Question 1
Question
A nurse is assessing a client who has an acute respiratory infection that puts her at risk for hypoxemia. Which of the following findings are early indications that should alert the nurse that the client is developing hypoxemia? (Select all that apply.)
Answer
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Restlessness
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Tachypnea
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Bradycardia
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Confusion
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Pallor
Question 2
Question
A nurse is caring for a client who is having difficulty breathing. The client is lying in bed and is already receiving oxygen therapy via nasal cannula. Which of the following interventions is the nurse’s priority?
Answer
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Increase the oxygen flow.
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Assist the client to Fowler’s position.
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Promote removal of pulmonary secretions.
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Obtain a specimen for arterial blood gases.
Question 3
Question
A nurse is preparing to perform endotracheal suctioning for a client. Which of the following are appropriate guidelines for the nurse to follow? (Select all that apply.)
Answer
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Apply suction while withdrawing the catheter.
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Perform suctioning on a routine basis, every 2 to 3 hr.
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Maintain medical asepsis during suctioning.
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Use a new catheter for each suctioning attempt.
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Limit suctioning to two to three attempts.
Question 4
Question
A nurse is caring for a client who has a tracheostomy. Which of the following actions should the nurse take each time he provides tracheostomy care? (Select all that apply.)
Answer
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Apply the oxygen source loosely if the SpO2 decreases during the procedure.
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Use surgical asepsis to remove and clean the inner cannula.
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Clean the outer surfaces in a circular motion from the stoma site outward.
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Replace the tracheostomy ties with new ties.
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Cut a slit in gauze squares to place beneath the tube holder.
Question 5
Question
A provider is discharging a client with a prescription for home oxygen therapy via nasal cannula. Client and family teaching by the nurse should include which of the following instructions? (Select all that apply.)
Answer
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Apply petroleum jelly around and inside the nares.
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Remove the nasal cannula during mealtimes.
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Check the position of the cannula frequently.
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Report any nasal stuffiness, nausea, or fatigue.
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Post “no smoking” signs in a prominent location.
Question 6
Question
You are an ER nurse treating a 3-year-old trauma patient. When assessing the patient's respirations, you note that the rate is 28 per minute. According to this finding, you should
Answer
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move on to your next area of assessment. The patient's respirations are normal.
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call the respiratory therapist. The patient is hyperventilating.
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call the physician to see if he would like to order a bronchodilator.
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try to distract the patient and make them relax. They are tachypneic.
Question 7
Question
What does a pulmonary toilet do?
Answer
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Prevents atelectasis and removes respiratory secretions
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Prevents bronchospasm
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Thins and cleans blood to help prevent pulmonary emoblism.
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Dilates bronchioles and improves gas exchange.
Question 8
Question
Which of the following is NOT a technique to thin respiratory secretions?
Question 9
Question
Which of the following is a high-flow oxygen delivery system?
Answer
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Non-rebreather mask
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Nasal cannula
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Venturi mask
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Simple face mask.
Question 10
Question
How would you instruct patients to use an incentive spirometer and peak flow meter?
Question 11
Question
Pursed lip breathing works well with what types of patients?
Answer
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COPD
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Pneumonia
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Lung cancer
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Cystic fibrosis
Question 12
Question
Which of the following is NOT a sign of anemia?
Answer
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Skin pallor
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Tachypnea and/or dyspnea
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Decreased hemoglobin
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Decreased hematocrit
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Bradycardia
Question 13
Question
Which of the following reflects the normal ranges for RBC count, hemoglobin, and hematocrit (respectively)?
Answer
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4.2-5.14 x 10(6) cells/ mm(3); 11.7-17.4 g/dL; 38- 44%
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3.1- 5.14 x 10(6) cells/ mm(3); 11.0- 17.0 g/dL; 38- 54%
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5.6- 7.9 x 10(6) cells/ mm(3); 12.3- 19.7 g/dL; 42- 51%
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3.6- 5.14 x 10(6) cells/mm(3); 11.7- 17.4 g/dL; 40- 48%
Question 14
Question
The amount of blood circulating and entering the right atrium is the
Answer
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Preload
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Afterload
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Stroke volume
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Cardiac output
Question 15
Question
Heart rate X Stroke volume=
Answer
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Preload
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Afterload
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Rate of perfusion
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Cardiac ouput
Question 16
Question
The pressure the heart must pump against is the
Answer
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Preload
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Afterload
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Stroke volume
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Cardiac ouput
Question 17
Question
Which of the following symptoms can indicate decreased cardiac output?
Answer
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Low hematocrit
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Low hemoglobin
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Low urine output
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Dyspnea
Question 18
Question
The SA node is found
Answer
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At the top of the right atrium
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At the top of the left atrium
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At the bottom of the right ventricle.
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Next to the tricuspid valve.
Question 19
Question
Which of the following correctly identifies the path of an electrical impulse through the heart?
Answer
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SA node --> AV junction --> HIS bundle --> bundle branches --> purkinjie fibers --> ventricular muscle
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AV junction --> SA node --> bundle branches --> HIS bundle --> purkinjie fibers --> ventricular muscle
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SA node --> HIS bundle --> AV junction --> purkinjie fibers --> bundle branches --> ventricular muscle
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SA node --> AV junction --> bundle branches --> HIS bundle --> purkinjie fibers --> ventricular muscle
Question 20
Question
The stroke volume of the heart increases in response to an increase in the volume of blood filling the heart (the end diastolic volume) when all other factors remain constant is also know as
Question 21
Question
Which of the following is NOT a sign or symptom of heart failure?