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Respiratory Quiz- EVOLVE EXAM 2025 QUESTIONS AND CORRECT ANSWER
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Respiratory Quiz- EVOLVE EXAM 2025 QUESTIONS AND CORRECT ANSWER
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Respiratory Quiz- EVOLVE EXAM 2025 QUESTIONS AND CORRECTANSWER
In which order will the nurse perform these prescribed actions for a client who is in the
emergency department with sudden onset of dyspnea and possible pulmonary embolism?
1. Administer unfractionated heparin.
2. Obtain blood for coagulation studies.
3. Place client on cardiac monitor.
4. Check oxygen saturation using pulse oximetry.
5. Administer oxygen to keep saturation higher than 93%. - answer>>>ANS: 4, 5, 3, 2, 1,
Rationale:
The initial action for a client with dyspnea and chest pain will be obtain a baseline oxygen
saturation and then start oxygen administration. Because dysrhythmias can occur because of
hypoxemia secondary to pulmonary embolus, the nurse will start cardiac monitoring. Rapid
administration of anticoagulants is needed, but baseline coagulation studies are needed prior
to starting anticoagulation.
Which finding would be of most concern when the nurse is assessing a client with pulmonary
embolism diagnosis who is receiving intravenous heparin?
A. Client reports stools are black
B. Oxygen saturation is 93%.
C. Respiratory rate is 25 breaths per minute.
D. Client has an ecchymosis on the ankle. - answer>>>ANS: A
Rationale:
Because anticoagulaten use increases the risk for gastrointestinal bleeding, the nurse would
report the black-colored stools to the HCP and anticipate action such as testing stools for occult
,blood, administration of protein pump inhibitor to decrease ulcer risk, and checking complete
blood count.
B- An oxygen saturation of 93% in a client with pulmonary embolus is acceptable.
C- A slightly elevated respiratory rate in a client with pulmonary embolus is a compensatory
mechanism to prevent hypoxemia.
D- Because low platelet counts increase risk for bleeding, an ecchymosis on this client's ankle
would not be of high concern.
The nurse caring for a client who has had a hysterectomy is concerned about the client's risk for
postoperative thrombosis. The nurse remembers that, after pelvic surgery, the majority of
pulmonary emboli begin as deep vein thromboses in which area?
A. Calf
B. Thoracic cavity
C. Pelvis and thighs
D. Extremities and abdomen - answer>>>ANS: C
Rationale:
Most pulmonary emboli after surgery of the pelvic floor originate in the deep veins of the pelvis
and thighs because of the extensive vascular network in the region.
The calf, thoracic cavity, extremities, and abdomen are not where most pulmonary emboli
originate after surgery involving the pelvic floor.
The nurse is assessing four different clients. Which client is at risk of pleuritis?
,Client A: Crackles (Sound), Right and left lung bases (Site)
Client B: Rhonchi (Sound), Over trachea and bronchi (Site)
Client C: Wheezes (Sound), Overall lung fields (Site)
Client D: Pleural friction rub (Sound) Over anterior lateral lung field (Site) - answer>>>ANS: D
Rationale:
Inflammation of the pleura is known as pleuritis. In this condition, a pleural friction rub sound
can be heard prominently over the anterior lateral lung field, as in the case of client D.
Client A has a crackling sound in the right and left lung bases; this osund may be caused by the
reinflation of groups pf alveoli.
Client B has rhonchi sounds over the trachea and bronchi, which may be due to muscular spasm
in the larger airways.
Client C has wheezing sounds over the lung fields. This sound indicates an obstructed airway.
A client with COPD is admitted to the hospital with a tentative diagnosis of pleuritis. It is
important for the nurse to perform which intervention?
A. Administer opioids frequently.
B. Assess for signs of pneumonia.
C. Give medication to suppress coughing.
D. Limit fluid intake to prevent pulmonary edema. - answer>>>ANS: B
Rationale:
Clients with pleuritic disease are prone to developing pneumonia because of impaired lung
expansion, air exchange, and drainage.
, A- Opioids are contraindicated because opioids depress respirations.
C- Coughing should not be suppressed; it enhances lung expansion, air exchange, and lung
drainage.
D- Oral fluids should be encouraged; pulmonary edema does not develop unless the client has
severe cardiovascular disease.
Which type of adventitious breath sound would the nurse expect when auscultating the
posterior chest of a client with pleurisy who is reporting sharp chest pain with deep breathing?
A. Stridor
B. Rhonchi
C. Pleural friction rub
D. High-pitched crackles - answer>>>ANS: C
Rationale:
Pleurisy is caused by inflammation of the pleural surfaces, and a frequent clinical manifestation
is a pleural friction rub, which is a rough, scratching, grating, creaking sound caused by inflamed
pleural surfaces rubbing together. It is frequently associated with chest pain.
A- Stridor is a high-pitched, shrill, harsh sound caused by laryngeal obstruction and can be
heard on auscultation over the upper airways or with the naked ear.
B- Rhonchi are continuous, low-pitched, coarse sounds often described as having a snoring or
moaning quality that occur with partial bronchial obstruction caused by mucus, bronchospasm,
foreign bodies, or tumors.
D- High pitched crackles are fine, short, interrupted popping sounds best heard on inspiration
that occur with problems such as heart failure when air passes through fluid within the alveoli.
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