Nokea
The patient who had a bronchoscopy 1 hour ago asks when eating will be possible. Which response would be most helpful?
- A. In 24 hours, but must take cold liquids for the rest of the day
- B. If there is no blood in his sputum
- C. In 8 hours after a period of nothing by mouth
- D. When the gag reflex returns
Correct Answer: D
Rationale: Following a bronchoscopy, the patient can eat as soon as the gag reflex returns, usually in about 2 hours.
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Exposure to an asthma trigger can cause which aspect of asthma to occur next?
- A. Inflammatory process in the mast cells of the lungs
- B. Increase in edema and mucus production in the bronchioles
- C. Release of histamine
- D. Narrowing of the airways
Correct Answer: A
Rationale: The allergen activates the mast cells in the lungs, which release histamine, causing an increase in edema and mucus production that narrows the airways and causes the classic signs of asthma.
An 83-year-old patient is admitted with a temperature of 102°F (38.8°C), chest pain, and fatigue. Which term describes the infected fluid that the health care provider removes from the pleural cavity?
- A. Emboli
- B. Emphysema
- C. Sputum
- D. Empyema
Correct Answer: D
Rationale: If the fluid between the lung and the membrane lining the pleural cavity becomes infected, it is called empyema.
Which patient assessment indicates the most severe respiratory distress?
- A. Nasal flaring, symmetrical chest wall expansion, SaO2 88%
- B. Abdominal breathing, SaO2 97%
- C. Substernal retraction, SaO2 84%
- D. Substernal retraction, SaO2 90%
Correct Answer: C
Rationale: Observe the patient's facial expressions and signs of respiratory distress, such as flaring nostrils, substernal or clavicular retractions, asymmetrical chest wall expansion, and abdominal breathing. The lower the SaO2, the more severe the respiratory distress.
How will the kidneys respond in respiratory acidosis?
- A. Retain bicarbonate to increase the pH.
- B. Excrete more urine to reduce potassium.
- C. Concentrate the urine to conserve circulating fluid in the bloodstream.
- D. Lower the pH by excretion of bicarbonate.
Correct Answer: A
Rationale: In respiratory acidosis, the pH is low. The kidneys will retain bicarbonate to increase the pH.
The nurse assessing an 11 year old who is having an asthma attack expects to hear which adventitious sounds?
- A. Friction rub.
- B. Expiratory wheezes
- C. Crackles.
- D. Absent breath sounds.
Correct Answer: B
Rationale: The narrowed bronchioles characteristic of an asthma attack would produce wheezes, which are high-pitched whistling sounds.