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Melissa Ackerly
SUNY Delhi
NURS-603-11253-201709
Kirsty Digger
The correct answer is D because data collection such as vital sign monitoring are within the
scope of Licensed Nurses scope of practice and the sedated patients vital signs require
Rationale: Answer A is incorrect because again teaching is out of the LVN/LPN scope of
practice and would have been done by the RN prior to sedation, answer B because the patient
would be NPO prior to the procedure, and answer C is also incorrect because the sedated patient
Blooms: Analysis
The nurse is able to differentiate scope of practice duties and assigns vital signs as a critical need
Management of Care
2. On a skilled nursing unit, an LVN/LPN reports to a staff nurse that a client is short of breath.
What is the most important initial response by the RN?
The correct answer is C because the RN requires specific data of the patients condition from
Rationale: Answer A is incorrect because yes or no does not describe the patients condition,
answer B assumes there is an urgent situation, and answer D does not address the current
situation in determining what the patient is doing at the moment (Lagerquist, 2012).
Blooms: Analysis
The nurse is eliminating assumption and and asking for evidence to make a decision how
3. A nurse prepares to admit a child diagnosed with respiratory syncytial virus (RSV). Which
infection control measure would be most appropriate for this child?
Blooms: Application
The nurse must be able to apply principles of infection control by selecting the most appropriate
4. Which nursing intervention should a nurse perform on a young child suspected of having a
diagnosis of acute epiglottitis whose oxygen saturation is 93% on room air?
Blooms: Application
RESPIRATORY CONCEPTS EXAM 4
The nurse is using assessments to determine what is best for the patient by mentally applying
each of the options to construct a picture of what would be the most effective or necessary
5. A 7-year-old child is hospitalized for a tonsillectomy. What are priority nursing actions when
caring for this child after surgery? (Select all that apply)
The correct answer is A, C, D because after a tonsillectomy ice chips and advancing intake are
encouraged as tolerated, the bleeding times are monitored because the bleeding of the tonsils
post-op could occlude the airway, and pain control is most effective when provided at regular
Rationale: Answers B and E are incorrect due to increased pressure from coughing and the
invasive nature suctioning would have on the surgical site (Lagerquist, 2012).
Blooms: Analysis
The nurse is processing care to separate what would help from what would harm the patient
(Huitt, 2011).
6. Which prescribed drugs would a nurse most likely give the client for respiratory stridor, with
wheezing, and hypotension after a beesting? (Select all that apply)
a. Epinephrine
b. Diphenhydramine
c. Corticosteroid (Solu-Medrol)
d. Furosemide (Lasix)
e. Acetaminophen (Tylenol)
f. Ranitidine (Zantac)
RESPIRATORY CONCEPTS EXAM 5
Blooms: Application
The nurse can previously learned knowledge to select answers that fit the situation by
7. A client has just been extubated. Which assessment by a nurse would indicate signs of
laryngeal edema?
Blooms: Analysis
The nurse must have lungs sound assessment skills to differentiate wheezes and crowing sounds
as well the ability to interpret ABGs to separate right from wrong answers (Huitt, 2011).
Blooms: Analysis
The student will compare and contrast the options to arrive at the answer which could cause
potential harm to the patient (Huitt, 2011). The distractors are safe orders and the correct answer
9. In a closed chest drainage system, which area regulates the amount of suction?
a. Chamber 1
b. Chamber 2
c. Chamber 3
4. Tube to the client
The correct answer is A. The nurse needs to understand exactly how the chest drainage system
functions in order to safely manipulate the suction when disconnecting the patient for ambulation
and reconnecting after. Failure to appropriately monitor suction to the chamber could be
Blooms: Comprehension
The nurse has been taught about chest drainage systems and now must explain where the suction
control comes from in the device. For this question and illustration the knowledge level could
also apply as recall is required to find the correct answer by looking at the illustration (Huitt,
2011).
Psychosocial Integrity
10. A nurse has just received morning report and is organizing and prioritizing the client
assignment. Prioritize the nurses actions by placing each client in the correct order.
The correct answer is C, D, B, A. Chest discomfort is always a priority complaint for C. Client
D needs to be assessed next because his problem is unknown to the nurse. Patient B needs to be
assessed related to alcohol withdrawal and an elevated Na level. Sending patient A home requires
RESPIRATORY CONCEPTS EXAM 7
the nurse to take her time with the patient in assuring proper education and support for a safe
Blooms: Analysis
The nurse is using evidence to categorize the patients priority needs. The nurse must have some
foundational knowledge and experience with cardiac concerns verses an electrolyte imbalance to
References
Huitt, W. (2011). Bloom et al.'s taxonomy of the cognitive domain. Educational Psychology
Lagerquist, S. L. (2012). Davis's NCLEX-RN success (3rd Ed.). Philadelphia, PA: F.A. Davis.
Oermann, M. H., & Gaberson, K. B. (2014). Evaluation and testing in nursing education (4th