Nokea
The nurse is performing a respiratory assessment of a patient who has been experiencing episodes of hypoxia. The nurse is aware that this is ultimately attributable to impaired gas exchange. On what factor does adequate gas exchange primarily depend?
- A. An appropriate perfusion-diffusion ratio
- B. An adequate ventilation-perfusion ratio
- C. Adequate diffusion of gas in shunted blood
- D. Appropriate blood nitrogen concentration
Correct Answer: B
Rationale: Adequate gas exchange depends on an adequate ventilation-perfusion ratio. There is no perfusion-diffusion ratio. Adequate gas exchange does not depend on the diffusion of gas in shunted blood or a particular concentration of nitrogen.
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The nurse has assessed a patients family history for three generations. The presence of which respiratory disease would justify this type of assessment?
- A. Asthma
- B. Obstructive sleep apnea
- C. Community-acquired pneumonia
- D. Pulmonary edema
Correct Answer: A
Rationale: Asthma is a respiratory illness that has genetic factors. Sleep apnea, pneumonia, and pulmonary edema lack genetic risk factors.
A sputum study has been ordered for a patient who has developed coarse chest crackles and a fever. At what time should the nurse best collect the sample?
- A. Immediately after a meal
- B. First thing in the morning
- C. At bedtime
- D. After a period of exercise
Correct Answer: B
Rationale: Sputum samples ideally are obtained early in the morning before the patient has had anything to eat or drink.
A patient is being treated for a pulmonary embolism and the medical nurse is aware that the patient suffered an acute disturbance in pulmonary perfusion. This involved an alteration in what aspect of normal physiology?
- A. Maintenance of constant osmotic pressure in the alveoli
- B. Maintenance of muscle tone in the diaphragm
- C. pH balance in the pulmonary veins and arteries
- D. Adequate flow of blood through the pulmonary circulation.
Correct Answer: D
Rationale: Pulmonary perfusion is the actual blood flow through the pulmonary circulation. Perfusion is not defined in terms of pH balance, muscle tone, or osmotic pressure.
The nurse is performing a respiratory assessment of an adult patient and is attempting to distinguish between vesicular, bronchovesicular, and bronchial (tubular) breath sounds. The nurse should distinguish between these normal breath sounds on what basis?
- A. Their location over a specific area of the lung
- B. The volume of the sounds
- C. Whether they are heard on inspiration or expiration
- D. Whether or not they are continuous breath sounds
Correct Answer: A
Rationale: Normal breath sounds are distinguished by their location over a specific area of the lung; they are identified as vesicular, bronchovesicular, and bronchial (tubular) breath sounds. Normal breath sounds are heard on both inspiration and expiration, and are continuous. They are not distinguished solely on the basis of volume.
The nurse is caring for a patient who has just undergone a mediastinotomy. What should be the focus of the nurses postprocedure care?
- A. Assisting with pulmonary function testing (PFT)
- B. Maintaining the patients chest tube
- C. Administering oral suction as needed
- D. Performing chest physiotherapy
Correct Answer: B
Rationale: Chest tube drainage is required after mediastinotomy. PFT, chest physiotherapy, and oral suctioning would all be contraindicated because of the patients unstable health status.