NINE (⁠◕⁠ᴗ⁠◕⁠✿⁠) MEDSURG (1) COMPAPP PRETEST

1. the nurse is monitoring a client who has recently 5. The nurse is developing a plan for a client who is
undergone pericardiocentesis, the nurse suspects going home with a new diagnosis of heart failure.
cardiac The nurse is teaching the client to monitor fluid
tamponade after observing which of the following? status. The best instruction is to teach the client to
do which of the following?
a. rapid increase in blood pressure and
flushing a. Restrict fluid intake to 800 mL per day
b. jugular vein distention ( jvd. and narrowing b. increase the dose of diuretics if there is
pulse pressure) decreased urination
c. bradycardia and bilateral crackles c. Record body weight everyday before
d. louder and harsher heart sounds breakfast and record a weight gain of 3 or
more pounds in a week.
2. a 54-year-old male client was recently diagnosed d. Keep track of daily output and call the
with subacute Bacterial endocarditis (sbe), the nurse doctor if it is less than 1 L on any day.
determines that the client understands the discharge
teaching when he does which of the following? 6. The nurse is caring for a client who has just had a
cardiac catheterization. The client insists on getting
a. asks for a referral to a dietician for a up to go to the bathroom to urinate immediately
low-sodium diet when he is brought back to his room. Which of the
b. explains to his wife why he needs following would be the nurse's best response?
antibiotics before seeing the dentist
c. asks when he can start to take his antibiotics a. You can't walk yet. tbu may be too weak
in pill form after the procedure and may fall."
d. explains his plans to quit smoking b. If you bend your leg, you will rsk bleeding
from the insertion site. It is an artery, and
3. The nurse on a cardiac unit is caring for a client it could lead to complications."
admitted with an acute exacerbation of heart failure. c. "If you get out of bed, you may have an
The nurse concludes that the client is developing arrhythmia from the catheterization. Your
pulmonary edema after observing which change in heart has to rest after this procedure.
the client? d. "The doctor has ordered that you stay on
bedrest for the next 6 hours. It is important
a. Bradycardia that you follow these orders."
b. Increased urination
c. Cough with pink frothy sputum 7. A client is getting ready to go home after a
d. Increased sleepiness myocardial infarction (MI), The client is asking
questions about his medications, and wants to know
4. A client is scheduled for a cardiac angiography. In why metoprolol (Lopressor was prescribed. The
reviewing the client's record what significant finding nurse's best response would be which of the
needs to be following?
reported to the physician Before the exam?
a. "Your heart was resting too slowly, and
a. The client reported an allergy to shrimp. Lopressor increases your heart rate."
b. The client 's ECG shows atrial fonillaticn. b. "Lopressor helps to increase the blood
c. The potassium level is 5.0 mEq/L supply to the heart by dilating your
d. The client has a history of chronic renal coronary arteries."
failure.

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NINE (⁠◕⁠ᴗ⁠◕⁠✿⁠) MEDSURG (1) COMPAPP PRETEST

c. This medication helps make your heart beat b. pH= 7.50: Pa02=50; PaCO2 =55; HCO3=27
stronger to supply more blood to your booy. c. pH=7.20; Pa02=50; PaC02 =35; HC03=27
d. "It slows your heart rate and decreases the d. pH=7.50; Pa02=50; PaCO2 =35; HCO3=27
amount of work it has to do so it can heal."
12. Upon assessment you noticed that he has an over
8. A dient is taking digoxin (Lanoxin, and furosemide accumulation of secretion. The physician orders
(Lasix. for heart failure. Which of the following would suctioning this is
be the Best menu choices for this dient? done properly by:

a. Chicken with baked potato and banana a. hyperoxygenate him before and after
b. Eggs and ham suctioning
c. Grilled cheese sandwich and French fried b. suction him for at least 30 seconds
potatoes c. Use clean technique during the Suctioning
d. pizza with pepperoni d. Keep him flat while suctioning

9. A nurse is preparing to admit a client with 13. Which nursing diagnosis is most important for
restrictive cardiomyopathy to the hospital for the this dient?
management of worsening heart failure. Which of the
following would be the most appropriate nursing a. Activity intolerance related to fatigue
diagnosis for this client? b. Ineffective breathing pattern related to
health status
a. fear related to new onset of symptoms c. Risk for infection related to retained
b. Hopelessness related to lack of cure and secretions
debilitating symptoms d. Impaired gas exchange related to airflow
c. Knowledge deficit related to medication obstruction
regime
d. Activity intolerance related to decreased 14.For this client with advanced COPD, which nursing
cardiac output action best promotes adequate gas exchange?

10. The nurse is preparing to utilize an external a. encouraging the client to drink three glasses
pacemaker for a client with dysrhythmia. The nurse of fluid daily
knows that this pacemaker is often necessary when a b. keeping the client in semi-fowler's position
client is in which of the following cardiac rhythms? c. using a high-flow venturi mask to deliver
oxygen as prescribed Based kay Quizlet
a. Ventricular fibrillation d. administering a sedative as prescribed
b. Atrial Fibrillation
c. Ventricular tachycardia 15. Which of the following should the nurse teach Mr.
d. Second-degree heart block X to encourage proper breathing exercises?

11. Situation: Mr. X is a 60-year-old man admitted to a. encourage pursed-lip breathing

the hospital with difficulty of breathing. He has a b. inhalation should be two to three times that
history of emphysema, which has resulted in chronic of exhalation
obstructive pulmonary disease (COPD. What possible c. encourage high abdominal breathing using
acid/base imbalance would you anticipate to this type the muscles of the diaphragm
of client? d. inhale through the mouth and out through
the nose
a. pH= 7.20; Pa02=50, PaCO2 =55; HCO3=27

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NINE (⁠◕⁠ᴗ⁠◕⁠✿⁠) MEDSURG (1) COMPAPP PRETEST

SITUATION: A client is admitted for chronic SITUATION: Mr. Bates, 27, was admitted because of
bronchitis in the respiratory unit with productive sudden dyspnea. His diagnosis was Spontaneous
cough with copious Bates was admitted to the RR.
sputum. The client seems to be cyanotic and bloated Rneumothorax. He immediately underwent an
emergency surgery for insertion of a chest tube.
16. The nurse teaches a client with COPD to assess After the surgery, Mr. Bates was admitted to the RR.
for signs and symptoms of right-sided heart failure.
Which of the 20. His diagnosis was best described as:
following signs and symptoms should be included in
the teaching plan? a. It is a condition where air enters but can't
leave pleural space.
a. Clubbing of nail beds b. It is a condition where air enters the pleural
b. Peripheral edema space as a result of injury to the chest wall,
c. Hypertension respiratory structures esophagus
d. Increased appetite c. is a condition where air enters the pleural
space when air-filled blebs on the lung
17. When instructing clients on how to decrease the surface rupture.
risk of copd, the nurse should emphasize which of d. None of the above
the following behaviors?
21.Nurse Bols received Mr. Bates at the RR with a
a. Participate regularly in aerobic exercises chest tube inserted and clamped. She would
b. Maintain high-protein diet immediately:
c. Avoid exposure to people with known
respiratory Either sa ila di nga dowa but
based on the Local Board key
a. Check Mr. Jaypee's respiratory status
d. Abstain from cigarette smoking. answers letter C and answer kay
dapat STOP in ABSTAIN
b. Check Mr. Jaypee's chest tubes
c. Check Mr. Jaypee's I and o
18.A client's arterial blood gas values are as follows: d. Check Mr. Jaypee's level of consciousness
pH, 7.31; Pa02, 60 mmHg; PaC02, 65 mmHg; HCO3, 36
mEq/L. Which of the following is not a sign or 22. Mr. Bates' RR is 30/min and shows mild
symptom would the nurse expect? intercostals retractions. He does not exhibit cyanosis.
The nurse's action
a. Cyanosis would be correct is she:
b. Irritability
c. Flushed skin Based kay Nurseslabs a. Connect the chest tube to the water-seal
d. Confusion drainage
b. Flush the chest tube with 30-60 cc of sterile
19. The nurse should place the client in which NSS q6h.
position to effectively perform percussion and c. Milk the chest tube in the direction of the
postural drainage to the patient.
basal segments of his lungs? d. Place client on semi-Fowler's position

a. sitting 23. The nurse determines that the 3-bottle-closed

b. Trendelenburg chest drainage system of Mr. Bates is functioning
c. side-lying effectively ifall,
d. prone but one is present:

a. Bubbling in the second bottle is continuous

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NINE (⁠◕⁠ᴗ⁠◕⁠✿⁠) MEDSURG (1) COMPAPP PRETEST

b. Continuous bubbling in the 3rd bottle c. Fluid in the chest tube

c. Immersed glass rod in the 2nd bottle d. Fluctuation of fluid in the second bottle
fluctuating with patient's breathing
d. Blood seen in the first bottle. 28. Upon further assessment of a client with a chest
tube, you note that his lung are fully expanded, and
24. A client has a chest tube attached to a water-seal the chest tube is scheduled to be removed. During
drainage system and fluid the nurse notes that the the removal procedure, he should be instructed to:
fluid in the
The water seal column has stopped fluctuating. a. hold his breath
Which of the following is the explanation? b. breath normally
c. forcibly exhale while bearing down
a. the lung had expanded d. take several rapid shallow breaths
b. the lung had collapsed e.
c. the chest tube is in the pleural space 29. A chest tube is inserted in a client with
d. the mediastinal space decreases pneumothorax for which of the following reasons?

25. The nurse observes a constant gentle bubbling in a. For administration of oxygen
the second bottle of the water-seal drainage system. b. To promote lung scar formation
The nurse c. To insert antibiotics into the pleural space
should prompt the nurse to do which of the d. To remove air and fluid
following?
30. A man with a ten-year history of asthma presents
a. Continue monitoring as usual; this is with respiratory distress with labored breathing, use
expected of accessory muscles, and audible inspiratory and
b. Check the connectors between the chest expiratory wheezes. Which of the following would
and drainage tubes indicate his condition is worsening?
c. Decrease the suction pressure and continue
observing for the next several hours a. Audible expiratory wheezes with lessening
d. Drain half of the water from the water seal inspiratory wheezes.
chamber b. Increasing expectoration of thick, tenacious
sputum with decreasing wheezing lung
26. Which of the following should be readily available sounds.
at the bedside of a client with chest tube in place? c. Absence of audible inspiratory and
expiratory wheezes with increasing
a. a tracheostomy tray somnolence.
b. another sterile chest tube d. Decreasing respiratory rate with decreased
c. a bottle of sterile water use of accessory muscles.
d. a spirometer
31. alarm (PAP) begins to sound repeatedly. The client
27. A client who is recovering from chest trauma is to is sleeping quietly. What is the most appropriate
be discharged with a chest tube drainage system initial response by the nurse?
intact. The nurse should instruct the client to call the
physician for which of the following? a. Call the respiratory therapist to check the
ventilator.
a. Respiratory rate greater than 16 per minute b. Turn the client to stimulate coughing.
b. Continuous bubbling in the water seal c. Obtain arterial blood for blood gas analysis.
chamber d. Check the ventilator tubing.

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NINE (⁠◕⁠ᴗ⁠◕⁠✿⁠) MEDSURG (1) COMPAPP PRETEST

effective in helping a client who has had abdominal

32. The nurse is assessing a person with surgery to breathe deeply?
long-standing chronic obstructive pulmonary disease
(COPD. Which findings would the nurse expect to a. Oxygen via nasal prongs
find? b. Incentive spirometry.
c. Periodic ambulation.
a. Low-grade fever. d. Verbal encouragement.
b. Weak, thready pulse.
c. Increased chest diameter. 37. An adult is admitted to the surgical floor with a
d. Crepitus. diagnosis of a tumor, right lung. Upon return to the
surgical unit following a right pneumonectomy, the
33. While assessing the client with a history of nurse should place the client in which position?
allergic asthma, the nurse questions the client about
what precipitates an attack. Which is the client a. Left lateral decubitus.
response least likely to include? b. Right lateral decubitus.
c. Semi-Fowler
a. Climate changes. d. High-Fowler
b. Exposure to high pollen and mold counts.
c. Exposure to animal dander. 38. The nurse assesses a client's respiratory status.
d. Seasonal changes. Which observation indicates that the client is
34. An adult is receiving rifampin (Rifadin). Teaching experiencing difficulty breathing?
by the nurse should include alerting the client to
which of the following common side effects? a. Diaphragmatic breathing
b. Use of accessory muscles
a. Vertigo. c. Pursed Lip Breathing
b. Skin rash. d. Controlled breathing
c. Tingling in the feet.
d. Orange-tinged body fluids. 39. A client is admitted to the intensive care unit with
multiple trauma and acute respiratory insufficiency.
35. A child has been brought to the emergency room The physician orders arterial blood gas (ABG,
with an asthma attack. What signs and symptoms analysis to determine the client's ventilatory and gas
would the nurse expect to see? exchange status.
Because the client's arms are in casts from above the
a. A prolonged inspiratory time and a short elbow to the fingertips, the clinician takes the ABG
expiratory time. sample from the femoral artery. After the sample is
b. Frequent productive coughing of clear, drawn, the nurse should apply continuous pressure
frothy, thin mucus progressing to thick, to the puncture site for
tenacious mucus heard only on auscultation.
c. Hypoinflation of the alveoli with resulting a. 3 minutes
poor gas exchange from increasingly b. 5 minutes
shallow inspirations. c. 8 minutes
d. Swelling of the bronchial mucosa, with d. 10 minutes
wheezes starting on expiration and
spreading to continuous. 40. A client with colorectal carcinoma is devastated
after learning that the cancer has spread to the liver
36. To prevent postoperative pulmonary and lungs and the client has only a 5% chance of
complications, which of the following will be most surviving for 5 years.

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NINE (⁠◕⁠ᴗ⁠◕⁠✿⁠) MEDSURG (1) COMPAPP PRETEST

Which comment by the nurse would best help the c. Vitamin K

client cope with this news? d. Heparin
e.
a. "I've seen clients in your situation who have 45. For a client with chronic obstructive pulmonary
lived almost 20 years. disease, which nursing intervention would help
b. "It must be hard to hear that prognosis. maintain a patent airway?
Would it help you to talk to me or the a. Restricting fluid intake to 1,000 ml/day
chaplain?" b. Enforcing absolute bed rest
c. This might be a good time to think about an c. Teaching the client how to perform
advance directive in case you run into controlled coughing
problems while you're here.' d. Administering prescribed sedatives
d. "These are just numbers. You have to live regularly and in large amounts
each day fully and not worry about dying."
46. Which of the following would be most appropriate
41. A client hospitalized for treatment of a pulmonary for a client with an arterial blood gas (ABG. of pH 7.5,
embolism develops respiratory alkalosis. Which PaCO2 26 mm Hg, 02 saturation 96%, HCO3 24
clinical findings commonly accompany respiratory mEa/L, and Pa02 94 mm Hg?
alkalosis?
a. Nausea or vomiting a. Administer a prescribed decongestant
b. Abdominal pain or diarrhea b. Offer the client fluids frequently.
c. Hallucinations or tinnitus c. Instruct the client to breathe into a paper
d. Light-headedness or paresthesia bag.
d. Administer prescribed supplemental
42. The nurse is caring for a client who has just oxygen.
returned to the surgical unit following a femoral
arteriogram. Which initial assessment by the nurse is 47. The nurse observes constant bubbling in the
most essential? water-seal chamber of a closed chest drainage
a. Auscultating the lungs: system. What should the nurse conclude?
b. Palpating the carotid pulse
c. Obtaining a blood pressure. a. The system is functioning normally.
d. Inspecting the groin area. b. The client has a pneumothorax,
c. The system has an air leak
43. The nurse is caring for a man who has angina. He d. The chest tube is obstructed.
complains of chest pain. Nitroglycerin is given
because it 48. An adult male is transferred to the step-down
a. slows and strengthens the heart rate. unit on the third day after a myocardial infarction.
b. increases venous return to the heart. Which of the following should the nurse include in
c. assists smooth muscles to contract. his care plan at this time?
d. reduces both preload and afterload.
a. Enforcing complete bed rest,
44. A patient has received thromboembolytic therapy b. Performing passive range of motion
following a Myocardial Infarction with Streptokinase. exercises.
Which of the following drugs should the nurse have c. Supervising short walks in the hallway.
on hand if the patient develops excessive bleeding or d. Having him sit on the side of the bed and
hemorrhage? dangle his legs.
a. Protamine Sulfate
b. Aminocaproic Acid (Amicar.

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NINE (⁠◕⁠ᴗ⁠◕⁠✿⁠) MEDSURG (1) COMPAPP PRETEST

49. Mr. C. is receiving 0 2 at 3 liters per nasal cannula, a. Prone position

His roommate lights a cigarette and tosses the match, b. Supine position with head elevated 30
catching the curtain on fire. What is the priority degrees
action for the nurse? c. Positioned with the right side dependent
d. Positioned with the left side dependent
a. Turn off the oxygen.
b. Try to extinguish the flames. 54. The nurse is making a home visit to a 70-year-old
c. Sound the fire alarm. client with emphyseme. Which assessment finding
d. Remove the clients from the room. has the most serious implication for this client's
nursing care?
50. During the insertion of a rigid scope for
bronchoscopy, a client experiences a vasovagal a. Increased anterior posterior diameter of
response. The nurse should expect: the chest
b. Bilateral crackles throughout the lung fields
a. the client's pupils to become dilated. c. Pursed-lip breathing
b. the client to experience bronchodilation d. Circumoral cyanosis
c. a decrease in the client's gastric secretions.
d. a drop in the client's heart rate. 55. A postoperative client with emphysema is
receiving oxygen at 2 L/min via nasal cannula when
he/she complains of feeling dyspneic. The spouse
Respiratory Disorders asks the nurse to increase the oxygen intake to beip
him/her breathe easier. Which response by the nurse
51. A client underwent bronchoscopy using conscious is appropriate?
sedation. Which of the following outcomes is most
important to be met prior to discharging the client? a. Switch the oxygen to a 100%
non-rebreathing mask
a. The client verbalizes symptoms to report to b. Explain to the spouse that high
the physician following discharge. concentration of oxygen may depress
b. The client has an intact gag reflex. breathing
c. The client is afebrile. c. Ask the wife to leave the room to let the
d. The client is taking oral fluids. client get some sleep
d. Administer pain medication
52. A client is admitted to the hospital with the
medical diagnosis of traumatic brain injury. From the 56. For the client with bacterial pneumonia, the nurse
assessment finding of slow, shallow respirations, the expects the finding of;
nurse concludes that which area of the brain is
affected by the injury? a. Normal white blood cell count
b. Atelectasis
a. Anterior pituitary. c. Productive cough
b. Hypothalamus d. Unremarkable chest x-ray
c. Medulla
d. Cerebral cortex 57. The occupational health nurse teaches a group of
employees to follow all safety practices because
53. In the client with right lung pneumonia, the nurse irreversible lung damage can result from
should encourage which position to facilitate optimal occupational exposure ro substances suchas coal,
oxygenation? asbestos, or glass because of:

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NINE (⁠◕⁠ᴗ⁠◕⁠✿⁠) MEDSURG (1) COMPAPP PRETEST

a. Chronic inflammation of lung tissue c. Correct the client reports no episodes of

b. Frequent antigen -antibody reaction to chest pain.
foreign substances d. Incorrect pulse oximetry shows the client's
c. Chronic air trapping oxygen saturation is improved.
d. Surfactant Deficiency
62.Ms.F. has developed angina pectoris secondary to
58. In developing the care plan for a client with coronary artery disease. A low fat, low cholesterol
pulmonary mycobacterium tuberculosis, what diet Is prescribed for her. The nurse should praise
primary precautions should be included? Ms.F. for a wise choice If she selected which of the
following for an evening snack?
a. Contact skin precautions
b. the use of special mask to avoid inhaling a. Incorrect Cheese cubes and crackers.
infected airborne droplets b. Incorrect Half tuna salad sandwich.
c. Avoidance of blood contamination c. Incorrect Yogurt with fresh strawberries.
d. Containment of draining wounds d. Correct Jello mold with fruit slices.

59. The family of a client with emphysema asks the 63. The nurse is assessing a 70-year-old woman.
nurse about the disease process.The nurse explains Which statement by the client indicates that she has
that the disorder results from a decreased oxygen achieved integrity according to Erickson's stages of
supply because of: personality development?

a. .Paralysis of respiratory muscles. a. Incorrect "My life has been wasted."

b. Infectious obstructions. b. Incorrect "My children no longer visit me. I
c. Pleural effusion am just waiting to die."
d. Loss of surface area for gas exchange c. Incorrect "I was a good nurse when I was
younger, but now I am nothing."
60. In the dient with new rib fractures, which d. Correct "I have a good life and I still enjoy
assessment finding would best alert the nurse to the it, but i feel ready to go when it is time."
possible development of a pneumothorax?
64. A cient is admitted to the emergency department
a. Pink,frothy sputum with an acute asthma attack. The physician
b. Hoarseness prescribes ephedrine sulfate, 25 mg subcutaneously
c. Decreased breath sounds on affected side (S.C.). How soon should the ephedrine take effect?
d. Dullness to percussion on the unaffected
Based kay Quizlet
side a. Rapidly
b. In 3 minutes
61.A nitroglycerin transdermal patch was prescribed c. In 1 hour
six weeks ago for an adult to treat angina d. In 2 hours
pectoris.The nurse knows that the patch has been
effective if; 65. A client is chronically short of breath and yet has
normal lung ventilation, clear lungs, and an arterial
a. Incorrect the client's serum cholesterol oxygen saturation Sa02 of 96% or better. The client
level has decreased. most likely has:
b. Incorrect the client's pressure is within
normal limits. a. poor peripheral perfusion.
b. a possible hematologic problem.

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NINE (⁠◕⁠ᴗ⁠◕⁠✿⁠) MEDSURG (1) COMPAPP PRETEST

c. a psychosomatic disorder. b. vitamin K1 (phytonadione).

d. left-sided heart failure. c. vitamin C.
d. protamine sulfate.
66. A client with a suspected pulmonary disorder
undergoes pulmonary function tests. To interpret 70.Before administering ephedrine, the nurse
test results accurately, the nurse must be familiar assesses the client's history. Because of ephedrine's
with the terminology used to describe pulmonary central nervous system (CNS, effects, it is not
functions. Which term refers to the volume of air recommended for:
inhaled or exhaled during each respiratory cycle?
a. clients with an acute asthma attack.
a. Vital capacity b. clients with narcolepsy.
b. Functional residual capacity c. clients under age 6
c. Tidal volume d. elderly clients
d. Maximal voluntary ventilation
71. A client with chronic obstructive lung disease
67.A client with lung cancer has developed an tells the nurse that he feels short of breath.The
intractable, nonproductive cough that is unrelieved client's respiratory rate is 36 breaths/minute and the
by nonnarcotic antitussive agents. The physician nurse auscultates diffuse wheezes. His arterial
prescribes codeine, 10 mg P.O. every 4 hours. Which oxygen saturation is 84%. The nurse calls the
statement accurately describes codeine? assigned respiratory therapist to administer a
prescribed nebulizer treatment. The therapist says “ I
a. It is centrally acting antitussive and doesn't have several more percussion to do on the unit where
cause dependence. I am now. As soon as I am done, I'll come assess the
b. It's peripherally acting antitussive and client” The nurse's most appropriate action is to:
doesn't cause dependence.
c. It's a centrally acting antitussive and can a. notify the primary physician immediately.
cause dependence. b. stay with the dient until the therapist
d. It's peripherally acting antitussive and can arrives.
cause dependence. c. Administer the treatment by metered
dose-inhaler.
68. For a client with advanced chronic obstructive d. give the nebulizer treatment herself. Based kay Quizlet

pulmonary disease (COPD., which nursing action

best promote adequate gas exchange? 72. What is the normal pH range for arterial blood?

a. Encouraging the client to drink three a. 7 to 7.49

glasses of fluid daily b. 7.35 to 7.45
b. Keeping the client in semi-Fowler's c. 7.50 to 7.00
position d. 7.55 to 7.65
c. Using a high-flow Venturi mask to deliver
oxygen as prescribed 73. A client is diagnosed with a partial airway
d. Administering a sedative as prescribed obstruction. During assessment, the nurse expects to
find:
69. A client recovering from a pulmonary embolism is
receiving warfarin (Coumadin). To counteract a a. respiratory arrest.
warfarin overdose, the nurse would administer: b. inability to speak.
c. loss of consciousness
a. heparin. d. cyanosis

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NINE (⁠◕⁠ᴗ⁠◕⁠✿⁠) MEDSURG (1) COMPAPP PRETEST

a. It makes the central respiratory center more

74. A client comes to the emergency department sensitive to carbon dioxide and stimulates. Based kay Proprofs

complaining of sudden onset of diarrhea, anorexia, b. It Inhibits the enzyme phosphodiesterase,

malaise, cough, headache, and recurrent chills. Based decreasing degradation of cyclic adeno
on the client's history and physical findings, the bronchodilator.
physician suspects legionnaires' disease. What is the c. c. It stimulates adenosine receptors, causing
drug of choice for treating legionnaires' bronchodilation.
disease?While awaiting diagnostic test results, the d. It alters diaphragm movement, increasing
client is admitted to the facility and stated on chest expansion and enhancing the lung's
antibiotic therapy. capacity for gas exchange.
What is the drug of choice for treating legionnaires'
disease? 78. A client Is to receive I.V, vancomycin (Vancocin).
When preparing to administer this drug, the nurse
a. erythromycin (Erythrocin. should keep in mind that:
b. rifampin (Rifadin.
c. amantadine (Symmetrel a. vancomycin should be infused over 60 to
d. amphotericin B (Fungizone 90 minutes in a large volume of fluid.
b. vancomycin may cause irreversible
75. The nurse assessing a client for tracheal neutropenia.
displacement should know that the trachea will c. vancomycin should be administered rapidly
deviate toward the : in a large volume of fluid.
d. vancomycin should be administered over i
a. contralateral side in a simple pneumothorax to 2 minutes as an I.V. bolus.
b. affected side in a hemothorax.
c. affected side in a tension pneumothorax 79. The nurse is caring for a client experiencing an
d. contralateral side in a hemothorax Based kay CourseHero acute asthma attack. The dient stops wheezing and
breath sounds aren't audible. The reason for this
76. A client with chronic obstructive pulmonary change is that:
disease (COPD). is intubated and placed on
continuous mechanical ventilation. Which equipment a. The attack is over.
is most important for the nurse to keep at this clients b. The airways are so swollen that no air can
bedside: get through.
c. the swelling has decreased.
a. Water-seal chest drainage set-up d. crackles have replaced wheezes.
b. Manual resuscitation bag
c. Oxygen analyzer 80. The nurse is planning care for a client after a
d. tracheostomy cleaning kit tracheostomy. One of the client's goals is to
overcome verbal communication impairment. Which
77.A client with chronic obstructive pulmonary of the following interventions should the nurse
disease (COPD. takes anhydrous theophylline, 200 include in the plan of care?
mg P.O. Every 8 hours, During a routine clinic visit,
the client asks the nurse how the drug works. What is a. Make an effort to read the client's lips to
the mechanism of action of anhydrous theophylline foster communication.
in treating a nonreversible obstructive airway disease b. Encourage the client's communication
such as COPD ? attempts by allowing him time to select or
write words.

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NINE (⁠◕⁠ᴗ⁠◕⁠✿⁠) MEDSURG (1) COMPAPP PRETEST

c. Answer questions for the client to reduce condition deteriorates rapidly, and endotracheal (ET.
his frustration. intubation and mechanical ventilation are initiated.
d. Avoid using a tracheostomy plug because it When the high-pressure alarm on the mechanical
blocks the airway. ventilator sounds,the nurse starts to check for the
cause. Which condition triggers the high-pressure
81. The nurse is teaching a client with emphysema alarm?
how to perform pursed-lip breathing. The client asks
the nurse to a. . Kinking of the ventilator tubing
explain the purpose of this breathing technique. b. A disconnected ventilator tube
Which explanation should the nurse provide? c. An ET cuff leak
d. A change in the oxygen concentration
a. It helps prevent early airway collapse. without resetting the oxygen level alarm
b. It increases inspiratory muscle strength.
c. It decréases use of accessory breathing 85. The nurse prepares to perform postural drainage.
muscles How should the nurse ascertain the best position to
d. d. It prolongs the inspiratory phase of facilitate clearing the lungs?
respiration,
a. Inspection
82. A client with asthma is receiving a theophylline b. Chest X-ray
preparation to promote bronchodilation. Because of c. Arterial blood gas (ABG. levels
the risk of drug toxicity, the nurse must monitor the d. Auscultation
client's serum theophylline level closely. The nurse
knows that the therapeutic theophylline 86. After receiving an oral dose of codeine for an
concentration falls within which range? intractable cough, the client asks the nurse,"How
long will it take for this drug to work?" How should
a. 1 to 2 mcg/mi the nurse respond?
b. 2 to 5 mcg/ml
c. 5 to 10 mcg/ml a. In 30 minutes
d. 10 to 20 mcg/mi Based kay RNpedia b. In 1 hour
c. In 2.5 hours
83. A client has undergone a left hemicolectomy for d. In 4 hours
bowel cancer. Which activities prevent the
occurrence of postoperative pneumonia in this 87.A client admitted with multiple traumatic injuries
client? receives massive fluid resuscitation. Later, the
physician suspects that the client has aspirated
a. Administering oxygen, coughing, breathing stomach contents. The nurse knows that this client is
deeply, and maintaining bed rest at highest risk for:
b. Coughing, breathing deeply, maintaining
bed rest, and using an incentive spirometer a. chronic obstructive pulmonary disease
c. Coughing, breathing deeply, frequent (COPD..
repositioning, and using an incentive b. bronchial asthma.
spirometer c. adult respiratory distress syndrome
d. Administering pain medications, frequent (ARDS).
repositioning, and limiting fluid intake d. renal failure.

84. A client suffers adult respiratory distress

syndrome as a consequence of shock. The dient's

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NINE (⁠◕⁠ᴗ⁠◕⁠✿⁠) MEDSURG (1) COMPAPP PRETEST

88. A client with emphysema will be discharged in a b. lung movement inward during expiration
few days. During a discharge teaching session, what and outward during inspiration. Based kay Studocu

should the nurse instruct this client to avoid? c. a decreased respiratory rate.
d. lung movement outward during expiration
a. Fumes and inward during inspiration.
b. People
c. Exercise 93. A client has a sucking stab wound to the chest.
d. Telephone calls Which action should the nurse take first?

89. For a client who has a chest tube connected to a a. Draw blood for a hematocrit and
closed water-seal drainage system, the nurse should hemoglobin level.
include which action in the plan of care? b. Apply a dressing over the wound and tape
it on three sides.
a. Measuring and documenting the drainage c. Prepare a chest tube insertion tray.
in the collection chamber d. Prepare to start an IV line.
b. Maintaining continuous bubbling in the
water-seal chamber 94. After a tonsillectomy, a client is being prepared
c. Keeping the collection chamber at chest for discharge. The nurse should instruct the client to
level- report which sign or symptom immediately?
d. Stripping the chest tube every hour
a. Bleeding
90. A client on mechanical ventilation is receiving b. Difficulty swallowing
pancuronium bromide (Pavulon), 0.01 mg/kg I.V. as c. Throat pain
needed. Which assessment finding indicates that the d. Difficulty talking
client needs another pancuronium dose?
95. A dient reports difficulty breathing and a sharp
a. Leg movement pain in the right side of the chest. The respiratory
b. Finger movement rate measures 40 breaths/minute. The nurse should
c. Lip Movement assign highest priority to which goal of care?
d. Fighting the ventilator
a. Maintaining an adequate circulatory volume
91. After undergoing a left thoracotomy, a client has a b. Maintaining effective respirations
chest tube in place. When caring for this client, the c. Reducing anxiety
nurse must: d. Relieving pain

a. report fluctuations in the water-seal 96.A client, confused and short of breath, is brought
chamber. to the emergency department by a family member.
b. clamp the chest tube once every shift. The medical history reveals chronic bronchitis and
c. encourage coughing and deep breathing. hypertension. To learn more about the client's
d. milk the chest tube every 2 hours. current respiratory problem, the physician orders a
chest X-ray and arterial blood gas (ABG. analysis.
92. Nursing assessment reveals that a client has When reviewing the ABG report, the nurse sees many
paradoxical chest expansion. Such expansion is best abbreviations. What does a lowercase "a" in an ABG
described as: value represent?

a. a form of tachypnea. a. Acid-base balance

b. Arterial blood

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NINE (⁠◕⁠ᴗ⁠◕⁠✿⁠) MEDSURG (1) COMPAPP PRETEST

c. Arterial oxygen saturation

d. Alveoli

97. A client with a pulmonary embolism has the

following arterial blood gas (ABG. values: pH, 7:49;
partial pressure of arterial oxygen (Pa02), 60 mm Hg;
partial pressure of arterial carbon dioxide (PaCO2),
30 mm Hg; bicarbonate (HCO3-) 25 mEa/L. What
should the nurse do first?

a. Instruct the client to breathe into a paper

bag.
b. Administer oxygen by nasal cannula as
prescribed.
c. Auscultate breath sounds bilaterally every 4
hours.
d. Encourage the client to deep-breathe and
cough every 2 hours.

98. The nurse is caring for a client with a chest tube.

If the chest drainage system is accidentally
disconnected, what should the nurse plan to do?

a. Place the end of the chest tube in a

container of sterile saline.
b. Apply an occlusive dressing and notify the
physician.
c. Clamp the chest tube immediately.
d. Secure the chest tube with tape.

99. A nurse caring for a client with deep vein

thrombosis must be especially alert for
complications such as pulmonary embolism. Which
findings suggest pulmonary embolism?

a. Nonproductive cough and abdominal pain

b. Hypertension and lack of fever
c. Bradypnea and bradycardia
d. Chest pain and dyspnea

100. The nurse must administer theophylline

(Theo-Dur) to a client. This drug treats asthma by:

a. depressing the myocardium.

b. decreasing diuresis.
c. Improving respiratory drive.
d. relaxing bronchial smooth muscle.

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