PRE-TEST

Total points38/50
 
 
1. The term “pink puffer” refers to the client with which of the following symptoms?*
1/1

a. ARDS
b. Asthma
c. Chronic obstructive bronchitis
d. Emphysema.
 
 
2. The term “blue bloater” refers to which of the following conditions?*
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a. adult respiratory distress syndrome

b. asthma
c. chronic obstructive bronchitis
 
d. emphysema

 
3. The most important environmental risk factor for emphysema is:*
1/1

a. air pollution.
b. allergens
c. infectious agents.
d. cigarette smoking
 
 
4. Which of the following should the nurse assess in patient with pneumothorax?*
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a. Tracheal alignment
b. Expansion of the chest
c. Breath sounds
d. All of the above
 
 
5. The following are types of pneumothorax except:*
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a. Trauma.
b. Simple.
c. Tension
d. Direct
 
 
6. An initial characteristic symptom of a simple pneumothorax is:*
1/1

a. ARDS
b. Severe respiratory distress.
c. Sudden onset of chest pain.
d. Tachypnea and chest discomfort.
 
 
7. The pressure required in the pleural space to keep the lungs inflated is:*
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a. Positive.
b. Negative.
 
c. Atmospheric.
d. All of the above

 
8. A client admitted from home is diagnosed with community-acquired pneumonia.
Which organism does the nurse suspect is the cause of this infection?*
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a. Escherichia coli
b. Staphylococcus aureus
c. Pneumococcus
 
d. Pneumocystis jiroveci
 
9. Which system effect of pneumonia should the nurse monitor?*
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a. Hemoptysis
b. Cyanosis
 
c. Excess mucus production
d. Shortness of breath

 
10. The nurse is caring for a pregnant woman new to the clinic. Which question will
uncover whether the client has the highest risk for developing pneumonia?*
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a. "Does anyone smoke in the house?"

b. "Do you have any medical conditions?"
c. "Do you have a history of asthma?"
d. "Are your immunizations up to date?"
 
Correct answer
a. "Does anyone smoke in the house?"

 
11. The nurse is preparing discharge instructions for the parents of a young child
recovering from pneumonia. Which information should the nurse provide to help prevent
the reoccurrence of the disease?*
1/1

a. "Report worsening of symptoms to the provider."

b. "Complete all prescribed medications."
 
c. "Provide for periods of rest."
d. "Ensure that all vaccinations are up to date."

 
12. The nurse informs a client with pneumonia that a respiratory therapist is
scheduled to perform chest physiotherapy. The client asks, "What does that mean?"
Which response by the nurse is best?*
1/1
a. "Chest physiotherapy will help remove the infecting organism from your lungs."
b. "Chest physiotherapy will help prevent excessive coughing so you can rest better."
c. "Chest physiotherapy will help move the liquid out of your lungs."
 
d. "Chest physiotherapy will help you breathe better."

 
13. A client with pneumonia is prescribed 100% oxygen. Which type of oxygen
delivery device should the nurse use?*
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a. Nasal cannula
b. Venturi mask
c. Simple face mask
d. Nonrebreather mask
 
 
14. The nurse is planning the interventions for a client diagnosed with pneumococcal
pneumonia. Which intervention should provide the most improvement in the client's
ventilation?*
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a. Assisting the client with coughing

 
b. Providing pulmonary hygiene
c. Providing fluids of at least 2500 mL/day
d. Providing adequate pain relief

Correct answer
d. Providing adequate pain relief

 
15. A patient with acute respiratory distress syndrome (ARDS) is receiving oxygen by
a non-rebreather mask, but arterial blood gas measurements still show poor
oxygenation. As the nurse responsible for this patient’s care, you would anticipate a
physician order for what action?*
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a. Perform endotracheal intubation and initiate mechanical ventilation.

b. Immediately begin continuous positive airway pressure (CPAP) via the patient’s nose and
mouth.
c. Administer furosemide (Lasix) 100 mg IV push stat.
d. Call a code for respiratory arrest.
 
Correct answer
a. Perform endotracheal intubation and initiate mechanical ventilation.

 
16. The nurse is caring for a patient with chronic obstructive pulmonary disease
(COPD). Which intervention for airway management should you delegate to a nursing
assistant?*
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a. Assisting the patient to sit up on the side of the bed.

b. Instructing the patient to cough effectively.
c. Teaching the patient to use incentive spirometry.
 
d. Auscultation of breath sounds every 4 hours.

Correct answer
a. Assisting the patient to sit up on the side of the bed.

 
17. After a change of shift, you are assigned to care for the following patients. Which
patient should you assess first?*
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a. A 60-year old patient on a ventilator for whom a sterile sputum specimen must be sent to the
lab.
b. A 55-year old with COPD and a pulse oximetry reading from the previous shift of 90%
saturation.
 
c. A 70-year old with pneumonia who needs to be started on intravenous (IV) antibiotics.
d. A 50-year old with asthma who complains of shortness of breath after using a bronchodilator.

Correct answer
d. A 50-year old with asthma who complains of shortness of breath after using a bronchodilator.

 
18. The patient with COPD has a nursing diagnosis of Ineffective Breathing Pattern.
Which is an appropriate action to delegate to the experienced LPN under your
supervision?*
0/1

a. Observe how well the patient performs pursed-lip breathing.

b. Plan a nursing care regimen that gradually increases activity intolerance.
c. Assist the patient with basic activities of daily living.
d. Consult with the physical therapy department about reconditioning exercises.
 
Correct answer
a. Observe how well the patient performs pursed-lip breathing.

 
19. When assessing a 22-year old patient who required emergency surgery and
multiple transfusions 3 days ago, you find that the patient looks anxious and has
labored respirations at the rate of 38 breaths/min. The oxygen saturation is 90% with
the oxygen delivery at 6 L/min via nasal cannula. Which action is most appropriate?*
0/1

a. Increase the flow rate on the oxygen to 10 L/min and reassess the patient after about 10
minutes.
b. Assist the patient in using the incentive spirometer and splint his chest with a pillow while he
coughs.
 
c. Administer the ordered morphine sulfate to the patient to decrease his anxiety and reduce the
hyperventilation.
d. Switch the patient to a nonrebreather mask at 95% to 100% oxygen and call the physician to
discuss the patient’s status.

Correct answer
d. Switch the patient to a nonrebreather mask at 95% to 100% oxygen and call the physician to
discuss the patient’s status.

 
20. Which of these medication orders for a patient with a pulmonary embolism is
more important to clarify with the prescribing physician before administration?*
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a. Warfarin (Coumadin) 1.0 mg by mouth (PO)

 
b. Morphine sulfate 2 to 4 mg IV
c. Cephalexin (Keflex) 250 mg PO
d. Heparin infusion at 900 units/hr
 
21. An elderly client with pneumonia may appear with which of the following
symptoms first?*
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a. Altered mental status and dehydration

 
b. Fever and chills
c. Hemoptysis and dyspnea
d. Pleuritic chest pain and cough

 
22. Which of the following pathophysiological mechanisms that occur in the lung
parenchyma allows pneumonia to develop?*
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a. Atelectasis
b. Bronchiectasis
c. Effusion
d. Inflammation
 
 
23. 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?*
1/1

a. Adult respiratory distress syndrome (ARDS)

b. Asthma
c. Chronic obstructive bronchitis
 
d. Emphysema

 
24. The term “blue bloater” refers to which of the following conditions?*
1/1

a. Adult respiratory distress syndrome (ARDS)

b. Asthma
c. Chronic obstructive bronchitis
 
d. Emphysema

 
25. The term “pink puffer” refers to the client with which of the following conditions?*
1/1

a. ARDS
b. Asthma
c. Chronic obstructive bronchitis
d. Emphysema
 
 
26. 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?*
0/1

a. ARDS
 
b. Asthma
c. Chronic obstructive bronchitis
d. Emphysema

Correct answer
d. Emphysema

 
27. Exercise has which of the following effects on clients with asthma, chronic
bronchitis, and emphysema?*
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a. It enhances cardiovascular fitness.

b. It improves respiratory muscle strength.
c. It reduces the number of acute attacks.
d. It worsens respiratory function and is discouraged
 
Correct answer
a. It enhances cardiovascular fitness.

 
28. Clients with chronic obstructive bronchitis are given diuretic therapy. Which of the
following reasons best explains why?*
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a. Reducing fluid volume reduces oxygen demand.

 
b. Reducing fluid volume improves clients’ mobility.
c. Restricting fluid volume reduces sputum production.
d. Reducing fluid volume improves respiratory function.

 
29. A 69-year-old client appears thin and cachectic. He’s short of breath at rest and
his dyspnea increases with the slightest exertion. His breath sounds are diminished
even with deep inspiration. These signs and symptoms fit which of the following
conditions?*
0/1

a. ARDS
 
b. Asthma
c. Chronic obstructive bronchitis
d. Emphysema

Correct answer
d. Emphysema

 
30. A client with emphysema should receive only 1 to 3 L/minute of oxygen if
needed, or he may lose his hypoxic drive. Which of the following statements is correct
about hypoxic drive?*
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a. The client doesn’t notice he needs to breathe.

b. The client breathes only when his oxygen levels climb above a certain point.
c. The client breathes only when his oxygen levels dip below a certain point.
 
d. The client breathes only when his carbon dioxide level dips below a certain point.

 
31. Teaching for a client with chronic obstructive pulmonary disease (COPD) should
include which of the following topics?*
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a. How to have his wife learn to listen to his lungs with a stethoscope from Wal-Mart.
b. How to increase his oxygen therapy.
c. How to treat respiratory infections without going to the physician.
d. How to recognize the signs of an impending respiratory infection.
 
 
32. A nurse plans care for a client with chronic obstructive pulmonary disease,
knowing that the client is most likely to experience what type of acid-base imbalance.*
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a. Respiratory acidosis
 
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis

 
33. Clients with chronic illnesses are more likely to get pneumonia when which of the
following situations is present?*
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a. Dehydration
b. Group living
 
c. Malnutrition
d. Severe periodontal disease

 
34. Which of the following pathophysiological mechanisms that occur in the lung
parenchyma allow pneumonia to develop?*
1/1

a. Atelectasis
b. Bronchiectasis
c. Effusion
d. Inflammation
 
 
35. Which of the following organisms most commonly causes community-acquired
pneumonia in adults?*
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a. Haemophilus influenzae
b. Klebsiella pneumoniae
c. Streptococcus pneumoniae
 
d. Staphylococcus aureus

 
36. An elderly client with pneumonia may appear with which of the following
symptoms first?*
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a. Altered mental status and dehydration

 
b. Fever and chills
c. Hemotysis and dyspnea
d. Pleuritic chest papin and cough

 
37. When auscultating the chest of a client with pneumonia, the nurse would expect
to hear which of the following sounds over areas of consolidation?*
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a. Bronchial
 
b. Bronchovesicular
c. Tubular
d. Vesicular

 
38. A 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?*
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a. Antibiotics
b. Bed rest
c. Oxygen
 
d. Nutritional intake

 
39. A client has been treated with antibiotic therapy for right lower-lobe pneumonia
for 10 days and will be discharged today. Which of the following physical findings would
lead the nurse to believe it is appropriate to discharge this client?*
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a. Continued dyspnea
b. Fever of 102*F
c. Respiratory rate of 32 breaths/minute.
d. Vesicular breath sounds in the right base.
 
 
40. Which of the following treatments would the nurse expect for a client with a
spontaneous pneumothorax?*
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a. Antibiotics
b. Bronchodilators
c. Chest tube placement
d. Hyperbaric chamber
 
Correct answer
c. Chest tube placement

 
41. Which of the following methods is the best way to confirm the diagnosis of a
pneumothorax?*
1/1

a. Auscultate breath sounds.

b. Have the client use an incentive spirometer.
c. Take a chest x-ray.
 
d. Stick a needle in the area of decreased breath sounds.

 
42. A pulse oximetry gives what type of information about the client?*
1/1

a. Amount of carbon dioxide in the blood

b. Amount of oxygen in the blood
c. Percentage of hemoglobin carrying oxygen
 
d. Respiratory rate

 
43. A client’s ABG analysis reveals a pH of 7.18, PaCO2 of 72 mm Hg, PaO2 of 77
mm Hg, and HCO3- of 24 mEq/L. What do these values indicate?*
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a. Metabolic acidosis
b. Respiratory alkalosis
c. Metabolic alkalosis
d. Respiratory acidosis
 
 
44. A 79-year-old client is admitted with pneumonia. Which nursing diagnosis should
take priority?*
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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.
 
 
45. A client is experiencing confusion and tremors is admitted to a nursing unit. An
initial ABG report indicates that the PaCO2 level is 72 mm Hg, whereas the PaO2 level
is 64 mm Hg. A nurse interprets that the client is most likely experiencing:*
1/1

a. Carbon monoxide poisoning

b. Carbon dioxide narcosis
 
c. Respiratory alkalosis
d. Metabolic acidosis
 
46. 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?*
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a. Position changes q4h.

b. Nasotracheal suctioning to clear secretions.
c. Frequent linen changes.
 
d. Frequent offering of a bedpan.

 
47. The cyanosis that accompanies bacterial pneumonia is primarily caused by
which of the following?*
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a. Decreased cardiac output.

b. Pleural effusion.
c. Inadequate peripheral circulation.
 
d. Decreased oxygenation of the blood.

Correct answer
d. Decreased oxygenation of the blood.

 
48. Which of the following mental status changes may occur when a client with
pneumonia is first experiencing hypoxia?*
1/1

a. Coma
b. Apathy
c. Irritability
 
d. Depression

 
49. A client with pneumonia has a temperature ranging between 101° and 102°F and
periods of diaphoresis. Based on this information, which of the following nursing
interventions would be a priority?*
1/1

a. Maintain complete bed rest.

b. Administer oxygen therapy.
c. Provide frequent linen changes.
d. Provide fluid intake of 3 L/day.
 
 
50. Which of the following would be an appropriate expected outcome for an elderly
client recovering from bacterial pneumonia?*
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a. A respiratory rate of 25 to 30 breaths per minute.

b. The ability to perform ADLs without dyspnea.
 
c. A maximum loss of 5 to 10 pounds of body weight.
d. Chest pain that is minimized by splinting the ribcage.