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CHECK UP TEST RESPIRATORY SYSTEM

1) CHECK ALL THAT APPLY: Which of the following are early s/sx of ARDS?
1. Retractions not always (tissues between ribs and above sternum pull in)
2. Dyspneic
3. Non-productive cough
4. Accessory muscle used
5. Pallor or cyanosis
6. Significant CXR changes; pulmonary infiltrates
7. Restlessness
8. CXR clear
9. Respiratory alkalosis
10. Respiratory acidosis
2) CHECK ALL THAT APPLY: Which of the following are the 5 characteristics of ARDS?
1. Dyspnea
2. Myasthenia Gravis
3. Refractory hypoxemia
4. Cyanosis
5. Dense pulmonary infiltrates on CXR
6. Decreased pulmonary compliance
7. Non-cardiac pulmonary edema
8. Chest pain
3) A firefighter who was involved in extinguishing a house fire is being treated for smoke
inhalation. He develops severe hypoxia 48 hours after the incident, requiring intubation and
mechanical ventilation. Which of the following conditions has he most likely developed?
1. Acute respiratory distress syndrome (ARDS).
1. Atelectasis.
2. Bronchitis.
3. Pneumonia.
4) During the Fibrotic Phase of ARDS, ____________________ .
1. fluids shift into the alveoli, the alveoli and bronchii collapse, and lose lung compliance
2. the lung starts to repair itself; this is where the patient starts to get better or the condition
deteriorates.
3. Fibrous tissue forms and lungs dont expand well; the effort to breathe increases O2
demand which causes more effort to breathe.
5) A nurse is taking pulmonary artery catheter measurements of a male client with acute
respiratory distress syndrome. The pulmonary capillary wedge pressure reading is 12mm Hg.
The nurse interprets that this readings is:
1. High and expected
2. Low and unexpected
3. Normal and expected
4. Uncertain and unexpected
6) A male client has been admitted with chest trauma after a motor vehicle accident and has
undergone subsequent intubation. A nurse checks the client when the high-pressure alarm on
the ventilator sounds, and notes that the client has absence of breathe sounds in right upper
lobe of the lung. The nurse immediately assesses for other signs of:
1. Right pneumothorax
2. Pulmonary embolism
3. Displaced endotracheal tube
4. Acute respiratory distress syndrome
7) A black male client with asthma seeks emergency care for acute respiratory distress.
Because of this clients dark skin, the nurse should assess for cyanosis by inspecting the:
1. lips.
2. mucous membranes.

3. nail beds.
4. earlobes.
8) True or False: Management of ARDS are usually only supportive, there is little we can do to
reverse the process.
True
False
9) Acute Respiratory Distress Syndrome (ARDS) can be defined as
___________________________.
1. Sudden life-threatening deterioration of gas exchange in the lungs
2. Non-cardiac pulmonary edema with increasing hypoxemia despite treatment with O2
3. Sudden life-threatening pulmonary edema that causes a deterioration of gas exchange
despite treatment with O2
10) Which of the following would lead the nurse to suspect that a client with a fracture of the
right femur may be developing a fat embolus?
1. Acute respiratory distress syndrome
2. Migraine like headaches
3. Numbness in the right leg
4. Muscle spasms in the right thigh
11) A nurse is assessing a female client with multiple trauma who is at risk for developing acute
respiratory distress syndrome. The nurse assesses for which earliest sign of acute respiratory
distress syndrome?
1. Bilateral wheezing
2. Inspiratory crackles
3. Intercostal retractions
4. Increased respiratory rate
12) During the Acute Exudate Phase of ARDS, ____________________ .
1. fluids shift into the alveoli, the alveoli and bronchii collapse, and lose lung compliance
2. the lung starts to repair itself; this is where the patient starts to get better or the condition
deteriorates.
3. Fibrous tissue forms and lungs dont expand well; the effort to breathe increases O2
demand which causes more effort to breathe.
13) During the Proliferative Phase of ARDS, ____________________ .
1. fluids shift into the alveoli, the alveoli and bronchii collapse, and lose lung compliance
2. the lung starts to repair itself; this is where the patient starts to get better or the condition
deteriorates.
3. Fibrous tissue forms and lungs dont expand well; the effort to breathe increases O2
demand which causes more effort to breathe.
14) CHECK ALL THAT APPLY: Which of the following are advanced s/sx of ARDS?
1. Retractions though not always (tissues between ribs and above sternum pull in)
2. Dyspneic
3. Non-productive cough
4. Accessory muscle used
5. Pallor or cyanosis
6. Significant CXR changes; pulmonary infiltrates
7. Restlessness
8. CXR clear
9. Respiratory alkalosis
10. Respiratory acidosis
15) A male client suffers acute respiratory distress syndrome as a consequence of shock. The
clients condition deteriorates rapidly, and endotracheal (ET) intubation and mechanical
ventilation are initiated. When the high-pressure alarm on the mechanical ventilator sounds, the
nurse starts to check for the cause. Which condition triggers the high-pressure alarm?
1. Kinking of the ventilator tubing
2. A disconnected ventilator tube
3. An ET cuff leak
4. A change in the oxygen concentration without resetting the oxygen level alarm
PNEUMONIA
1. Clients with chronic illnesses are more likely to get pneumonia when which of the following
situations is present?
1. Dehydration

2. Group living
3. Malnutrition
4. Severe periodontal disease
2. Which of the following pathophysiological mechanisms that occurs in the lung parenchyma
allows pneumonia to develop?
1.
2.
3.
4.

Atelectasis
Bronchiectasis
Effusion
Inflammation

3. Which of the following organisms most commonly causes community-acquired pneumonia


in adults?
1.
2.
3.
4.
4.

Haemiphilus influenzae
Klebsiella pneumoniae
Steptococcus pneumoniae
Staphylococcus aureus

An elderly client with pneumonia may appear with which of the following symptoms first?
1.
2.
3.
4.

Altered mental status and dehydration


Fever and chills
Hemoptysis and dyspnea
Pleuritic chest pain and cough

5. When auscultating the chest of a client with pneumonia, the nurse would expect to hear
which of the following sounds over areas of consolidation?
1.
2.
3.
4.
6.

Bronchial
Bronchovestibular
Tubular
Vesicular

A diagnosis of pneumonia is typically achieved by which of the following diagnostic tests?


1.
2.
3.
4.

ABG analysis
Chest x-ray
Blood cultures
sputum culture and sensitivity

7. A client with pneumonia develops dyspnea with a respiratory rate of 32 breaths/minute and
difficulty expelling his secretions. The nurse auscultates his lung fields and hears bronchial
sounds in the left lower lobe. The nurse determines that the client requires which of the
following treatments first?
1.
2.
3.
4.

Antibiotics
Bed rest
Oxygen
Nutritional intake

8. A client has been treated with antibiotic therapy for right lower-lobe pneumonia for 10 days
and will be discharged today. Which of the following physical findings would lead the nurse to
believe it is appropriate to discharge this client?
1.
2.
3.
4.

Continued dyspnea
Fever of 102*F
Respiratory rate of 32 breaths/minute
Vesicular breath sounds in right base

9. The right forearm of a client who had a purified protein derivative (PPD) test for tuberculosis
is reddened and raised about 3mm where the test was given. This PPD would be read as
having which of the following results?
1. Indeterminate

2. Needs to be redone
3. Negative
4. Positive
10. A client with primary TB infection can expect to develop which of the following conditions?
1.
2.
3.
4.

Active TB within 2 weeks


Active TB within 1 month
A fever that requires hospitalization
A positive skin test

ASTHMA AND COPD


1. An elderly client with pneumonia may appear with which of the following symptoms first?
1.
2.
3.
4.

Altered mental status and dehydration


fever and chills
Hemoptysis and dyspnea
Pleuretic chest pain and cough

2. Which of the following pathophysiological mechanisms that occurs in the lung parenchyma
allows pneumonia to develop?
1.
2.
3.
4.

Atelectasis
Bronchiectasis
Effusion
Inflammation

3. A 7-year-old client is brought to the E.R. Hes tachypneic and afebrile and has a respiratory
rate of 36 breaths/minute and a nonproductive cough. He recently had a cold. From his history,
the client may have which of the following?
1.
2.
3.
4.

Acute asthma
Bronchial pneumonia
Chronic obstructive pulmonary disease (COPD)
Emphysema

4. Which of the following assessment findings would help confirm a diagnosis of asthma in a
client suspected of having the disorder?
1.
2.
3.
4.

Circumoral cyanosis
Increased forced expiratory volume
Inspiratory and expiratory wheezing
Normal breath sounds

5. Which of the following types of asthma involves an acute asthma attack brought on by an
upper respiratory infection?
1.
2.
3.
4.

Emotional
Extrinsic
Intrinsic
Mediated

6. A client with acute asthma showing inspiratory and expiratory wheezes and a decreased
expiratory volume should be treated with which of the following classes of medication right
away?
1.
2.
3.
4.

Beta-adrenergic blockers
Bronchodilators
Inhaled steroids
Oral steroids

7. A 19-year-old comes into the emergency department with acute asthma. His respiratory rate
is 44 breaths/minute, and he appears to be in acute respiratory distress. Which of the following
actions should be taken first?
1. Take a full medication history

2. Give a bronchodilator by neubulizer


3. Apply a cardiac monitor to the client
4. Provide emotional support to the client.
8. A 58-year-old client with a 40-year history of smoking one to two packs of cigarettes a day
has a chronic cough producing thick sputum, peripheral edema, and cyanotic nail beds. Based
on this information, he most likely has which of the following conditions?
1.
2.
3.
4.

Adult respiratory distress syndrome (ARDS)


Asthma
Chronic obstructive bronchitis
Emphysema

9. The term blue bloater refers to which of the following conditions?


1.
2.
3.
4.

Adult respiratory distress syndrome (ARDS)


Asthma
Chronic obstructive bronchitis
Emphysema

10. The term pink puffer refers to the client with which of the following conditions?
1.
2.
3.
4.

ARDS
Asthma
Chronic obstructive bronchitis
Emphysema

11. A 66-year-old client has marked dyspnea at rest, is thin, and uses accessory muscles to
breathe. Hes tachypneic, with a prolonged expiratory phase. He has no cough. He leans
forward with his arms braced on his knees to support his chest and shoulders for breathing. This
client has symptoms of which of the following respiratory disorders?
1.
2.
3.
4.

ARDS
Asthma
Chronic obstructive bronchitis
Emphysema

12. Its highly recommended that clients with asthma, chronic bronchitis, and emphysema have
Pneumovax and flu vaccinations for which of the following reasons?
1.
2.
3.
4.

All clients are recommended to have these vaccines


These vaccines produce bronchodilation and improve oxygenation.
These vaccines help reduce the tachypnea these clients experience.
Respiratory infections can cause severe hypoxia and possibly death in these clients.

13. Exercise has which of the following effects on clients with asthma, chronic bronchitis, and
emphysema?
1.
2.
3.
4.

It enhances cardiovascular fitness.


It improves respiratory muscle strength.
It reduces the number of acute attacks.
It worsens respiratory function and is discouraged.

14. Clients with chronic obstructive bronchitis are given diuretic therapy. Which of the following
reasons best explains why?
1.
2.
3.
4.

Reducing fluid volume reduces oxygen demand.


Reducing fluid volume improves clients mobility.
Restricting fluid volume reduces sputum production.
Reducing fluid volume improves respiratory function.

15. A 69-year-old client appears thin and cachectic. Hes short of breath at rest and his dyspnea
increases with the slightest exertion. His breath sounds are diminished even with deep
inspiration. These signs and symptoms fit which of the following conditions?
1. ARDS

2. Asthma
3. Chronic obstructive bronchitis
4. Emphysema

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