Where do you look for signs of respiratory distress indicating cyanosis?

Nail beds, Lips, Mucous membranes

What are rhonci sounds?

Continuous, low-pitched, snoring type sound cause by fluid/mucus

What can indicate manifested long-term hypoxia?

Clubbing of the fingers or toes

What is a funnel chest?

A marked sunken sternum & costal cartilage

A nurse is inspecting a client's anterior chest. Which of the following should the nurse expect?

The ribs are sloping down at an angle

What is a barrel chest ?

A hyperinflation of the lungs due to COPD

What is ataxic breathing?

Unexpected breathing w/ varying respirations & apnea.

Slow breathing under the rate of 12

When assessing a px w/ minimal airmovement during inspiration, which should be recognized as contributing factors?

Chest trauma, Pneumonia, Prolonged bed rest

Rapid breathing over the rate of 20

Vesicular breath sounds are heard where ?

Over the anterior & posterior chest wall

Bronchial breath sounds are heard where ?

To the right & left of the trachea & larynx

Tracheal breath sounds are heard where ?

Over the trachea of the anterior neck

What are stridor sounds?

High-pitched growing sound that can be heard without a stethoscope

What is a pigeon chest?

A protrusion of the sternum with a backward sloping of the ribs

What is hypoventilation ?

Pattern of irregular but shallow respirations, often < the normal rate

What is a pleural friction rub?

Low-pitched, coarse, grating tone like rubbing leather together

Difficulty breathing when lying down

A nurse is preparing education material for a px to maintain a healthy respiratory status. What info should be included?

Educate px that hand hygiene is the first line of defense to prevent illnes, Instruct & encourage the px to obtain the influenza vaccine, Counsel the client about smoking cessation

What is hyperventilation?

Pattern of rapid, deep breathing at a rate of 24 or higher

Unexpected findings during a respiratory assessment for position of breathing?

Tripod position, Using accessory muscles to breathe, Hypertrophied neck muscles, Diaphragmatic breathing

Intermittent rattling, popping or bubbling sound, high or low pitched

What is Cheyne-strokes breathing?

"Start-stop" breathing. Typically seen at the end of life

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Unit V : Respiratory

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Questions 35

Answers

1
Which of the following can contribute to hyperventilation?
Nausea
Pain
Fear
Anxiety
2
The right lung has how many lobes?
1
4
3
2
3
General pallor can be an indicator of what during a respiratory assessment?
Neurological irritation
Anemia
Left-sided heart failure
Food poisoning
4
Where do you look for signs of respiratory distress indicating cyanosis?
Nail beds
Scelera
Lips
Mucous membranes
5
What are rhonci sounds?
Intermittent rattling, popping or bubbling sound, high or low pitched
Low-pitched, coarse, grating tone like rubbing leather together
Continuous, low-pitched, snoring type sound cause by fluid/mucus
High pitched musical sound
High-pitched growing sound that can be heard without a stethoscope
6
What is dyspnea?
Difficulty breathing when lying down
Shortness of breath
7
What can indicate manifested long-term hypoxia?
Tripod position
Petechiae
Pallor
Clubbing of the fingers or toes
8
What is a funnel chest?
A marked sunken sternum & costal cartilage
A protrusion of the sternum with a backward sloping of the ribs
A hyperinflation of the lungs due to COPD
9
A nurse is inspecting a client's anterior chest. Which of the following should the nurse expect?
Rales noted along the lower aspects of the lungs
Rib deformities felt at the thoracic level
The spine is without deformaties
The ribs are sloping down at an angle
10
What is a barrel chest ?
A marked sunken sternum & costal cartilage
A protrusion of the sternum with a backward sloping of the ribs
A hyperinflation of the lungs due to COPD
11
A pulse oximeter reading is unreliable in cases of ?
COPD
Elevated temperature
Cardiac arrest
Hypothermia
12
What is ataxic breathing?
"Start-stop" breathing. Typically seen at the end of life
Unexpected breathing w/ varying respirations & apnea.
Pattern of irregular but shallow respirations, often < the normal rate
Pattern of rapid, deep breathing at a rate of 24 or higher
Rapid breathing over the rate of 20
Slow breathing under the rate of 12
13
Bronchovesicular breath sounds are heard where?
Over the anterior & posterior chest wall
Over the left & right bronchi
To the right & left of the trachea & larynx
Over the trachea of the anterior neck
14
When assisting a client who is hyperventilating, your priority is to?
Ensure the client's safety
Help them to slow their breathing
Take vitals
15
What is bradypnea?
Pattern of rapid, deep breathing at a rate of 24 or higher
Unexpected breathing w/ varying respirations & apnea.
Rapid breathing over the rate of 20
"Start-stop" breathing. Typically seen at the end of life
Slow breathing under the rate of 12
Pattern of irregular but shallow respirations, often < the normal rate
16
When assessing a px w/ minimal airmovement during inspiration, which should be recognized as contributing factors?
Chest trauma
Fever
Pneumonia
Prolonged bed rest
17
What is tachypnea?
Rapid breathing over the rate of 20
Pattern of irregular but shallow respirations, often < the normal rate
"Start-stop" breathing. Typically seen at the end of life
Unexpected breathing w/ varying respirations & apnea.
Pattern of rapid, deep breathing at a rate of 24 or higher
Slow breathing under the rate of 12
18
Vesicular breath sounds are heard where ?
To the right & left of the trachea & larynx
Over the left & right bronchi
Over the anterior & posterior chest wall
Over the trachea of the anterior neck
19
Bronchial breath sounds are heard where ?
Over the left & right bronchi
Over the trachea of the anterior neck
Over the anterior & posterior chest wall
To the right & left of the trachea & larynx
20
Tracheal breath sounds are heard where ?
Over the anterior & posterior chest wall
Over the left & right bronchi
Over the trachea of the anterior neck
To the right & left of the trachea & larynx
21
What are stridor sounds?
Intermittent rattling, popping or bubbling sound, high or low pitched
Low-pitched, coarse, grating tone like rubbing leather together
High-pitched growing sound that can be heard without a stethoscope
Continuous, low-pitched, snoring type sound cause by fluid/mucus
High pitched musical sound
22
What is a pigeon chest?
A hyperinflation of the lungs due to COPD
A protrusion of the sternum with a backward sloping of the ribs
A marked sunken sternum & costal cartilage
23
What is hypoventilation ?
Rapid breathing over the rate of 20
"Start-stop" breathing. Typically seen at the end of life
Slow breathing under the rate of 12
Unexpected breathing w/ varying respirations & apnea.
Pattern of rapid, deep breathing at a rate of 24 or higher
Pattern of irregular but shallow respirations, often < the normal rate
24
A breathing rate of 12-20 is referred to as ?
Tachypnea
Eupnea
Apnea
Bradypnea
25
A nurse is caring for a px who is in respiratory distress. Which position should the nurse assist the px into?
Lying flat on back
Trendelesburg
Low-fowlers position
Tripod position
26
What is a pleural friction rub?
Low-pitched, coarse, grating tone like rubbing leather together
High pitched musical sound
Intermittent rattling, popping or bubbling sound, high or low pitched
High-pitched growing sound that can be heard without a stethoscope
Continuous, low-pitched, snoring type sound cause by fluid/mucus
27
What is orthopnea?
Shortness of breath
Difficulty breathing when lying down
28
What are wheezes?
Intermittent rattling, popping or bubbling sound, high or low pitched
High pitched musical sound
Continuous, low-pitched, snoring type sound cause by fluid/mucus
Low-pitched, coarse, grating tone like rubbing leather together
High-pitched growing sound that can be heard without a stethoscope
29
Which normal breath sounds are heard over the largest portions of the lungs, soft sounding like wind through trees?
Tracheal
Rales
Wheeze
Vesicular
30
A nurse is preparing education material for a px to maintain a healthy respiratory status. What info should be included?
Inform px about wearing a mask during the change of the season to prevent 🦠
Educate px that hand hygiene is the first line of defense to prevent illnes
Instruct & encourage the px to obtain the influenza vaccine
Counsel the client about smoking cessation
31
What is hyperventilation?
Pattern of rapid, deep breathing at a rate of 24 or higher
Unexpected breathing w/ varying respirations & apnea.
Pattern of irregular but shallow respirations, often < the normal rate
Rapid breathing over the rate of 20
Slow breathing under the rate of 12
"Start-stop" breathing. Typically seen at the end of life
32
Unexpected findings during a respiratory assessment for position of breathing?
Tripod position
Using accessory muscles to breathe
Hypertrophied neck muscles
Thoracic breathing
Diaphragmatic breathing
Using pillows to prop themselves up
33
The left lung has how many lobes?
1
4
3
2
34
What are crackles ?
Low-pitched, coarse, grating tone like rubbing leather together
High-pitched growing sound that can be heard without a stethoscope
High pitched musical sound
Intermittent rattling, popping or bubbling sound, high or low pitched
Continuous, low-pitched, snoring type sound cause by fluid/mucus
35
What is Cheyne-strokes breathing?
Rapid breathing over the rate of 20
"Start-stop" breathing. Typically seen at the end of life
Unexpected breathing w/ varying respirations & apnea.
Pattern of irregular but shallow respirations, often < the normal rate
Slow breathing under the rate of 12
Pattern of rapid, deep breathing at a rate of 24 or higher

Unit V : Respiratory Flashcards | StudBud