NCLEX Questions: Respiratory Disorders

NCLEX Questions: Respiratory Disorders

ScienceMedicinePulmonology melanie_gangapersaud Save Respiratory Disorders NCLEX questi...43 terms SetfiretoitPreview Respiratory NCLEX Questions 131 terms rwillia2Preview Med-Surge Respiratory Disorders N...78 terms wmk14001Preview Cardiac 50 terms Nar Dr. Jones prescribes albuterol sulfate (Proventil) for a patient with newly diagnose asthma. When teaching the patient about this drug, the nurse

should explain that it may cause:

• Nasal congestion
• Nervousness
• Lethargy
• Hyperkalemia
• Nervousness

Albuterol may cause nervousness. The inhaled form of the drug may cause dryness and irritation of the nose and throat.Hypokalemia may occur with high doses.Other adverse effects of albuterol include tremor, dizziness, headache, tachycardia, palpitations, hypertension, heartburn, nausea, vomiting, and muscle cramps.Miriam, a college student with acute rhinitis sees the campus nurse because of excessive nasal drainage. The nurse asks the patient about the

color of the drainage. In a acute rhinitis, nasal drainage normally is:

• Yellow
• Green
• Clear
• Gray
• Clear

Nasal drainage in acute rhinitis is clear.Yellow or green drainage would indicate an infection.Grey drainage would indicate a secondary infection.

A male adult patient hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis?

• Nausea or vomiting
• Abdominal pain or diarrhea
• Hallucinations or tinnitus
• Lightheadedness or paresthesia
• Lightheadedness or paresthesia

Patient with respiratory alkalosis may complain of lightheadedness or paresthesia (numbness & tingling in arms and legs).Nausea, vomiting, abdominal pain, & diarrhea may accompany respiratory acidosis.Hallucinations & tinnitus are rarely associated with respiratory alkalosis & any other acid-base imbalance.Before administering ephedrine, Nurse Tony assesses the patient's history. Before of ephedrine's central nervous system (CNS) effects, it is not

recommended for:

• Patients with an acute asthma attack
• Patients with narcolepsy
• Patients under age 6
• Elderly patients
• Elderly patients

Ephedrine is not recommended for elderly patients who are particularly susceptible to CNS reactions (like confusion & anxiety) & to cardiovascular reactions (such as increased systolic blood pressure, coldness in extremities, & angina pain).Ephedrine is used for its bronchodilator effects with acute & chronic asthma & occasionally for its CNS stimulant actions for narcolepsy.It can be administered to children age 2 & older.A female patient suffers adult respiratory distress syndrome as a consequence of shock. The patient's condition deteriorates rapidly, & the endotracheal intubation & mechanical ventilator are initiated. When the high pressure alarm on the mechanical ventilator, alarm sounds, the nurse starts to check for the cause. Which condition triggers the high pressure alarm?

• Kinking of the ventilator tubing
• A disconnected ventilator tube
• A endotracheal cuff leak
• A change in the oxygen concentration without setting the oxygen level alarm
• Kinking of the ventilator tubing

The high pressure alarm can be triggered by kinking of the ventilator tubing, bronchospasm, pulmonary embolus, mucus plugging, water int he tube, coughing or biting on endotracheal tube, or patient being out of breathing rhythm with the ventilator.

A male adult patient on mechanical ventilation is receiving pancuronium bromide (Pavulon), 0.01 mg/kg I.V. as needed. Which assessment finding indicates that the patient needs another pancuronium dose?

• Leg movement
• Finger movement
• Lip movement
• Fighting the ventilator
• Fighting the ventilator

Pancuronium is a non depolarizing blocking agent and is used for muscle relaxation and paralysis. It assists mechanical ventilation by promoting endotracheal intubation & paralyzing the patient so that the mechanical ventilator can do its work. Fighting the ventilator is a sign that the patient needs another dose.On auscultation, which finding suggests a right pneumothorax?

• Bilateral inspiratory and expiratory crackles
• Absence of breath sounds in the right thorax
• Inspiratory wheezes in the right thorax
• Bilateral pleural friction rub
• Absence of breath sounds in the right thorax

With a pneumothorax, the alveoli are deflated and no air exchange occurs. Therefore, breath sounds in the affected lung field are absent.Bilateral crackles may result from pulmonary congestion.Inspiratory wheezes may signal asthma.Pleural friction rub may indicated pleural inflammation.Rhea, confused and short breath, is brought to the emergency department by a family member. The medical history reveals chronic bronchitis and hypertension. To learn more about the current respiratory problem, the doctor orders a chest x-ray and arterial blood gas (ABG) analysis.When reviewing the ABG report, the nurses sees many abbreviations. What does a lowercase "a" in ABG value present?

• Acid-base balance
• Arterial Blood
• Arterial oxygen saturation
• Alveoli
• Arterial blood

A lowercase "a" in an ABG value represents arterial blood.

A male patient is admitted to the health care facility for treatment of chronic obstructive pulmonary disease. Which nursing diagnosis is most important for this patient?

• Activity intolerance related to fatigue
• Anxiety related to actual threat to health status
• Risk for infection related to retained secretions
• Impaired gas exchange related to airflow obstruction
• Impaired gas exchange related to airflow obstruction

Patient's airway & an adequate breathing pattern are the top priority for any patient, therefore "impaired gas exchange related to airflow obstruction" is the most important.Nurse Ruth assessing a patient for tracheal displacement should know that the trachea will deviate toward the:

• Contralateral side in a simple pneumothorax
• Affected side in a hemothorax
• Affected side in a tension pneumothorax
• Contralateral side in hemothorax
• Contralateral side in hemothorax

The trachea will shift according to the pressure gradients within the thoracic cavity. In tension pneumothorax & hemothorax, acumulation of air or fluid causes a shift away from the injured side. If there is no significant air or fluid acumulation, the trachea will not shift.After undergoing a left pneumonectomy, a female patient has a chest tube in place for drainage. When caring for this client, the nurse must:

• Report fluctuations in the water-seal chamber.
• Clamp the chest tube once every shift.
• Encourage coughing and deep breathing.
• Milk the chest tube every 2 hours.
• Encourage coughing and deep breathing

When caring for a patient who is recovering from a pneumonectomy, the nurse should encourage coughing & deep breathing to prevent pneumonia in the unaffected lung.Since the lung has been removed, the water seal chamber should display no fluctuations.When caring for a male patient who has just had a total laryngectomy, the nurse should plan to:

• Encourage oral feeding as soon as possible
• Develop an alternative communication method
• Keep the tracheostomy cuff fully inflated
• Keep the patient flat in bed
• Develop an alternative communication method

This patient will not be able to speak and still needs to be able to communicate.To decrease the swelling, the patient should be in semi-fowler's position.