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Final Review- Rest
Final Review- Rest
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1
What should the nurse do if a Cor Pulmonae patient is in respiratory distress?
Complete Focused assessment and question patient on specifics of the event
None of the above
Administer bronchodilators and ASA 81mg
Administer Corticosteroids STAT and place on 2L oxygen per NC
2
The patient should take a deep breath and hold (valsalva maneuver) during chest tube removal
True
False
3
What is the most common cause for the need of a chest tube?
Cancer
Asthma
Pneumothorax
Broken Rib
4
When using multiple inhalers, the order of administration does not matter.
False
True
5
If multiple inhalers are ordered, you should wait 5 mins. in between inhalers.
False
True
6
Which of the following are appropriate to prepare for a Bronchoscopy procedure?
Consent
Do Not Hold any ordered bronchodilators
Patient must be on 3-5 L Oxygen by NC
Review Labs (CBC and Coag Times)
bowel prep
NPO 4-8 hours
7
What term is used to group lung diseases that are caused by inhalation and retention of mineral or dust particles?
Mineralized Pneumonitis
Pneumoconiosis
Asbestosis al mineralis
Pneumonitis
8
Which of these patients should the nurse go and see first?
A patient with a productive cough with thick green mucus
Patient with jugular venous distention and peripheral edema
Patient with loud expiratory wheezes
Patient with respiratory rate of 38 per min
9
A deviation of the trachea to the left or the right indicates what Condition that required IMMEDIATE ACTION?
Open pneumothorax
Tension pneumothorax
Secondary pneumothorax
Spontaneous pneumothorax
10
What questions should be asked of a client who presents with symptoms or is perceived to have lung cancer.
Do you smoke or are you exposed to smoke?
Have you been exposed to high levels of pollution, radiation or asbestos?
Do you have a history of hypertension or diabetes?
Have you had prolonged or heavy exposure to industrial agents
11
Of these lung sounds which is an emergency: Wheezing, Stridor, Crackles (Rales) or Rhonchi?
Rhonchi
Stridor
Wheezing
Rales
12
Continuous bubbling in the water seal chamber of a chest tube drainage system
Signals an air leak in the system
means the pneumothorax has resolved
occurs when the patient coughs
is a normal finding
13
Which
two
statements are true of Pneumonia?
Rhonchi lung sounds are usually a good indication of pneumonia
Crackles on lung sounds are usually a good indication of pneumonia
Rotovirus is a common cause of pneumonia
Flu is a common cause of pneumonia
14
Complications of COPD include Car Pulmonale, Acute exacerbations, Acute Respiratory Failure
False
True
15
What is important for the nurse to monitor for after a thoracentesis?
Select all that apply
Pulse oximetry
Deviation of trachea
Increased work of breathing
Signs of hypertrophy
16
Your asthmatic patient is on multiple inhalers. Which should he use first?
Bronchodilator
Corticosteroid
Anticholinergic
Leukotriene Receptor Antagonist
17
What are three interventions that can help patients decrease anxiety and pain with asthma exaccerbation?
Abdominal Breathing
Rescue Breathing
Provide rest and a quiet calm environment
Pursed lip breathing
18
Identify the class of TB: Positive TB skin test with no active disease but can develop active TB at some point later
Extra Pulmonary TB
Latent TB Infection
Acute TB Infection
Primary TB Infection
19
After a total laryngectomy, the patient will have a __________ opening and will need rehab for _________ restoration.
Permanent Opening ; Voice Restoration
Temporary Opening ; Voice Restoration
Permanent Opening ; Swallow Restoration
Temporary Opening ; Swallow Restoration
20
Which finding in a chest tube drainage system 4 days after placement would cause alarm?
Dark brown drainage
> 100 ml per hour of bright red blood
50 ml of bright red blood
None, the system is supposed to collect blood
21
Chlorhexadine oral care to patients on a ventilator does what?
Prevents the patient from developing oral ulcers from dry mouth
Prevents the patient from developing oral mucosa sloughing
Prevents intubation abscess
Prevents ventilator associated pneumonia
22
What order are Asthma medications administered in?
Albuterol, Methylprednisolone, Ipratropium
Albuterol, Ipratropium, Methylprednisolone
Ipratropium, Methylprednisolone, Albuterol
23
keep the chest tube drainage system ______ the level of the chest
below
above
24
What foods should be encouraged to a client receiving radiation for head/neck cancer treatment?
SATA
Foods that dissolve to reduce swallowing effort
Foods high in Vitamin C
Soft Non Abrasive Foods
High protein bland Foods
25
Tuberculosis is a highly contagious easily transmitted disease.
True or False
True
False
26
Which of the following are appropriate nursing actions if a trach tube comes out and you cannot get it back in?
Lay flat to allow lungs to fully expand
Assess level of distress / ability to breathe
Cover Stoma with sterile dsg and ventilate with bag mask until help arrives
Elevate head of bed to Semi Fowlers
27
What does it mean if tidaling stops in the water chamber?
Increasing hemothorax
A normal finding for no tidaling in the water chamber
Increasing pneumothorax
lung reexpansion or an obstruction within the system
28
Identify the class of TB: Positive TB skin test but is asymptomatic with no active disease
Acute TB Infection
Latent TB Infection
Extra Pulmonary TB
Primary TB Infection
29
If a client is admitted for probable bacterial pneumonia, which of the following is important for the nurse to do?
Swab the nares for pneumonia spores
Obtain blood culture from central line
Obtain blood cultures from two sites
Obtain sputum for candida detection
30
which are true of Acute Respiratory Failure Symptoms? SATA
Tachycardia with numbness to BUE
Clubbing of fingers and non blanch able
Inability to speak in complete sentences without passing out
Acute Altered Mental Status
31
What are the three things Mrs Burris told us to remember regarding the diagnosis and treatment of PE
D Dimer
Warfarin and ASA 81 mg
Heparin
Oxygen
32
What should the nurse do if a patients AFB remains positive after two months of TB medication therapy?
Assess for possible non adherence to regimen
Request that patient be placed on alternate medication therapy
Re-collect specimen
33
Flail chest is occurs when:
more than three ribs are fractured on the same side of chest
segment of chest wall is detached from the thoracic cage
segment of fractured ribs bulges during inhalation phase
multiple ribs are fractures on both sides of thoracic cage
34
Nurse is caring for a pt with Car Pulmonale, the nurse should monitor the pt for which expected finding?
Chest pain
Elevated Temperature
Peripheral Edema
Finger Clubbing
35
What are the signs and symptoms of Acute Respiratory Failure? Select all that apply
inability to speak in complete sentences w/out passing out
Tripod position
Acute mental status change
Barrel chest and red face
New Onset- Headache
Tremors
36
Symptoms of tension pneumothorax. SATA
Compression on the heart
Tracheal deviation
Dyspnea and unequal chest rise
JVD
37
Signs and symptoms associated with pneumothorax include:
SATA
Hyperthermia, tachycardia, and flushing
Diminished breath sounds on affected side
complaints of not being able to breathe
hyper resonance with percussion
38
In Case of accidentally
Dislodging a Chest Tube ...?
Cover w/ Transparent Film dressing
Gently, Carefully Reinsert Chest Tube
Cover w/ Sterile Gauze & Tape on Four Sides
Cover w/ Occlusive Vaseline Gauze & Tape on Three Sides
39
Tidaling in a chest tube collection device is?
Rising with expiration, falling with inspiration
An abnormal finding
indicative of an air leak
Rises with inspiration, Falls with expiration
40
What position is best to decrease edema and limit suture tension following a Total Laryngectomy during the 1st 24 hrs?
High Fowlers
Tri-pod positioning
Supine
Semi-Fowlers
41
Which manifestation associated with a chest tube pt should the nurse intervene for immediately?
Drainage of 75 mL/hr
Tracheal deviation
Pain at insertion site
Production of pink sputum
42
Identify the class of TB that needs to be treated with mono-drug therapy but does not have active disease.
Acute TB Infection
Latent TB Infection
Active TB Infection
Primary TB Infection
43
Surgery is generally not indicated for which type of lung cancer due to its rapid growth and dissemination
Small Cell Lung Cancer
Non Small Cell Lung Cancer
44
Nursing measures after a bronchoscopy include:
assess gag reflex
put patient in fowlers position
assess for decreased cough reflex
elevate legs for venous return
Assess for patent airway
45
Flail chest is...
Paradoxical motion of the chest on inspiration & expiration
Expansion of the lungs by compressing the torso
46
Identify the class of TB: Immune responses encapsulate the organism and the disease does not progress. (most people)
Extra Pulmonary TB
Primary TB Infection
Acute TB Infection
Latent TB Infection
47
Symptoms of pulmonary embolism include? SATA
dyspnea
bradypnea
change in mental status
chest pain
48
A young adult who denies hx of smoking is seen for a new Dx of COPD. The nurse would plan to teach the patient about ...
a1-antitrypsin testing
leukotriene modifiers
Continuous pulse oximetry
use of the nicotine patch for cessation
49
Upon assessment the nurse notes stridor on inspiration and exhalation. What does this indicate?
Complete airway obstruction
Lower airway obstruction
Middle airway obstruction
Upper airway obstruction
50
Which of the following statements regarding stridor is correct
caused by incorrect airway positioning
high pitched, crowing upper airway sound
suggests presence of fluid in lungs
whisltling sound heard in the lower airway
51
Common position for thoracentesis.
High Fowler’s with legs on pillows and arms extended forward
Left lateral position with arms extended anteriorly
Right lateral with back bowed and knees drawn up to abdomen
Sitting with his arms supported on an anchored bedside table
52
Which two symptoms would be caused from a child who is taking a bronchodilator such as albuterol for example
Hyperactivity
Lethargy
Rhinitis
Tremors
53
Immediate Nursing intervention when a trach tube becomes dislodged
Attempt to reinsert
Notify physician
Cover stoma
Call charge nurse
54
COPD is the inability to take in Air?
True
False
55
What can occur when patients are switched to inhaled steroids after receiving systemic steroids without tapering slowly?
Steroid Overload
Cushings Syndrome
Addisonion Crisis
Thyroid Storm
56
1.
Discontinuation of isolation precautions for pulmonary tuberculosis patient is based on:
- Improvement ox X-ray images
3 weeks Ongoing on appropriate therapy
- 3 AFB negatives under appropriate treatment
- improvement of respiratory symptoms
