1. The client reports having thick and sticky sputum. What is the best action the nurse can take to help the clients secretions ?
A. ambulate more often
B. use the incentive spirometer
C. cough and deep breaths
D. drink more fluids
2. When managing the care of clients with conditions such as emphysema, the nurse should recognize which one of the following facts as being more important ?
A. The drive to breathe may be dependent on low levels of oxygen in the blood
B. Lung stretch receptors may fail to monitor the patterns of breathing
C. Respiratory rate may increased a significant but fail to relax during expiration
D. Intercostal muscles contract during inspiration cause of COPD
3. Which of the following is the most common cause of COPD ?
A. Repeated respiratory infections
B. Alcohol abuse
C. Genetic
D. Smoking
4. The nurse places their stethoscope over the anterior third of the chest near the sternum and hears breath sounds that have inspiration and expiration of equal duration. What type of breath sounds is the nurse hearing ?
A. Bronchial
B. Vesicular
C. Bronchovesicular
D. Tracheovesicular
5. A client needs IV fluids. The order reads. “Infuse 0.9% NS 1000 ml over 4 hours.” How may mL’s/hout should be given ? ( round the answer to the nearest whole number. Do not use a trailing zero. Do not label your answer. )
__________
6. On entering the clients room, the nurse notes the client’s oxygen saturation is 85%. Which actions should the nurse take first ?
A. Initiate humidification therapy
B. Raise the head of the bed
C. Encourage the client to cough and deep breathe
D. Increase the client’s fluid intake
7. Which of the following mechanisms are involved in the protection of the respiratory system ?
A. Snoring helps to protect the airway while sleeping
B. Sneezing helps to expel foreign particles
C. Surfactant reduces surface tension and helps to keep alveoli open
D. Mucus produced by goblet cells helps to trap foreign particles
E. Coughing is a respiratory defense mechanism used to keep the airway open
8. The nurse is performing a respiratory assessment on her client and hears an abnormal sound in the lower, posterior lobe of the right lung on inspiration that sounds like a fine snap and popping sound. She recognizes the adventitious breath should be which of the following ?
A. Rhonchi
B. Crackles
C. Wheezing
D. Apnea
9. A client with a known DVT reports a sudden onset of dyspnea. What is the priority action in this situation ?
A. Conduct a full head to toe assessment
B. Contact the provider
C. Administer oxygen
D. Reposition the client
10. The nurse receives a lab report on a resident in long term care. Which positive result requires immediate intervention ?
A. Candida albicans
B. Pseudomonas
C. staphylococcus
D. Acid-fast bacillus
11. Which of the following are signs and symptoms of sinusitis ?
A. Purulent nasal drainage, epistaxis
B. Clear nasal drainage, tenderness over the sinuses
C. Epistaxes, nasal stuffiness
D. Tenderness over the sinus, tooth pain
12. A client diagnosed with the flu asks the nurse why he was not given an antibiotic. What is the best response by the nurse ?
A. “T will speak to the provider about this.”
B. “ Antibiotics are only given for flu A.”
C. “ Antibiotics are only helpful if started within 48 hours of the onset of symptoms.”
D. “ Flu is a viral illness, so antibiotics will not help.”
13. Which of the following conditions is most likely to result in a barrel-shaped chest ?
A. Influenza
B. Tuberculosis
C. Pneumonia
D. COPD
14. What is the best way to avoid the cold virus ?
A. Wear a surgical mask
B. Do not touch any surfaces
C. Take high doses of vitamin c
D. Frequent hand washing
15. 1 cup = ____ ounces
16. If medication for primary pulmonary hypertensions fails, what is the best option for the client?
A. Heart transplantation
B. There is no further treatment
C. Lung reduction surgery
D. Lung transplantation
17. The nurse is preparing to instruct the client with pneumonia on managing the disease after discharge from the hospital. Which of the following is consistent with appropriate discharge planning for this client ?
A. Take all prescribed antibiotics until they are finished
B. Maintain a supine position when sleeping.
C. Continue to eat three main meals a day and do not worry about fluid intake
D. Avoid contact with all family members for one week
18.
19. A client with tuberculosis tells the nurse that he has not been taking his prescribed medication. What is the next most appropriate action of the nurse ?
A. Notify the clients provider immediately
B. Notify the department of health
C. Explore the clients reasons for nothing the medication
D. Place the client in contact isolation
20. The LPN is performing data collection on a client. The pulse oximeter reads 79% on room air. The client is speaking normally with no complaints of shortness of breath. What is the priority intervention by the nurse ?
A. Repostions the sensor
B. Consult the charge nurse
C. Apply oxygen
D. Call a rapid response
21. A client presents to the urgent care clinic with a nose bleed (epistaxis). The nurse is aware that this condition could be minor or could lead to hypovolemic shock if significant blood loss has occurred. Select the correct answer below that is the main goal of treatment for nosebleeds.
A. Do not be concerned with aspiration at this point
B. Stop the bleeding
C. Type and cross two units of blood
D. Pinch the nose with two finger for one minute
22. The nurse is performing a focused respiratory assessment on a client with an asthma exacerbation. What sound would the nurse expect to hear ?
A. Rhonchi
B. Stridor
C. Crackles
D. wheezes
23. “Barrel chest” in emphysema clients occurs as the result of which of the following ?
A. Chronic overdistension of the lungs
B. Chronically high hematocrit
C. Chronic use of oxygen
D. Chronic rapid respirations
24. A client comes to urgent care with a family member who reports that the client is having an asthma attack. On auscultation, the nurse hears absent sounds. Which of the following actions should the nurse do next ?
A. Start CPR
B. Alert the provider immediately
C. Lie the client down and keep calm
D. Tell the client to puff his inhaler
25. Which of the following disorders is more common in clients with COPD than the general population ?
A.
B.
C. Gastroesophageal reflux disease
D. Peptic ulcer disorder
26. The major risk factor for cancer of the larynx is which of the following ?
A. Tonsillectomy
B. Recurrent strep infection
C. Smoking
D. Hot liquids
27. When the nurse is collecting subjective data while caring for a client with asthma, which of the following is the most important history term to know ?
A. Dairy products are safe to eat/drink at any time
B. What stimulus triggers the asthma response ?
C. Fluids are not as important with asthma clients.
D. Does the client remove all possible triggers ?
28. The nurse is aware that coarse crackles, sonorous and sibilant wheezes, pleural friction rub, and stridor are examples of which type of breath sounds ?
A. Bronchial
B. Adventitious
C. Bronchial vesicular
D. Vesicular
29. Which statement is true about the purified protein derivative (PPD) test for tuberculosis (TB)?
A. It helps distinguish between active and latent disease
B. It is used to screen health care workers
C. It is administered via the intramuscular route
D. It is not useful in screening clients who have been exposed to TB.
30. A client has nail polish on their fingernails and toenails. Which of the following locations would be the best place to apply the pulse oximeter probe ?
A. Earlobe
B. Toe
C. Finger
D. Forehead
31. Which of the following should be removed from the food tray of a client who had a tonsillectomy ?
A. Ice
B. Ice cream
C. Plastic straw
D. Apple juice
32. The highest priority for the client with epiglottis is which of the following ?
A. Hydration
B. Antibiotic therapy
C. Pain control
D. Airway protection
33. Which adventitious breath sound indicates an airway obstruction ?
A. Crackles
B. Friction rub
C. Wheezing
D. Stridor
34. Which client below should receive the pneumococcal vaccine ?
A. 60-year old recovering from the flu
B. 55-year old healthy female
C. 25-year old with cystic fibrosis
D. 48-year old to be admitted for a cardiac catheterization
35. A client with primary pulmonary hypertension tells the nurse, “it is so unfair that I got his disease. I am so depressed.” What is the most appropriate response by the nurse ?
A. “ Sometimes life is unfair.”
B. “ Tell me more about your feelings.”
C. “At least you don’t have cancer.”
D. “ I will speak to your doctor about ordering you something for depression.”
36. Which client below is at risk for atelectasis ?
A. A client with asthma exacerbation
B. A client with a hip replacement who is ambulating
C. A client with tonsillectomy who reports ai with swallowing
D. A client who had chest surgery and reports pain of 8/10
37. A client weighs 109 lbs. What is the client’s weight in kg ? ( Record answer to the nearest tenth. Do not use a trailing zero. Do not label your answer )
_______
38. A client with COPD tried to quit smoking but failed. What is the most appropriate next action by the nurse ?
A. Encourage the client to try again
B. Do nothing the client already has significant lung damage
C. Explain to the client that they are risk of death
D. Suggest the client use vaping products instead
39. A client on the medical -surgical unit begins having difficulty breathing the after admission. A chest X-ray is ordered, and the client is diagnosed with pneumonia. Which of the following correctly identifies this type of pneumonia ?
A. Healthcare-associated pneumonia
B. Hospital-acquired pneumonia
C. Ventilator-associated pneumonia
D. community – acquired pneumonia
40. A medication order states, administer furosemide oral solution 20 mg PO stat. Available is furosemide 40mg/5 mL oral solution. How many mL should the nurse administer ? ( record the answer to the nearest tenth 25. Use a leading zero if it applies. Do not use a trailing zero. Do not label your answer. )
_________
41. The nurse has received reports from the off- going shift. Which of the following clients would have the highest priority ?
A. A client who is short of breath
B. A client whose IV antibiotic dose is due
C. A client with temperature of 101.4 F
D. A client who is requesting pain medication
42. Which of the following is a known cause of asthma ?
A. Genetics
B. Vitamin deficiency
C. col d weather
D. Allergens
43. Which factors below make elderly clients more susceptible to respiratory complications ? (select all that apply.)
A. Increased lung elastic recoil
B. Decreased ciliary action
C. Senile pneumothorax
D. Muscle atrophy
E. Decreased cough reflex
44. A client in the medical – surgical unit asks the nurse why he must get enoxaparin injections. What is the most appropriate response by the nurse ?
A. “Enoxaparin is given to prevent blood clots until you are more active.”
B. “Enoxaparin can be given as needed, so you can stop taking if you want.”
C. “Enoxaparin is used to increase your red blood cells while healing.”
D. “Enoxaparin is given to prevent hospital-acquired pneumonia.”
45. Which of the following is a common side effect of albuterol ?
A. Nausea
B. Heartburn
C. Itching
D. Rapid heartbeat
46. What is the cause of cystic fibrosis ?
A. Asbestos
B. Breathing fumes
C. Smoking
D. Genetic
47. Which of the following actions is not associated with transmission of influenza ?
A. Sharing a beverage with an infected person
B. Contact with an infected person
C. Contact with the virus on inanimate objects
D. Going out in the cold with no hat
48. A client has been diagnosed with strep pharyngitis and given antibiotics by the provider. The client asks when she will no longer be contagious. What is the best response by the nurse ?
A. “ You will no longer be contagious after 48 hours on antibiotics.”
B. “ You will no longer be contagious after 24 hours on antibiotics.”
C. “You will no longer be contagious when your symptoms are gone .”
D. “You will no longer be contagious when you have finished the antibiotics .”
49. The nurse is getting a client ready for a chest computerized axial tomography (CAT) scan with contrast. WHat is the priority data to collect for this client ?
A. Has the client had a CAT scan in the past ?
B. Is the client claustrophobic ?
C. Is the client allergic to shellfish ?
D. Is the client able to sit up straight ?
50. 1 teaspoon = ____ ML
51. Which of the following statements is not true about healthcare – associated pneumonia ?
A. It is relatively easy to treat
B. It increases the cost of health care
C. It lengthens the hospital stay for the client
D. It can be prevented by vigilant nursing and respiratory care
52. Which of the following is not a treatment for epistaxis ?
A. Ice packs
B. Direct pressure
C. Tilting the head back
D. Resting quietly
53. A medication order states, administer digoxin 0.5 mg PO stat. Available is digoxin 0.25 mg/tablet. How many tablet(s) should the nurse administer ? (record answer as a whole number, do not use a trailing zero. Do not label your answer.)
________
54. Which of the following should not be given to a client with s recent tonsillectomy ? (select all that apply.)
A. Pudding
B. Jello – O
C. Orange juice
D. Hot tea
E. Toast
55. A medication order states, administer prednisone 30 mg for acute asthma. Available is prednisone 10 mg tablets. How many tablet(s) should the nurse administer ? ( Round answer to the nearest whole number. Do not use a trailing zero. Do not label your answer)
___________________
56. The client has an oxygen saturation level of 82%. Which of the following findings would be most concerning ?
A. Dry skin
B. Confusion
C. Nausea
D. Temp of 100.2 F
57. Which of the following is not a symptom of throat cancer ?
A. Sore throat for more than 2 weeks
B. Enlarged cervical lymph nodes
C. Nasal pain
D. Difficulty swallowing
58. Which of the following clients are at risk for acute respiratory distress syndrome (ARDS) (select all that apply.)
A. A client who sustained multiple trauma in a motor vehicle crash
B. A client with sepsis who is mechanically ventilated
C. A client who has been recently diagnosed with tuberculosis
D. A client with pneumonia being treated as an outpatient
E. A client with an asthma exacerbation
59. The LPN is changing the ties around a tracheostomy tube. What is the priority action of the nurse ?
A. Place a nasal cannula on the client while changing the tube
B. Have the client hold his/her breathe until the procedure is done
C. Pre-treat the client with 100% oxygen
D. Hold the tracheostomy tube in place at all times
60. Untreated strep pharyngitis can lead to which of the following ?
A. Throat cancer
B. Airway obstruction
C. Pneumonia
D. Glomerulonephritis
61. The nurse is caring for a client who just came to the floor after having a tonsillectomy. Which symptom below requires immediate intervention ?
A. Pain with swallowing
B. Frequent swallowing
C. Fatigue
D. Sore throat
62. Which of the following devices can help clients with asthma monitor their symptoms at home?
A. Peak flow meter
B. Nasal cannula
C. Incentive spirometer
D. Pulse oximeter
63. A client is recovering from laryngoscopy. The client asks when he can have something to eat. What is the best response by the nurse ?
A. “ You can eat when your gag reflex returns .”
B. “ You can eat when your cough reflex returns.”
C. “ You can eat in 2 hours .”
D. “ You can eat when you are discharged .”
64. A client comes to the clinic, stating that he is having an “asthma attack.” Which adventitious breath sound should the nurse expect to hear ?
A. Friction rub
B. Crackles
C. Stridor
D. Pulse oximeter
65. Which of the following measures should the nurse take when caring for a client with TB in an acute care facility ?
A. Wear an N95 mask
B. Place in room closest to nurse station
C. Instruct the lenient to always wear a surgical mask
D. Follow contact precautions with the client
66. A 72-year old female client is about to be discharged home after being in the hospital for 3 days with bronchitis. Which of the following should be included in her discharge teaching ?
A. Only rest once or twice per day for short naps
B. Limit fluid intake
C. Avoid respiratory irritants, large crowds, and people who are coughing
D. Take all your medication until you feel better
67. 1 gram = _____mg
68. A client with active tuberculosis will be admitted to a medical surgical floor. What should the nurse do before the client arrives ?
A. Place surgical masks outside the room
B. Call maintenance to check the negative-pressure room
C. Place gown and gloves outside the room
D. Alert security that no one can visit the client
69. Acute bronchitis is usually caused by which of the following ?
A. Fungi
B. Viruses
C. Bacteria
D. Smoking
70. A newly admitted client has an audible expiratory wheeze. Which of the following is most liek;y the cause of the wheeze ?
A. Pneumonia
B. Congestive heart failure
C. Asthma
D. sinusitis
71. The LPN is performing data collection on a client who has limited mobility because of bilateral femur fractures. The client reports sudden onset of painful respiration and shortness of breath. Which of the following is the priority action for the nurse to take ?
A. Increase the IV fluids
B. Lie the client flat and keep calm
C. Place the client on a 100% non-rebreather mask and call for help
D. Page the clients provider
72. A client tells the nurse, “ I don’t want to get the flu shot because I heard it can give you the flu.” which below is the best response by the nurse ?
A. “There a no side- effects associated with the flu vaccine.”
B. “The flu vaccine is 100% effective at preventing the flu, so if I were you, I would get it.”
C. “It is rare but possible to get the flu from the flu vaccine.”
D. “You may get mild aches and pains , but you will not get the flu from the flu vaccine.”
73. Why is early detection of tuberculosis important ? (select all that apply)
A. The spread to others will be minimized
B. The client will experience less side-effects from the medication
C. Early detection makes treatment more effective
D. The client will have fewer complications
E. The period of disability will be shorter for the client
74. A nurse is discussing diagnostic tests with the parents of a child who is suspected of having cystic fibrosis. Which diagnostic text can the nurse anticipate the child will need ?
A. Sweat chloride test
B. Pulmonary function test
C. Sputum culture
D. Stoo; fat content analysis
75. Which of the following is a common cause of pulmonary edema ?
A. Chronic bronchitis
B. Left ventricular failure
C. Pneumonia
D. Asthma
