NCM 103 END TERM EXAMINATION

1st Semester SY 2016-2017

INSTRUCTIONS : Use black pen. Read carefully and analyze your answer.
Circle the letter that corresponds to your correct answer. Erasures are not
allowed. ( Pls. write your name at the LEFT upper corner)
1. Which one of the following is NOT a function of the Upper airway?
A. For clearance mechanism such as coughing
B. Transport gases to the lower airways
C. Warming, Filtration and Humidification of inspired air
D. Protect the lower airway from foreign mater

2. This is the paranasal sinus found between the eyes and the nose that
extends backward into the skull
A. Ehtmoid
B. Sphenoid

C. Maxillary
D. Frontal

3. Gene De Vonne Katrouchuacheulujiki wants to change her surname to

something shorter, The court denied her request which depresses her
and find herself binge eating. She accidentally aspirate a large piece of
nut and it passes the carina. Probabilty wise, Where will the nut go?
A. Right main stem bronchus
B. Left main stem bronchus

C. Be dislodged in between the carina

D. Be blocked by the closed epiglottis

4. Which cell secretes mucus that help protect the lungs by trapping debris
in the respiratory tract?
A. Type I pneumocytes
B. Type II pneumocytes

C. Goblet cells
D. Adipose cells

5. Refers to the extra air that can be inhaled beyond the normal tidal
volume
A. Inspiratory reserve volume
B. Expiratory reserve volume

C. Functional residual capacity

D. Residual volume

6. Casssandra, A 22 year old grade Agnostic, Asked you, how many spikes
of bones are there in my ribs? Your best response is which of the
following?

A. We have 13 pairs of ribs Cassandra

B. We have 12 pairs of ribs Cassandra
C. Humans have 16 pairs of ribs, and that was noted by Vesalius in 1543
D. Humans have 8 pairs of ribs. 4 of which are floating

7. Which of the following is considered as the main muscle of respiration?

A. Lungs
B. Intercostal Muscles

C. Diaphragm
D. Pectoralis major

8. All but one of the following is a purpose of steam inhalation

A. Mucolytic
B. Warm and humidify air

C. Administer medications
D. Promote bronchoconstriction

9. When should a nurse suction a client?

A. As desired
B. As needed
C. Every 1 hour
D. Every 4 hours

10.
Ernest Arnold Hamilton, a 60 year old American client was mobbed
by teen gangsters near New york, Cubao. He was rushed to John Hopio
Medical Center and was Unconscious. You are his nurse and you are to
suction his secretions. In which position should you place Mr. Hamilton?
A. High fowlers
B. Semi fowlers

C. Prone
D. Side lying

11.
There are four catheter sizes available for use, which one of these
should you use for Mr. Hamilton?
A. Fr. 18

C. Fr. 10

B. B. Fr. 12

D. Fr. 5

12.
Which of the following is the initial sign of hypoxemia in an adult
client?
A. Tachypnea and Tachycardia

C. Tachycardia and Flaring of Nares

B. Tachycardia and Irritability

D. Cyanosis and Pallor

13.
Which of the following oxygen delivery method can deliver 100%
Oxygen at 15 LPM?
A. Nasal Cannula

C. Non Rebreather mask

B. Simple Face mask

D. Partial Rebreather mask

14.
Roberto San Andres, A new nurse in the hospital is about to
administer oxygen on patient with Respiratory distress. As his senior
nurse, you should intervene if Roberto will:
A. Uses venture mask in oxygen administration
B. Put a non rebreather mask in the patient before opening the oxygen source
C. Use a partial rebreather mask to deliver oxygen
D. Check for the doctors order for Oxygen administration

15.
Which of the following will alert the nurse as an early sign of
hypoxia?
A. Client is tired and dyspneic

C. The clients heart rate is 50 BPM

B. The client is coughing out blood

side to side

D. Client is frequently turning from

16.
Miguelito de balboa, An OFW presents at the admission with an A:P
Diameter ratio of 2:1, Which of the following associated finding should
the nurse expect?
A. Pancytopenia
B. Anemia

C. Fingers are Club-like

D. Hematocrit of client is decreased

17.
The best method of oxygen administration for client with COPD
uses:
A. Cannula

C. Non rebreather mask

B. Simple Face mask

D. Venturi mask

18.
Mang Dagul, a 50 year old chronic smoker was brought to the E.R
because of difficulty in breathing. Pleural effusion was the diagnosis and
CTT was ordered. What does C.T.T Stands for?
A. Chest tube thoracotomy

C. Closed tube thoracotomy

B. Chest tube thoracostomy

D. Closed tube thoracostmy

19.
Where will the CTT be inserted if we are to drain fluids
accumulated in Mang daguls pleura?
A. 2nd ICS

C. 5th ICS

B. 4th ICS

D. 8th ICS

20.
There is a continuous bubbling in the water sealed drainage
system with suction. And oscillation is observed. As a nurse, what
should you do?
A. Consider this as normal findings
B. Notify the physician
dressing

C. Check for tube leak

D. Prepare a petrolatum gauze

21.
An elderly client with pneumonia may appear with which of the
following symptoms first?
A. Altered mental status and dehydration
B. fever and chills
C. Hemoptysis and dyspnea
D. Pleuretic chest pain and cough
22.
Which of the following pathophysiological mechanisms that occurs
in the lung parenchyma allows pneumonia to develop?
A. Atelectasis
C. Effusion
B. Bronchiectasis
D. Inflammation
23. 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?
A. Acute asthma
C. Chronic obstructive pulmonary
disease (COPD)
B. Bronchial pneumonia
D. Emphysema
24. Which of the following assessment findings would help confirm a
diagnosis of asthma in a client suspected of having the disorder?
A. Circumoral cyanosis
C. Inspiratory and expiratory wheezing
B. Increased forced expiratory volume D. Normal breath sounds
25. Which of the following types of asthma involves an acute asthma attack
brought on by an upper respiratory infection?
A. Emotional
C. Intrinsic
B. Extrinsic
D. Mediated

26.
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?
a. Beta-adrenergic blockers
c. Inhaled steroids
b. Bronchodilators
d. Oral steroids
27.
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?
a. Take a full medication history
b. Give a bronchodilator by neubulizer
c. Apply a cardiac monitor to the client
d. Provide emotional support to the client.
28.
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?
a. Adult respiratory distress syndrome (ARDS)
b. Asthma
c. Chronic obstructive bronchitis
d. Emphysema
29.
The term blue bloater refers to which of the following
conditions?
a. Adult respiratory distress syndrome (ARDS)
b. Asthma
c. Chronic obstructive bronchitis
d. Emphysema
30.
The term pink puffer refers to the client with which of the
following conditions?
a. ARDS
c. Chronic obstructive bronchitis
b. Asthma
d. Emphysema
31.
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?
a. ARDS
c. Chronic obstructive bronchitis
b. Asthma
d. Emphysema
32.
Its highly recommended that clients with asthma, chronic
bronchitis, and emphysema have Pneumovax and flu vaccinations for
which of the following reasons?
a. All clients are recommended to have these vaccines
b. These vaccines produce bronchodilation and improve oxygenation.
c. These vaccines help reduce the tachypnea these clients experience.
d. Respiratory infections can cause severe hypoxia and possibly death in these
clients.
33.
Exercise has which of the following effects on clients with asthma,
chronic bronchitis, and emphysema?
a. It enhances cardiovascular fitness.
b. It improves respiratory muscle strength.

c. It reduces the number of acute attacks.

d. It worsens respiratory function and is discouraged.
34.
Clients with chronic obstructive bronchitis are given diuretic
therapy. Which of the following reasons best explains why?
a. Reducing fluid volume reduces oxygen demand.
b. Reducing fluid volume improves clients mobility.
c. Restricting fluid volume reduces sputum production.
d. Reducing fluid volume improves respiratory function.
35.
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?
a. ARDS
c. Chronic obstructive bronchitis
b. Asthma
d. Emphysema
36.
A client with emphysema should receive only 1 to 3 L/minute of
oxygen, if needed, or he may lose his hypoxic drive. Which of the
following statements is correct about hypoxic drive?
a. The client doesnt notice he needs to breathe.
b. The client breathes only when his oxygen levels climb above a certain point.
c. The client breathes only when his oxygen levels dip below a certain point.
d. The client breathes only when his carbon dioxide level dips below a certain
point.
37.
Teaching for a client with chronic obstructive pulmonary disease
(COPD) should include which of the following topics?
a. How to have his wife learn to listen to his lungs with a stethoscope from WalMart.
b. How to increase his oxygen therapy.
c. How to treat respiratory infections without going to the physician.
d. How to recognize the signs of an impending respiratory infection.
38.
Which of the following respiratory disorders is most common in the
first 24 to 48 hours after surgery?
a. Atelectasis
c. Pneumonia
b. Bronchitis
d. Pneumothorax
39.
Which of the following measures can reduce or prevent the
incidence of atelectasis in a post-operative client?
a. Chest physiotherapy
c. Reducing oxygen requirements
b. Mechanical ventilation
d. Use of an incentive spirometer
40.
Emergency treatment of a client in status asthmaticus includes
which of the following medications?
a. Inhaled beta-adrenergic agents
c. I.V. beta-adrenergic agents
b. Inhaled corticosteroids
d. Oral corticosteroids
41.
Dr. Jones prescribes albuterol sulfate (Proventil) for a patient
with newly diagnose asthma. When teaching the patient about this
drug, the nurse should explain that it may cause:
A. Nasal congestion
C. Lethargy
B. Nervousness
D. Hyperkalemia
42.Miriam, a college student with acute rhinitis sees the campus nurse
because of excessive nasal drainage. The nurse asks the patient about the
color of the drainage. In a acute rhinitis, nasal drainage normally is:
A. Yellow
C. Clear
B. Green
D. Gray

43.A male adult patient hospitalized for treatment of a pulmonary embolism

develops respiratory alkalosis. Which clinical findings commonly accompany
respiratory alkalosis?
A. Nausea or vomiting
C. Hallucinations or tinnitus
B. Abdominal pain or diarrhea
D. Lightheadedness or paresthesia
44.Before administering ephedrine, Nurse Tony assesses the patients history.
Because of ephedrines central nervous system (CNS) effects, it is not
recommended for:
A. Patients with an acute asthma attack C. Patients under age 6
B. Patients with narcolepsy
D. Elderly patients
45.A female patient suffers adult respiratory distress syndrome as a
consequence of shock. The patients condition deteriorates rapidly, and
endotracheal intubation and mechanical ventilation are initiated. When the
high pressure alarm on the mechanical ventilator, alarm sounds, the nurse
starts to check for the cause. Which condition triggers the high pressure
alarm?
A. Kinking of the ventilator tubing
B. A disconnected ventilator tube
C. An endotracheal cuff leak
D. A change in the oxygen concentration without resetting the oxygen level alarm
46.A male adult patient on mechanical ventilation is
receiving pancuronium bromide (Pavulon), 0.01 mg/kg I.V. as needed. Which
assessment finding indicates that the patient needs
another pancuronium dose?
A. Leg movement
B. Finger movement
C. Lip movement
D. Fighting the ventilator
47.On auscultation, which finding suggests a right pneumothorax?
A. Bilateral inspiratory and expiratory crackles
B. Absence of breaths sound in the right thorax
C. Inspiratory wheezes in the right thorax
D. Bilateral pleural friction rub.
48.Rhea, confused and short breath, is brought to the emergency department
by a family member. The medical history reveals chronic
bronchitis and hypertension. To learn more about the current respiratory
problem, the doctor orders a chest x-ray and arterial blood gas (ABG)
analysis. When reviewing the ABG report, the nurses sees many
abbreviations. What does a lowercase a in ABG value present?
A. Acid-base balance
B. Arterial Blood
C. Arterial oxygen saturation
D. Alveoli
49.A male patient is admitted to the health care facility for treatment of
chronic obstructive pulmonary disease. Which nursing diagnosis is most
important for this patient?
A. Activity intolerance related to fatigue
B. Anxiety related to actual threat to health status
C. Risk for infection related to retained secretions
D. Impaired gas exchange related to airflow obstruction
50.Nurse Ruth assessing a patient for tracheal displacement should know that
the trachea will deviate toward the:
A. Contralateral side in a simple pneumothorax
B. Affected side in a hemothorax
C. Affected side in a tension pneumothorax
D. Contralateral side in hemothorax
51.After undergoing a left pneumonectomy, a female patient has a chest tube
in place for drainage. When caring for this patient, the nurse must:
A. Monitor fluctuations in the water-seal chamber
B. Clamp the chest tube once every shift
C. Encourage coughing and deep breathing
D. Milk the chest tube every 2 hours

52.When caring for a male patient who has just had a total laryngectomy, the
nurse should plan to:
A. Encourage oral feeding as soon as possible
B. Develop an alternative communication method
C. Keep the tracheostomy cuff fully inflated
D. Keep the patient flat in bed
53.A male patient has a sucking stab wound to the chest. Which action should
the nurse take first?
A. Drawing blood for a hematocrit and hemoglobin level
B. Applying a dressing over the wound and taping it on three sides
C. Preparing a chest tube insertion tray
D. Preparing to start an I.V. line
54.For a patient with advance chronic obstructive pulmonary disease (COPD),
which nursing action best promotes adequate gas exchange?
A. Encouraging the patient to drink three glasses of fluid daily
B. Keeping the patient in semi-fowlers position
C. Using a high-flow venture mask to deliver oxygen as prescribe
D. Administering a sedative, as prescribe
55.A male patients X-ray result reveals bilateral white-outs, indicating adult
respiratory distress syndrome (ARDS). This syndrome results from:
A. Cardiogenic pulmonary edema
B. Respiratory alkalosis
C. Increased pulmonary capillary permeability
D. Renal failure
56.For a female patient with chronic obstructive pulmonary disease, which
nursing intervention would help maintain a patent airway?
A. Restricting fluid intake to 1,000 ml per day
B. Enforcing absolute bed rest
C. Teaching the patient how to perform controlled coughing
D. Administering prescribe sedatives regularly and in large amounts
57.Nurse Lei caring for a client with a pneumothorax and who has had a chest
tube inserted notes continues gentle bubbling in the suction control
chamber. What action is appropriate?
A. Do nothing, because this is an expected finding
B. Immediately clamp the chest tube and notify the physician
C. Check for an air leak because the bubbling should be intermittent
D. Increase the suction pressure so that the bubbling becomes vigorous
58.Nurse Maureen has assisted a physician with the insertion of a chest tube.
The nurse monitors the client and notes fluctuation of the fluid level in the
water seal chamber after the tube is inserted. Based on this assessment,
which action would be appropriate?
A. Inform the physician
B. Continue to monitor the client
C. Reinforce the occlusive dressing
D. Encourage the client to deep-breathe
59.Nurse Reynolds caring for a client with a chest tube turns the client to the
side, and the chest tube accidentally disconnects. The initial nursing action
is to:
A. Call the physician
B. Place the tube in bottle of sterile water
C. Immediately replace the chest tube system
D. Place a sterile dressing over the disconnection site
60.A nurse is assisting a physician with the removal of a chest tube. The nurse
should instruct the client to:
A. Exhale slowly
B. Stay very still
C. Inhale and exhale quickly
D. Perform the Valsalva maneuver
61.While changing the tapes on a tracheostomy tube, the male client coughs
and tube is dislodged. The initial nursing action is to:
A. Call the physician to reinsert the tube
B. Grasp the retention sutures to spread the opening

C. Call the respiratory therapy department to reinsert the tracheotomy

D. Cover the tracheostomy site with a sterile dressing to prevent infection
62.Nurse Oliver is caring for a client immediately after removal of the
endotracheal tube. The nurse reports which of the following signs
immediately if experienced by the client?
A. Stridor
B. Occasional pink-tinged sputum
C. A few basilar lung crackles on the right
D. Respiratory rate 24 breaths/min
63.An emergency room nurse is assessing a male client who has sustained a
blunt injury to the chest wall. Which of these signs would indicate the
presence of a pneumothorax in this client?
A. A low respiratory rate
B. Diminished breath sounds
C. The presence of a barrel chest
D. A sucking sound at the site of injury
64.Nurse Reese is caring for a client hospitalized with acute exacerbation of
chronic obstructive pulmonary disease. Which of the following would the
nurse expect to note on assessment of this client?
A. Hypocapnia
B. A hyperinflated chest noted on the chest x-ray
C. Increased oxygen saturation with exercise
D. A widened diaphragm noted on the chest x-ray
65.An oxygen delivery system is prescribed for a male client with chronic
obstructive pulmonary disease to deliver a precise oxygen concentration.
Which of the following types of oxygen delivery systems would the nurse
anticipate to be prescribed?
A. Face tent
B. Venturi mask
C. Aerosol mask
D. Tracheostomy collar
66.Blessy, a community health nurse is conducting an educational session with
community members regarding tuberculosis. The nurse tells the group that
one of the first symptoms associated with tuberculosis is:
A. Dyspnea
B. Chest pain
C. A bloody, productive cough
D. A cough with the expectoration of mucoid sputum
67.A nurse performs an admission assessment on a female client with a
diagnosis of tuberculosis. The nurse reviews the result of which diagnosis
test that will confirm this diagnosis?
A. Bronchoscopy
B. Sputum culture
C. Chest x-ray
D. Tuberculin skin test
68.A nurse is caring for a male client with emphysema who is receiving oxygen.
The nurse assesses the oxygen flow rate to ensure that it does not exceed:
A. 1 L/min
B. 2 L/min
C. 6 L/min
D. 10 L/min
69.A nurse instructs a female client to use the pursed-lip method of breathing
and the client asks the nurse about the purpose of this type of breathing.
The nurse responds, knowing that the primary purpose of pursed-lip
breathing is to:
A. Promote oxygen intake
B. Strengthen the diaphragm
C. Strengthen the intercostal muscles
D. Promote carbon dioxide elimination
70.A nurse is caring for a male client with acute respiratory distress syndrome.
Which of the following would the nurse expect to note in the client?

A. Pallor
B. Low arterial PaO2
C. Elevated arterial PaO2
D. Decreased respiratory rate
71.A nurse is preparing to obtain a sputum specimen from a male client. Which
of the following nursing actions will facilitate obtaining the specimen?
A. Limiting fluid
B. Having the client take deep breaths
C. Asking the client to spit into the collection container
D. Asking the client to obtain the specimen after eating
72.Nurse Joy is caring for a client after a bronchoscopy and biopsy. Which of
the following signs, if noticed in the client, should be reported immediately
to the physician?
A. Dry cough
B. Hermaturia
C. Bronchospasm
D. Blood-streaked sputum
73.A nurse is suctioning fluids from a male client via a tracheostomy tube.
When suctioning, the nurse must limit the suctioning time to a maximum of:
A. 1 minute
B. 5 seconds
C. 10 seconds
D. 30 seconds
74.A nurse is suctioning fluids from a female client through an endotracheal
tube. During the suctioning procedure, the nurse notes on the monitor that
the heart rate is decreasing. Which if the following is the appropriate
nursing intervention?
A. Continue to suction
B. Notify the physician immediately
C. Stop the procedure and reoxygenate the client
D. Ensure that the suction is limited to 15 seconds
75.A male adult client is suspected of having a pulmonary embolus. A nurse
assesses the client, knowing that which of the following is a common
clinical manifestation of pulmonary embolism?
A. Dyspnea
B. Bradypnea
C. Bradycardia
D. Decreased respirations
76.A slightly obese female client with a history of allergy-induced
asthma,hypertension, and mitral valve prolapse is admitted to an acute
care facility for elective surgery. The nurse obtains a complete history and
performs a thorough physical examination, paying special attention to the
cardiovascular and respiratory systems. When percussing the clients chest
wall, the nurse expects to elicit:
A. Resonant sounds.
B. Hyperresonant sounds.
C. Dull sounds.
D. Flat sounds.
77.A male client who weighs 175 lb (79.4 kg) is receiving aminophylline
(Aminophyllin) (400 mg in 500 ml) at 50 ml/hour. The theophylline level is
reported as 6 mcg/ml. The nurse calls the physician who instructs the nurse
to change the dosage to 0.45 mg/kg/hour. The nurse should:
A. Question the order because its too low.
B. Question the order because its too high.
C. Set the pump at 45 ml/hour.
D. Stop the infusion and have the laboratory repeat the theophylline
measurement.
78.The nurse is teaching a male client with chronic bronchitis about breathing
exercises. Which of the following should the nurse include in the teaching?
A. Make inhalation longer than exhalation.
B. Exhale through an open mouth.

C. Use diaphragmatic breathing.

D. Use chest breathing.
79.Which phrase is used to describe the volume of air inspired and expired
with a normal breath?
A. Total lung capacity
B. Forced vital capacity
C. Tidal volume
D. Residual volume
80.A male client abruptly sits up in bed, reports having difficulty breathing and
has an arterial oxygen saturation of 88%. Which mode of
oxygen delivery would most likely reverse the manifestations?
A. Simple mask
B. Non-rebreather mask
C. Face tent
D. Nasal cannula
81.A female client must take streptomycin for tuberculosis. Before therapy
begins, the nurse should instruct the client to notify the physician if which
health concern occurs?
A. Impaired color discrimination
B. Increased urinary frequency
C. Decreased hearing acuity
D. Increased appetite
82.A male client is asking the nurse a question regarding the Mantoux test for
tuberculosis. The nurse should base her response on the fact that the:
A. Area of redness is measured in 3 days and determines whether tuberculosis
is present.
B. Skin test doesnt differentiate between active and dormant tuberculosis
infection.
C. Presence of a wheal at the injection site in 2 days indicates active
tuberculosis.
D. Test stimulates a reddened response in some clients and requires a second
test in 3 months.
83.A female adult client has a tracheostomy but doesnt require continuous
mechanical ventilation. When weaning the client from the tracheostomy
tube, the nurse initially should plug the opening in the tube for:
A. 15 to 60 seconds.
B. 5 to 20 minutes.
C. 30 to 40 minutes.
D. 45 to 60 minutes.
84.Nurse Oliver observes constant bubbling in the water-seal chamber of a
closed chest drainage system. What should the nurse conclude?
A. The system is functioning normally
B. The client has a pneumothorax.
C. The system has an air leak.
D. The chest tube is obstructed.
85.A black 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:
A. Lips.
B. Mucous membranes.
C. Nail beds.
D. Earlobes.
86.For a male client with an endotracheal (ET) tube, which nursing action is
most essential?
A. Auscultating the lungs for bilateral breath sounds
B. Turning the client from side to side every 2 hours
C. Monitoring serial blood gas values every 4 hours
D. Providing frequent oral hygiene
87.The nurse assesses a male clients respiratory status. Which observation
indicates that the client is experiencing difficulty breathing?
A. Diaphragmatic breathing
B. Use of accessory muscles

C. Pursed-lip breathing
D. Controlled breathing
88.A female client is undergoing a complete physical examination as a
requirement for college. When checking the clients respiratory status, the
nurse observes respiratory excursion to help assess:
A. Lung vibrations.
B. Vocal sounds.
C. Breath sounds.
D. Chest movements.
89.A male client comes to the emergency department complaining of sudden
onset of diarrhea, anorexia, malaise, cough, headache, and recurrent chills.
Based on the clients history and physical findings, the physician suspects
legionnaires disease. While awaiting diagnostic test results, the client is
admitted to the facility and started on antibiotic therapy. What is the drug
of choice for treating legionnaires disease?
A. Erythromycin (Erythrocin)
B. Rifampin (Rifadin)
C. Amantadine (Symmetrel)
D. Amphotericin B (Fungizone)
90.A male client with chronic obstructive pulmonary disease (COPD) is
recovering from a myocardial infarction. Because the client is extremely
weak and cant produce an effective cough, the nurse should monitor
closely for:
A. Pleural effusion.
B. Pulmonary edema.
C. Atelectasis.
D. Oxygen toxicity.
91.The nurse in charge is teaching a client with emphysema how to perform
pursed-lip breathing. The client asks the nurse to explain the purpose of
this breathing technique. Which explanation should the nurse provide?
A. It helps prevent early airway collapse.
B. It increases inspiratory muscle strength.
C. It decreases use of accessory breathing muscles.
D. It prolongs the inspiratory phase of respiration.
92.After receiving an oral dose of codeine for an intractable cough, the male
client asks the nurse, How long will it take for this drug to work? How
should the nurse respond?
A. In 30 minutes
B. In 1 hour
C. In 2.5 hours
D. In 4 hours
93.A male client suffers adult 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?
A. Kinking of the ventilator tubing
B. A disconnected ventilator tube
C. An ET cuff leak
D. A change in the oxygen concentration without resetting the oxygen level
alarm
94.A female client with chronic obstructive pulmonary disease (COPD) takes
anhydrous theophylline, 200 mg P.O. every 8 hours. During a routine clinic
visit, the client asks the nurse how the drug works. What is the mechanism
of action of anhydrous theophylline in treating a nonreversible obstructive
airway disease such as COPD?
A.It makes the central respiratory center more sensitive to carbon dioxide and
stimulates the respiratory drive.
B. It inhibits the enzyme phosphodiesterase, decreasing degradation of cyclic
adenosine monophosphate, a bronchodilator.
C. It stimulates adenosine receptors, causing bronchodilation.

D. It alters diaphragm movement, increasing chest expansion and enhancing

the lungs capacity for gas exchange.
95.A male client with pneumococcal pneumonia is admitted to an acute care
facility. The client in the next room is being treated for
mycoplasmal pneumonia. Despite the different causes of the various types
of pneumonia, all of them share which feature?
A. Inflamed lung tissue
B. Sudden onset
C. Responsiveness to penicillin.
D. Elevated white blood cell (WBC) count
96.A client with Guillain-Barr syndrome develops respiratory acidosis as a
result of reduced alveolar ventilation. Which combination of arterial blood
gas (ABG) values confirms respiratory acidosis?
A. pH, 5.0; PaCO2 30 mm Hg
B. pH, 7.40; PaCO2 35 mm Hg
C. pH, 7.35; PaCO2 40 mm Hg
D. pH, 7.25; PaCO2 50 mm Hg
97.A male client admitted to an acute care facility with pneumonia is receiving
supplemental oxygen, 2 L/minute via nasal cannula. The clients history
includes chronic obstructive pulmonary disease (COPD) and coronary artery
disease. Because of these history findings, the nurse closely monitors the
oxygen flow and the clients respiratory status. Which complication may
arise if the client receives a high oxygen concentration?
A. Apnea
B. Anginal pain
C. Respiratory alkalosis
D. Metabolic acidosis
98.At 11 p.m., a male client is admitted to the emergency department. He has
a respiratory rate of 44 breaths/minute. Hes anxious, and wheezes are
audible. The client is immediately given oxygen by face mask and
methylprednisolone (Depo-medrol) I.V. At 11:30 p.m., the clients arterial
blood oxygen saturation is 86% and hes still wheezing. The nurse should
plan to administer:
A. Alprazolam (Xanax).
B. Propranolol (Inderal)
C. Morphine.
D. Albuterol (Proventil).
99.After undergoing a thoracotomy, a male client is receiving epidural
analgesia. Which assessment finding indicates that the client has developed
the most serious complication of epidural analgesia?
A. Heightened alertness
B. Increased heart rate
C. Numbness and tingling of the extremities
D. Respiratory depression
100.
The nurse in charge formulates a nursing diagnosis of Activity
intolerance related to inadequate oxygenation and dyspnea for a client
with chronic bronchitis. To minimize this problem, the nurse instructs the
client to avoid conditions that increase oxygen demands. Such conditions
include:
A. Drinking more than 1,500 ml of fluid daily.
B. Being overweight.
C. Eating a high-protein snack at bedtime.
D. Eating more than three large meals a day.