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RN Targeted Medical Surgical Respiratory Online Practice 2019

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John Marsh
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ATI RN Targeted Medical Surgical Respiratory Online Practice 2019

 

1. A nurse is caring for a client who’s receiving mechanical ventilation when the lowpressure alarm sounds. which of the following situations should the nurse recognize
as a possible cause of the alarm?
A.) Excess secretions
B.) Kinks in the tubing
C.) Artificial airway cuff leak
D.) Biting on the endotracheal tube
2. A nurse is providing discharge teaching to a client who has a temporary tracheostomy.
which of the following statements by the client indicates an understanding of the
teaching?
A.) I’ll cleanse the cannula with half-strength hydrogen peroxide
B.) I’ll remove the old twill ties after the new ties are in place.
C.) I’ll cut a slit in a clean gauze pad to use as a stoma dressing.
D.) I’ll insert the obturator after cleaning my stoma.
3. A nurse is caring for 4 clients. which of the following clients is at greatest risk for a
pulmonary embolism?
A.) A client who is 48 hr postoperative following a total hip arthroplasty
B.) A client who is 8 hr postoperative following an open surgical appendectomy
C.) A client who is 2 hr postoperative following an open reduction external fixation of
the right radius
D.) A client who is 4 hr postoperative following a laparoscopic cholecystectomy
4. A nurse is caring for a newly admitted client who has emphysema. the nurse should
place the client in which of the following positions to promote effective breathing?
A.) Lateral position with a pillow at the back and over the chest to support the arm
B.) High-Fowler’s position with the arms supported on the overbed table
C.) Semi-Fowler’s position with pillows supporting both arms
D.) Supine position with the head of the bed elevated to 15°
5. A nurse is caring for a client who has asthma and is receiving albuterol. for which of
the following adverse effects should the nurse monitor the client?
A.) Hyperkalemia
B.) Dyspnea
C.) Tachycardia
D.) Candidiasis
6. A nurse is preparing a client for discharge following a bronchoscopy with the use of
moderate sedation. the nurse should identify that which of the following assessments
if the priority?
A.) presence of gag reflex
B.) pain level rating using 0 to 10 scale
C.) hydration status
D.) appearance of the IV insertion site
7. A nurse is assessing a client who has lung cancer. which of the following
manifestations should the nurse expect?
A.) Blood-tinged sputum
B.) Decreased tactile fremitus
C.) Resonance with percussion
D.) Peripheral edema
8. A nurse working in an ED is caring for a client following an acute chest trauma.
which of the following findings should indicate to the nurse that the client is possibly
experiencing a tension pneumothorax?
A.) Collapsed neck veins on the affected side
B.) Collapsed neck veins on the unaffected side
C.) Tracheal deviation to the affected side
D.) Tracheal deviation to the unaffected side
9. A nurse developing a plan of care for a client who has active TB. which of the
following isolation precautions should the nurse include in the plan?
A.) Airborne
B.) Neutropenic
C.) Contact
D.) Droplet
10. A nurse in an ED is caring for a client who’s experiencing acute respiratory failure.
which of the following lab findings should the nurse expect?
A.) Arterial pH 7.50
B.) PaCO2 25 mm Hg
C.) SaO2 92%
D.) PaO2 58 mm Hg
11. A nurse in an ED is caring for a client who’s experiencing a pulmonary embolism.
which of the following actions should the nurse take first?
A.) Apply supplemental oxygen.
B.) Increase the rate of IV fluids.
C.) Administer pain medication.
D.) Initiate cardiac monitoring.
12. A charge nurse is providing an in-service to a group of staff nurses about endotracheal
suctioning. which of the following statements by a staff nurse indicates an
understanding of the teaching?
A.) “I will use clean technique when suctioning a client’s endotracheal tube.”
B.) “I will use a rotating motion when removing the suction catheter.”
C.) “I will suction the oropharyngeal cavity prior to suctioning the endotracheal tube.”
D.) “I will suction a client’s endotracheal tube every 2 hours.”
13. A nurse is assessing a client who’s 4 hr postoperative following a total laryngectomy.
which of the following findings is the priority for the nurse to report to the provider?
A.) Bleeding at the surgical site
B.) Decreased oxygen saturation
C.) Urinary retention
D.) Increased pain level
14. A nurse is assisting a provider who’s performing a thoracentesis at the beside of a
client. which of the following actions should the nurse take?(Select Multiple)
a.) Wear goggles and a mask during the procedure.
b.) Cleanse the procedure area with an antiseptic solution.
c.) Instruct the client to take deep breaths during the procedure.
d.) Position the client laterally on the affected side before the procedure.
e.) Apply pressure to the site after the procedure.
15. A nurse is caring for a client who’s 1 hr postoperative following a thoracentesis.
which of the following is the priority assessment finding?
A.) Pallor
B.) Insertion site pain
C.) Persistent cough
D.) Temperature 37.3° C (99.1° F)
16. A nurse is assessing a client who has bacterial pneumonia. which of the following
manifestations should the nurse expect?
A.) decreased fremitus
B.) SaO2 95% on room air
C.) temperature 38.8° C (101.8° F)
D.) bradypnea
17. A nurse receives prescriptions from the provider for performing nasopharyngeal
suctioning on 4 clients. for which of the following clients should the nurse clarify the
provider’s prescription?
A.) A client who has epistaxis
B.) A client who has amyotrophic lateral sclerosis
C.) A client who has pneumonia
D.) A client who has emphysema
18. A nurse is caring for a client who has a chest tube following a lobectomy. which of
the following items should the nurse keep easily accessible for the client?
A.) Extra drainage system
B.) Suture removal kit
C.) Container of sterile water
D.) Non adherent pads
19. A nurse is creating a plan of care for a client who has COPD. which of the following
interventions should the nurse include?
A.) Schedule respiratory treatments following meals.
B.) Have the client sit up in a chair for 2-hr periods three times per day.
C.) Provide a diet that is high in calories and protein.
D.) Combine activities to allow for longer rest periods between activities.
20. A nurse is providing teaching to a client who has chronic asthma and a new
prescription for montelukast. which of the following client statements indicates an
understanding of the teaching?
A.) “I will monitor my heart rate every day while taking this medication.”
B.) “I will make sure I have this medication with me at all times.”
C.) “I will need to carefully rinse my mouth after I take this medication.”
D.) “I will take this medication every night even if I don’t have symptoms.”
21. A nurse is caring for a client who’s postoperative and has an RR of 9/min secondary
to general anesthesia effects na incisional pain. which of the following ABG values
indicates the client is experiencing respiratory acidosis?
A.) pH 7.50, PO2 95 mm Hg, PaCO2 25 mm Hg, HCO3- 22 mEq/L
B.) pH 7.50, PO2 87 mm Hg, PaCO2 35 mm Hg, HCO3- 30 mEq/L
C.) pH 7.30, PO2 90 mm Hg, PaCO2 35 mm Hg, HCO3- 20 mEq/L
D.) pH 7.30, PO2 80 mm Hg, PaCO2 55 mm Hg, HCO3- 22 mEq/L
22. A nurse is assessing a client who has acute respiratory distress syndrome (ARDS).
which of the following findings should the nurse report to the provider?
A.) Decreased bowel sounds
B.) Oxygen saturation 92%
C.) CO2 24 mEq/L
D.) Intercostal retractions
23. A nurse in a provider’s office is assessing a client who has COPD. which of the
following findings is the priority for the nurse to report to the provider?
A.) Increased anterior-posterior chest diameter
B.) Productive cough with green sputum
C.) Clubbing of the fingers
D.) Pursed-lip breathing with exertion
24. A charge nurse is reviewing the care of a client who has a chest tube connected to a
water seal drainage system in a place following thoracic surgery w/ newly licensed
nurse. which of the following statements by the newly licensed nurse indicates an
understanding of when to notify the provider?
A.) “I will notify the provider if there is a fluctuation of drainage in the tubing with
inspiration.”
B.) “I will notify the provider if there is continuous bubbling in the water seal
chamber.”
C.) “I will notify the provider if there is drainage of 60 milliliters in the first hour after
surgery.”
D.) “I will notify the provider if there are several small, dark-red blood clots in the
tubing.”
25. A nurse is caring for a client who’s in respiratory distress. which of the following lowflow delivery devices should the nurse use to provide the client w/ highest level of
oxygen?
A.) Nasal cannula
B.) Nonrebreather mask
C.) Simple face mask
D.) Partial rebreather mask
26. A nurse is planning care for a client who has asthma. which of the following meds
should the nurse plan to administer during an acute asthma attack?
A.) cromolyn sodium
B.) prednisone
C.) fluticasone/salmeterol
D.) albuterol
27. A nurse is caring for a client who’s in acute respiratory failure and is receiving
mechanical ventilation. which of the following assessments is the best method for the
nurse to use to determine the effectiveness of the current treatment regimen?
A.) BP
B.) Cap refill
C.) ABGs (Arterial blood gases)
D.) HR
28. A nurse is assessing a client who has emphysema. which of the following findings
should the nurse report to the provider?
A.) Rhonchi on inspiration
B.) Elevated temperature
C.) Barrel-shaped chest
D.) Diminished breath sounds
29. A nurse is caring for a client who has pulmonary embolism. which of the following
interventions is the nurse’s priority?
A.) Provide a quiet environment
B.) Encourage use of incentive spirometer every 1-2 hrs
C.) Obtain blood sample for electrolyte study
D.) Administer heparin via continuous IV infusion
30. A nurse is providing discharge teaching to a client who has pulmonary TB and a new
prescription for rifampin. which of the following instructions should the nurse
include?
A.) “Ringing in the ears is an adverse effect of this medication.”
B.) “Have your skin test repeated in 4 months to show a positive result.”
C.) “Expect your urine and other secretions to be orange while taking this
medication.”
D.) “Remember to take this medication with a sip of water just before your first bite
of each meal.”

 

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RN Targeted Medical Surgical Respiratory Online Practice 2019

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