Respiratory Exam

  1. What is a surfactant?
    A substance secreted by the macrophages that facilitates oxygen transport across the alveolar membrane.
  2. During inspiration, air enters the thoracic cavity because of
    a decrease in intrathoracic pressure relative to pressure at the airway
  3. The ability of the lungs to adequately oxygenate the arterial blood is determined by examination of the
    arterial oxygen tension (PaO2)
  4. The most important respiratory defense mechanism distal to the respiratory bronchioles is the
    alveolar macrophage
  5. A rightward shift of the oxygen-hemoblogin dissociation curve
    facilitates release of oxygen at the tissue level
  6. Signs and symptoms of inadequate oxygenation include all of the following EXCEPT
    increased peripheral perfusion, increased urine output
  7. When assessing activity, exercise patterns related to respiratory health, you should inquire about
    dyspnea during rest or exercise
  8. When percussing the chest, you should compare sounds heard
    on the left and right anterior and posterior chest in the same areas
  9. The left mainstem bronchus is
    more angulated than the right
  10. Respiration is most affected by
  11. Which of the following shift the oxyhemoglobin dissociation curve to the left?
    Decrease in temperature, Increase in pH
  12. During normal, quiet, relaxed, breathing, what will the intrapleural pressure be
    Equal to atmospheric pressure
  13. Adventitious breath sounds include all of the following EXCEPT
    bronchovesicular sounds
  14. Your patient's tidal volume is 1000cc's.  He is breathing 15 times a minute.  Calculate his minute volume
  15. Oxygen toxicity can occur when a patient receives O2
    at 50% or greater for more than 24 hours
  16. What range of O2 concentration does a nasal cannula provide?
    Between 24% and 40%
  17. Early signs of O2 toxicity include
    numbness in the extremities and dry, hacking cough
  18. A healthy person's respiratory drive depends on
  19. The blood's O2-carrying capacity can be limited to
  20. Lower than normal O2 saturation in arterial blood is called
  21. Which of the following is a high-flow O2 delivery device
    venturi mask
  22. Percentage normal for Ambient air?
  23. Your client has had GI surgery with a large abdominal incision. When you assess your client, you note that she has a respiratory rate of 26.  Which breath sounds would lead you to call the physician immediately?
    Expiratory wheezes throughout
  24. If acidosis results from a slow, shallow respiratory rate, you'd expect the following change in acid/base balance
    pH decreased and PaCO2 increased
  25. After assisting the client to properly use her incentive spirometer, you note an increase in the percentage of her pulse oximetry.  To what anatomical/physiologic change is this related?
    The increased oxygen diffusion from alveoli to capillaries
  26. When a patient hyperentilates, you would base your interventions on the knowledge that he is likely to experience
    increased pH from CO2 depletion
  27. What recommendations would you give a patient to maximize the therapeutic effect of pseudoephedrine, a nasal decongestant?
    Drink plenty of fluids
  28. You are caring for a 14-year-old patient who came to the clinic with her mother.  Privately, the mother tells you that she is concerned that her child might be smoking because she is constantly asking her to buy Robitussin (dextromethorphan) for a cough.  With your knowledge of this drug, what further information would you need from the mother?
    Have you noticed any unusual or agitated behavior?
  29. You are the nurse working a telephone hot line to answer questions about health problems.  A patient calls and tells you he has been taking Fexofenadine, an antihistamine, for seasonal allergies.  The drug is effective, but the patient reports having an upset stomach after taking it and wonders if he must stop taking the drug. What advice should you give?
    Take the drug with food
  30. Pseudoephedrine (Sudafed) works by:
    Mimicking the action of the sympathetic nervous system
  31. Pseudoephedrine (Sudafed) is indicated for the treatment of which of the following?
    Viral upper respiratory infection
  32. How does oxymetazoline (afrin) differ from pseudoephedrine (Sudafed)?
    Route and decreased incidence of adverse effects
  33. Which of the following adverse effects may occur during pseudoephedrine (Sudafed) therapy?
  34. Cromolyn sodium (NasalCrom) works by
    Preventing the breakdown of mast cells
  35. Which of the following statements concerning drug-drug interactions of Guaifenesin (Robitussin) is accurate?
    There are no known drug-drug interactions
  36. Which of the following nasal sprays is a steroidal anti-inflammatory drug?
    Dexamethasone sodium phosphate (Turbinaire)
  37. An expectorant drug, such as Guaifenesin (Robitussin), is used to relieve?
    A dry, hacking cough
  38. Which of the following statements concerning the adverse effects of Dextromethorphan (Benylin) is correct?
    There are few minor adverse affects
  39. Antihistamines, such as Fexofenadine (Allegra), are the treatment of choice for?
    Allergic rhinitis
  40. Dextromethorphan (Benylin) works by
    Inhibition of the cough center in the medulla
  41. Fexofenadine (Allegra), a second-generation antihistamine, differs from first-generation antihistmaines such as diphenhydramine (Benadryl) by?
    Decreased sedation
  42. Your 46-year-old patient calls the clinic to speak with the advice nurse.  The patient reports having a cough for the past 4 weeks and says she has been self-treating with Guaifenesin (Robitussin) from the local drug store.  The patient states, "This is barely helping me.  I need something else."  Which of the following statements is the most appropriate?
    "Because your cough has been with you for so long, it's best if you come to the clinic for a checkup."
  43. Which of the following patients should refrain from pseudoephedrine (Sudafed) therapy?
    The patient with severe hypertension
  44. Which of the following statements would be appropriate for patient teaching regarding pseudoephedrine (Sudafed) therapy?
    In addition to this medication, you should use a humidifier and drink at least 10 glasses of water a day.
  45. Patient teaching for the patient receiving dextromethorphan (Benylin) should include
    Do not drive until you see how this drug affects you.
  46. Patient teaching for the patient taking Fexofenadine (Allegra) should include
    Try sugarless gum or candy if your mouth is dry.
  47. For the hospitalized patient, a priority nursing diagnosis for the patient receiving hydrocodone bitartrate is
    Risk for constipation
  48. Patient teaching for the patient receiving pseudoephedrine (Sudafed) should include
    Do not take any OTC medications without asking your doctor or pharmacist
  49. Your patient has a viral upper respiratory infection, and dextromethorphan (Benylin) is prescribed every 4 hours.  You note that the patient is taking fluoxetine, a selective serotonin reuptake inhibitor (SSRI).  You would advise this patient to:
    Call if symptoms such as fever, nausea, or hallucinations occur
  50. Your 5-year-old patient has allergic rhinitis.  Which of the following drugs would be best for this?
    Cetirizine (Zyrtec)
  51. Which of the following patients should refrain from Fexofenadine (Allegra) therapy?
    The patient that is breast feeding.
  52. A client is being discharged with nasal packing in place.  He should be told to implement which of the following activities into his home care?
    perform frequent mouth care
  53. The nurse is planning to give preoperative instructions to a client who will be undergoing rhinoplasty.  Which of the following instructions should be included?
    Aspirin-containing medications should not be taken for 2 weeks before surgery
  54. The nurse is teaching a client how to manage a nosebleed.  Which of the following instructions would be appropriate to give the client?
    Sit down, lean forward, and pinch the soft portion of your nose
  55. Which of the following assessments would be a priority immediately after nasal surgery?
    Assessing respiratory status
  56. After nasal surgery, the client expresses concern about how to decrease facial pain and swelling while recovering at home.  Which of the following discharge instructions would be most effective for decreasing pain and edema?
    Apply cold compresses to the area
  57. An elderly client had posterior packing inserted to control a severe nosebleed.  After insertion of the packing, the client should be closely monitored for which of the following complications?
  58. Which of the following activities should the nurse teach the client to implement after the removal of nasal packing on the second postoperative day?
    Apply water-soluble jelly to lubricate the nares.
  59. Which of the following statements would indicate to the nurse that a client has understood the discharge instructions provided after her nasal surgery?
    I will take stool softeners and modify my diet to prevent constipation
  60. A client who has undergone outpatient nasal surgery is ready for discharge and the nasal packing in place.  Which of the following discharge instructions would be apropriate for the client?
    Avoid activities that elicit the Valsalva maneuver
  61. A 27-year-old woman has had elective nasal surgery for a deviated septum.  Which of the following would be an important initial clue that bleeding was occurring even if the nasal drip pad remained dry and intact?
    Repeated swallowing
  62. If your client had a pulmonary contusion, for what complication will you watch?
  63. Which complication are fractures of the left lower ribs associated with?
    Splenic Injury
  64. Which physical assessment finding is most frequently associated with a traumatic diaphragmatic rupture?
    Bowel sounds in the chest
  65. What action is most appropriate when an object is impaled in a patient's chest?
    Stabilize the wound site
  66. Signs of a tension pneumothorax on the right side include a tracheal shift toward which side?
    The left with absent breath sounds on the right.
  67. The most common chest wall injuries are:
    Fractures of the 5th through 9th ribs.
  68. To prepare for chest tube removal,  you would:
    disconnect the unit from the suction
  69. A small volume of air enters the pleural space from the lung and is absorbed in a few days.Indicate whether the explanation refers to an:
    closed pneumothorax
  70. A semi-Fowler's position, turning toward the side of the chest tube, coughing, and exhaling help to
    promote drainage
  71. After chest tube removal, your most important patient assessment is for
    any indicators of pneumothorax
  72. Bubbling in the water seal when the patient exhales or coughs tells you that:
    the patient still has air in the pleural space.
  73. Fluctuations of 5-10 mm in the water seal of a gravity drainage system occur
    normally in the patient whose lung hasn't yet reexpanded.
  74. The definitive indicator of lung reexpansion after pleural drainage is
    chest x-ray confirmation
  75. A few days after surgery, your patient's drainage diminishes to little or nothing and the water-seal solution fluctuates with each breath, what does this probably indicate?
    lung has probably reexpanded
  76. Air from the lungs and a chest wound moves in and out of the pleural space as the patient breathes
    open pneumothorax
  77. When a flutter valve is used instead of a traditional chest drainage system, it:
    doesn't work well with serous drainage
  78. Your patient has a gunshot wound and has been treated for an open pneumothorax.  Two hours after placement of her chest tube, you find that she has dislodged it.  What is an appropriate nursing intervention?
    cover the wound with an occlusive dressing, leaving one side untaped
  79. When an attached suction pump is turned off and gravity drainage is begun,  you should
    disconnect the suction pump tubing
  80. Intra pleural pressure collapses the affected lung and pushes mediastinal structures toward the opposite side of the chest:
    tension pneumothorax.
  81. In a one-bottle system that serves as both a water seal and a collection chamber, which additional feature must be present?
    an exit vent to the atmosphere.
Card Set
Respiratory Exam
flash cards for nursing resp exam