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Respiratory Concepts Exam

Assignment 1: Objective Tests: Design and Considerations

Melissa Ackerly

SUNY Delhi


Kirsty Digger

Measurement and Evaluation in Nursing Education

October 31, 2017


Safe and Effective Care Environment

1. A client is prepared for a bronchoscopic procedure. The RN gives an IV sedative. Which

activity would be delegated to an LVN/LPN?

a. Teaching the client about the procedure

b. Giving the client small sips of water for dry mouth
c. Walking the client to the bathroom before the procedure
d. Checking the clients blood pressure and pulse

The correct answer is D because data collection such as vital sign monitoring are within the

scope of Licensed Nurses scope of practice and the sedated patients vital signs require

monitoring. The RN assesses the results (Lagerquist, 2012).

Rationale: Answer A is incorrect because again teaching is out of the LVN/LPN scope of

practice and would have been done by the RN prior to sedation, answer B because the patient

would be NPO prior to the procedure, and answer C is also incorrect because the sedated patient

would not be ambulated (Lagerquist, 2012).

Blooms: Analysis

The nurse is able to differentiate scope of practice duties and assigns vital signs as a critical need

for the patient (Huitt, 2011).

Management of Care

2. On a skilled nursing unit, an LVN/LPN reports to a staff nurse that a client is short of breath.
What is the most important initial response by the RN?

a. Ask the LVN/LPN if this is a new symptom

b. Do an independent nursing assessment of the client
c. Ask the LVN/LPN to describe what is meant by shortness of breath
d. Check the clients chart for a current x-ray report

The correct answer is C because the RN requires specific data of the patients condition from

the LVN/LPN to explain what is meant by shortness of breath.


Rationale: Answer A is incorrect because yes or no does not describe the patients condition,

answer B assumes there is an urgent situation, and answer D does not address the current

situation in determining what the patient is doing at the moment (Lagerquist, 2012).

Blooms: Analysis

The nurse is eliminating assumption and and asking for evidence to make a decision how

immediate the patients problem may be (Huitt, 2011).

Safety and Infection Control

3. A nurse prepares to admit a child diagnosed with respiratory syncytial virus (RSV). Which
infection control measure would be most appropriate for this child?

a. Place child in a negative pressure room

b. Place child on contact precautions
c. Place child on airborne precautions
d. Place child in a positive pressure room

The correct answer is B (Lagerquist, 2012).

Blooms: Application

The nurse must be able to apply principles of infection control by selecting the most appropriate

option related to opportunities for disease transmission (Huitt, 2011).

Health Promotion and Maintenance

4. Which nursing intervention should a nurse perform on a young child suspected of having a
diagnosis of acute epiglottitis whose oxygen saturation is 93% on room air?

a. Allow the child to sit in a position of comfort

b. Provide small amounts of liquid orally via a syringe
c. Inspect the childs nares to assess degree of swelling
d. Apply 100% oxygen via mask

The correct answer is A (Lagerquist, 2012).

Blooms: Application

The nurse is using assessments to determine what is best for the patient by mentally applying

each of the options to construct a picture of what would be the most effective or necessary

intervention (Huitt, 2011).

5. A 7-year-old child is hospitalized for a tonsillectomy. What are priority nursing actions when
caring for this child after surgery? (Select all that apply)

a. Advancing diet as tolerated

b. Encouraging coughing to clear the throat
c. Monitoring PT and PTT
d. Administering pain medication around the clock
e. Suctioning mouth and throat frequently

The correct answer is A, C, D because after a tonsillectomy ice chips and advancing intake are

encouraged as tolerated, the bleeding times are monitored because the bleeding of the tonsils

post-op could occlude the airway, and pain control is most effective when provided at regular

intervals for procedures which cause known pain.

Rationale: Answers B and E are incorrect due to increased pressure from coughing and the

invasive nature suctioning would have on the surgical site (Lagerquist, 2012).

Blooms: Analysis

The nurse is processing care to separate what would help from what would harm the patient

(Huitt, 2011).

Physiological Integrity 676 896

6. Which prescribed drugs would a nurse most likely give the client for respiratory stridor, with
wheezing, and hypotension after a beesting? (Select all that apply)

a. Epinephrine
b. Diphenhydramine
c. Corticosteroid (Solu-Medrol)
d. Furosemide (Lasix)
e. Acetaminophen (Tylenol)
f. Ranitidine (Zantac)

The correct answer is A, B, C (Lagerquist, 2012).

Blooms: Application

The nurse can previously learned knowledge to select answers that fit the situation by

interpreting the use of the medications (Huitt, 2011).

7. A client has just been extubated. Which assessment by a nurse would indicate signs of
laryngeal edema?

a. Diffuse, wheezing breath sounds

b. Arterial blood gases show a Pco2 of 52mm hg and Po2 of 90%
c. Pulse oximeter of 91% with cool extremities
d. High pitched crowing sounds on inspiration

The correct answer is D (Lagerquist, 2012).

Blooms: Analysis

The nurse must have lungs sound assessment skills to differentiate wheezes and crowing sounds

as well the ability to interpret ABGs to separate right from wrong answers (Huitt, 2011).

Pharmacological and Parenteral Therapies

8. Which order by a physician should a nurse question?

a. A client with COPD who is prescribed metoprolol (Lopressor)

b. A client with chronic renal failure receiving an aluminum hydroxide gel
c. A client with abdominal aortic aneurysm (AAA) taking diltiazem (Cardizem)
d. A client on long term hemodialysis receiving epoetin alfa (Epogen)

The correct answer is A (Lagerquist, 2012).

Blooms: Analysis

The student will compare and contrast the options to arrive at the answer which could cause

potential harm to the patient (Huitt, 2011). The distractors are safe orders and the correct answer

is unsafe for the patient (Oermann, & Gaberson, 2014).

Reduction of Risk Potential


9. In a closed chest drainage system, which area regulates the amount of suction?

a. Chamber 1
b. Chamber 2
c. Chamber 3
4. Tube to the client

The correct answer is A. The nurse needs to understand exactly how the chest drainage system

functions in order to safely manipulate the suction when disconnecting the patient for ambulation

and reconnecting after. Failure to appropriately monitor suction to the chamber could be

detrimental to the patient (Lagerquist, 2012).

Blooms: Comprehension

The nurse has been taught about chest drainage systems and now must explain where the suction

control comes from in the device. For this question and illustration the knowledge level could

also apply as recall is required to find the correct answer by looking at the illustration (Huitt,


Psychosocial Integrity

10. A nurse has just received morning report and is organizing and prioritizing the client
assignment. Prioritize the nurses actions by placing each client in the correct order.

____a. The client with depression scheduled for discharge

____b. The client who is in alcohol withdrawal with a serum sodium of 150mEq/L
____c. The client with anxiety disorder complaining of chest pain
____d. The client with aphasia requesting a piece of paper

The correct answer is C, D, B, A. Chest discomfort is always a priority complaint for C. Client

D needs to be assessed next because his problem is unknown to the nurse. Patient B needs to be

assessed related to alcohol withdrawal and an elevated Na level. Sending patient A home requires

the nurse to take her time with the patient in assuring proper education and support for a safe

discharge (Lagerquist, 2012).

Blooms: Analysis

The nurse is using evidence to categorize the patients priority needs. The nurse must have some

foundational knowledge and experience with cardiac concerns verses an electrolyte imbalance to

differentiate the priority patient (Huitt, 2011).



Huitt, W. (2011). Bloom et al.'s taxonomy of the cognitive domain. Educational Psychology

Interactive. Retrieved from

Lagerquist, S. L. (2012). Davis's NCLEX-RN success (3rd Ed.). Philadelphia, PA: F.A. Davis.

NCSBN (2017). Test plans. Retrieved from

Oermann, M. H., & Gaberson, K. B. (2014). Evaluation and testing in nursing education (4th

ed.). Springer: New York, NY.