Exam 1 Practice Exam - January 23, 2024 PDF

Exam 1 Practice Exam Prof. Copley/Prof. Livers January 23, 2024 1. The nurse is suctioning a tracheostomy for a client who had the tracheostomy tube placed 3 days ago. Which is the correct procedure for suctioning at this time? a. Use a sterile catheter each time the client is suctioned. b...

Exam 1 Practice Exam Prof. Copley/Prof. Livers January 23, 2024 1. The nurse is suctioning a tracheostomy for a client who had the tracheostomy tube placed 3 days ago. Which is the correct procedure for suctioning at this time? a. Use a sterile catheter each time the client is suctioned. b. Clean the catheter in sterile water after each use, and reuse for no longer than 8 hours c. Protect the catheter in sterile packaging between suctioning episodes d. Use a clean catheter with each suctioning, and disinfect it in hydrogen peroxide between uses 2. The nurse team leader is making rounds and observes a client who had a tracheostomy tube inserted 2 days ago. The nursing policy manual recommends the use of the gauze pad. What should the nurse do? a. Make sure the gauze pad is dry and the client is in a comfortable position b. Ask the unlicensed assistive personnel to the tracheostomy tube ties in the back of the client’s neck c. Reposition the gauze pad around the stoma with the open end downward d. Ask a registered nurse to change the ties and position another gauze pad around the stoma 3. The nurse is caring for a client with bacterial pneumonia. The effectiveness of the client’s oxygen therapy can be best determined by which indicator of oxygenation? a. Absence of cyanosis b. Client's respiratory rate c. Arterial blood gas (ABG) values d. Client's level of consciousness 4. A client with bacterial pneumonia is to be started on intravenous antibiotics. The nurse should verify that which diagnostic test has been completed before administering the antibiotic? a. Urinalysis b. Sputum culture c. Chest radiograph  d. Red blood cell count 5. The health care provider has prescribed guaifenesin 300 mg four times a day. The dosage strength of the liquid is 200 mg/5 mL. How many mL should the nurse administer for each dose? Round to the nearest tenth. ______ mL 6. The nurse is developing a teaching plan for the client newly diagnosed with chronic obstructive pulmonary disease (COPD). Which information should be included in the plan? Select the three (3) that apply. a. Pulmonary rehabilitation programs offer very little benefit b. Pneumococcal vaccination is contraindicated for clients with lung disease c. High humidity increases the effort of breathing d. A bronchodilator with a metered-dose inhaler should be readily available e. Smoking cessation is important to slow or stop disease progression 7. The nurse is assessing a client with chronic obstructive pulmonary disease. Which finding requires immediate intervention? a. Distant heart sounds b. Diminished lung sounds c. Inability to speak d. Pursed-lip breathing 8. A client with chronic obstructive pulmonary disease (COPD) is experiencing dyspnea and has a low partial pressure of arterial oxygen (PaO2) level. The nurse plans to administer oxygen as prescribed. Which statement is true concerning oxygen administration to a client with COPD? a. High oxygen concentrations will cause coughing and dyspnea b. High oxygen concentrations may inhibit the hypoxic stimulus to breathe c. Increased oxygen use will cause the client to become dependent on oxygen d. Administration of oxygen is contraindicated in clients who are using bronchodilators 9. A client with a history of asthma is admitted to the emergency department. The nurse notes that the client is dyspneic, with a respiratory rate of 35 breaths/min, nasal flaring, and use of accessory muscles. Auscultation of the lung fields reveals greatly diminished breath sounds. What should the nurse do first? a. Initiate oxygen therapy as prescribed, and reassess the client in 10 minutes  b. Draw blood for an arterial blood gas test c. Encourage the client to relax and breathe slowly through the mouth d. Administer bronchodilators as prescribed 10. The nurse is instructing a client with acute asthma who is undergoing short-term corticosteroid therapy. The nurse should tell the client that steroids will have which expected outcome? a. Promote bronchodilation b. Act as an expectorant c. Have an anti-inflammatory effect d. Prevent the development of respiratory infections 11. The nurse is assessing a client with asthma. Which finding would most likely indicate the presence of a respiratory infection? a. Cough productive of yellow sputum b. Bilateral expiratory wheezing c. Chest tightness d. Respiratory rate of 30 breaths/min 12. A client has a chest tube and water seal drainage system. What should the nurse do to ensure safe effective use of the drainage system? a. Verify that the air vent on the water seal drainage system is capped when the suction is off b. Strip the chest drainage tubes at least every 4 hours if excessive bleeding occurs c. Ensure that the chest tube is clamped when moving the client out of the bed d. Make sure that the drainage apparatus is always below the client’s chest level 13. The nurse observes a constant gentle bubbling in the water seal column of a water seal chest drainage system. What should the nurse do next? a. Continue monitoring as usual; this is expected b. Check the connectors between the chest and drainage tubes and where the drainage tube enters the chest drainage system c. Decrease the suction, and continue observing the system for changes in bubbling during the next several hours d. Notify the health care provider (HCP) 14. The nurse is preparing to assist with the removal of a chest tube. Which dressing is appropriate at the site from which the chest tube is removed?  a. Adhesive strips b. Petroleum gauze c. Dry 4x4 gauze d. Moist saline 15. A nurse is preparing to administer 10 mg of morphine sulfate to a client with three fractured ribs. The available concentration for this drug is 15 mg/mL. How many mL should the nurse administer? Round to the nearest tenth. ______ mL 16. A client with rib fractures and a pneumothorax has a chest tube inserted that is connected to a water seal chest tube drainage system. The nurse notes that the fluid in the water seal column is fluctuating with each breath that the client takes. What is the significance of this fluctuation? a. An obstruction is present in the chest tube b. The client is developing subcutaneous emphysema c. The chest tube system is functioning properly d. There is a leak in the chest tube system 17. A client has been in an automobile accident, and the nurse is assessing the client for possible pneumothorax. What finding should the nurse immediately report to the health care provider? a. Sudden, sharp chest pain b. Wheezing breath sounds over the affected side c. Hemoptysis d. Cyanosis 18. A client is undergoing a thoracentesis. What should the nurse monitor the client for during and immediately after the procedure? Select the four (4) that apply, a. Pneumothorax b. Subcutaneous emphysema c. Tension pneumothorax d. Pulmonary edema e. Infection 19. The nurse is positioning a client with acute respiratory distress syndrome (ARDS) who is receiving mechanical ventilation. To improve oxygenation, which is the best position for this client?  a. Supine b. Semi-fowler c. Lateral side d. Prone 20. The nurse is planning care for a client with a crushing chest injury. The client is in an intensive care unit, and the client’s vital signs have not stabilized. Which finding puts the client at risk for acute respiratory distress syndrome (ARDS)? a. History of smoking b. Low serum potassium c. Hypercapnia d. Hypovolemia 21. The nurse is conducting a focused assessment for a client at risk for acute respiratory distress syndrome (ARDS). Which finding indicates the client is becoming hypoxemic? a. Elevated carbon dioxide level b. Hypoxia not responsive to oxygen therapy c. Metabolic acidosis d. Severe, unexplained electrolyte imbalance 22. A client with acute respiratory distress syndrome (ARDS) is showing signs of increased dyspnea. The nurse reviews a report of blood gas values: pH 7.35, PaCO2 25 mmHg, HCO3- 22 mEq/L, and PaO2 95 mmHg. Which finding is concerning? a. pH b. Partial pressure of carbon dioxide (PaCO2) c. Bicarbonate (HCO3-) d. Partial pressure of arterial oxygen (PaO2) 23. The nurse is caring for a group of clients on a pulmonary unit. The nurse can delegate which task to unlicensed assistive personnel (UAP)? a. Assisting a client with adjusting their nasal cannula b. Adjusting flow rates based on client responses c. Monitoring a client for adverse effects of oxygen therapy d. Assessing a client for the best method of oxygen delivery 24. A nurse is caring for a group of clients. Which of the following clients are at risk for a pulmonary embolism? Select the three (3) that apply. a. A client who has a BMI of 30  b. A female client who is postmenopausal c. A client who has a fractured femur d. A client who is a marathon runner e. A client who has chronic atrial fibrillation 25. A nurse is assessing a client following a bronchoscopy. Which of the following findings should the nurse report to the provider? a. Blood-tinged sputum b. Dry, nonproductive cough c. Sore throat d. Bronchospasms ANSWER KEY: 1. A 2. A 3. C 4. B 5. 7.5 mL 6. C, D, E 7. C 8. B 9. D 10. C 11. A 12. D 13. B 14. B 15. 0.7 mL 16. C 17. A 18. A, B, C, D 19. D 20. D 21. B 22. B 23. A 24. A, C, E 25. D