1. The nurse helps the health care
What is the priority nursing
provider perform a thoracentesis at the
bedside. In which position does the
nurse place the client to facilitate needs
insertion and promote comfort?
A. Fetal position lying unaffected side
with knees drawn to the abdomen and
hands clasped around them
B. Lying on the affected side with head
of the bed elevated to 30-45 degrees
C. Prone with head turned to the
affected side and arms over the head,
supported by a pillow
D. Upright leaning forward over the
bedside table, with arms supported on
pillows
2. A school nurse observe a 3-year-old
begin to choke and turn while eating
lunch. What should be the nurse's initial
action?
A. Abdominal thrusts
B. Back blows and chest thrusts
C. Blind sweep of the child's mouth
D. Call 911 for an ambulance
3. A school nurse observe a 3-year-old
begin to choke and turn while eating
lunch. What should be the nurse's initial
action?
A. Abdominal thrusts
B. Back blows and chest thrusts
C. Blind sweep of the child's mouth
D. Call 911 for an ambulance
4. The nurse is assessing a client an
hour a left lung lobectomy. The client is
awake alert, and oriented, and reports
pain of 6 on a 0-10 scale. Pulse oximetry
is 92% on 4L oxygen via nasal cannula.
The chest tube is set to continuous
water seal suction at -20 cm H2o. The
collection changer has accumulated 320
mL of frank red drainage in the last
hour.
action?
A. Clamp the chest tube immediately
B. Increase oxygen to 6 L via nasal
cannula
C. Medicate client for pain and
document the findings
D. Notify the health care provider
immediately
5. The nurse removes personal
protective equipment after completing
a wound dressing change for a client in
airborne transmission based
precautions. Which PPE should the
nurse remove first?
A. Face shield/ goggles
B. Gloves
C. Gown
D. Mask/ respirator
6. A client with latent tuberculosis has
been taking oral isoniazid (INH) 300 mg
daily for 2 months. The client tells the
nurse that for the past week she has
had numbness, burning sensation, and
tinging in her hands and feet. Additional
intake of which of the following would
most likely have prevented this?
A. Folic acid
B. Vitamin B6
C. Vitamin B12
D. Vitamin D
7. A client with active pulmonary
tuberculosis is prescribed 4-drug
therapy with ethambutol. The
community health nurse instructs the
client to notify the health care provider
immediately, if which adverse effect
associated with ethambutol occurs?
A. Blurred vision
B. Dark-colored urine
C. Difficulty hearing
D. Yellow skin
8. A client had a thoracotomy 2 days
ago to remove a lung mass and has a
right chest tube attached to negative
suction. Immediately after turning the
client to the left side to assess the lungs,
the nurse observes a rush of
approximately 125 mL of dark bloody
drainage into the drainage tubing and
collection chamber. What is the
appropriate nursing action? Check on
the exhibit for additional information.
A. Document and continue to monitor
chest drainage
B. Immediately clamp the chest tube
C. Notify the health care provider
D. Request repeat hematocrit and
hemoglobin levels
9. The client with malignant left pleural
effusion undergoes a thoracentesis and
900 mL of excess pleural fluid is
removed. Which of these
manifestations, if noted on the post-
procedure assessment, should the
nurse report to the health care provider
immediately?
A. Asymmetrical chest expansion and
decreased breath sounds on the left
B. Blood pressure 100/65 mmH (mean
arterial pressure 71 mmHg)
C. Client complains of 6/10 pain at the
needle insertion site
D. Respiratory rate 24/min pulse
oximetry 94% on oxygen 2 L/min
10. A client with a tracheostomy is alert
and oriented and able to tolerate oral
intake. Which action would be
appropriate to reduce the client's risk of
aspiration preumonia?
A. Fully inflate the cuff before feeding
B.Have the client sit in an upright
position with the neck hyperextended
C. Partially or fully deflated the cuff
D. Provide a modified diet of pureed
foods
11. When caring for a patient with
acute bronchitis, which of the following
would the nurse prioritize?
A. auscultating lung sounds.
B. encouraging fluid restriction.
C. administering antibiotic therapy.
D. teaching the patient to avoid cough
suppressants.
12. Which of the following would be
appropriate nursing intervention for a
patient with pneumonia with the
nursing diagnosis of ineffective airway
clearance related to thick secretions
and fatigue?
A. perform postural drainage every
hour. B. provide analgesics as ordered
to promote patient comfort.
C. administer 02 as prescribed to
maintain optimal oxygen levels.
D. teach the patient how to cough
effectively to bring secretions to the
mouth.
13. A patient with TB has been admitted
to the hospital and is placed in an
airborne infection isolation room. What
should the patient be taught (select all
that apply)?
A. Expect routine TST to evaluate
infection.
B. Visitors will not be allowed while in
airborne isolation.
C. Take all medications for full length
of time to prevent multidrug-resistant
TB.
D. Wear a standard isolation mask if
leaving the airborne infection isolation
room.
E. Maintain precautions in airborne
infection isolation room by coughing
into a paper tissue.
14. 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 regarding home care
15. The emergency department nurse is
caring for patients exposed to a chlorine
leak from a local factory. Which of the
following would the nurse closely
monitor with these patients?
A. pulmonary edema.
B. anaphylactic shock.
C. respiratory alkalosis.
D. acute tubular necrosis.
16. Which of the following signs and
symptoms will the nurse identifies a flail
chest in a trauma patient?
A. multiple rib fractures are determined
by x-ray.
B. a tracheal deviation to the unaffected
side is present.
C. paradoxical chest movement occurs
during respiration.
D. there is decreased movement of the
involved chest wall.
17. The nurse notes tidaling of the
water level in the tube submerged in
the water-seal chamber in a patient
with closed chest tube drainage. What
should the nurse do?
A. continue to monitor the patient.
B. check all connections for a leak in the
system.
C. lower the drainage collector further
from the chest.
D. clamp the tubing at progressively
distal points away from the patient until
the tidaling stops.
18. What is the appropriate nursing
intervention for a patient post
pneumonectomy?
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.
19. What is the priority nursing
intervention for a patient who has just
undergone a chemical pleurodesis for
recurrent pleural effusion?
A. administering ordered analgesia.
B. monitoring chest tube drainage.
C. sending pleural fluid for laboratory
analysis.
D. monitoring the patient's level of
consciousness.
20. When planning care for a patient at
risk for pulmonary embolism. Which of
the following would the nurse
prioritize?
A. maintaining the patient on bed rest.
B. using sequential compression
devices.
C. encouraging the patient to cough and
deep breathe.
D. teaching the patient how to use the
incentive spirometer.
21.Which statements) describe(s) the
management of a patient following lung
transplantation (select all that apply)?
A. The lung is biopsied using a
transtracheal method.
B. High doses of oxygen are
administered around the clock.
C. The use of a home spirometer will
help to monitor lung function.
D. Immunosuppressant therapy usually
involves a three-drug regimen.
E. Most patients experience an acute
rejection episode in the first 3 days
22.A patient is concerned that he may
have asthma. Of the symptoms that he
relates to the nurse, which ones suggest
asthma or risk factors for asthma (select
all that apply)?
A. Allergic rhinitis
B. Prolonged inhalation
C. History of skin allergies
D. Cough, especially at night
E. Gastric reflux or heartburn
23.In evaluating an asthmatic patient's
knowledge of self care, which of the
following statement would the nurse
recognizes that additional instruction?
A. "I use my corticosteroid inhaler
when I feel short of breath."
B. "I get a flu shot every year and see
my health care provider if I have an
upper respiratory tract infection."
C. "I use my inhaler before I visit my
aunt who has a cat, but I only visit for a
few minutes because of my allergies."
D. "I walk 30 minutes every day but
sometimes I have to use my
bronchodilator inhaler before walking
to prevent me from getting short of
breath."
24.Which of the following activities
would be a plan of care for the patient
with COPD? (select all that apply)
A. exercise such as walking.
B. high flow rate of 02 administration.
C. low-dose chronic oral corticosteroid
therapy.
D. use of peak flow meter to monitor
the progression of COPD.
E. breathing exercises such as pursed-
lip breathing that focus on exhalation.
25.Which of the following are effects of
cigarette smoking on the respiratory
system?
A. hypertrophy of capillaries causing
hemoptysis.
B. hyperplasia of goblet cells and
increased production of mucus.
C. increased proliferation of cilia and
decreased clearance of mucus.
D. proliferation of alveolar
macrophages to decrease the risk for
infection.
26.What is the major advantage of
Venturi mask?
A. deliver up to 80% 02.
B. provide continuous 100% humidity.
C. deliver a precise concentration of 02.
D. be used while a patient eats and
sleeps.
27. Which guideline would be a part of
teaching patients how to use a
metered-dose inhaler (MDI)?
A. After activating the MDI, breathe in
as quickly as you can.
B. Estimate the amount of remaining
medicine in the MDI by floating the
canister in water.
C. Disassemble the plastic canister from
the inhaler and rinse both pieces under
running water every week.
D. To determine how long the canister
will last, divide the total number of
puffs in the canister by the puffs
needed per day.
28. Which treatments in CF would the
nurse expect to implement in the
management plan of patients with CF
(select all that apply)?
A. Sperm banking
B. IV corticosteroids on a chronic basis
C. Airway clearance techniques (e.g.,
Acapella)
D. GoLYTELY given PRN for severe
constipation
E. Inhaled tobramycin to combat
Pseudomonas infection
29. A patient who has bronchiectasis
asks the nurse, "What conditions would
warrant a call to the clinic?'
A. Blood clots in the sputum
B. Sticky sputum on a hot day
C. Increased shortness of breath after
eating a large meal
D. Production of large amounts of
sputum on a daily basis
30. A patient was seen in the clinic for
an episode of epistaxis, which was
controlled by placement of anterior
nasal packing. During discharge
teaching, which of the following
statement would the nurse instructs the
patient?
A. use aspirin for pain relief.
B. remove the packing later that day.
C.skip the next dose of antihypertensive
medication.
D. avoid vigorous nose blowing and
strenuous activity.
31.A patient with allergic rhinitis reports
severe nasal congestion; sneezing; and
watery, itchy eyes and nose at various
times of the year. Which of the
following statement of the nurse would
teach the patient to control these
symptoms?
A. avoid all intranasal sprays and oral
antihistamines.
B. limit the usage of nasal decongestant
spray to 10 days.
C.use oral decongestants at bedtime to
prevent symptoms during the night.
D.keep a diary of when the allergic
reaction occurs and what precipitates
it.
32.Which of the following is the best
method for determining the risk of
aspiration in a patient with a
tracheostomy?
A. consult a speech therapist for
swallowing assessment.
B. have the patient drink plain water
and assess for coughing.
C. assess for change of sputum color 48
hours after patient drinks small amount
of blue dye.
D.suction above the cuff after the
patient eats or drinks to determine
presence of food in trachea.
33.Which nursing action would be of
highest priority when suctioning a
patient with a tracheostomy?
A. Auscultating lung sounds after
suctioning is complete
B. Providing a means of communication
for the patient during the procedure
C. Assessing the patient's oxygenation
saturation before, during, and after
suctioning
D. Administering pain and/or
antianxiety medication 30 minutes
before suctioning
34.While in the recovery room, a
patient with a total laryngectomy is
suctioned and has bloody mucus with
some clots. Which nursing interventions
would apply?
A. Notify the physician immediately.
B. Place the patient in the prone
position to facilitate drainage.
C.Instill 3 mL of normal saline into the
tracheostomy tube to loosen secretions.
D. Continue your assessment of the
patient, including 02 saturation,
respiratory rate, and breath sounds.
35.The nurse is preparing to suction
secretions from the airway of an
unconscious client whose lungs are
mechanically ventilated with an
endotracheal tube. Place the steps for
suctioning the endotracheal tube in the
correct order. All options must be used
1. Advance catheter into the trachea
2. Evaluate client tolerance and
document
3. Gently rotate the catheter while
suctioning
4. Hyperoxygenate the lungs
5. Perform hand hygiene and don gloves
6. Suction the oropharynx and perform
oral care
A. 564132
B. 123456
C. 561234
D. 162453
36.The client with malignant left pleural
effusion undergoes a thoracentesis and
900 mL of excess pleural fluid is
removed. Which of these
manifestations, if noted on the post-
procedure assessment should the nurse
report to the health care provider
immediately?
A. Asymmetrical chest expansion and
decreased breath sounds on the left
B. Blood pressure 100/65 mmH (mean
arterial pressure 17 mmHg)
C. Client complains of 6/10 pain at the
needle insertion site
D. Respiratory rate 24/min pulse
oximetry 94% on oxygen 2 L/min
37.A client with active pulmonary
tuberculosis is prescribed 4-drug
therapy with ethambutol. The
community health nurse instructs the
client to notify the health care provider
immediately if which adverse effect
associated with ethambutol occurs?
A. Foggy vision
B. Dark-colored urine
C. Difficulty hearing
D. Pricking sensation in fingers
38.The nurse caring for a client with left
lobar preumonia responds to an alarm
from the continuous pulse oximeter.
The client is short of breath with an
oxygen saturation of 78%. After
applying oxygen, the nurse should place
the client in which position to improve
oxygenation?
A. Left lateral
B. Right lateral
C. Supine
D. Trendelenburg
39.The nurse is teaching a 9-year-old
child with asthma how to use a metered
dose inhaler. Place the instructions in
the appropriate order. All option must
be used.
1. Exhale completely
2. Deliver one putt of medication into
spacer
3. Place lips tightly around the mouth
piece
4. Rinse mouth with water
5. Shake MDI and attach it to spacer
6. Take a slow deep breath and hold for
10 seconds
A. 123456
B.513264
C.531264
D.512346
40.The nurse performs tracheostomy
care for a client with a disposable inner
cannula and tracheostomy dressing.
Place the steps in the correct order. All
options must be used
1. Gather supplies and position client
2. Don mask, goggles and clean gloves
3. Remove soiled dressing
4. Don sterile gloves, remove old
disposable cannula and replace with a
new one
5. Clean around stoma with sterile
water or saline, dry and replace sterile
gauze pad
A. 41532
B. B. 41523
C. 45215
D. 12345
41.A client with deep vein thrombosis is
receiving a continuous infusion of
unfractionated heparin. The client asks
the nurse what the heparin is for. How
should the nurse respond?
A. Heparin is a blood thinner that will
help to dissolve the clot in your leg
B. Heparin will help stabilize the clot in
your leg and prevent it from breaking
off and traveling to your lungs
C. Heparin will keep the current clot
from getting bigger and help prevent
new clots from forming
D. I'm sorry, this is something that your
health care provider can answer better
upon arriving
42.The nurse prepares to care for a
client being admitted with a confirmed
diagnosis of middle east respiratory
syndrome. Which personal protective
equipment will the nurse use when
providing care to the client?
A. Gloves and gown
B. Gloves and mask
C. Gown and N95 respirator
D. Gown gloves, N95 respirator, and
eye protection
43.The nurse assesses a child who has
been treated for an acute asthma
exacerbation. Which client assessment
is the best indicator that treatment has
been effective?
A. Episodes of spasmodic coughing have
decreased
B. No wheezes are audible on chest
auscultation
C. Oxygen saturation has increased
from 88-93%
D. Peak expiratory flow rate has
dropped from 212L/min to 127L/min
44.A client with asthma was recently
prescribed fluticasone/salmeterol. After
the client has received instructions
about this medication, which statement
would require further teaching by the
nurse?
A. After taking this medication, I will
rinse my mouth with water
B. At the first sign of an asthma attack,
I will take this medication
C. I have been smoking for 12 years, but
I just quit a month ago
D. I received the pneumococcal vaccine
about a month ago

45.The nurse caring for a client with

tuberculosis transport the client to the
radiology department for a chest x-ray.
The nurse ensures that the client uses
which personal protective equipment
when out of the negative pressure
room?

A. Isolation gown, surgical mask,

goggles and gloves
B. Isolation gown and surgical mask
C. N95 respiratory mask
D. Surgical mask