Respiratory Disorders of the Adult Client

625. The emergency department nurse is assessing a client

who has sustained a blunt injury to the chest
wall. Which finding indicates the presence of a
pneumothorax in this client?
1. A low respiratory rate
2. Diminished breath sounds
3. The presence of a barrel chest
4. A sucking sound at the site of injury

626. The nurse is caring for a client hospitalized with

acute exacerbation of chronic obstructive pulmonary
disease. Which findings would the nurse
expect to note on assessment of this client? Select
all that apply.
1. A low arterial PCo2 level
2. Ahyperinflated chest noted on the chest x-ray
3. Decreased oxygen saturation with mild exercise
4. A widened diaphragm noted on the chest x-ray
5. Pulmonary function tests that demonstrate increased vital capacity

627. The nurse instructs a client to use the pursed-lip

method of breathing and evaluates the teaching
by asking the client about the purpose of this type
of breathing. The nurse determines that the client
understands if the client states that the primary
purpose of pursed-lip breathing is to promote
which outcome?
1. Promote oxygen intake
2. Strengthen the diaphragm
3. Strengthen the intercostal muscles
4. Promote carbon dioxide elimination

628. The nurse is preparing a list of home care instructions

for a client who has been hospitalized and treated for
tuberculosis. Which instructions should the nurse
include on the list? Select all that apply.
1. Activities should be resumed gradually.
2. Avoid contact with other individuals, except
family members, for at least 6 months.
3. A sputum culture is needed every 2 to 4 weeks
once medication therapy is initiated.
4. Respiratory isolation is not necessary because
family members already have been exposed.
5. Cover the mouth and nose when coughing or
sneezing and put used tissues in plastic bags.
6. When 1 sputum culture is negative, the client
is no longer considered infectious and
usually can return to former employment.

629. The nurse is caring for a client after a bronchoscopy

and biopsy. Which finding, if noted in the client,
should be reported immediately to the health care
provider?
1. Dry cough
2. Hematuria
3. Bronchospasm
4. Blood-streaked sputum

630. The nurse is preparing to suction a client via a tracheostomy

tube. The nurse should plan to limit the suctioning
time to a maximum of which time period?
1. 5 seconds
2. 10 seconds
3. 30 seconds
4. 60 seconds

631. The nurse is suctioning a client via an endotracheal

tube. During the suctioning procedure, the nurse
notes on the monitor that the heart rate is decreasing.
Which nursing intervention is appropriate?
1. Continue to suction.
2. Notify the health care provider immediately.
3. Stop the procedure and reoxygenate the client.
4. Ensure that the suction is limited to 15 seconds.

632. The nurse is assessing the respiratory status of a client

who has suffered a fractured rib. The nurse
should expect to note which finding?
1. Slow, deep respirations
2. Rapid, deep respirations
3. Paradoxical respirations
4. Pain, especially with inspiration

633. A client with a chest injury has suffered flail chest.

The nurse assesses the client for which most distinctive
sign of flail chest?
1. Cyanosis
2. Hypotension
3. Paradoxical chest movement
4. Dyspnea, especially on exhalation
634. A client has been admitted with chest trauma after a
motor vehicle crash and has undergone subsequent
intubation. The nurse checks the client when the
high-pressure alarm on the ventilator sounds,
and notes that the client has absence of breath
sounds in the right upper lobe of the lung. The nurse
immediately assesses for other signs of which
condition?
1. Right pneumothorax
2. Pulmonary embolism
3. Displaced endotracheal tube
4. Acute respiratory distress syndrome

635. The nurse is assessing a client with multiple trauma

who is at risk for developing acute respiratory
distress syndrome. The nurse should assess for
which earliest sign of acute respiratory distress
syndrome?
1. Bilateral wheezing
2. Inspiratory crackles
3. Intercostal retractions
4. Increased respiratory rate

636. The nurse is discussing the techniques of chest

physiotherapy and postural drainage (respiratory
treatments) to a client having expectoration problems
because of chronic thick, tenacious mucus
production in the lower airway. The nurse explains
that after the client is positioned for postural drainage
the nurse will perform which action to help
loosen secretions?
1. Palpation and clubbing
2. Percussion and vibration
3. Hyperoxygenation and suctioning
4. Administer a bronchodilator and monitor peak flow

637. The nurse has conducted discharge teaching with a

client diagnosed with tuberculosis who has been
receiving medication for 2 weeks. The nurse determines
that the client has understood the information
if the client makes which statement?
1. “I need to continue medication therapy for
1 month.”
2. “I can’t shop at the mall for the next 6 months.”
3. “I can return to work if a sputum culture comes
back negative.”
4. “I should not be contagious after 2 to 3 weeks of medication therapy.”
638. The nurse is preparing to give a bed bath to an
immobilized client with tuberculosis. The nurse
should wear which items when performing this care?
1. Surgical mask and gloves
2. Particulate respirator, gown, and gloves
3. Particulate respirator and protective eyewear
4. Surgical mask, gown, and protective eyewear

639. A client has experienced pulmonary embolism.

The nurse should assess for which symptom, which
is most commonly reported?
1. Hot, flushed feeling
2. Sudden chills and fever
3. Chest pain that occurs suddenly
4. Dyspnea when deep breaths are taken

640. A client who is human immunodeficiency virus

(HIV)–positive has had a tuberculin skin test
(TST). The nurse notes a 7-mm area of induration
at the site of the skin test and interprets the result as
which finding?
1. Positive
2. Negative
3. Inconclusive
4. Need for repeat testing

641. A client with acquired immunodeficiency syndrome

(AIDS) has histoplasmosis. The nurse
should assess the client for which expected finding?
1. Dyspnea
2. Headache
3. Weight gain
4. Hypothermia

642. The nurse is giving discharge instructions to a client

with pulmonary sarcoidosis. The nurse concludes
that the client understands the information if the
client indicates to report which early sign of
exacerbation?
1. Fever
2. Fatigue
3. Weight loss
4. Shortness of breath

643. The nurse is taking the history of a client with occupational

lung disease (silicosis). The nurse should
assess whether the client wears which item during
periods of exposure to silica particles?
1. Mask
2. Gown
3. Gloves
4. Eye protection

644. An oxygen delivery system is prescribed for a client

with chronic obstructive pulmonary disease to
deliver a precise oxygen concentration. Which oxygen
delivery system would the nurse prepare for the
client?
1. Face tent
2. Venturi mask
3. Aerosol mask
4. Tracheostomy collar

645. The nurse is instructing a hospitalized client with a

diagnosis of emphysema about measures that will
enhance the effectiveness of breathing during dyspneic
periods. Which position should the nurse
instruct the client to assume?
1. Sitting up in bed
2. Side-lying in bed
3. Sitting in a recliner chair
4. Sitting up and leaning on an overbed table

646. The community health nurse is conducting an

educational session with community members
regarding the signs and symptoms associated with
tuberculosis. The nurse informs the participants that
tuberculosis is considered as a diagnosis if which
signs and symptoms are present? Select all that
apply.
1. Dyspnea
2. Headache
3. Night sweats
4. A bloody, productive cough
5. A cough with the expectoration of mucoid sputum

647. The nurse performs an admission assessment on a

client with a diagnosis of tuberculosis. The nurse
should check the results of which diagnostic test
that will confirm this diagnosis?
1. Chest x-ray
2. Bronchoscopy
3. Sputum culture
4. Tuberculin skin test
648. The low-pressure alarm sounds on a ventilator. The
nurse assesses the client and then attempts to determine
the cause of the alarm. If unsuccessful in
determining the cause of the alarm, the nurse
should take what initial action?
1. Administer oxygen
2. Check the client’s vital signs
3. Ventilate the client manually
4. Start cardiopulmonary resuscitation