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Bio 103 Chapter 23 Testbank uestions

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BIO 103

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Bergen Community College

Detailed and comprehensive testbank that contains questions and correct answers on Ch 23 Management of Patients with Chest and Lower Respiratory Tract Disorders

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TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017) 454

Chapter23:ManagementofPatientswithChestandLowerRespiratory
TractDisorders


1. Aperioperativenurseiscaringforapostoperativepatient.Thepatienthasashallowrespiratorypattern
andisreluctanttocoughortobeginmobilizing.Thenurseshouldaddressthepatientsincreasedriskfor
whatcomplication?

A) Acuterespiratorydistresssyndrome(ARDS)

B) Atelectasis

C) Aspiration

D) Pulmonaryembolism

Ans: B

Feedback:

Ashallow,monotonousrespiratorypatterncoupledwithimmobilityplacesthepatientatanincreased
riskofdevelopingatelectasis.Thesespecificfactorsarelesslikelytoresultinpulmonaryembolismor
aspiration.ARDSinvolvesanexaggeratedinflammatoryresponseanddoesnotnormallyresultfrom
factorssuchasimmobilityandshallowbreathing.

2. Acritical-carenurseiscaringforapatientdiagnosedwithpneumoniaasasurgicalcomplication.The
nursesassessmentrevealsthatthepatienthasanincreasedworkofbreathingduetocopious
tracheobronchialsecretions.Whatshouldthenurseencouragethepatienttodo?

A) Increaseoralfluidsunlesscontraindicated.

B) Callthenursefororalsuctioning,asneeded.

C) LieinalowFowlersorsupineposition.

D) Increaseactivity.

Ans: A

Feedback:

Thenurseshouldencouragehydrationbecauseadequatehydrationthinsandloosenspulmonary
secretions.Oralsuctioningisnotsufficientlydeeptoremovetracheobronchialsecretions.Thepatient
shouldhavetheheadofthebedraised,andrestshouldbepromotedtoavoidexacerbationofsymptoms.

,TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017) 455

3. ThepublichealthnurseisadministeringMantouxteststochildrenwhoarebeingregisteredfor
kindergarteninthecommunity.Howshouldthenurseadministerthistest?

A) Administerintradermalinjectionsintothechildrensinnerforearms.

B) Administerintramuscularinjectionsintoeachchildsvastuslateralis.

C) Administerasubcutaneousinjectionintoeachchildsumbilicalarea.

D) Administerasubcutaneousinjectionata45-degreeangleintoeachchildsdeltoid.

Ans: A

Feedback:

Thepurifiedproteinderivative(PPD)isalwaysinjectedintotheintradermallayeroftheinneraspectof
theforearm.Thesubcutaneousandintramuscularroutesarenotutilized.

4. Thenurseiscaringforapatientwhohasbeeninamotorvehicleaccidentandthecareteamsuspects
thatthepatienthasdevelopedpleurisy.Whichofthenursesassessmentfindingswouldbestcorroborate
thisdiagnosis?

A) Thepatientisexperiencingpainlesshemoptysis.

B) Thepatientsarterialbloodgases(ABGs)arenormal,buthedemonstratesincreasedworkof
breathing.

C) Thepatientsoxygensaturationlevelisbelow88%,buthedeniesshortnessofbreath.

D) Thepatientspainintensifieswhenhecoughsortakesadeepbreath.

Ans: D

Feedback:

Thekeycharacteristicofpleuriticpainisitsrelationshiptorespiratorymovement.Takingadeepbreath,
coughing,orsneezingworsensthepain.ThepatientsABGswouldmostlikelybeabnormaland
shortnessofbreathwouldbeexpected.

5. Thenursecaringforapatientrecentlydiagnosedwithlungdiseaseencouragesthepatientnottosmoke.
Whatistheprimaryrationalebehindthisnursingaction?

A) Smokingdecreasestheamountofmucusproduction.

B) Smokeparticlescompeteforbindingsitesonhemoglobin.

, TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017) 456

C) Smokingcausesatrophyofthealveoli.

D) Smokingdamagestheciliarycleansingmechanism.

Ans: D

Feedback:

Inadditiontoirritatingthemucouscellsofthebronchiandinhibitingthefunctionofalveolar
macrophage(scavenger)cells,smokingdamagestheciliarycleansingmechanismoftherespiratory
tract.Smokingalsoincreasestheamountofmucusproductionanddistendsthealveoliinthelungs.It
reducestheoxygen-carryingcapacityofhemoglobin,butnotbydirectlycompetingforbindingsites.

6. ApatienthasbeenbroughttotheEDbytheparamedics.ThepatientissuspectedofhavingARDS.What
interventionshouldthenursefirstanticipate?

A) Preparingtoassistwithintubatingthepatient

B) Settingupoxygenat5L/minutebynasalcannula

C) Performingdeepsuctioning

D) Settingupanebulizertoadministercorticosteroids

Ans: A

Feedback:

ApatientwhohasARDSusuallyrequiresintubationandmechanicalventilation.Oxygenbynasal
cannulawouldlikelybeinsufficient.Deepsuctioningandnebulizersmaybeindicated,butthepriorityis
tosecuretheairway.

7. Thenurseiscaringforapatientwhoisscheduledforalobectomyforadiagnosisoflungcancer.While
assistingwithasubclavianveincentrallineinsertion,thenursenotestheclientsoxygensaturation
rapidlydropping.Thepatientcomplainsofshortnessofbreathandbecomestachypneic.Thenurse
suspectsapneumothoraxhasdeveloped.Furtherassessmentfindingssupportingthepresenceofa
pneumothoraxincludewhat?

A) Diminishedorabsentbreathsoundsontheaffectedside

B) Paradoxicalchestwallmovementwithrespirations

C) Suddenlossofconsciousness

D) Muffledheartsounds

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