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Respiratory-Medsurge Exam Test Questions with 100% correct answers|Verified|Rated A+

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The nurse is caring for a client hospitalized with acute exacerbation of chronic obstructive pulmonary disease. Which finding would the nurse expect to note on assessment of this client? Select all that apply. 1. Hypocapnia 2.A hyperinflated chest noted on the chest x-ray 3.Decreased oxygen sat...

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  • August 11, 2024
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  • 2024/2025
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  • Respiratory-Medsurge
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Respiratory-Medsurge Exam Test Questions
with 100% correct answers|Verified|Rated A+
The nurse is caring for a client hospitalized with acute exacerbation of chronic obstructive pulmonary
disease. Which finding would the nurse expect to note on assessment of this client? Select all that apply.



1. Hypocapnia

2.A hyperinflated 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 - ANSWER-2.A hyperinflated chest
noted on the chest x-ray

3.Decreased oxygen saturation with mild exercise



Rationale:

Clinical manifestations of chronic obstructive pulmonary disease (COPD):

hypoxemia,

hypercapnia,

dyspnea on exertion and at rest,

oxygen desaturation with exercise,

use of accessory muscles of respiration.

Chest x-rays reveal:

a hyperinflated chest

a flattened diaphragm if the disease is advanced. Pulmonary function tests will demonstrate decreased
vital capacity.



The nurse instructs a client to use the pursed-lip method of breathing and the client asks the nurse
about the purpose of this type of breathing. The nurse responds, knowing 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 - ANSWER-4. promote carbon dioxide elimination



Rationale:

Pursed-lip breathing facilitates maximal expiration for clients with obstructive lung disease. This type of
breathing allows better expiration by increasing airway pressure that keeps air passages open during
exhalation. Options 1, 2, and 3 are not the purposes of this type of breathing.



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 one sputum culture is negative, the client is no longer considered infectious and usually can
return to former employment - ANSWER-1. Activities should be resumed gradually



3. A sputum culture is needed every 2 to 4 weeks once medication therapy is initiated.

,5. Cover the mouth and nose when coughing or sneezing and put used tissues in plastic bags.



6. When one sputum culture is negative, the client is no longer considered infectious and usually can
return to former employment



Rationale:




-The nurse should provide the client and family with information about tuberculosis and allay concerns
about the contagious aspect of the infection.

-Instruct the client to follow the medication regimen exactly as prescribed and always to have a supply
of the medication on hand.

-Advise the client of the side effects of the medication and ways of minimizing them to ensure
compliance.

-Reassure the client that after 2 to 3 weeks of medication therapy, it is unlikely that the client will infect
anyone.

-Inform the client that activities should be resumed gradually and about the need for adequate nutrition
and a well-balanced diet that is rich in iron, protein, and vitamin C to promote healing and prevent
recurrence of infection.

-Inform the client and family that respiratory isolation is not necessary because family members already
have been exposed.

-Instruct the client about thorough handwashing and to cover the mouth and nose when coughing or
sneezing and to put used tissues into plastic bags.

-Inform the client that a sputum culture is needed every 2 to 4 weeks once medication therapy is
initiated.

-When the results of three sputum cultures are negative, the client is no longer considered infectious
and can usually return to former employment.



List the FOUR first-line medications used to treat TB? - ANSWER-1. INH

2. Rifampin (Rifadin)

3. Pyrazinamide (PZD)

4. Ethambutol (Myambutol)

, Which types of foods patients should avoid while taking INH? - ANSWER-food contain tyramine and
histamine: tuna, aged cheese, red wine, soy sauce, yeast extracts



What are the side effects if patients digest either tyramine while on INH treatment regiment? -
ANSWER-If eaten while patient is on INH, it may result in headache, flushing, hypotension,
lightheadedness, palpitations, and diaphoresis



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 - ANSWER-3. Bronchospasm



Rationale:



if a biopsy was performed during a bronchoscopy, blood-streaked sputum is expected for several hours.
Frank blood indicates hemorrhage. A dry cough may be expected.

-The client should be assessed for signs/symptoms of complications, which would include cyanosis,
dyspnea, stridor, bronchospasm, hemoptysis, hypotension, tachycardia, and dysrhythmias.

-Hematuria is unrelated to this procedure.



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?

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