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Respiratory - Kaplan

Terms in this set (93)

The LPN obtains a sputum specimen. What actions should the LPN take to obtain the specimen?
Instruct the client to avoid brushing teeth prior to test. Collect the specimen early in the morning. Use a sterile container to collect the specimen.
The client was diagnosed with lung cancer with at least one metastatic location three weeks ago. the client was given six months to live. The client is very angry and lashes out vebally at the LPN during the office visit. Which approach by the LPN is best?
Use therapeutic communication techniques, and do not attempt to confront the client about angry feelings.
The LPN cares for the client diagnosed with tracheal stenosis. While cleaning the client's #8 cuffed tracheostomy tube, the LPN notes heavily encrusted secretions on the inner cannula. The secretions cannot be completely removed, despite soaking the inner cannula in a hydrogen peroxide solution and scrubbing with a flexible brush. Which action does the LPN take next?
Obtains a new #8 inner cannula and places it in the traceostomy.
The health fair participant asks the LPN, "How does getting older change some of these things?" Which is the correct response, based on the LPN's knowledge?
"There is a loss of lung elasticity."
The LPN cares for a client diagnosed with active tuberculosis. Which is the most appropriate action for the LPN to take while caring for this client?
Assist the client to place a mask over mouth and nose if outside room.
The LPN suctions a client's tracheostomy. What is the maximum amount of time the suction should be applied during withdrawal of the catheter?
10 seconds
The LPN cares for a client with a fenestrated tracheostomy. The LPN knows this type of tracheostomy is different from a regular tracheostomy in what way?
Allows clients to talk when inner cannula is removed.
The LPN leaves a client's room and prepares to remove personal protective equipment (PPE). What is the correct order for removal of the PPE?
Gloves, goggles, gown, mask
A client is learning to use a metered dose inhaler and has received instructions. The LPN knows the client understands the proper technique when which is observed?
The client inhales and holds the breath for several seconds.
A client is recovering from abdominal surgery. The LPN helps the client cough and deep breathe as part of the post operative plan of care. How should the client carry out this procedure?
Breathe in deeply 3 times and then cough 3 times.
The LPN assists with the care of a 4-year-old child immediately after a tonsillectomy. Which observation should be reported immediately to the nurse?
The child swallows frequently.
The LPN cares for a client who is to have a thoracentesis. The LPN recalls which as the correct positioning of the client for the procedure?
Client sits on teh side of the bed and leans upper torso over the bedside table with head resting on folded arms.
The LPN assists in the care for the client diagnosed with a pneumothorax. The client's baseline oxygen saturation leve is 80%, and the client's baseline respiratory rate is 26 breaths per minute. After a chest tube is placed, which would indicate to the LPN an improvement in the client's conditions?
An O2 saturation of 92%
The client is scheduled for pulmonary function testing. Which statement by the client indicates to the LPN that further teaching is necessary?
"I can eat a meal within an hour and a half before the test is scheduled."
A client is receiving powdered medication through an inhaler. The LPN knows this inhaler is different from an inhaler for liquid medications in what way?
Client only inhales deeply through the mouthpiece.
The LPN cares for a client diagnosed with a pneumothorax. The client has a closed chest drainage system. Which is the most appropriate action for the LPN to take?
Assist the client with incentive spirometry every hour.
A client asks the LPN about interpretation of a tuberculin skin (Mantoux) test. What is the best response by the LPN?
"To determine if the test is positive, a raised area must be present."
A client is having difficulty breathing due to pneumonia. Which nursing intervention in teh care plan should the LPN implement first?
Place client in Fowler's position
The LPN knows that the respiratory system functions in which ways?
Provides oxygen for the blood to release into the body. Regulates part of the acid-base balance. Filters air inspired into the lungs. Warms inspired air through the nose.
A client is instructed about the use of phenylephrine nose drops. Which statement by the client indicates that the LPN needs to reinforce the teaching?
"I will breathe through my nose as I instill the phenylephrine."
The LPN observes for cyanosis on a dark skinned client. What is teh best location to observe for cyanosis?
Oral mucous membranes
The LPN observes an LPN student during tracheostomy care. Which action by the LPN student requires an immediate intervention by the LPN?
The LPN student opens a container of saline after putting on sterile gloves.
A client is recovering from surgery with a cuffed tracheostomy tube in place with the cuff uninflated. The order is for the cuff to be inflated for 30 minutes after each meal. The LPN understands the reason for cuff inflation at that time is to prevent what?
Aspiration
The LPN cares for a client with severe chronic obstructive pulmonary disease. Which medication would the LPN expect to administer to the client?
Albuterol
In preparing an answer to the client's question, "At the hospital they told me that chronic obstructive pulmonary disease (COPD) was really a lot of different diseases. Does that mean I have more than one disease? The LPN recalss that which is classified as COPD disorder?
Emphysema
A child is hospitalized with laryngotracheobronchitis (croup). The LPN caring for this child should observe for which symptoms most likely indicating an acute emergency of epiglottitis?
Dyspnea and drooling
The LPN cares for a client who experiences orthopnea. The LPN recallsthat which is the correct definition of orthopnea?
Difficulty breathing in a supine position
A client with chronic obstructive pulmonary disease (COPD) is instructed in teh use of arformoterol. Which statement by the client indicates that the LPN needs to reinforce the teaching?
"I will use this medication when I get short of breath."

RATIONALE: Arformoterol is a preventive treatment and does not treat sudden exacerbation of breathing problems
The LPN cares for a client diagnosed with pneumococcal pneumonia. What will the LPN expect to observe?
Productive cough
A client says to the LPN, "My asthma has been so bad that I have been using my albuterol inhaler more than I should." What will the LPN expect to observe?
Hand tremors
The LPN observes a client's respirations following surgery. Which type of respirations indicate the client is resting comfortably with no respiratory distress?
Diaphragmatic respirations
The LPN is caring for a client 12 hours after surgery. One of the orders reads, "Turn, cough, and deep breathe evey 2 hours while awake." The LPN knwos that this is done to prevent which respiratory disorder?
Atelectasis
The LPN is caring for a client with acute bronchitis and no complicating factors. The anticipated treatment would include which items?
Rest and fluids. Antiinflammatory medications. Cough suppressing agents.
The LPN cares for the 84-year-old client in the extended care facility who is diagnosed with acute bronchitis. The LPN emphasizes the importance of thorough hand washing for which reason?
Acute bronchitis is generally caused by a virus. It is especially important in an extended care setting that the virus does not spread. Hand washing is one way to prevent spreading.
The LPN is caring for a client following a laryngectomy 1 day ago to remove cancer of the larynx. The client has a tracheostomy. What would the LPN recognize as the most important diagnosis in the client's plan of care?
Impaired verbal communication
The LPN cares for a client after a bronchoscopy. What is the most important nursing care for this client?
Maintain the client nil per os status for several hours.
A client is eating a hot dog in the hospital cafeteria and suddenly begins gasping for air and looks frightened. The client clutches throat while gasping. What should the LPN do first?
Apply the Heimlich maneuver
The LPN cares for the client receiving cetirizine and zolpidem. The LPN expects this medication combination to cause what occurrence?
An additive effect
Which nursing diagnoses would teh LPN expect to have identified as the most important in the care plan for a clietn with asthma?
Ineffective breathing patterns.
The LPN cares for a preschooler diagnosed with acute epiglottitis. Which nursing action is of highest priority?
Observe respiratory effort and rate continually.
A client is admiitted to the emergency department ofllowing a car accident. The LPN observes the client coughing up and spitting out some blood. This hemoptysis is most likely due to an injury in what part of the body?
The bronchi or lungs
The client is taking guaifenesin-phenylephrine-hydrocodone-brompheniramine for a cold and cough. The LPN would observe the client for which adverse reactions?
Dizziness and drowsiness
The nurse prepares to teach a client about signs and symptoms of ethambutol toxicity. Which symptoms will the LPN suggest to include in the teaching?
Optic neuritis
The LPN is caring for a client postoperatively. The client's record indicates there are crackles and wheezes in the lungs. How would these be classified?
Adventitious breath sounds.
The LPN recalls that which is an organism that may have caused community-acquired pneumonia?
Streptococcus pneumoniae
The LPN cares for a client recently diagnosed with lung cancer. What will the LPN expect the client to report?
Persistent cough
A client is to receive aminophylline intravenously. Which important factor about this medicaiton would the LPN know is the most important factor?
It may be incompatible with other medications.
A client is taking beclomethasone, a steroid inhaler, for asthma. The LPN knows this medication is effective when the client makes which statement?
"I have not had an asthma attack since taking this drug for 2 months."
The LPN cares for a client with asthma. The LPN knows the client uses an inhaled glucocorticosteroid daily for which reason?
To prophylactically reduce the number of asthma attacks.
A client takes cefditoren for treatment of chronic bronchitis. The LPN knows this medication should be taken in what way?
With meals
What is the best description of Cheyne-Stokes respirations?
Increasing and decreasing depth or respiration with periods of apnea.
The LPN assists with care of a preschool diagnosed with epiglottitis. Which action is of highest priority for this client?
Observe respiratory effort and rate continually.
Which clients are at highest risk to develop hospital-acquired penumonia?
A client diagnosed with chronic bronchitis. A client receiving Prednisone after a renal transplant. A client 2 days after a tracheostomy procedure.
The LPN admits a 22-year-old to an acute care unit for the treatment of cystic fibrosis. What will the LPN expect to observe?
Thick, sticky mucous.
A client begins to cough weakly and has stridor when breathing. What should the LPN prepare to use to assist the client?
Abdominal thrust maneuver.
A child with asthma has an acute asthma attack. A diagnosis of acute bronchospasm is made. The LPN anticipates which treatment is given to this child first?
Albuterol by nebulizer
The LPN finishes a nasogastric (NG) tube feeding for a client diagnosed with a decreased level of consciousness. Which action should the LPN take next?
Elevate the head of the bed for at least an hour.
A client diagnosed with bonchiectasis has a nursing diagnosis of ineffective airway clearance related to increased retention of pulmonary secretions. The LPN woudl plan to complete which nursing intervention?
Frequent position changes
The LPN cares for a client who had a medication overdose. The client is lethargic but responds to deep stimuli. The LPN should take which actions to prevent respiratory complications?
Position the client laterally with head turned to the side to prevent aspiration.
The LPN cares for a client recuperating from a splenectomy. The LPN should address which health care need as the most important in the immediate postoperative period?
To breathe deeply frequently
After the intravenous (IV) antibiotic finishes and while the LPN regulates teh primary IV, the client with hospital-acquired pneumonia (HAP) says, "I'm really having a hard time getting my breath. I feel like I am about to smother." The LPN takes which action?
Raises the head of the bed and calls over the intercom to page the RN to the room stat.
A client who is eating a hot dog in the hospital cafeteria suddenly begins gasping for air and looks frightened. The LPN knows which assessment by a health care provider will best determine if the client is experiencing airway obstruction?
Observation fo the client grasping for the throat.
A client has just started treatment with triamcinolone. Whihc client statement indicates to the LPN the medication has been effective?
"My skin has stopped itching."
The LPN cares for a client diagnosed with a flail chest following an automobile accident. Which type of respiratory pattern should the LPN anticipate when making respiratory observations?
Paradoxical chest movements
A client with asthma has received teaching regarding the medication ordered. The LPN determines a need for reinforcement of the teaching if the client makes which statement?
"If I get an acute attack, I will take an extra dose of my fluticasone."

RATIONALE: A rescue medication is needed for an acute attack and will be different from the daily medications.
An adult client diagnosed with obstructive sleep pnea is started on continuous positive airway pressure (CPAP). What does the LPN know about the purpose of this treatment?
Keeps airways open using positive pressure.
A hospitalized client uses an inahled glucocorticoid medication because of asthma. What action by the LPN woudl be most important for this client following use of the medication?
Provide a glass of water and an emesis basin.
A client is one day post-operative after a splenectomy. The LPN is collecting data and finds the temperature to be 101.9, respirations 26, shallow and labored, pulse 86, and BP 146/88. Whch action should the LPN take first.
Have the client cough and deep breathe.

RATIONALE: These are symptoms of atelectasis and the first thing to do is to have the client cough and deep breathe.
A client comes to the clinic with a cough that is somewhat productive. The LPN anticipates the health care provider will order what type of medication to help incease the productivity of the cough by increasing secretions?
Expectorant
The LPN cares for a 9-year-old diagnosed with cystic fibrosis. What will the nurse expect to observe?
Abdominal distension. Shortness of breath. Salty taste to skin. Foul smelling stools.
The LPN cares for a client diagnosed with a right closed pneumothorax. What will the LPN expect to observe?
Chest pain with inspiration. Unequal chest expansion. Decreased breath sounds in right lung.
The LPN reinforces teaching about pursed lip breathing. Which observation indicates understanding of the instructions?
The client exhales against partially closed lips.
The LPN cares for a client diagnosed wigh deep vnous thrombosis. What will the LPN expect to observe if pulmonary embolism occurs?
Sudden onset of shortness of breath. Hemoptysis.
The LPN cares for a client diagnosed with chronic bronchitis. What will the LPN expect to observe?
Cough with increased mucous production.
The LPN assists with the care of a client who had a bronschoscopy 2 hours ago. What is a priority observation for the LPN to make?
Gag reflex
The LPN cares for the client who was exposed to active tuberculosis (TB) three months ago. The medication isoniazid has been prescribed for prophylaxis. Which statement by the client indicates correct understanding about this medication?
"I will continue to take this medicaiton for at least 6-9 months."
The LPN reinforces teaching of the client about oxygen therapy. Which statement by the client indicates to the LPN that further teaching is necessary?
"If my spouse smokes at the other end of the room, that will not be a problem with my oxygen."
The LPN cares for the client receiving oxygen therapy via a nonrebreathing maks. The LPN recallsthat a fractonof inspired oxygen of 0.8 is equal to what percentage of oxygen delivery?
80%
The LPN reinforces teaching for teh client about warfarin for a pulmonar embolism, including side effects and expected length of therapy. Which statement by the client indicates the teaching is effective?
"Wearing supportive hose will decrease my chances of having another pulmonary embolus."
A client receives heparin. The LPN recalls which is a possible adverse reaction to this medication?
Anaphylaxis
The LPN cares for a client after a cesarean birth. The client had an epidural anesthetic during the procedure. What is a priority observation for the LPN to make?
Breath sounds
The client says, "I'm taking that medication called 'gemoifloxacin'. What is it for?" Which statement by the LPN correctly answers the client's question?
This medication is given for bronchitis that gets worse.
A client with cystic fibrosis is taking dornase alfa. What does the LPN know to be the purpose of this medication?
Reduce respiratory infections
A client is diagnosed with chronic fatigue. Which client teaching does the LPN reinforce?
Encourage adequate rest to decrease fatigue.
An adult client is newly recovering from abdominal surgery. Which nursing intervention would the LPN recognize as the most important for this client's recovery?
Splinting the incision for coughing.
The LPN gives home care to a client with a mechanical ventilator. What is the most important care for this client?
Physicla care of the client
The LPN massages the fundus of a postpartum client. The LPN recognizes that which is the purpose of this massage?
Contract the uterus to clamp arteries
The LPN is caring for a client following a laryngectomy 1 day ago to remove cancer of the larynx. The client has a tracheostomy. What would the LPN recognize as the most important nursing diagnosis in the client's plan of care?
Impaired verbal communication
A client has received instruction about themedication ipratropium. Which client statement indicates to the LPN the instruction needs to be reinforced?
"I can use this medication when I get short of breath."
A client with sinusitis takes levofloxacin. The LPN knows the client understands the teaching regarding this medication when which client statement is made?
"I will drink lots of water while taking this medication."
Which nursing diagnosis would the LPN expect to have identified as the most important in teh care plan for a client with asthma?
Ineffective breathing patterns
The LPN reinforces teaching for a client receiving isoniazid. It is most important for the LPN to include which statement in the teaching?
"You must have regular blood tests."
The LPN cares for a client diagnosed with emphysema. The client receives treatment for a respiratory tract infection. Why does the client receive oxygen at only 2 liters per minute via nasal catheter?
The client has an hypoxic drive and high levels of oxygen can cuase respiratory distress.
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