Introduction Respiratory System Practice Answer Key

Introduction to Respiratory System Practice Quiz 1. The nurse is caring for a client who is in respiratory distress. The physician orders arterial blood gases (ABGs) to determine various factors related to blood oxygenation. What site can ABGs be obtained from? A) B) The trachea and bronchi C) The pleural surfaces D) A catheter in the arm vein 2. The nurse working in the radiology clinic is assisting with a pulmonary angiography. The nurse knows that when monitoring clients after a pulmonary angiography, what should the physician be notified about? A) Raised temperature in the affected limb B) Excessive capillary refill C) D) Flushed feeling in the client 3. The nurse is in the radiology unit of the hospital. The nurse is caring for a client who is scheduled for a lung scan. The nurse knows that lung scans need the use of radioisotopes and a scanning machine. Before the perfusion scan, what must the client be assessed for? A) Bleeding B) C) Dysrhythmias D) Inflammation 4. The nursing instructor is discussing with senior nursing students about diagnostic procedures used in respiratory diseases. The instructor discusses thoracentesis, defining it as a procedure performed for diagnostic purposes or to aspirate accumulated excess fluid or air from the pleural space. What would the instructor tell the students purulent fluid indicates? A) Cancer B) C) Inflammation D) Heart failure Page 1 5. The client has just had an invasive procedure to assess the respiratory system. What does the nurse know should be assessed on this client? A) Watery sputum B) Loss of consciousness C) D) Masses in pleural space 6. An 18-month-old child is brought to the emergency department by his parents who explain that their child swallowed a watch battery. Radiologic studies show that the battery is in the lungs. Which area of lung is the battery most likely to be in? A) B) Left upper lung C) Right lower lung D) Left lower lung 7. What happens to the diaphragm during inspiration? A) It relaxes and raises. B) . C) It relaxes and flattens. D) It contracts and raises. 8. The nurse is studying for a physiology test over the respiratory system. What should the nurse know about central chemoreceptors in the medulla? A) B) They respond to changes in the O2 levels in the brain. C) They respond to changes in CO2 levels in the brain. D) They respond to changes in O2 levels and bicarbonate levels in the cerebrospinal fluid. 9. What is the difference between respiration and ventilation? A) Ventilation is the process of gas exchange. B) C) Ventilation is the process of getting oxygen to the cells. D) Ventilation is the exchange of gases in the lung. Page 2 10. Perfusion refers to blood supply to the lungs, through which the lungs receive nutrients and oxygen. What are the two methods of perfusion? A) The two methods of perfusion are the bronchial and alveolar circulation. B) The two methods of perfusion are the bronchial and capillary circulation. C) The two methods of perfusion are the bronchial and pulmonary circulation. D) The two methods of perfusion are the alveolar and pulmonary circulation. 11. A nurse is caring for a client who has frequent upper respiratory infections. Which structure is most helpful in protecting against infection? A) Cilia B) Sinus cavity C) Tonsils D) Turbinates 12. The nurse is suctioning a client who is unable to expectorate respiratory secretions. At which point does the nurse expect the client to experience coughing? A) When the catheter reaches the back of the pharynx B) When the catheter enters the main bronchus of the lung C) When the catheter reaches the point of the carina D) When the catheter tickles the uvula 13. A client arrived in the emergency department with a sharp object penetrating the diaphragm. When planning nursing care, which nursing diagnosis would the nurse identify as a priority? A) Acute Pain B) Potential for Infection C) Impaired Gas Exchange D) Ineffective Airway Clearance 14. The nurse is caring for an adolescent client injured in a snowboarding accident. The client has a head injury, a fractured right rib, and various abrasions and contusions. The client has a blood pressure of 142/88 mm Hg, pulse of 102 beats/minute, and respirations of 26 breaths/minute. Which laboratory test best provides data on a potential impairment in ventilation? A) Blood gases B) Complete blood count C) Blood chemistry D) Serum alkaline phosphate Page 3 15. The nurse is analyzing a client's blood pH of 7.1. Which symptom would indicate that the client's body is working to stabilize? A) Respirations are increasing. B) Urine output is decreased. C) Heart rate is regular. D) WBC count is within normal limits. 16. The nurse is providing health education on the body's ability to exchange oxygen and carbon dioxide through the alveolar capillary membrane. Which statement, provided by the nurse, is most correct when asked about diffusion during inspiration? A) During inspiration, the concentration of oxygen is equal in both the alveoli and the capillaries. B) During inspiration, oxygen diffuses from the arterial system through to the alveolar capillary membrane. C) During inspiration, carbon dioxide provides the basis for all diffusion gradients. D) During inspiration, oxygen is greater in the alveoli than in the capillaries. 17. The nurse is caring for clients on the neurologic unit. Which triad of neurologic mechanisms does the nurse identify as most responsible when there is abnormality in ventilation control? A) Medulla oblongata, cerebellum, and heart rate B) Pons, cerebellum, and oxygen receptors C) Medulla oblongata, mitral valve, and central receptors D) Aortic arch, pons, and CO2 receptor sites 18. The nurse is caring for a client with hypoxemia of unknown cause. Which of the following oxygen transport considerations does the nurse identify as crucial to circulate oxygen in the body system? Select all that apply. A) Oxygen is dissolved. B) High blood pressure disrupts oxygen transport. C) Oxyhemoglobin circulates to the body tissue. D) All systemic oxygen is available for diffusion. E) Adequate red blood cells are needed for oxygen transport. 19. The nurse is caring for a client with a decrease in airway diameter causing airway resistance. The client experiences coughing and mucus production. Upon lung assessment, which adventitious breath sounds are anticipated? A) Crackles B) Rhonchi C) Rubs D) Wheezes Page 4 20. The client is returning from the operating room following a bronchoscopy. Which action, performed by the nursing assistant, would the nurse stop if began prior to nursing assessment? A) The nursing assistant is assisting the client to a semi-Fowler's position. B) The nursing assistant is assisting the client to the side of the bed to use a urinal. C) The nursing assistant is pouring a glass of water to wet the client's mouth. D) The nursing assistant is asking a question requiring a verbal response. 21. The nurse is performing a physical assessment on a client who has a history of a respiratory infection. Which documentations, completed by the nurse, indicate the resolution of the infection? Select all that apply. A) Lung fields documented as clear in the bases. B) Palpable vibrations over the chest wall when the client speaks. C) Decreased fremitus when the client speaks “99.” D) Dull sounds percussed over the lung tissue. E) Bronchovesicular sounds heard over the upper lung fields. 22. The student nurse is learning breath sounds while listening to a client in the physician's office. An experienced nurse assists and notes air movement over the trachea to the upper lungs. The air movement is noted equally on inspiration as expiration. Which breath sounds would the nurse document? A) Abnormal vesicular sounds B) Normal bronchial sounds C) Normal bronchovesicular sounds D) Abnormal bronchial sounds 23. The nurse is caring for a client whose respiratory status has declined since shift report. The client has tachypnea, is restless, and displays cyanosis. Which diagnostic test should be assessed first? A) Arterial blood gases B) Pulmonary function test C) Pulse oximetry D) Chest X-ray Page 5 24. The nurse is caring for a client with an exacerbation of COPD and scheduled for pulmonary function studies using a spirometer. Which client statement would the nurse clarify? A) “My study is scheduled for 10 AM, several hours after I eat.” B) “I brought comfortable clothes and shoes for the test.” C) “I am ordered a bronchodilator to note lung improvement following use.” D) “I will breathe in through my mouth and out through my nose.” 25. A client presents to the emergency department in respiratory compromise. The client's temperature is 102.4°F, heart rate 88 beats/minute and regular, and blood pressure 138/76 mm Hg. The client is dyspneic, pale, and expectorating green-tinged sputum. The physician orders medications, including antibiotics, antipyretics, nebulizer treatments, and IV fluids. A chest X-ray and sputum culture are to be completed. Which physician order would the nurse complete before beginning antibiotic therapy? A) Chest X-ray B) Sputum culture C) Nebulizer treatments D) Initiating IV fluids 26. A nurse is obtaining a health history from a client who reports hemoptysis for the past 2 months. The client reports occasional dyspnea. Which imaging study, ordered by the physician, will view the thoracic cavity while in motion? A) Fluoroscopy B) Chest X-ray C) Magnetic resonance imaging (MRI) D) Computed tomography (CT) scan 27. The nurse is instructing the client on the normal sensations, which can occur when contrast medium is infused during pulmonary angiography. Which statement, made by the client, demonstrates an understanding? A) “I will feel a dull pain when the catheter is introduced.” B) “I will feel light-headed when the contrast medium is introduced.” C) “I will feel waves of nausea throughout the procedure.” D) “I will feel warm and an urge to cough.” Page 6 28. The nurse is working on a busy respiratory unit. In caring for a variety of clients, the nurse must be knowledgeable of diagnostic studies. With which diagnostic studies would the nurse screen the client for an allergy to iodine? Select all that apply. A) Lung scan B) Chest X-ray C) Fluoroscopy D) Pulmonary angiography E) Bronchoscopy F) Pulmonary functions test 29. The nurse is caring for a client who states, “I am really worried about the thoracentesis. I know I won't be able to sleep tonight.” Which statement is most helpful to the client at this time? A) “Tell me what you are worried about.” B) “Is there something that I can help you with?” C) “Is there someone that you would like me to call to be with you?” D) “The physician will see you before the procedure and can answer any questions.” 30. The nurse is caring for a client in the immediate post–thoracentesis period. In which position is the client placed? A) In the supine position B) Lying on the unaffected side C) In the high Fowler's position D) Prone with a pillow under the head 31. The nurse receives an order to obtain a sputum sample from a client with hemoptysis. When advising the client of the physician's order, the client states not being able to produce sputum. Which suggestion, offered by the nurse, is helpful in producing the sputum sample? A) Tickle the back of the throat to produce the gag reflex. B) Drink 8 oz of water to thin the secretions for expectoration. C) Use the secretions present in the oral cavity. D) Take deep breaths and cough forcefully. Page 7 32. A client arrives at the physician's office stating 2 days of febrile illness, dyspnea, and cough. Upon assisting the client into a gown, the nurse notes that the client's sternum is depressed, especially on inspiration. Crackles are noted in the bases of the lung fields. Based on inspection, which will the nurse document? A) The client has a funnel chest. B) The client has chronic respiratory disease. C) The client has pneumonia in the bases. D) The client needs a cough suppressant. 33. A client arrives at the physician's office stating dyspnea; a productive cough for thick, green sputum; respirations of 28 breaths/minute, and a temperature of 102.8°F. The nurse auscultates the lung fields, which reveal poor air exchange in the right middle lobe. The nurse suspects a right middle lobe pneumonia. To be consistent with this anticipated diagnosis, which sound, heard over the chest wall when percussing, is anticipated? A) Tympanic B) Resonant C) Hyperresonant D) Dull 34. A client experiences a head injury in a motor vehicle accident. The client's level of consciousness is declining, and respirations have become slow and shallow. When monitoring a client's respiratory status, which area of the brain would the nurse realize is responsible for the rate and depth? A) The pons B) The frontal lobe C) Central sulcus D) Wernicke's area Page 8 Answer Key 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. A C B B C A B A B C C C C A A D D A, C, E D C A, B, E C C D B A D A, C, D A B D A D A Page 9