RESPIRATORY FUNCTION 1. A patient with sinus congestion reports discomfort when the nurse is palpating the supraorbital ridges. The nurse is aware that the patient is referring to which sinus? a. Frontal b. Ethmoidal c. Maxillary d. Sphenoidal 2. When the nurse is assessing the older adult patient, which gerontologic changes in the respiratory system will the nurse be aware of? (Select all that apply.) a. Decreased alveolar duct diameter b. Increased presence of mucus c. Decreased gag reflex d. Increased presence of collagen in alveolar walls x e. Decreased presence of mucus 3. Anurse caring for a patient with a pulmonary embolism understands that high ventilation-perfusion ratio may exist. What does this mean for the patient? a. Perfusion exceeds ventilation b. There is an absence of perfusion and ventilation c. Ventilation exceeds perfusion d. Ventilation matches perfusion 4. The nurse is measuring a patient pulse oxim-etry reading after the patient reports slight shortness of breath when ambulating. Which oxygen saturation reading will the nurse identify as acceptable? a. 40 mm Hgb. 75 mm Hg c. 80 mm Hg d. 95mm Hg 5. The nurse is taking a respiratory history for a patient who has come into the clinic with a chronic cough. Which information will the nurse obtain from this patient? (Select all that apply.) a. Financial ability to pay the bill b. Social support c. Previous history of lung disease in the patient or family d. Occupational and environmental influences e. Previous history of smoking 6. A patient comes to the emergency depart-ment reporting a knifelike pain when taking a deep breath. What does this type of pain likely indicate to the nurse? a. Bacterial pneumonia b. Bronchogenic carcinoma c. Lung infarction d. Pleurisy 7. The nurse is caring for a patient with a pulmonary disorder. Which observation by the nurse is indicative of a very late symptom of hypoxia? a. Cyanosis b. Dyspnea c. Restlessness d. Confusion 8. The nurse inspects the thorax of a patient with advanced emphysema. How does the nurse document the chest configuration for this patient? a. Barrel chest b. Funnel chest c. Kyphoscoliosis d. Pigeon chest9. The nurse is performing chest auscultation for a patient with asthma. How does the nurse describe the high-pitched, sibilant, musical sounds that are heard? a. Rales b. Crackles c. Wheezes d. Rhonchi 10. The nurse auscultates crackles in a patient with a respiratory disorder. Which condition does the nurse identify correlates with this assessment finding? a. Asthma b. Bronchospasm c. Collapsed alveoli d. Pulmonary fibrosis 11. When performing an assessment for a patient, the nurse percusses tactile fremitus with hyperresonant sounds. Which diagno-sis does the nurse correlate these assessment findings with? a. Bronchitis b. Emphysema c. Atelectasis d. Pulmonary edema 12. The nurse is reviewing the blood gas results for a patient with pneumonia. Which arterial blood gas measurement best reflects the adequacy of alveolar ventilation? a. PaO2 b. PaCO2 c. pH d. Sa02 13. The nurse is instructing the patient on the collection of a sputum specimen. Which will be included in the instructions? (Select all that apply.)a. Initially, clear the nose and throat. b. Spit surface mucus and saliva into a sterile specimen container. c. Take a few deep breaths before coughing. d. Use diaphragmatic contractions to aid in the expulsion of sputum. e. Rinse with mouthwash prior to providing the specimen. 14. A health care provider requests a study of diaphragmatic motion because of suspected pathology. Which diagnostic test will the nurse prepare the patient for? a. Barium swallow b. Bronchogram c. Fluoroscopy d. Tomogram 15. The nurse is educating a patient scheduled for a perfusion lung scan. Which will be included in the information related to the procedure? (Select all that apply.) a. Amask will be placed over the nose and mouth during the test. b. The patient will be expected to lie under the camera. c. The imaging time will amount to 20 to 40 minutes. d. The patient will be expected to be NPO for 12 hours prior to the procedure. e. An injection will be placed into the lung during the procedure. 16. The nurse is performing an assessment for a patient with congestive heart failure and asks if the patient has difficulty breathing in any position other than upright. How will the nurse document this finding when the patient confirms that they do have difficulty? a. Dyspnea b. Orthopnea c. Tachypnea d. Bradypnea 17. The nurse is interviewing a patient who reports a dry, irritating cough that is not "bringing anything up." Which medication will the nurse question the patient about taking?a. Angiotensin-converting enzyme (ACE) inhibitors b. Aspirin c. Bronchodilators d. Cardiac glycosides 18. Which assessment finding by the nurse indi-cates that the patient has chronic hypoxia? a. Crackles b. Peripheral edema c. Clubbing of the fingers d. Cyanosis 19. When observing the chest wall of a patient, the nurse detects a depression in the lower portion of the sternum. Which assessment finding will the nurse anticipate detecting due to this condition? a. Clubbing of fingers b. Cyanosis c.Crackles d. Murmurs 20. The nurse is performing an assessment of a patient who arrived in the emergency department with a barbiturate overdose. The respirations are normal for 3 to 4 breaths followed by a 60-second period of apnea. How will the nurse document the respirations? a. Cheyne-Stokes b. Tachypnea c. Bradypnea d. Biot respirationsUPPER RESPIRATORY INFECTIONS 1. A patient comes to the clinic reporting symptoms of the common cold and wants something to help relieve the symptoms. Which will the nurse include in educating the patient about the uncomplicated common cold? (Select all that apply.) a. Tell the patient to take prescribed antibiotics to decrease the severity of symptoms. b. Inform the patient about the symptoms of secondary infection. c. Suggest that the patient take adequate fluids and get plenty of rest. d. Inform the patient that the virus is conta-gious for 2 days before symptoms appear and during the first part of the symptom-atic phase. e. Inform the patient that taking an antihis-tamine will help to decrease the duration of the cold. 2. A patient has herpes simplex infection that developed after having the common cold. Which prescribed medication will the nurse educate the patient about regarding treatment of the herpes simplex? a. An antiviral agent such as acyclovir b. An antibiotic such as amoxicillin c. An antihistamine such as diphenhydramine d. An ointment such as bacitracin 3. A patient has been diagnosed with acute rhinosinusitis caused by a bacterial organism. Which antibiotic of choice for treatment of this disorder will the nurse educate the patient about? a. Amoxicillin-clavulanate b. Cephalexin c. Azithromycin d. Clarithromycin4. The nurse is educating a patient diagnosed with acute bacterial rhinosinusitis about Interventions that may assist with symptom control. Which will the nurse include in this information? (Select all that apply.) a. Take an over-the-counter nasal decongestant. b. Take an over-the-counter antihistamine. c. Ensure an adequate fluid intake. d. Increase the humidity in the home. e. Apply local heat to promote drainage. 5. A patient comes to the clinic reporting a sore throat and is diagnosed with acute pharyngi-tis. Which causative bacteria does the nurse identify was the likely cause of the acute pharyngitis? a. Group A, beta-hemolytic streptococci b. Gram-negative Klebsiella c. Pseudomonas aeruginosa d. Staphylococcus aureus 6. A patient diagnosed 2 weeks ago with acute pharyngitis comes to the clinic stating that the sore throat got better for a couple of days and is now back along with an earache. Which complications should the patient be assessed for related to the acute pharyngitis? (Select all that apply.) a. Mastoiditis b. Otitis media c. Peritonsillar abscess d. Pericarditis e. Encephalitis 7. The nurse is educating the patient diagnosed with acute pharyngitis on methods to alle. viate discomfort, Which interventions should the nurse include in the information? (Select all that apply.) a. Apply an ice collar.b. Stay on bed rest during the febrile stage of the illness. c. Gargle with an alcohol-based mouthwash d. Try a liquid or soft diet during the acute stage of the disease. e. Drink warm or hot liquids during the acute stage of the disease. 8. A patient comes to the clinic and is diagnosed with tonsillitis and adenoiditis. Which bacterial pathogen does the nurse identify is commonly associated with tonsillitis and adenoiditis? a. Gram-negative Klebsiella b. Pseudomonas aeruginosa c. Group A, beta-hemolytic streptococcus d. Staphylococcus aureus 9. A patient comes to the clinic reporting a pos. sible upper respiratory infection. Which will the nurse assess that would indicate that an upper respiratory infection may be present? a. The nasal mucosa b. The buccal mucosa c. The frontal sinuses d. The tracheal mucosa 10. A patient playing softball was hit in the nose by the ball and has been determined to have an uncomplicated fractured nose with epistaxis. Which task will the nurse prepare to assist the health care provider with? a. Preparing the patient for a septoplasty b. Applying nasal packing c. Administering nasal lavage d. Applying steroidal nasal spray11. A patient arrives in the emergency depart-ment with an edematous face, tongue, and difficulty breathing after starting a new medication for hypertension. When reviewing medication, which antihypertensive would the nurse suspect as the likely causative factor? a. Metoprolol succinate b. Amlodipine c. Enalapril d. Valsartan 12. The nurse is assessing a patient who smokes two packs of cigarettes per day and has a strong family history of cancer. Which early sign of cancer of the larynx does the nurse assess for in this patient? a. Burning of the throat when hot liquids. are ingested b. Enlarged cervical nodes c. Dysphagia d. Affected voice sounds 13. A patient is diagnosed as being in the early stage of laryngeal cancer of the glottis with only one vocal cord involved. For which type of surgical intervention will the nurse plan to provide education? a. Total laryngectomy b. Cordectomy c. Vocal cord stripping d. Partial laryngectomy 14. A patient with an advanced laryngeal tumor is to have radiation therapy. The patient tells the nurse, "If | am going to have radiation, | won't need surgery.’ Which is the best response by the nurse? a. "That is correct. The radiation will eradicate the tumor and you won't have to have further treatment.” b. "Radiation is used to shrink the tumor size and is an adjunct to surgery.” c. "All patients have to have radiation before they have surgery. It is protocol.”d. "You really don't have to have radiation but you won't have to have such invasive surgery if you have the radiation first.” 15. The nurse is caring for a patient who had a total laryngectomy and has drains in place. When does the nurse understand that the drains will most likely be removed? a. When the patient has less than 30 mL for 2 consecutive days b. When the patient states that there is discomfort and requests removal c. When the drainage tube comes out d. In 1 week when the patient no longer has serous drainageLOWER RESPIRATORY TRACT DISORDERS 1. The nurse is developing a plan of care for a patient with acute tracheobronchitis. Which nursing interventions will be included in the plan of care? (Select all that apply.) a. Increasing fluid intake to remove secretions b. Encouraging the patient to remain in bed c. Using cool-vapor therapy to relieve laryngeal and tracheal irritation d. Giving 3-L fluid per day e. Administering a narcotic analgesic for pain 2. The nurse is collecting a sputum culture to identify the causative organism for a patient with acute tracheobronchitis, Which causative fungal organism does the nurse suspect? a. Aspergillus b. Haemophilus c. Mycoplasma pneumoniae d. Streptococcus pneumoniae 3. The nurse is conducting a community pro-gram about prevention of respiratory illness, Which illness does the nurse recognize is the most common cause of death in the United States? a. Atelectasis b. Pulmonary embolus c. Pneumonia d. Tracheobronchitis4. A patient comes to the clinic reporting fever, cough, and chest discomfort. The nurse aus-cultates crackles in the left lower base of the lung and suspects that the patient may have pneumonia. Which does the nurse identify is the most common organism that causes community- acquired pneumonia? a. Staphylococcus aureus b. Mycobacterium tuberculosis c. Pseudomonas aeruginosa d. Streptococcus pneumoniae 5. A patient has a Mantoux skin test prior to being placed on a biologic medication for the treatment of Crohn's disease. Which results would determine that the medication may be administered as prescribed by the nurse? a.0to4mm b. 5to6mm c.7to8mm d.9mm 6. The nurse is educating a patient who will be started on an antituberculosis medication regimen. The patient asks the nurse, "How long will | have to be on these medications?" Which statement by the nurse is most Informative? a. "You will need to take the medication for 3 months." b. "Depending on your symptoms, 3 to 5 months is the most you will take them." c. "It is important that you take the medica. tion as prescribed for 6 to 12 months." d. "Most patients have to take the medica-tion for at least 13 to 18 months."7. The nurse is caring for a patient with pleurisy, Which symptoms does the nurse identify correlate with the patient's illness? a. Dullness or flatness on percussion over areas of collected fluid b. Dyspnea and coughing c. Fever and chills d. Stabbing pain during respiratory movement 8. The nurse is auscultating the patient's lung sounds to determine if there is the presence of fluid overload, Which adventitious lung sounds are significant for pulmonary edema? a. Crackles in the lung bases b. Low-pitched rhonchi during expiration c. Pleural friction rub d. Sibilant wheezes 9. A patient is being educated by the nurse about the administration of isoniazid (INH) therapy for tuberculosis. Which statement made by the patient indicates that the education is understood? a. "lam going to have a tuna fish sandwich for lunch." b. "It is all right if | drink a glass of red wine with my dinner." c. "It is all right if | have a grilled cheesem sandwich with American cheese." d. "It is fine if | eat sushi with a little bit of soy sauce.”10. A patient who wears contact lenses is to be placed on rifampin for tuberculosis therapy: Which information will the nurse provide to the patient? a. "Only wear your contact lenses during the day and take them out in the evening before bed." b. "You should switch to wearing your glasses while taking this medication." "The health care provider can give you eye drops to prevent any problems." d. "There are no significant problems with wearing contact lenses."X 11. The nurse is caring for a patient with sus-pected acute respiratory distress syndrome (ARDS) with a PO2 of 53. The patient is placed on oxygen via facemask and the PO2 remains the same. Which key characteristic of ARDS does the nurse identify is occurring? a. Unresponsive arterial hypoxemia b. Diminished alveolar dilation c. Tachypnea d. Increased PaO2 12. A patient is admitted to the hospital with pulmonary arterial hypertension. Which significant assessment finding by the nurse will be reported to the health care provider? a. Ascites b. Dyspnea c. Hypertension d. Syncope13. The nurse is assessing a patient who has been admitted with possible acute respiratory distress syndrome (ARDS). Which findings would distinguish ARDS from cardiogenic pulmonary edema? a. Elevated white blood count b. Elevated troponin levels c. Elevated myoglobin levels d. Elevated B-type natriuretic peptide (BNP) levels 14. A patient with pulmonary hypertension has a positive vasoreactivity test. Which medica-tion will the nurse administer to the patient as prescribed? a. Calcium channel blockers b. Angiotensin-converting enzyme inhibitor c. Beta-blockers d. Angiotensin receptor blockers 15. The nurse assesses a patient for a possible pulmonary embolism. Which frequent sign of pulmonary embolus does the nurse Identify on assessment? a. Cough b. Hemoptysis c. Syncope d. Tachypnea 16. The nurse is administering anticoagulant therapy with heparin. Which international normalized ratio (INR) does the nurse identify as within therapeutic range and will continue administration of the heparin? a. 0.5 to 1.0 b. 1.5'to:2:5 c. 2.0 to 2.5 d. 3.0 to 3.517. The nurse is planning the care for a patient at risk for the development of a pulmonary embolism. Which nursing actions will be included in the care plan? (Select all that apply.) a. Encourage a liberal fluid intake. b. Assist the patient to do leg elevations above the level of the heart. c. Instruct the patient to dangle the legs over the side of the bed for 30 minutes, four times a day. d. Use elastic stockings, especially when decreased mobility would promote venous stasis. e. Apply a sequential compression device. 18. The nurse is assisting with an endotracheal insertion for a patient in respiratory failure. Which nursing action will ensure that the endotracheal tube is placed in the appropriate position? a. Obtain a chest x-ray for confirmation of tube placement. b. Observe condensation in the endotracheal tube. c. Listen to breath sounds on the anterior chest wall. d. Observe the patient's oxygen saturation level. 19. The nurse is having an information session with a women’s group at the YMCA about lung cancer. Which frequent and commonly Cexperienced symptom will the nurse include in the session? a. Copious sputum production b. Coughing c. Dyspnea d. Severe pain20. A patient arrives in the emergency department after being involved in a motor vehicle crash. The nurse observes paradoxical chest movement when removing the patient's shirt. What does the nurse know that this finding indicates? a. Pneumothorax b. Flail chest c. ARDS d. Tension pneumothoraxCHRONIC PULMONARY DISEASES 1. A patient comes to the clinic for the third time in 2 months with chronic bronchitis. Which clinical symptoms does the nurse assess in this patient? a. Chest pain during respiration b. Sputum and a productive cough c. Fever, chills, and diaphoresis d. Tachypnea and tachycardia 2. The nurse is assigned to care for a patient with COPD experiencing hypoxemia and hypercapnia. When planning care for this patient, which outcome of treatment will the nurse evaluate? a. The patient will demonstrate adequate oxygenation. b. The patient will avoid the use of sup-plementary oxygen to decrease hypoxic drive. c. Monitor pulse oximetry every 8 hours while awake. d. Educate the patient about the use of dia-phragmatic breathing techniques. 3. A nurse notes that the FEV1/FVC ratio is less than 70% for a patient with COPD. Which stage should the nurse document the patient is in? a.0 b.1 c. Il d. Ill4. Upon assessment, the nurse suspects that a patient with COPD may have bronchospasm. Which manifestations validate the nurse's concern? (Select all that apply.) a. Compromised gas exchange b. Decreased airflow c. Wheezes d. Jugular vein distention e. Ascites 5. The health care provider prescribes a beta-2 adrenergic agonist agent that is short-acting and administered only by inhaler. Which medication does the nurse administer as prescribed? a. Metaproterenol b. Terbutaline c. Formoterol d. Isoproterenol 6. A patient with end-stage COPD and heart failure asks the nurse about lung reduction surgery. Which is the best response by the nurse? a. "You are not a candidate because you have heart failure.” b. "You would have a difficult time recovering from the procedure." c. "At this point, do you really want to go through something like that?" d. "You and your primary provider should discuss the options that are available for treatment." 7. The nurse is monitoring a patient with bron-chiectasis. Which complication should the nurse be alert for? a. Atelectasis b. Emphysema c. Pleurisy d. Pneumonia8. A patient is prescribed a mast cell stabilizer for the treatment of asthma. Which com-monly used medication will the nurse edu-cate the patient about? a. Albuterol b. Budesonide c. Cromolyn sodium d. Theophylline 9. The nurse is caring for a patient with status asthmaticus in the intensive care unit (ICU). Which blood gas analysis related to hyper- ventilation does the nurse observe with this patient? a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis 10. A child is having an asthma attack and the parent cannot remember which inhaler to use for quick relief. The nurse accesses the child's medication information and tells the parent to use which inhalant? a. Cromolyn sodium b. Theophylline c. Salmeterol d. Albuterol 11. The nurse is educating a patient with asthma about preventative measures to avoid having an asthma attack. Which preventative inter- vention will the nurse educate the patient about to prevent an asthma attack? a. Use a long-acting steroid inhaler when an attack is coming. b. Avoid exercise and any strenuous activity.c. Prepare a written action plan. d. Stay in the house if it is too cold or too hot. 12. The nurse is assigned to care for a patient in the intensive care unit (ICU) with status asthmaticus. Why does the nurse include fluid intake as being an important aspect of the plan of care? (Select all that apply.) a. To combat dehydration b. To assist with the effectiveness of the corticosteroids c. To loosen secretions d. To facilitate expectoration e. To relieve bronchospasm 13. A patient is being treated for status asthmat icus. Which arterial blood gas analysis does the nurse evaluate that can indicate impend. Ing respiratory failure? a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosis 14. A patient with cystic fibrosis is admitted to the hospital with pneumonia. When will the nurse administer the pancreatic enzymes that the patient has been prescribed? a. After meals and at bedtime b. One hour prior to mealtime in the morning c. With meals d. Three times a day regardless of meal time 15. The nurse is instructing the patient with asthma in the use of a newly prescribed leu-kotriene receptor antagonist. Which education will the nurse include?a. Take the medication with meals because it may cause nausea. b. Take the medication separately without other medications. c. Take the medication an hour before meals or 2 hours after a meal. d. Take the medication with a small amount of liquid.