1 Aminophylline (theophylline) is prescribed for a client with acute bronchitis.

A nurse administers the

medication, knowing that the primary action of this medication is to:

A. Promote expectoration.

B. Suppress the cough.

C. Relax smooth muscles of the bronchial airway.

D. Prevent infection.

2 Immediately following a thoracentesis, which clinical manifestations indicate that a complication has
occurred and the physician should be notified?

A. Serosanguineous drainage from the puncture site.

B. Increased temperature and blood pressure.

C. Increased pulse and pallor.

D. Hypotension and hypothermia

3 female client is scheduled to have a chest radiograph. Which of the following questions is of most
importance to the nurse assessing this client?

A. “Is there any possibility that you could be pregnant?”

B. “Are you wearing any meHth easily?”

D. “Are you able to hold your arms above your head?”

4 client has just returned to a nursing unit following bronchoscopy. A nurse would implement which of
the following nursing interventions for this client?

A. Encouraging additional fluids for the next 24 hours

B. Ensuring the return of the gag reflex before offering foods or fluids

C. Administering atropine intravenously

D. Administering small doses of midazolam (Versed)

5 A nurse is assessing a client with chronic airflow limitation and notes that the client has a “barrel
chest.” The nurse interprets that this client has which of the following forms of chronic airflow
limitation?

A. Chronic obstructive bronchitis

B. Emphysema

C. Bronchial asthma

D. Bronchial asthma and bronchitis

6 Which of the following would be an expected outcome for a client recovering from an upper
respiratory tract infection? The client will:

A. Maintain a fluid intake of 800 ml every 24 hours.

B. Experience chills only once a day.

C. Cough productively without chest discomfort.

D. Experience less nasal obstruction and discharge.

7 Which of the following individuals would the nurse consider to have the highest priority for receiving
an influenza vaccination?

A. A 60-year-old man with a hiatal hernia.

B. A 36-year-old woman with 3 children.

C. A 50-year-old woman caring for a spouse with cancer.

D. A 60-year-old woman with osteoarthritis.

8 A client with allergic rhinitis asks the nurse what he should do to decrease his symptoms. Which of the
following instructions would be appropriate for the nurse to give the client?
A. “Use your nasal decongestant spray regularly to help clear your nasal passages.”

B. “Ask the doctor for antibiotics. Antibiotics will help decrease the secretion.”

C. “It is important to increase your activity. A daily brisk walk will help promote drainage.”

D. “Keep a diary when your symptoms occur. This can help you identify what precipitates your attacks.”

9 An elderly client has been ill with the flu, experiencing headache, fever, and chills. After 3 days, she
developed a cough productive of yellow sputum. The nurse auscultates her lungs and hears diffuse
crackles. How would the nurse best interpret these assessment findings?

A. It is likely that the client is developing a secondary bacterial pneumonia.

B. The assessment findings are consistent with influenza and are to be expected.

C. The client is getting dehydrated and needs to increase her fluid intake to decrease secretions

D. The client has not been taking her decongestants and bronchodilators as prescribed.

10 A client with COPD reports steady weight loss and being “too tired from just breathing to eat.” Which
of the following nursing diagnoses would be most appropriate when planning nutritional interventions
for this client?

A. Altered nutrition: Less than body requirements related to fatigue.

B. Activity intolerance related to dyspnea.

C. Weight loss related to COPD.

D. Ineffective breathing pattern related to alveolar hypoventilation

11 When developing a discharge plan to manage the care of a client with COPD, the nurse should
anticipate that the client will do which of the following?

A. Develop infections easily.

B. Maintain current status.

C. Require less supplemental oxygen.

D. Show permanent improvement.

12 Which of the following outcomes would be appropriate for a client with COPD who has been
discharged to home? The client:

A. Promises to do pursed lip breathing at home.

B. States actions to reduce pain.

C. States that he will use oxygen via a nasal cannula at 5 L/minute.

D. Agrees to call the physician if dyspnea on exertion increases.

13 Which of the following physical assessment findings would the nurse expect to find in a client with
advanced COPD?

A. Increased anteroposterior chest diameter.

B. Underdeveloped neck muscles.

C. Collapsed neck veins.

D. Increased chest excursions with respiration.

14 Which of the following is the primary reason to teach pursed-lip breathing to clients with
emphysema?

A. To promote oxygen intake.

B. To strengthen the diaphragm.

C. To strengthen the intercostal muscles.

D. To promote carbon dioxide elimination.

15 Which of the following is a priority goal for the client with COPD?

A. Maintaining functional ability.

B. Minimizing chest pain.

C. Increasing carbon dioxide levels in the blood.

D. Treating infectious agents

16 A client’s arterial blood gas levels are as follows: pH 7.31; PaO2 80 mm Hg, PaCO2 65 mm Hg; HCO3-
36 mEq/L. Which of the following signs or symptoms would the nurse expect?

A. Cyanosis

B. Flushed skin

C. Irritability

D. Anxiety

17 When teaching a client with COPD to conserve energy, the nurse should teach the client to lift
objects:

A. While inhaling through an open mouth.

B. While exhaling through pursed lips.

C. After exhaling but before inhaling.

D. While taking a deep breath and holding it.

18 The nurse teaches a client with COPD to assess for s/s of right-sided heart failure. Which of the
following s/s would be included in the teaching plan?

A. Clubbing of nail beds

B. Hypertension

C. Peripheral edema

D. Increased appetite

19 The nurse assesses the respiratory status of a client who is experiencing an exacerbation of COPD
secondary to an upper respiratory tract infection. Which of the following findings would be expected?
A. Normal breath sounds

B. Prolonged inspiration

C. Normal chest movement

D. Coarse crackles and rhonchi

20 Which of the following ABG abnormalities should the nurse anticipate in a client with advanced
COPD?

A. Increased PaCO2

B. Increased PaO2

C. Increased pH

D. Increased oxygen saturation

21 The nurse is planning to teach a client with COPD how to cough effectively. Which of the following
instructions should be included?

A. Take a deep abdominal breath, bend forward, and cough 3 to 4 times on exhalation.

B. Lie flat on back, splint the thorax, take two deep breaths and cough.

C. Take several rapid, shallow breaths and then cough forcefully.

D. Assume a side-lying position, extend the arm over the head, and alternate deep breathing with
coughing.

22 A 34-year-old woman with a history of asthma is admitted to the emergency department. The nurse
notes that the client is dyspneic, with a respiratory rate of 35 breaths/minute, nasal flaring, and use of
accessory muscles. Auscultation of the lung fields reveals greatly diminished breath sounds. Based on
these findings, what action should the nurse take to initiate care of the client?
A. Initiate oxygen therapy and reassess the client in 10 minutes.

B. Draw blood for an ABG analysis and send the client for a chest x-ray.

C. Encourage the client to relax and breathe slowly through the mouth.

D. Administer bronchodilators.

23 The nurse would anticipate which of the following ABG results in a client experiencing a prolonged,
severe asthma attack?

A. Decreased PaCO2, increased PaO2, and decreased pH.

B. Increased PaCO2, decreased PaO2, and decreased pH.

C. Increased PaCO2, increased PaO2, and increased pH.

D. Decreased PaCO2, decreased PaO2, and increased pH.

24 A client with acute asthma is prescribed short-term corticosteroid therapy. What is the rationale for
the use of steroids in clients with asthma?

A. Corticosteroids promote bronchodilation.

B. Corticosteroids act as an expectorant.

C. Corticosteroids have an anti-inflammatory effect.

D. Corticosteroids prevent development of respiratory infections.

25 The nurse is teaching the client how to use a metered-dose inhaler (MDI) to administer a
Corticosteroid drug. Which of the following client actions indicates that he is using the MDI correctly?
Select all that apply.

A. The inhaler is held upright.

B. Head is tilted down while inhaling the medication.

C. Client waits 5 minutes between puffs.

D. Mouth is rinsed with water following administration.

E. Client lies supine for 15 minutes following administration.

26 Which of the following health promotion activities should the nurse include in the discharge teaching
plan for a client with asthma?

A. Incorporate physical exercise as tolerated into the treatment plan.

B. Monitor peak flow numbers after meals and at bedtime.

C. Eliminate stressors in the work and home environment.

D. Use sedatives to ensure uninterrupted sleep at night.

27 The client with asthma should be taught which of the following is one of the most common
precipitating factors of an acute asthma attack?

A. Occupational exposure to toxins.

B. Viral respiratory infections.

C. Exposure to cigarette smoke.

D. Exercising in cold temperatures.

28 female client comes into the emergency room complaining of SOB and pain in the lung area. She
states that she started taking birth control pills 3 weeks ago and that she smokes. Her VS are: 140/80, P
110, R 40. The physician orders ABG’s, results are as follows: pH: 7.50; PaCO2 29 mm Hg; PaO2 60 mm
Hg; HCO3- 24 mEq/L; SaO2 86%. Considering these results, the first intervention is to:

A. Begin mechanical ventilation.

B. Place the client on oxygen.

C. Give the client sodium bicarbonate.

D. Monitor for pulmonary embolism

29 If a client continues to hypoventilate, the nurse will continually assess for a complication of:

A. Respiratory acidosis

B. Respiratory alkalosis

C. Metabolic acidosis

D. Metabolic alkalosis

30 client is admitted to the hospital with acute bronchitis. While taking the client’s VS, the nurse notices
he has an irregular pulse. The nurse understands that cardiac arrhythmias in chronic respiratory distress
are usually the result of:

A. Respiratory acidosis

B. A build-up of carbon dioxide

C. A build-up of oxygen without adequate expelling of carbon dioxide.

D. An acute respiratory infection.

31 Auscultation of a client’s lungs reveals crackles in the left posterior base. The nursing intervention is
to:

A. Repeat auscultation after asking the client to deep breathe and cough.

B. Instruct the client to limit fluid intake to less than 2000 ml/day.

C. Inspect the client’s ankles and sacrum for the presence of edema.

D. Place the client on bedrest in a semi-Fowler's position.

32 A client with COPD has developed secondary polycythemia. Which nursing diagnosis would be
included in the plan of care because of the polycythemia?

A. Fluid volume deficit related to blood loss.

B. Impaired tissue perfusion related to thrombosis.

C. Activity intolerance related to dyspnea.

D. Risk for infection related to suppressed immune response.

33 Assessing a client who has developed atelectasis postoperatively, the nurse will most likely find:

A. A flushed face.

B. Dyspnea and pain.

C. Decreased temperature.

D. Severe cough and no pain.

34 Miriam, a college student with acute rhinitis sees the campus nurse because of excessive nasal
drainage. The nurse asks the patient about the color of the drainage. In acute rhinitis, nasal drainage
normally is:

A. Yellow

B. Green

C. Clear

D. Gray

35 On auscultation, which finding suggests a right pneumothorax?

A. Bilateral inspiratory and expiratory crackles.

B. Absence of breaths sound in the right thorax.

C. Inspiratory wheezes in the right thorax.

D. Bilateral pleural friction rub.

36 A male patient is admitted to the healthcare facility for treatment of chronic obstructive pulmonary
disease. Which nursing diagnosis is most important for this patient?

A. Activity intolerance related to fatigue.

B. Anxiety related to actual threat to health status.

C. Risk for infection related to retained secretions.

D. Impaired gas exchange related to airflow obstruction.

37 When caring for a male patient who has just had a total laryngectomy, the nurse should plan to:

A. Encourage oral feeding as soon as possible.

B. Develop an alternative communication method.

C. Keep the tracheostomy cuff fully inflated.

D. Keep the patient flat in bed

38 For a patient with advanced chronic obstructive pulmonary disease (COPD), which nursing action best
promotes adequate gas exchange?

A. Encouraging the patient to drink three glasses of fluid daily.

B. Keeping the patient in semi-Fowler's position.

C. Using a high-flow venturi mask to deliver oxygen as prescribed.

D. Administering a sedative, as prescribed.

39 For a female patient with chronic obstructive pulmonary disease, which nursing intervention would
help maintain a patent airway?

A. Restricting fluid intake to 1,000 ml per day.

B. Enforcing absolute bed rest.

C. Teaching the patient how to perform controlled coughing.

D. Administering prescribed sedatives regularly and in large amounts.

40 Nurse Lei, caring for a client with a pneumothorax and who has had a chest tube inserted, continues
gentle bubbling in the suction control chamber. What action is appropriate?

A. Do nothing, because this is an expected finding.

B. Immediately clamp the chest tube and notify the physician.

C. Check for an air leak because the bubbling should be intermittent.

D. Increase the suction pressure so that the bubbling becomes vigorous.

41 Nurse Reynolds caring for a client with a chest tube turns the client to the side, and the chest tube
accidentally disconnects. The initial nursing action is to:

A. Call the physician.

B. Place the tube in a bottle of sterile water.

C. Immediately replace the chest tube system.

D. Place a sterile dressing over the disconnection site.

42 A nurse is assisting a physician with the removal of a chest tube. The nurse should instruct the client
to:
A. Exhale slowly

B. Stay very still

C. Inhale and exhale quickly

D. Perform the Valsalva maneuver

43 Nurse Oliver is caring for a client immediately after removal of the endotracheal tube. The nurse
reports which of the following signs immediately if experienced by the client?

A. Stridor

B. Occasional pink-tinged sputum

C. A few basilar lung crackles on the right

D. Respiratory rate 24 breaths/min

44 An emergency room nurse is assessing a male client who has sustained a blunt injury to the chest
wall. Which of these signs would indicate the presence of a pneumothorax in this client?

A. A low respiratory rate.

B. Diminished breath sounds.

C. The presence of a barrel chest.

D. A sucking sound at the site of injury.

45 Nurse Reese is caring for a client hospitalized with acute exacerbation of chronic obstructive
pulmonary disease. Which of the following would the nurse expect to note on assessment of this client?

A. Hypocapnia

B. A hyperinflated chest noted on the chest x-ray.

C. Increased oxygen saturation with exercise.

D. A widened diaphragm noted on the chest x-ray.

46 Blessy, a community health nurse is conducting an educational session with community members
regarding tuberculosis. The nurse tells the group that one of the first symptoms associated with
tuberculosis is:

A. Dyspnea

B. Chest pain

C. A bloody, productive cough.

D. A cough with the expectoration of mucoid sputum

47 A nurse is caring for a male client with acute respiratory distress syndrome. Which of the following
would the nurse expect to note in the client?

A. Pallor

B. Low arterial PaO2

C. Elevated arterial PaO2

D. Decreased respiratory rate

48 A nurse is suctioning fluids from a female client through an endotracheal tube. During the suctioning
procedure, the nurse notes on the monitor that the heart rate is decreasing. Which if the following is the
appropriate nursing intervention?

A. Continue to suction.

B. Notify the physician immediately.

C. Stop the procedure and reoxygenate the client.

D. Ensure that the suction is limited to 15 seconds.

49 A male adult client is suspected of having a pulmonary embolism. A nurse assesses the client,
knowing that which of the following is a common clinical manifestation of pulmonary embolism?

A. Dyspnea

B. Bradypnea

C. Bradycardia

D. Decreased respirations

50 slightly obese female client with a history of allergy-induced asthma, hypertension, and mitral valve
prolapse is admitted to an acute care facility for elective surgery. The nurse obtains a complete history
and performs a thorough physical examination, paying special attention to the cardiovascular and
respiratory systems. When percussing the client’s chest wall, the nurse expects to elicit:

A. Resonant sounds.

B. Hyperresonant sounds.

C. Dull sounds.

D. Flat sounds.

51 The nurse is teaching a male client with chronic bronchitis about breathing exercises. Which of the
following should the nurse include in the teaching?

A. Make inhalation longer than exhalation.

B. Exhale through an open mouth.

C. Use diaphragmatic breathing.

D. Use chest breathing.

52 A male client with chronic obstructive pulmonary disease (COPD) is recovering from a myocardial
infarction. Because the client is extremely weak and can’t produce an effective cough, the nurse should
monitor closely for:

A. Pleural effusion

B. Pulmonary edema

C. Atelectasis

D. Oxygen toxicity

53 An elderly client with pneumonia may appear with which of the following symptoms first?

A. Altered mental status and dehydration

B. Fever and chills

C. Hemoptysis and dyspnea

D. Pleuritic chest pain and cough

54 A 7-year-old client is brought to the E.R. He’s tachypneic and afebrile and has a respiratory rate of 36
breaths/minute and a nonproductive cough. He recently had a cold. From his history, the client may
have which of the following?

A. Acute asthma

B. Bronchial pneumonia

C. Chronic obstructive pulmonary disease (COPD)

55 A client with acute asthma showing inspiratory and expiratory wheezes and a decreased expiratory
volume should be treated with which of the following classes of medication right away?
A. Beta-adrenergic blockers

B. Bronchodilators

C. Inhaled steroids

D. Oral steroids

56 A 19-year-old comes into the emergency department with acute asthma. His respiratory rate is 44
breaths/minute, and he appears to be in acute respiratory distress. Which of the following actions
should be taken first?

A. Take a full medication history.

B. Give a bronchodilator by nebulizer.

C. Apply a cardiac monitor to the client.

D. Provide emotional support to the client.

57 A 58-year-old client with a 40-year history of smoking one to two packs of cigarettes a day has a
chronic cough producing thick sputum, peripheral edema, and cyanotic nail beds. Based on this
information, he most likely has which of the following conditions?

A. Adult respiratory distress syndrome (ARDS)

B. Asthma

C. Chronic obstructive bronchitis

D. Emphysema

58 A 66-year-old client has marked dyspnea at rest, is thin, and uses accessory muscles to breathe. He’s
tachypneic, with a prolonged expiratory phase. He has no cough. He leans forward with his arms braced
on his knees to support his chest and shoulders for breathing. This client has symptoms of which of the
following respiratory disorders?
A. ARDS

B. Asthma

C. Chronic obstructive bronchitis

D. Emphysema

59 It’s highly recommended that clients with asthma, chronic bronchitis, and emphysema have
Pneumovax and flu vaccinations for which of the following reasons?

A. All clients are recommended to have these vaccines.

B. These vaccines produce bronchodilation and improve oxygenation.

C. These vaccines help reduce the tachypnea these clients experience.

D. Respiratory infections can cause severe hypoxia and possibly death in these clients.

60 Which of the following respiratory disorders is most common in the first 24 to 48 hours after surgery?

A. Atelectasis

B. Bronchitis

C. Pneumonia

D. Pneumothorax

61 Emergency treatment of a client in status asthmaticus includes which of the following medications?

A. Inhaled beta-adrenergic agents

B. Inhaled corticosteroids
C. I.V. beta-adrenergic agents

D. Oral corticosteroids

62 client has started a new drug for hypertension. Thirty minutes after he takes the drug, he develops
chest tightness and becomes short of breath and tachypnea. He has a decreased level of consciousness.
These signs indicate which of the following conditions?

A. Asthma attack

B. Pulmonary embolism

C. Respiratory failure

D. Rheumatoid arthritis

63 A client’s ABG results are as follows: pH: 7.16; PaCO2 80 mm Hg; PaO2 46 mm Hg; HCO3- 24 mEq/L;
SaO2 81%. This ABG result represents which of the following conditions?

A. Metabolic acidosis

B. Metabolic alkalosis

C. Respiratory acidosis

D. Respiratory alkalosis

64 A nurse reviews the arterial blood gas results of a patient and notes the following: pH 7.45; PCO2 30
mm Hg; and bicarbonate concentration of 22 mEq/L. The nurse analyzes these results as indicating:

A. Metabolic acidosis, compensated.

B. Metabolic alkalosis, uncompensated.

C. Respiratory alkalosis, compensated.

D. Respiratory acidosis, compensated.

65 A nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse
monitors the client, knowing that the client is at risk for which acid-base disorder?

A. Respiratory acidosis

B. Respiratory alkalosis

C. Metabolic acidosis

D. Metabolic alkalosis

66 A nurse caring for a client with an ileostomy understands that the client is most at risk for developing
which acid-base disorder?

A. Respiratory acidosis

B. Respiratory alkalosis

C. Metabolic acidosis

D. Metabolic alkalosis

67 A nurse is caring for a client with diabetic ketoacidosis and documents that the client is experiencing
Kussmaul’s respirations. Based on this documentation, which of the following did the nurse observe?

A. Respirations that are abnormally deep, regular, and increased in rate.

B. Respirations that are regular but abnormally slow.

C. Respirations that are labored and increased in depth and rate.

D. Respirations that cease for several seconds.

68 An unconscious client is admitted to an emergency room. Arterial blood gas measurements reveal a
pH of 7.30, a low bicarbonate level, a normal carbon dioxide level, and a normal oxygen level. An
elevated potassium level is also present. These results indicate the presence of:

A. Metabolic acidosis

B. Respiratory acidosis

C. Combined respiratory and metabolic acidosis

D. Over compensated respiratory acidosis

69 A male client admitted to an acute care facility with pneumonia is receiving supplemental oxygen, 2
L/minute via nasal cannula. The client’s history includes chronic obstructive pulmonary disease (COPD)
and coronary artery disease. Because of these history findings, the nurse closely monitors the oxygen
flow and the client’s respiratory status. Which complication may arise if the client receives a high oxygen
concentration?

A. Apnea

B. Anginal pain

C. Respiratory alkalosis

D. Metabolic acidosis

70 The nurse in charge formulates a nursing diagnosis of Activity intolerance related to inadequate
oxygenation and dyspnea for a client with chronic bronchitis. To minimize this problem, the nurse
instructs the client to avoid conditions that increase oxygen demands. Such conditions include:

A. Drinking more than 1,500 ml of fluid daily.

B. Being overweight.

C. Eating a high-protein snack at bedtime.

D. Eating more than three large meals a day.

71 client with pneumonia develops dyspnea with a respiratory rate of 32 breaths/minute and difficulty
expelling his secretions. The nurse auscultates his lung fields and hears bronchial sounds in the left lower
lobe. The nurse determines that the client requires which of the following treatments first?

A. Antibiotics

B. Bed rest

C. Oxygen

D. Nutritional intake

72 A client has active TB. Which of the following symptoms will he exhibit?

A. Chest and lower back pain.

B. Chills, fever, night sweats, and hemoptysis.

C. Fever of more than 104*F and nausea.

D. Headache and photophobia.

73 A client with a productive cough, chills, and night sweats is suspected of having active TB. The
physician should take which of the following actions?

A. Admit him to the hospital in respiratory isolation.

B. Prescribe isoniazid and tell him to go home and rest.

C. Give a tuberculin test and tell him to come back in 48 hours and have it read.

D. Give a prescription for isoniazid, 300 mg daily for 2 weeks, and send him home.

74 A client is diagnosed with active TB and started on triple antibiotic therapy. What signs and
symptoms would the client show if therapy is inadequate?

A. Decreased shortness of breath.

B. Improved chest x-ray.

C. Nonproductive cough.

D. Positive acid-fast bacilli in a sputum sample after 2 months of treatment.

75 A client diagnosed with active TB would be hospitalized primarily for which of the following reasons?

A. To evaluate his condition.

B. To determine his compliance.

C. To prevent spread of the disease.

D. To determine the need for antibiotic therapy.

76 A client with shortness of breath has decreased to absent breath sounds on the right side, from the
apex to the base. Which of the following conditions would best explain this?

A. Acute asthma

B. Chronic bronchitis

C. Pneumonia

D. Spontaneous pneumothorax

77 A 79-year-old client is admitted with pneumonia. Which nursing diagnosis should take priority?

A. Acute pain related to lung expansion secondary to lung infection.

B. Risk for imbalanced fluid volume related to increased insensible fluid losses secondary to fever.

C. Anxiety related to dyspnea and chest pain.

D. Ineffective airway clearance related to retained secretions.

78 A community health nurse is conducting an educational session with community members regarding
TB. The nurse tells the group that one of the first symptoms associated with TB is:

A. A bloody, productive cough

B. A cough with the expectoration of mucoid sputum

C. Chest pain

D. Dyspnea

79 A nurse is caring for a client diagnosed with TB. Which assessment, if made by the nurse, would not
be consistent with the usual clinical presentation of TB and may indicate the development of a
concurrent problem?

A. Non Productive or productive cough

B. Anorexia and weight loss

C. Chills and night sweats

D. High-grade fever

80 A client with pneumonia has a temperature of 102.6*F (39.2*C), is diaphoretic, and has a productive
cough. The nurse should include which of the following measures in the plan of care?

A. Position changes q4h.

B. Nasotracheal suctioning to clear secretions.

C. Frequent linen changes.

D. Frequent offering of a bedpan

81 Which of the following symptoms is common in clients with TB?

A. Weight loss

B. Increased appetite
C. Dyspnea on exertion

D. Mental status changes

82 Which of the following family members exposed to TB would be at highest risk for contracting the
disease?

A. 45-year-old mother

B. 17-year-old daughter

C. 8-year-old son

D. 76-year-old grandmother

83 A client comes to the emergency department with a productive cough. Which symptom does the
nurse look for that will require immediate attention?

A. Blood in the sputum

B. Mucoid sputum

C. Pink frothy sputum

D. Yellow sputum

84 Four clients are sent back to the emergency department from triage at the same time. Which client
requires the nurse's immediate attention?

A. Client with acute allergic reaction

B. Client with dyspnea on exertion

C. Client with lung cancer with cough

D. Client with sinus infection with fever

85 In assessing the client's respiratory status, blood gas test results reveal pH of 7.50, PaO2 of 99, PaCO2
of 29, and HCO of 22. What action does the nurse need to take first?
A. Call the physician.

B. Encourage the client to slow his breathing rate.

C. Nothing. These results are within the normal range.

D. Provide oxygen support.

86 A client is admitted to the medical floor with a new diagnosis of lung cancer. How can the nurse assist
the client initially with the anxiety associated with the new diagnosis?

A. Encourage client to ask questions and verbalize concerns.

B. Leave client alone to deal with his own feelings.

C. Medicate client with diazepam (Valium) for anxiety every 8 hours.

D. Provide journals about cancer treatment

87 When caring for a patient with acute bronchitis, the nurse

will prioritize interventions by

A. auscultating lung sounds.

B. encouraging fluid restriction.

C administering antibiotic therapy.

D. teaching the patient to avoid cough suppressants.

88 Which patients have the greatest risk for aspiration

pneumonia? (select all that apply)

A. Patient with seizures

B. Patient with head injury

C Patient who had thoracic surgery

D. Patient who had a myocardial infarction

E. Patient who is receiving nasogastric tube feeding

89. An appropriate nursing intervention to assist a patient

with pneumonia manage thick secretions and fatigue

would be to

A. perform postural drainage every hour.

B. provide analgesics as ordered to promote patient

comfort.

C. administer O2 as prescribed to maintain optimal O2

levels.

D. teach the patient how to cough effectively and

expectorate secretions.27

90 A patient with TB has been admitted to the hospital and is placed on airborne precautions and in an
isolation room. What should the nurse teach the patient? (select all that apply)

A. Expect routine TB testing to evaluate the infection.

B. No visitors will be allowed while in airborne isolation.

C. Adherence to precautions includes coughing into a paper tissue.

D Take all medications for full length of time to prevent multidrug-resistant TB.

E. Wear a standard isolation mask if leaving the airborne infection isolation room.

91 . A patient has been receiving high-dose corticosteroids and broad-spectrum antibiotics for treatment
of an infection after a traumatic injury. The nurse plans care for the patient knowing that the patient is
most susceptible to

A candidiasis.
B cryptococcosis.

C histoplasmosis.

D coccidioidomycosis.

92 When caring for a patient with a lung abscess, what is the

nurse’s priority intervention?

A Postural drainage

B. Antibiotic administration

C Obtaining a sputum specimen

D Patient teaching about home care

93. The nurse receives an order for a patient with lung cancer to receive influenza vaccine and
pneumococcal vaccines.The nurse will

A. call the health care provider to question the order.

B. give both vaccines at the same time in different arms.

C give the pneumococcal vaccine and obtain a nasal influenza vaccine.

D. give the flu shot and tell the patient to come back in 1 week to have the pneumococcal vaccine.

28

94 After a pneumonectomy, an appropriate nursing intervention is

A. monitoring chest tube drainage and functioning.

B. positioning the patient on the unaffected side or back.

C. doing range-of-motion exercises on the affected upper limb.

D auscultating frequently for lung sounds on the affected side.

95 When planning care for a patient at risk for pulmonarY embolism, the nurse prioritizes

A. maintaining the patient on bed rest.

B. using intermittent pneumatic compression devices.

C. encouraging the patient to cough and deep breathe.

D. teaching the patient how to use the incentive spirometer29

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