Respiratory System: Multiple Choice Questions

Topics: Pulmonology, Nursing, Oxygen Pages: 8 (2081 words) Published: December 3, 2013
Silvestri: Saunders Comprehensive Review for the NCLEX-PN® Examination, 4th Edition

Chapter 48: Respiratory System

Test Bank

MULTIPLE CHOICE

1.A postoperative client with incisional pain complains to the nurse about completing respiratory exercises. The client is willing to do the deep breathing exercises but states that it hurts to cough. The nurse provides gentle encouragement and appropriate pain management to the client, knowing that coughing is needed to: 1.

Expel mucus from the airways.2.Dilate the terminal bronchioles.3.Provide for increased oxygen tension in the alveoli.4.Exercise the muscles of respiration.

ANS:1
Rationale: Coughing is one of the protective reflexes. Its purpose is to move mucus that is in the airways upward toward the mouth and nose. Coughing is needed in the postoperative client to mobilize secretions and expel them from the airways. The other options do not accurately address the purpose of coughing in the postoperative client. Test-Taking Strategy: Focus on the subject, the purpose of coughing in a postoperative client. Recalling the effects of anesthesia on the respiratory system and the respiratory complications that can occur will direct you to option 1. Review the purposes of coughing if you had difficulty with this question.

DIF:Level of Cognitive Ability: Application
REF:Linton, A., & Maebius, N. (2007). Introduction to medical-surgical nursing (4th ed.). Philadelphia: Saunders.OBJ:Client Needs: Physiological Integrity TOP:Content Area: Adult Health/Respiratory

MSC:Integrated Process: Nursing Process/Implementation

2.A client with chronic obstructive pulmonary disease (COPD) who is beginning oxygen therapy asks the nurse why the flow rate cannot be increased to more than 2 L/minute. The nurse responds that this would be harmful because it could: 1.Increase the risk of pneumonia from drier air passages2.Be drying to nasal passages3.Decrease the client’s oxygen-based respiratory drive4.Decrease the client’s carbon dioxide–based respiratory drive

ANS:3
Rationale: Normally respiratory rate varies with the amount of carbon dioxide present in the blood. In clients with COPD this natural center becomes ineffective after exposure to high carbon dioxide levels for prolonged periods. Instead, the level of oxygen provides the respiratory stimulus. The client with COPD cannot increase oxygen levels independently because it could deplete the respiratory drive, leading to respiratory failure. Test-Taking Strategy: Focus on the client’s diagnosis and recall that in clients with COPD, the level of oxygen provides the respiratory stimulus. This will direct you to option 3. Review the importance of oxygen and carbon dioxide tensions in the bloodstream if you had difficulty with this question.

DIF:Level of Cognitive Ability: Application
REF:Linton, A., & Maebius, N. (2007). Introduction to medical-surgical nursing (4th ed.). Philadelphia: Saunders.OBJ:Client Needs: Physiological Integrity TOP:Content Area: Adult Health/Respiratory

MSC:Integrated Process: Teaching and Learning

3.The chest x-ray report for a client states that the client has a left apical pneumothorax. The nurse would monitor the status of breath sounds in that area by placing the stethoscope: 1.Posteriorly under the left scapula2.Just under the left clavicle3.In the fifth intercostal space4.Near the lateral twelfth rib

ANS:2
Rationale: The apex of the lung is the rounded, uppermost part of the lung. To check breath sounds in a client with a left apical pneumothorax, the nurse would place the stethoscope just under the left clavicle. The other options are incorrect. Test-Taking Strategy: Focus on the strategic words “left apical pneumothorax.” This will assist in eliminating options 3 and 4. Next, use anatomical landmarks of the lungs to direct you to option 2 from the remaining options. Review data collection techniques for the respiratory system if you had difficulty...
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