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Med Surg Exam 2 Respiratory Exam/146 Questions with Answers 2024

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Med Surg Exam 2 Respiratory Exam/146 Questions with Answers 2024

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  • March 2, 2024
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Med Surg Exam 2 Respiratory Exam/146 Questions
with Answers 2024
Which of the following is part of the respiratory tract? Choose all that apply.

A. Bronchi
B. Pharynx
C. Larynx
D. Sinuses - -A. Bronchi
B. Pharynx
C. Larynx
D. Sinuses

-Because the pressure of CO2 is higher in the blood vessels than the
pressure of CO2 in the lungs, the CO2 moves from the blood to the lungs.

True
False - -True

-Which of the following would cause the medulla oblongata to increase the
respiratory rate?

A. Too much oxygen in blood stream
B. Too much carbon dioxide in blood stream
C. Decrease in metabolic needs - -B. Too much carbon dioxide in blood
stream

-The functional unit of the respiratory system is _______? - -alveoli

-A patient with acute shortness of breath is admitted to the hospital. Which
action should the nurse take during the initial assessment of the patient?

A. Complete a full physical examination to determine the systemic effect of
the respiratory distress.
B. Obtain a comprehensive health history to determine the extent of any
prior respiratory problems.
C. Delay the physical assessment and ask family members about any history
of respiratory problems.
D. Perform a respiratory system assessment and ask specific questions about
this episode of respiratory distress. - -D. Perform a respiratory system
assessment and ask specific questions about this episode of respiratory
distress.

, -On auscultation of a patient's lungs, you hear short, high-pitched sounds
during exhalation in the lower 1/3 of both lungs. You should record this
finding as

A. expiratory crackles at the bases.
B. expiratory wheezes in both lungs.
C. abnormal lung sounds in the bases of both lungs.
D. pleural friction rub in the right and left lower lobes. - -B. expiratory
wheezes in both lungs.

Wheezes are high-pitched sounds. In this case they are heard during the
expiratory phase of the respiratory cycle. Abnormal breath sounds are either
bronchial or bronchovesicular sounds heard in the peripheral lung fields.
Crackles are low-pitched, "bubbling" sounds. Pleural friction rubs are grating
sounds that are usually heard during both inspiration and expiration

-You palpate the posterior chest while the patient says "99" and note that no
vibration is felt. How should this be charted?

A. Diminished expansion
B. Dullness to percussion
C. Absent tactile fremitus
D. Decreased breath sounds - -C. Absent tactile fremitus

To assess for tactile fremitus, the nurse should use the palms of the hands to
assess for vibration when the patient repeats a word or phrase such as "99."
Different techniques are used to assess for dullness to percussion, decreased
breath sounds, and diminished expansion.

-When auscultating a patient's chest while the patient takes a deep breath,
you hear loud, high-pitched, "blowing" sounds at both lung bases. You will
document these as

A. normal sounds.
B. vesicular sounds.
C. abnormal sounds
D. adventitious sounds - -C. abnormal sounds

The description indicates that you hear bronchial breath sounds that are
abnormal when heard at the lung base. Adventitious sounds are extra breath
sounds such as crackles, wheezes, rhonchi, and friction rubs. Vesicular
sounds are low-pitched, soft sounds heard over all lung areas except the
major bronchi.

-Which of the following respiratory physiological changes occur as a result of
aging?

,A. Increase elastic recoil
B. Decrease functioning alveoli
C. Increase cough force
D. Increase response to high CO2 level - -B. Decrease functioning alveoli

-When assessing the respiratory system of a 78-year-old patient, which
finding indicates that you should take immediate action?

A. The chest appears barrel shaped.
B. The patient has a weak cough effort.
C. Crackles are heard from the lung bases to the midline.
D. Hyperresonance is present across both sides of the chest. - -C. Crackles
are heard from the lung bases to the midline.

-A patient with complicated deviated septum is hospitalized to have
septoplasty. Which of the following findings must you report
to the surgeon before the surgery?

A. Serum sodium is 134 mEq/L.
B. PT 12 seconds.
C. Serum potassium is 4.8 mEq/L.
D. Platelets counts is 120,000/ L - -D. Platelets counts is 120,000/ L

Low platelets= high risk for bleeding (NL 150,000-400,000 per microliter)

-After a patient has undergone a septoplasty, which nursing intervention will
be included in the plan of care?

A. Educate the patient about how to safely remove and reapply nasal splint.
B. Reassure the patient that the nose will look normal when the swelling
subsides
C. Instruct the patient to keep the head elevated for 48 hours to minimize
swelling and pain.
D. Teach the patient to use nonsteroidal anti-inflammatory drugs (NSAIDs)
for pain control. - -C. Instruct the patient to keep the head elevated for 48
hours to minimize swelling and pain.

Maintaining the head in an elevated position will decrease the amount of
nasal swelling. NSAIDs increase the risk for postoperative bleeding and
should not be used postoperatively. The patient would not be taught to
remove or reapply nasal packing, which is usually removed by the surgeon
on the day after surgery. Although return to a preinjury appearance is the
goal of the surgery, it is not always possible to achieve this result.

-Which action should you take first when a patient develops a nosebleed?

, A. Pack both nares tightly with 1/2-inch ribbon gauze.
B. Pinch the lower portion of the nose for 10 minutes.
C. Prepare supplies that will be needed for cauterization.
D. Apply ice compresses over the patient's nose and cheeks. - -B. Pinch the
lower portion of the nose for 10 minutes.

The first nursing action for epistaxis is to apply direct pressure by pinching
the nostrils. Application of cold packs may decrease blood flow to the area
somewhat, but will not be sufficient to stop bleeding. Cauterization or nasal
packing may be needed if pressure to the nares does not stop bleeding, but
these are not the first actions to take for nosebleed.

-You are caring for a hospitalized 82-year-old patient who has nasal packing
in place to treat a nosebleed. Which of the
following assessment findings will require the most immediate action?

A. The patient complains of level 7 (0 to 10 scale) pain.
B. The patient's temperature is 100.1° F (37.8° C).
C. The nose appears red and swollen.
D. The oxygen saturation is 89%. - -D. The oxygen saturation is 89%.

Older patients with nasal packing are at risk of aspiration or airway
obstruction. An O2 saturation of 89% should alert the nurse to assess further
for these complications. The other assessment data also indicate a need for
nursing action but not as immediately as the fall in O2 saturation.

-When teaching the patient with allergic rhinitis about management of the
condition, you should explain that

A. over-the-counter (OTC) antihistamines cause sedation, so prescription
antihistamines are usually ordered.
B. corticosteroid nasal sprays will reduce inflammation, but systemic effects
limit their use.
C. Identification and avoidance of environmental triggers are the best way to
avoid symptoms.
D. Use of oral antihistamines for a few weeks before the allergy season may
prevent reactions. - -C. Identification and avoidance of environmental
triggers are the best way to avoid symptoms.

-After discussing management of upper respiratory infections (URI) with a
patient who has acute viral rhinitis, you determine that additional teaching is
needed when the patient says:

A. "I can take acetaminophen (Tylenol) to treat discomfort."
B. "I will drink lots of juices and other fluids to stay hydrated."

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