pallor
B. Low arterial Pao2
C. Decreased respiratory rate
D. An elevated arterial Pao2
27. Which of the following nursing diagnoses would be priority for a client with ARDS?
A. Pain
B. Risk for Infection
C. Ineffective Breathing Pattern
D. Ineffective Health Maintenance
28. On the way to an X- ray examination a client with a chest tube becomes confused and pulls the chest tube
out. The nurse’s immediate action should be to:
A. Place the client in Trendelenburg’s position
B. Hold the insertion site open with Kelly clamp
C. Obtain sterile Vaseline gauze to cover the opening
D. Cover the opening with the cleanest material available
29. When suctioning client, the nurse must remember to:
A. Initiate suction as the catheter is inserted
B. Insert catheter until the cough reflex is active
C. Use a new sterile catheter with each insertion
D. Initiate suction as the catheter is being withdrawn
30. A tracheostomy is performed for a client with respiratory distress. After the procedure the client should be
placed in the:
A. Supine position
B. Orthopneic position
C. High-Fowler’s position
D. Semi-Fowler’s position
31. A nurse has assisted a physician with insertion of a chest tube. The nurse monitors the client and notes
fluctuation of fluid level in the water seal chamber after the tube is inserted. Based on this assessment,
which of the following actions would be most appropriate?
A. Inform the physician
B. Reinforce the occlusive dressing
C. Encourage the client to deep breathe
D. Continue to monitor, for this is an expected finding.
32. A nurse is assisting a physician with removal of a chest tube. The nurse most appropriately instructs the
client to:
A. Exhale slowly
B. Stay very still
C. Inhale and exhale quickly
D. Perform Valsalva maneuver
33. Upon auscultation, rales are heard in Mr. Tochan’s left lower lung segment. One of the orders in the care
and treatment of Mr. Tochan was postural drainage once a day. To perform the procedure it would involve
placing Mr. Tochan on:
A. back with a pillow under his hips
B. left side with a pillow under his hips
C. right side with a pillow under his hips
D. abdomen with a pillow under his chest
34. While waiting for the resident-on-duty to perform the physical examination, a dyspneic patient would be
most comfortable in which position?
A. Sitting on edge of bed
B. Lying flat on bed
C. Reclining forward on a chair
D. Supine with head of bed elevated
35. ABG measurements reveal a ph of 7.25, PaCO2 of 52 mmHg and a HCO3 level of 25 mEq/L. The result
indicates what acid-base imbalance?
A. Respiratory alkalosis, uncompensated
B. Respiratory acidosis, uncompensated
C. Metabolic alkalosis, compensated
D. Metabolic acidosis, compensated
36. Nursing assessment findings on a patient with pneumothorax would include:
A. Bradypnea and bronchovesicular breathe sounds
B. Chronic cough and sudden onset of chills
C. Rust-colored sputum and increase temperature
D. Dyspnea and asymmetrical chest expansion