Vision: A PREMIER UNIVERSITY delivering

“Excellent nursing education that

world-class education that promotes
provides graduates with self-
sustainable development amidst climate
change.
Benguet State University direction, competence and
compassion.”
Mission: To provide quality education to COLLEGE OF NURSING
enhance food security, sustainable La Trinidad, Benguet “The College of Nursing is committed
communities, industry innovation, climate to provide a strong academic and
resilience, gender equality, institutional
www.bsu.edu.ph/ 422- 2127 professional foundation for the
development and partnerships. practice of nursing.”

NCM 112
Care of clients with problems in Oxygenation, Fluid and Electrolytes, Infectious, Inflammatory
and immunologic response, Cellular Aberrations, Acute and Chronic.

WORKSHEET 2
Part 1: MULTIPLE CHOICE
1. Choose the initial part of the respiratory tract that is not considered part of the gas-exchange
airways.
a. Bronchioles
b. Respiratory bronchioles
c. Alveolar ducts
d. Alveolar sacs

2. Choose the alveolar cells that secrete surfactant.

a. Type I cells
b. Type II cells
c. Type III cells
d. Type I and II cells

3. The pulmonary circulation is considered a:

a. High-pressure, high-resistance system
b. Low-pressure, low-resistance system
c. High-pressure, low-resistance system
d. Low-pressure, high-resistance system

4. A nurse is caring for a patient with a pulmonary embolism understands that a high ventilation-
perfusion ratio exists. This means that:
a. Perfusion exceeds ventilation
b. There is an absence of perfusion and ventilation
c. Ventilation exceeds perfusion
d. Ventilation matches perfusion

5. A nurse understands that a safe but low level of oxygen saturation provides for adequate tissue
saturation. The normal oxygen saturation is:
a. 40 and above mmHg
b. 75 and above mmHg
c. 80 and above mmHg
d. 95 and above mmHg

6. The nurse inspects the thorax of a patient with advanced emphysema. The nurse expects chest
configuration change consistent with a deformity known as:
a. Barrel chest
b. Funnel chest
c. Kyphoscoliosis
d. Pigeon chest

7. Breath sounds that originate in the smaller bronchi and bronchioles and are high-pitched,
sibilant, and musical are called:
a. Wheezes
b. Rhonchi
c. Rales
d. Crackles

8. Crackles, noncontiguous breath sounds, would be assessed for a patient with:

a. Asthma
b. Bronchospasm
c. Pulmonary congestion
d. Pulmonary fibrosis
Vision: A PREMIER UNIVERSITY delivering
“Excellent nursing education that
world-class education that promotes
provides graduates with self-
sustainable development amidst climate
change.
Benguet State University direction, competence and
compassion.”
Mission: To provide quality education to COLLEGE OF NURSING
enhance food security, sustainable La Trinidad, Benguet “The College of Nursing is committed
communities, industry innovation, climate to provide a strong academic and
resilience, gender equality, institutional
www.bsu.edu.ph/ 422- 2127 professional foundation for the
development and partnerships. practice of nursing.”

9. During a preadmission assessment, the nurse would expect to find decreased tactile fremitus
and hyperresonant percussion sounds with a diagnosis of:
a. Bronchitis
b. Emphysema
c. Atelectasis
d. Pulmonary edema

10. Nursing directions to a patient from whom a sputum specimen is to be obtained should include
all of the following except directing the patient to: 30
a. Initially clear his or her nose and throat.
b. Spit surface mucus and saliva into a sterile specimen container.
c. Take a few deep breaths before coughing.
d. Use diaphragmatic contractions to aid in the expulsion of sputum.

11. The nurse should advise the patient who is scheduled for bronchoscopy that he or she will:
a. Have his or her throat sprayed with a topical anesthetic.
b. Be required to fast for 12 hours before the procedure.
c. Receive postoperative anesthesia after the procedure.
d. Experience all of the above.
Part 2:
SHORT ANSWER
Read each statement carefully. Write your response in the space provided.
1. Distinguish between the terms ventilation and respiration.
Ventilation is the process of breathing. It involes the movement of air in and out the lungs. Respiration is the process taking place inside the cell.
____________________________________________________________________________________________________
It is the use of oxygen in a chemical reaction that happens inside the mitochondria.
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________

2. Describe the function of the epiglottis.

The epiglottis prevents food from entering the trachea wherein it covers the opening of the larynx during swallowing.
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________

Pulmonary emphysema
3. List four conditions that cause low compliance or distensibility of the lungs: _______________________,
Chronic bronchitis ARDS Edema
_______________________, _____________________, and _____________________________.

4. Define the term partial pressure.

Partail pressure is the pressure exerted by each type of gas such as oxygen and carbon dioxide in a mixture of gases.
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________.

5. Name two centers in the brain that are responsible for the neurologic control of ventilation:
Apneustic center
_____________________________ Motaxic center
and _____________________________.

6. The alveoli begin to lose elasticity at about age _______

50 years, resulting in decreased gas diffusion.

7. List six major signs and symptoms of respiratory disease.

Cough
_______________________ Chest pain
__________________________
Wheezing
_______________________ Breathlessness/ Dyspnea
__________________________
Sputum production
_______________________ Clubbing of the fingers
__________________________

8. List four conditions that are influenced by genetic factors that affect respiratory function:
_________________,
Alpha-1 antitrypsin deficiency COPD
__________________, Asthma
___________________, Cystic Fibrosis
and ________________________.

9. Explain the breathing pattern characterized as Cheyne–Stokes respirations.

It is characterized byalternating episodes of apnea and periods of deep breathing. Deep respirations become increasingly shallow,
____________________________________________________________________________________________________
followed byapnea that may last approximately 20 seconds.
____________________________________________________________________________________________________
____________________________________________________________________________________________________.
Vision: A PREMIER UNIVERSITY delivering
“Excellent nursing education that
world-class education that promotes
provides graduates with self-
sustainable development amidst climate
change.
Benguet State University direction, competence and
compassion.”
Mission: To provide quality education to COLLEGE OF NURSING
enhance food security, sustainable La Trinidad, Benguet “The College of Nursing is committed
communities, industry innovation, climate to provide a strong academic and
resilience, gender equality, institutional
www.bsu.edu.ph/ 422- 2127 professional foundation for the
development and partnerships. practice of nursing.”

Part 3: Clinical Situations

CASE STUDY: Bronchoscopy
Mr. Beacon is scheduled for a bronchoscopy for the diagnostic purpose of locating a pathologic
process.
1. Because a bronchoscopy was ordered, the nurse knows that the suspected lesion was not in
the:
a. bronchus.
b. larynx.
c. pharynx.
d. trachea.

2. Nursing measures before the bronchoscopy include:

a. obtaining an informed consent.
b. supplying information about the procedure.
c. withholding food and fluids for 6 hours before the test.
d. all of the above.

3. The nurse is aware that possible complications of bronchoscopy include all of the following
except:
a. aspiration.
b. gastric perforation.
c. infection.
d. pneumothorax.

4. After the bronchoscopy, Mr. Beacon must be observed for:

a. dyspnea.
b. hemoptysis.
c. tachycardia.
d. all of the above.

5. After the bronchoscopy, Mr. Beacon:

a. can be given ice chips and fluids after he demonstrates that he can perform the gag
reflex.
b. should immediately be given a house diet to alleviate the hunger resulting from the
required fast.
c. should initially be given iced ginger ale to prevent vomiting and possible aspiration of
stomach contents.
d. will need to remain NPO for 6 hours to prevent pharyngeal irritation.

CASE STUDY:Thoracentesis
Mrs. Abad is admitted to the clinical area for a thoracentesis. The physician wants to remove excess air
from the pleural cavity (see figure below).
Vision: A PREMIER UNIVERSITY delivering
“Excellent nursing education that
world-class education that promotes
provides graduates with self-
sustainable development amidst climate
change.
Benguet State University direction, competence and
compassion.”
Mission: To provide quality education to COLLEGE OF NURSING
enhance food security, sustainable La Trinidad, Benguet “The College of Nursing is committed
communities, industry innovation, climate to provide a strong academic and
resilience, gender equality, institutional
www.bsu.edu.ph/ 422- 2127 professional foundation for the
development and partnerships. practice of nursing.”

1. Nursing responsibilities before the thoracentesis should include:

a. informing Mrs. Abad about pressure sensations that will be experienced during the
procedure.
b. making sure that chest radiograms ordered in advance have been completed.
c. seeing that the consent form has been explained and signed.
d. all of the above.

2. For the thoracentesis, the patient is assisted to any of the following positions except:
a. lying on the unaffected side with the bed elevated 30 to 40 degrees.
b. lying prone with the head of the bed lowered 15 to 30 degrees.
c. sitting on the edge of the bed with her feet supported and her arms and head on a
padded overbed table.
d. straddling a chair with her arms and head resting on the back of the chair.

3. Nursing intervention includes exposing the entire chest even though the thoracentesis site is
normally in the midclavicular line between the:
a. first and second intercostal spaces.
b. second and third intercostal spaces.
c. third and fourth intercostal spaces.
d. fourth and fifth intercostal spaces.

4. Nursing observations after the thoracentesis include assessment for:

a. blood-tinged mucus.
b. signs of hypoxemia.
c. tachycardia.
d. all of the above.

5. A chest x-ray film is usually ordered after the thoracentesis to rule out:
a. pleurisy.
b. pneumonia.
c. pneumothorax.
d. pulmonary edema.