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Lower Respiratory Problems

Questions from Book and Workbook: Ch 28
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In assessing a patient with pneumococcal pneumonia, the nurse recognizes that clinical manifestations of this condition include (select all that apply):
An abrupt onset of fever
Productive cough with rust-colored sputum
An appropriate nursing intervention for a patient with pneumonia with the nursing diagnosis of ineffective airway clearance related to thick secretions and fatigue would be to:
Teach the patient how to cough effectively to bring secretions to the mouth
A patient with TB has been admitted to the hospital and is placed in an airborne infection isolation room. Which of the following should the patient be taught (select all that apply)?
Take all medications for full length of time to prevent multidrug-resistant TB
Wear a standard isolation mask if leaving the airborne infection isolation room
Maintain precautions in airborne infection isolation room by coughing into a paper tissue
A patient has been receiving high-dose corticosteroids and broad-spectrum antibiotics for treatment secondary to a traumatic injury and infection. The nurse plans care for the patient knowing that the patient is most susceptible to:
Candidiasis
Which statement best describes the treatment of lung abscess?
Antibiotics given for a prolonged period are the usual treatment of choice
A common complication of many types of environmental lung diseases is:
Pulmonary fibrosis
The patient with lung cancer needs to receive influenza vaccine and pneumococcal vaccines. The nurse will
Administer both vaccines at the same time in different arms
The nurse identifies a flail chest in a trauma patient when:
Paradoxic chest movement occurs during respiration
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. The nurse should
Continue to monitor this normal finding
A nursing measure that should be instituted after a pneumonectomy is:
Range-of-motion exercises on the affected upper extremity
Guillain-Barre syndrome causes respiratory problems primarily by:
Interrupting nerve transmission to respiratory muscles
A patient is on a continuous epoprostenol infusion pump. The alarm goes off indicating an obstruction in the intravaneous line downstream. The nurse should:
Assess the central line immediately for any obstruction or accidental clamping of tubing
Which of the following statements describe the management of a patient following lung transplantation (select all that apply)?
The lung is biopsied using a transtracheal method
The use of a home spirometer will help to monitor lung function
Immunosuppressant therapy usually involves a three-drug regimen
After the health care provider sees a patient hospitalized with a stroke who developed a fever and adventitious lung sounds, the following orders are written. Which will the nurse implement first?
Sputum specimen for Gram stain and culture and sensitivity
A patient with pneumonia has a nursing diagnosis of ineffective airway clearance related to pain, fatigue and thick secretions. An appropriate nursing intervention for the patient is to
Encourage a fluid intake of at least 3L/day
During an annual health assessment of a 65 year old clinic patient, the patient tells the nurse he had the pneumonia vaccine when he was age 59. The nurse advises the patient that the best way for him to prevent pneumonia now is to
Obtain the pneumococcal vaccine this year with an annual influenza vaccine
The resurgence in TB resulting from the emergence of multidrug-resistant strains of Mycobacterium tuberculosis was primarily the result of
Poor compliance with drug therapy in patients with TB
A patient diagnosed with active TB 1 week ago is admitted to the hospital with symptoms of chest pain. Initially, the nurse gives the highest priority to
Admitting the patient to an airborne-infection isolation room
When obtaining a health history from a patient suspected of having early TB, the nurse asks the patient about experiencing
Fatigue, low grade fever and night sweats
A patient with active TB continues to have positive sputum cultures after 6 months of treatment because she says she cannot remember to take the medication all the time. The best action by the nurse is to
Arrange for directly observed therapy by a responsible family member or a public health nurse.
To decrease the patient's sense of panic during an acute asthma attack, the best action of the nurse is to
Stay with the patient and encourage slow, pursed-lip breathing
When a patient with asthma is admitted to the emergency department in severe respiratory distress, the nurse anticipates that initial drug treatment will most likely include administration of
Aerosolized albuterol
A dietary modification that helps meet the nutritional needs of patients with COPD is
Avoiding foods that require a lot of chewing
During an acute exacerbation of COPD, the patient is severely short of breath and the nurse identifies a nursing diagnosis of ineffective breathing pattern related to obstruction of airflow and anxiety. The best action by the nurse is to
Position the patient upright with the elbows resting on the over the bed table.
The primary treatment for cystic fibrosis is
Vigorous and consistent chest physiotherapy.
The classification of pneumonia as community-acquired pneumonia (CAP) or hospital- acquired pneumonia (HAP) is clinically useful because
Causative agents can be predicted, and empiric treatment is often effective
When obtaining a health history from a patient at the clinic with suspected CAP, the nurse expects the patient to report:
An abrupt onset of fever and chills
Initial antibiotic treatment for pneumonia is usually based on
History and physical examination and characteristics chest radiographic findings
After the health care provider sees a patient hospitalized with a stroke who developed a fever and adventitious lung sounds, the following orders are written, Which will the nurse implement first?
Sputum specimen for Gram stain and culture and sensitivity
Following assessment of a patient with pneumonia, the nurse identifies a nursing diagnosis of impaired gas exchange based on the findings of:
SpO2, of 86%
A patient is admitted to the hospital with fever, chills, a productive cough with rusty sputum, and pleuritic chest pain. Pneumococcal pneumonia is suspected. An appropriate nursing diagnosis for the patient based on the patient's manifestations is:
Hyperthermia related to acute infections process
A patient with pneumonia has a nursing diagnosis of ineffective airway clearance related to pain, fatigue, and thick secretions. An appropriate nursing intervention for the patient is to:
Encourage a fluid intake of at least 3L/day
During an annual health assessment of a 65 y/o clinic patient, the patient tells the nurse he had the pneumonia vaccine when he was 58. The nurse advises the patient that the best way from him to prevent pneumonia now is to:
Obtain the pneumococcal vaccine this year with an annual influenza vaccine
The resurgence in tuberculosis (TB) resulting from the emergence of multidrug-resistan strains of Mycobacterium tuberculosis was primarily the result of:
Poor compliance with drug therapy in patients with TB
A patient diagnosed with class 3 TB 1 week ago is admitted to the hospital with symptoms of chest pain. Initially, the nurse gives the highest priority to:
Admitting the patient to an airborne-infection isolation room
When obtaining a health history from a patient suspected of having early TB, the nurse asks the patient about experiencing
Fatigue, low-grade fever, and night sweats
A patient with active TB continues to have positive sputum cultures ater 6 months of treatment because she says she cannot remember to take the medication all the time. The best action by the nurse is to:
Arrange for directly observed therapy by a responsible family member of a public health nurse
A patient receiving chemotherapy for breast cancer develops a Cryptococcus infection of the lungs and is treated with IV amphotericin B. The nurse monitors the patient carefully during the drug's administration with the knowledge that this drug increases the patient's risk for (select all that apply)
Renal impairment
Nausea and vomiting
Malignant hyperthermia reaction
To reduce the risk for most occupation lung diseases, the most important measure promoted by the occupational nurse is:
Using masks and effective ventilation systems to reduce exposure to irritants
During a health-promotion program, the nurse plans to target women in a discussion of lung cancer prevention because (select all that apply)
Women develop lung cancer at a younger age than men
More women die of lung cancer than die from breast cancer
Women who smoke are at greater risk to develop lung cancer than men who smoke
Women are more likely to develop small cell carcinoma than men
A patient with a 40-pack-year history of smoking has recently stopped because of the fear of developing lung cancer. The patient asks the nurse what he can do to learn about whether he develops lung cancer. The best response for the nurse is,
"Screening measures for lung cancer are controversial, but we can discuss the advantages and disadvantages of various measures."
A patient with a lung mass found on chest x-ray is undergoing further testing. The nurse explains that a diagnosis of lung cancer can be confirmed by:
Biopsy positive for malignant cells
A patient with advanced lung cancer refuses pain medication saying, "I deserve everything this cancer can give me." The nurse's best response to the patient is:
Can you tell me what the pain means to you?
To determine whether a tension pneumothorax is developing in a patient with chest trauma, the nurse assesses the patient for:
Severe respiratory distress and tracheal deviation
Following a motor vehicle accident, the nurse assesses the driver for which distinctive sign of flail chest?
Paradoxical chest movement
The nurse should check for leaks in the chest tube and pleural drainage system when:
There is continuous bubbling in the water-seal chamber
When caring for the patient with a chest tube, the nurse should intervene when the nursing assistant is
Stripping or milking the chest tube to promote drainage
Following a thoracotomy, the patient has a nursing diagnosis of ineffective airway clearance related to inability to cough as a result of pain and positioning. The best nursing interventionfor this patient is to
Medicate the patient with analgesics 20-30 min before assisting to cough and deep-breathe
Two days after undergoing pelvic surgery, a patient develops marked dyspnea and anxiety. The first action the nurse should take is to:
Raise the head of the bed
A pulmonary embolus is suspected in a patient with a deep-vein thrombosis who develops hemoptysis, tachycardia, and pleuritic chest pain, and diagnostic testing is scheduled. The nurse plans to teach the patient about:
Spiral (helical) CT scan
While caring for a patient with primary pulmonary hypertension, the nurse observes that the patient has exertional dyspnea and chest pain, in addition to fatigue. The nurse knows that these symptoms are related to:
Right ventricular hypertrophy and dilation
The primary treatment for cor pulmonale is directed toward:
Treating the underlying pulmonary condition
Six days after a heart-lung transplant, the patient develops a low-grade fever and a decreased SpO2 with exercise. The nurse recognizes that this may indicate:
Acute rejection that can be treated with corticosteroids