Evolve Respiratory Nclex 7th Ed. Study Questions with 100% Correct Solutions
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Course
Evolve & NCLEX
Institution
Evolve & NCLEX
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 promot...
Evolve Respiratory Nclex 7th Ed. Study
Questions with 100% Correct Solutions
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? - ANSWER 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
Rationale:
This client has sustained a blunt or closed-chest injury. Basic symptoms of a closed
pneumothorax are shortness of breath and chest pain. A larger pneumothorax may cause
tachypnea, cyanosis, diminished breath sounds, and subcutaneous emphysema.
Hyperresonance also may occur on the affected side. A sucking sound at the site of injury
would be noted with an open chest injury.
,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. - ANSWER 1.
A low arterial PCo2 level
**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
Rationale:
Clinical manifestations of chronic obstructive pulmonary disease (COPD) include hypoxemia,
hypercapnia, dyspnea on exertion and at rest, oxygen desaturation with exercise, and the use
of accessory muscles of respiration. Chest x-rays reveal a hyperinflated chest and 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 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? - ANSWER 1.
Promote oxygen intake.
,2.
Strengthen the diaphragm.
3.
Strengthen the intercostal muscles.
** 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. - ANSWER **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.
Rationale:
The nurse should provide the client and family with information about tuberculosis and allay
concerns about the contagious aspect of the infection. The client needs to follow the
medication regimen exactly as prescribed and always have a supply of the medication on
hand. Side and adverse effects of the medication and ways of minimizing them to ensure
compliance should be explained. After 2 to 3 weeks of medication therapy, it is unlikely that
the client will infect anyone. Activities should be resumed gradually and a well-balanced diet
that is rich in iron, protein, and vitamin C to promote healing and prevent recurrence of
infection should be consumed. Respiratory isolation is not necessary because family members
already have been exposed. Instruct the client about thorough hand washing, to cover the
mouth and nose when coughing or sneezing, and to put used tissues into plastic bags. A
sputum culture is needed every 2 to 4 weeks once medication therapy is initiated. When the
results of 3 sputum cultures are negative, the client is no longer considered infectious and can
usually return to former employment.
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? - ANSWER 1.
Dry cough
2.
Hematuria
**3.
Bronchospasm
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