The nurse is caring for a 6-year-old boy with Russell traction applied to his left leg. Which intervention would be most appropriate to prevent complications?

The nurse is caring for a 6-year-old boy with Russell traction applied to his left leg. Which intervention would be most appropriate to prevent complications?

a) Assess the popliteal region carefully for skin breakdown.
b) Provide pin care as needed.
c) Adjust the weights as needed.
d) Clean and massage his entire leg daily.


Answer: a)Assess the popliteal region carefully for skin breakdown.

A nurse is reviewing the medical record of a child who has sustained a fracture. Documentation reveals a bowing deformity. The nurse interprets this fracture as which of the following?

A nurse is reviewing the medical record of a child who has sustained a fracture. Documentation reveals a bowing deformity. The nurse interprets this fracture as which of the following?

a) Bone that breaks into two pieces
b) Incomplete fracture
c) Bone buckling due to compression
d) Significant bending without actual breaking


Answer: d)Significant bending without actual breaking

An infant with a femur fracture is placed in Bryant traction. Which of the following would the nurse include in the infant's plan of care?

An infant with a femur fracture is placed in Bryant traction. Which of the following would the nurse include in the infant's plan of care?

a) Keeping the buttocks slightly elevated
b) Removing the traction boot every 8 hours
c) Provide range of motion to the unaffected extremity
d) Wrapping the bandages from the ankle to the knee


Answer: a)Keeping the buttocks slightly elevated

The nurse is caring for a child who has just had a plaster cast applied to the arm. The nurse is correct in doing which of the following with this child?

The nurse is caring for a child who has just had a plaster cast applied to the arm. The nurse is correct in doing which of the following with this child?

a) Keeping a clove-hitch restraint gently tied on the hand to stabilize the arm.
b) Encouraging the child to move the arm slowly up and down to help the cast dry.
c) Using only a draw sheet to move the casted arm.
d) Handling the cast with open palms when moving the arm.


Answer: d)Handling the cast with open palms when moving the arm.

In understanding the development of the musculoskeletal system, the nurse recognizes that which of the following is implanted in a gel-like substance during fetal life?

In understanding the development of the musculoskeletal system, the nurse recognizes that which of the following is implanted in a gel-like substance during fetal life?

a) Ligaments
b) Tendons
c) Joints
d) Cartilage


Answer: d)Cartilage

The nurse is caring for an active 11-year-old presenting with tenderness in the shoulder. He is the pitcher for his baseball team and complains of shoulder pain with active internal rotation but is able to continue past the pain with full range of motion. Based on these reported symptoms, the nurse is aware that the disorder is most likely which of the following?

The nurse is caring for an active 11-year-old presenting with tenderness in the shoulder. He is the pitcher for his baseball team and complains of shoulder pain with active internal rotation but is able to continue past the pain with full range of motion. Based on these reported symptoms, the nurse is aware that the disorder is most likely which of the following?

a) Sever's disease
b) Epiphysiolysis of the distal radius
c) Epiphysiolysis of the proximal humerus
d) Osgood-Schlatter disease


Answer: c)Epiphysiolysis of the proximal humerus

A nursing student tells the staff nurse on the pediatric orthopedic unit that she has heard of a musculoskeletal disorder in which there is an infection of the bone. Which of the following disorders does this statement describe?

A nursing student tells the staff nurse on the pediatric orthopedic unit that she has heard of a musculoskeletal disorder in which there is an infection of the bone. Which of the following disorders does this statement describe?

a) Osteosarcoma
b) Osteomyelitis
c) Muscular dystrophy
d) Juvenile rheumatoid arthritis


Answer: b)Osteomyelitis

The nurse is caring for an 8-year-old girl in traction. She has been in an acute care setting for two weeks and will require an additional 10 days in the hospital. She is showing signs of regression with thumb sucking and pleas for her tattered baby blanket. Which of the following would be the most helpful intervention?

The nurse is caring for an 8-year-old girl in traction. She has been in an acute care setting for two weeks and will require an additional 10 days in the hospital. She is showing signs of regression with thumb sucking and pleas for her tattered baby blanket. Which of the following would be the most helpful intervention?

a) "Would you like a coloring book?"
b) "Let's ask your mom to bring your friends for a visit."
c) "You are too big to suck your thumb."
d) "Do you want a book to read?"


Answer: b)"Let's ask your mom to bring your friends for a visit."

A type of traction sometimes used in the treatment of the child with scoliosis is called which of the following?

A type of traction sometimes used in the treatment of the child with scoliosis is called which of the following?

a) Bryant's traction
b) Dunlop's traction
c) Halo traction
d) Russell traction


Answer: c)Halo traction

The nurse is caring for a 10-year-old boy who plays on two soccer teams. He practices four days a week and his team travels to tournaments once a month. He has been diagnosed with a stress fracture in one of his vertebrae. Which of the following instructions is most important to emphasize to the boy and his parents?

The nurse is caring for a 10-year-old boy who plays on two soccer teams. He practices four days a week and his team travels to tournaments once a month. He has been diagnosed with a stress fracture in one of his vertebrae. Which of the following instructions is most important to emphasize to the boy and his parents?

a) "Ice will help reduce the inflammation."
b) "NSAIDs can help with pain control and inflammation."
c) "You will need to see a physical therapist for stretching and strengthening exercises."
d) "You and your coaches need to understand that you cannot play soccer for at least six weeks."


Answer: d)"You and your coaches need to understand that you cannot play soccer for at least six weeks."

The nurse is observing a 3-year-old boy who is sitting and playing in the waiting area of his pediatrician's office. The nurse calls the boy and his mother back for the boy's appointment. The boy rolls onto his stomach and pushes himself to his knees. Then he presses his hands against his ankles, knees, and thighs, walking up the front of his body, to stand. Which condition should the nurse suspect in this client?

The nurse is observing a 3-year-old boy who is sitting and playing in the waiting area of his pediatrician's office. The nurse calls the boy and his mother back for the boy's appointment. The boy rolls onto his stomach and pushes himself to his knees. Then he presses his hands against his ankles, knees, and thighs, walking up the front of his body, to stand. Which condition should the nurse suspect in this client?

a) Congenital myotonic dystrophy
b) Duchenne muscular dystrophy
c) Facioscapulohumeral muscular dystrophy
d) Juvenile arthritis


Answer: b)Duchenne muscular dystrophy

While an adolescent wears a body brace for scoliosis, you would teach her

While an adolescent wears a body brace for scoliosis, you would teach her

a) to wear the brace a maximum of 20 hours each day.
b) that secondary sex changes will stop until the brace is removed.
c) to continue with age-appropriate activities.
d) to stand absolutely still whenever she is out of the brace.


Answer: c)to continue with age-appropriate activities.

The nurse is caring for a child with osteomyelitis. Which of the following is true regarding this diagnosis? Select all that apply.

The nurse is caring for a child with osteomyelitis. Which of the following is true regarding this diagnosis? Select all that apply.

a) As abscess forms, ruptures and spreads infection in the metaphysis of the bone
b) Corticosteroids are the treatment of choice
c) Transmission-based precautions are followed in most cases
d) Caused by Staphylococcus aureus
e) Lab findings show a leukocyte count of 1,000 to 2,000 cells


Answer:


d)Caused by Staphylococcus aureus
c)Transmission-based precautions are followed in most cases
a)As abscess forms, ruptures and spreads infection in the metaphysis of the bone

The nurse is caring for a 10-year-old child in traction. After performing a skin assessment, she notices that the skin over the calcaneus appears slightly red and irritated. Which of the following should be the first intervention?

The nurse is caring for a 10-year-old child in traction. After performing a skin assessment, she notices that the skin over the calcaneus appears slightly red and irritated. Which of the following should be the first intervention?

a) Make sure the skin and linens are clean and dry.
b) Gently massage his foot and heel each shift.
c) Apply lotion to his foot and avoid friction to the area.
d) Reposition the child's foot on a pressure-reducing device.


Answer: d)Reposition the child's foot on a pressure-reducing device.

You are caring for a child with a broken wrist that has just been placed in a cast. You would elevate the arm to

You are caring for a child with a broken wrist that has just been placed in a cast. You would elevate the arm to

a) promote healing.
b) prevent edema.
c) ensure proper bone alignment.
d) discourage infection.


Answer: b)prevent edema.

A neonatal nurse examines an infant and notes decreased hip motion that causes pain upon movement. This nurse suspects Legg-Calvé-Perthes disease, a common pediatric hip disorder that causes pain and decreased hip motion, possibly leading to a femoral head deformity.

A neonatal nurse examines an infant and notes decreased hip motion that causes pain upon movement. This nurse suspects Legg-Calvé-Perthes disease, a common pediatric hip disorder that causes pain and decreased hip motion, possibly leading to a femoral head deformity.

a) True
b) False


Answer: a)True

A nurse is working with a 12-year-old girl with osteomyelitis who is recovering from surgery. Which of the following are nursing interventions that should be implemented in this case?

A nurse is working with a 12-year-old girl with osteomyelitis who is recovering from surgery. Which of the following are nursing interventions that should be implemented in this case? 

a) Instituting infection-control precautions related to drainage tubes
b) Instruction to the parents regarding the importance of the child maintaining bed rest
c) Casting of the affected limb
d) Instruction to the parents regarding how to care for an antibiotic IV line at home
e) Administration of IV antibiotics at the hospital
f) Instruction to the parents regarding proper traction of the limb


Answer:


e)Administration of IV antibiotics at the hospital
b)Instruction to the parents regarding how to care for an antibiotic IV line at home
b)Instruction to the parents regarding the importance of the child maintaining bed rest
a)Instituting infection-control precautions related to drainage tubes

Structural scoliosis is five times more common in girls than in boys.

Structural scoliosis is five times more common in girls than in boys.

a) False
b) True


Answer: b)True

A nursing instructor is preparing a class presentation about tibia vara. Which of the following would the instructor include as a risk factor?

A nursing instructor is preparing a class presentation about tibia vara. Which of the following would the instructor include as a risk factor?

a) Late walking
b) Lack of sunlight exposure
c) Hormonal alterations during puberty
d) Obesity


Answer: d)Obesity

The nurse is caring for a child with rickets. Which diagnostic test result would the nurse expect to find in the child's medical record?

The nurse is caring for a child with rickets. Which diagnostic test result would the nurse expect to find in the child's medical record?

a) Low serum calcium levels
b) Low alkaline phosphate levels
c) High serum phosphate levels
d) X-ray confirmation of adequate bone shape


Answer: a)Low serum calcium levels

In understanding the function of the musculoskeletal system, the nurse recognizes that which of the following allows for movement of the body parts?

In understanding the function of the musculoskeletal system, the nurse recognizes that which of the following allows for movement of the body parts?

a) Cartilage
b) Ligaments
c) Tendons
d) Joints


Answer: d)Joints

The nurse is caring for a 10-year-old girl in traction. The girl is experiencing muscle spasms associated with the traction. Which of the following would the nurse expect to administer if ordered?

The nurse is caring for a 10-year-old girl in traction. The girl is experiencing muscle spasms associated with the traction. Which of the following would the nurse expect to administer if ordered?

a) Alendronate
b) Pamidronate
c) Narcotic analgesics
d) Diazepam


Answer: Diazepam

A 2-year-old is diagnosed with osteomyelitis. Which of the following would you anticipate as a primary nursing intervention to include in the child's plan of care?

A 2-year-old is diagnosed with osteomyelitis. Which of the following would you anticipate as a primary nursing intervention to include in the child's plan of care?

a) Assisting the child with crutch walking
b) Restricting fluid to encourage red cell production
c) Keeping the child quiet while in skeletal traction
d) Maintaining intravenous antibiotic therapy


Answer: d)Maintaining intravenous antibiotic therapy

A 14-year-old girl is diagnosed as having scoliosis. When doing scoliosis screening with her, an important observation would be to note

A 14-year-old girl is diagnosed as having scoliosis. When doing scoliosis screening with her, an important observation would be to note

a) the angle of the iliac crest when she bends forward.
b) the angle of her lower chest when she sits down.
c) her posterior spine when she bends forward.
d) the posterior spine when she bends sideways.


Answer: c)her posterior spine when she bends forward.

A nurse applies ice to a patient's leg to relieve the pain due to a soft tissue injury. Which of the following is a recommended guideline for use of cold therapy?

A nurse applies ice to a patient's leg to relieve the pain due to a soft tissue injury. Which of the following is a recommended guideline for use of cold therapy?

a) Use cold therapy to increase blood flow in patients with impaired circulation.
b) Apply gel packs for no longer than 30 minutes and monitor closely for tissue damage.
c) Apply ice for the first 24 to 48 hours after injury to reduce edema.
d) Apply the ice to the injury, never immerse the injured part in cold water.


Answer: c)Apply ice for the first 24 to 48 hours after injury to reduce edema.

In discussing the treatment for children with scoliosis, a group of pediatric nurses makes the following statements. Which statement is most accurate related to the treatment of scoliosis?

In discussing the treatment for children with scoliosis, a group of pediatric nurses makes the following statements. Which statement is most accurate related to the treatment of scoliosis?

a) "Children treated for scoliosis by using braces have to wear the brace almost all the time."
b) "Children with severe scoliosis are treated using electrical stimulation."
c) "The only successful treatment for scoliosis is surgery within two weeks of the diagnosis."
d) "The treatment for children with scoliosis usually lasts three to four months."


Answer: a)"Children treated for scoliosis by using braces have to wear the brace almost all the time."

A group of students are reviewing information about the skeletal development in children. The students demonstrate understanding of the information when they identify that ossification is complete by what age?

A group of students are reviewing information about the skeletal development in children. The students demonstrate understanding of the information when they identify that ossification is complete by what age?

a) Adolescence
b) School age
c) Toddlerhood
d) Preschool age


Answer: a)Adolescence

The nurse is teaching a group of peers regarding different types of fractures. Which of the following best describes an open fracture?

The nurse is teaching a group of peers regarding different types of fractures. Which of the following best describes an open fracture?

a) A fracture in which the broken bone penetrates the skin.
b) A fracture in which there is a single break in the bone without penetration of the skin.
c) A fracture in which the fragments of the bone are separated.
d) A fracture in which the fragments of the bone remain partially joined.


Answer: a)A fracture in which the broken bone penetrates the skin.

After teaching the parents of a 6-year-old child about caring for a sprained wrist, which statement by the parents indicates the need for additional teaching?

After teaching the parents of a 6-year-old child about caring for a sprained wrist, which statement by the parents indicates the need for additional teaching?

a) "She'll need to limit any activity that involves the wrist."
b) "We'll apply a warm moist compress to the wrist for 20 minutes at a time."
c) "We'll make sure she keeps her arm above heart level."
d) "We can wrap the wrist in an elastic bandage to help reduce the swelling."


Answer: b)"We'll apply a warm moist compress to the wrist for 20 minutes at a time."

Fracture of the femur typically occurs when a small child is lifted by one hand, as happens when a parent pulls on one arm to lift the child over a curb or up a step.

Fracture of the femur typically occurs when a small child is lifted by one hand, as happens when a parent pulls on one arm to lift the child over a curb or up a step.

a) True
b) False


Answer: False

The nurse is caring for a child diagnosed with Legg-Calvé-Perthes disease. Of the following nursing interventions, which would be most important for the nurse to include in working with this child and the child's caregivers?

The nurse is caring for a child diagnosed with Legg-Calvé-Perthes disease. Of the following nursing interventions, which would be most important for the nurse to include in working with this child and the child's caregivers?

a) The nurse should help the caregivers to understand and the child to effectively use the corrective devices.
b) The nurse should support the caregivers in restricting activity during the treatment.
c) The nurse should provide information when the child or caregiver requests it.
d) The nurse should be a contact person when the child is hospitalized.


Answer: a)The nurse should help the caregivers to understand and the child to effectively use the corrective devices.

The nurse is caring for a group of children on the pediatric unit. The nurse should collect further data and explore the possibility of child abuse in which of the following situations?

The nurse is caring for a group of children on the pediatric unit. The nurse should collect further data and explore the possibility of child abuse in which of the following situations?

a) A 6-year-old with a greenstick fracture of the wrist, which the caregiver reports as having been caused when the child fell while ice-skating.
b) A 10-year-old with a simple fracture of the femur, which the caregiver reports as having been caused when the child fell down a set of stairs.
c) A 7-year-old with a spiral fracture of the humerus, which the caregiver reports as having been caused when the child was hit by a bat swung by a Little League teammate.
d) A 9-year-old with a compound fracture of the tibia, which the caregiver reports as having been caused when the child attempted a flip on a skateboard.


Answer: c)A 7-year-old with a spiral fracture of the humerus, which the caregiver reports as having been caused when the child was hit by a bat swung by a Little League teammate.

The nurse caring for a patient in a body cast knows that immobility can cause contractures, loss of muscle tone, or fixation of joints. Which of the following nursing interdisciplinary interventions are recommended to help prevent these adverse conditions?

The nurse caring for a patient in a body cast knows that immobility can cause contractures, loss of muscle tone, or fixation of joints. Which of the following nursing interdisciplinary interventions are recommended to help prevent these adverse conditions?

a) Encourage child to stifle cough and take shallow breaths to prevent ineffective breathing patterns.
b) Give the patient large, frequent meals with decreased fiber and increased protein and Vitamin C.
c) Encourage active and passive range-of-motion activities to prevent ineffective tissue perfusion.
d) Check for a normal capillary refill of 3 to 5 seconds on a daily basis to ensure there in adequate arterial supply.


Answer: c)Encourage active and passive range-of-motion activities to prevent ineffective tissue perfusion.

An infant appears floppy, sucks poorly, and has weak respiratory effort. She is diagnosed with congenital myasthenia gravis. In explaining this condition to the infant's mother, which of the following should she mention as the cause of the condition?

An infant appears floppy, sucks poorly, and has weak respiratory effort. She is diagnosed with congenital myasthenia gravis. In explaining this condition to the infant's mother, which of the following should she mention as the cause of the condition?

a) An inherited disorder involving faulty neurotransmitter transmission or reception
b) Infection of the bone by Streptococcus pyogenes
c) Degeneration of skeletal muscle fibers, possibly due to viral infection
d) An autoimmune disorder involving the development of circulating antibodies against body cells


Answer: a)An inherited disorder involving faulty neurotransmitter transmission or reception

You assist with the application of a full-body plaster cast to a child. The child immediately becomes diaphoretic and complains of being hot. Which nursing intervention would be indicated?

You assist with the application of a full-body plaster cast to a child. The child immediately becomes diaphoretic and complains of being hot. Which nursing intervention would be indicated?

a) Advise the child that this is to be expected.
b) Observe the child for infection.
c) Suggest removal of the cast to the orthopedist.
d) Moisten the cast with cool water.


Answer: a)Advise the child that this is to be expected.

The nurse is working with a group of caregivers of school-age children discussing fractures. The nurse explains that if the fragments of fractured bone are separated, the fracture is said to be which of the following?

The nurse is working with a group of caregivers of school-age children discussing fractures. The nurse explains that if the fragments of fractured bone are separated, the fracture is said to be which of the following?

a) Incomplete
b) Complete
c) Spiral
d) Greenstick


Answer: b)Complete

The type of fracture often seen in young children is a fracture in which there is not complete ossification of the bone and the bone bends and just partially breaks. This type of fracture is which of the following?

The type of fracture often seen in young children is a fracture in which there is not complete ossification of the bone and the bone bends and just partially breaks. This type of fracture is which of the following?

a) Epiphyseal
b) Spiral
c) Complete
d) Greenstick


Answer: d)Greenstick

The nurse is assessing a 10-year-old girl recently fitted with a cast on her wrist. Which assessment finding would alert the nurse to a possible infection?

The nurse is assessing a 10-year-old girl recently fitted with a cast on her wrist. Which assessment finding would alert the nurse to a possible infection?

a) Diminished pulse
b) Delayed capillary refill
c) Pallor of the fingers
d) Drainage on the cast


Answer: d)Drainage on the cast

The nurse is doing neurovascular checks on a child who has had a cast applied to treat a fracture. The nurse observes for diminished or absent sensation and numbness or tingling. In doing this the nurse is monitoring for which of the following symptoms?

The nurse is doing neurovascular checks on a child who has had a cast applied to treat a fracture. The nurse observes for diminished or absent sensation and numbness or tingling. In doing this the nurse is monitoring for which of the following symptoms?

a) Pallor
b) Pain
c) Paralysis
d) Paresthesia


Answer: d)Paresthesia

In caring for a child in traction, of the following interventions, which is the highest priority for the nurse?

In caring for a child in traction, of the following interventions, which is the highest priority for the nurse?

a) The nurse should clean the pin sites at least once every eight hours.
b) The nurse should monitor for decreased circulation every four hours.
c) The nurse should record accurate intake and output.
d) The nurse should provide age-appropriate activities for the child.


Answer: b)The nurse should monitor for decreased circulation every four hours.

The nurse is discussing types of treatment used when working with children who have orthopedic disorders. Which of the following forms of treatment covers the lower part of the body, usually from the waist down, and either one or both legs while leaving the feet open?

The nurse is discussing types of treatment used when working with children who have orthopedic disorders. Which of the following forms of treatment covers the lower part of the body, usually from the waist down, and either one or both legs while leaving the feet open?

a) Internal fixation device
b) Stockinette
c) Spica cast
d) External fixation device


Answer: c)Spica cast

The nurse is caring for a 14-year-old boy in Buck traction for a slipped capital femoral epiphysis (SCFE). Which of the following would the nurse include when completing a neurovascular assessment of the affected leg? Select all that apply.

The nurse is caring for a 14-year-old boy in Buck traction for a slipped capital femoral epiphysis (SCFE). Which of the following would the nurse include when completing a neurovascular assessment of the affected leg? Select all that apply.

a) Sensation
b) Capillary refill
c) Color
d) Vital signs
e) Pulse


Answer:


c)Color
a)Sensation
e)Pulse
b)Capillary refill

When interpreting the results of a Mantoux test, the nurse explains to the patient that a reaction occurs when the intradermal injection site shows

When interpreting the results of a Mantoux test, the nurse explains to the patient that a reaction occurs when the intradermal injection site shows

a) bruising.
b) redness and induration.
c) drainage.
d) tissue sloughing.



Answer: b) redness and induration.

A 23-year-old male client who has recently started working in a coal mine confides that he is concerned about his long-term health. The nurse instructs the client which of the following ways to prevent occupational lung disease? Select all that apply.

A 23-year-old male client who has recently started working in a coal mine confides that he is concerned about his long-term health. The nurse instructs the client which of the following ways to prevent occupational lung disease? Select all that apply.

a) Do not smoke or quit smoking if currently smoking.
b) Wear appropriate protective equipment when around airborne irritants and dusts.
c) Schedule an annual lung x-ray to monitor his health.
d) Try to find another occupation as soon as possible.



Answer:

a) Do not smoke or quit smoking if currently smoking.
b) Wear appropriate protective equipment when around airborne irritants and dusts.

Which of the following actions is most appropriate for the nurse to take when the patient demonstrates subcutaneous emphysema along the suture line or chest dressing 2 hours after chest surgery?

Which of the following actions is most appropriate for the nurse to take when the patient demonstrates subcutaneous emphysema along the suture line or chest dressing 2 hours after chest surgery?

a) Apply a compression dressing to the area.
b) Record the observation.
c) Measure the patient's pulse oximetry.
d) Report the finding to the physician immediately.


Answer: a) Apply a compression dressing to the area.

A patient suspected of developing acute respiratory distress syndrome (ARDS) is experiencing anxiety and agitation due to increasing hypoxemia and dyspnea. A nurse would implement which of the following interventions to improve oxygenation and provide comfort for the patient?

A patient suspected of developing acute respiratory distress syndrome (ARDS) is experiencing anxiety and agitation due to increasing hypoxemia and dyspnea. A nurse would implement which of the following interventions to improve oxygenation and provide comfort for the patient?

a) Assist the patient up to a chair
b) Force fluids for the next 24 hours
c) Position the patient in the prone position
d) Administer small doses of pancuronium (Pavulon)


Answer: c) Position the patient in the prone position

Which of the following terms refers to lung tissue that has become more solid in nature due to a collapse of alveoli or an infectious process?

Which of the following terms refers to lung tissue that has become more solid in nature due to a collapse of alveoli or an infectious process?

a) Bronchiectasis
b) Empyema
c) Atelectasis
d) Consolidation


Answer: d) Consolidation

A client admitted with pneumonia has a history of lung cancer and heart failure. A nurse caring for this client recognizes that he should maintain adequate fluid intake to keep secretions thin for ease in expectoration. The amount of fluid intake this client should maintain is:

A client admitted with pneumonia has a history of lung cancer and heart failure. A nurse caring for this client recognizes that he should maintain adequate fluid intake to keep secretions thin for ease in expectoration. The amount of fluid intake this client should maintain is:

a) 1.4 L.
b) unspecified.
c) 2 L.
d) 3 L.


Answer: a) 1.4 L.

A client admitted with multiple traumatic injuries receives massive fluid resuscitation. Later, the physician suspects that the client has aspirated stomach contents. The nurse knows that this client is at highest risk for:

A client admitted with multiple traumatic injuries receives massive fluid resuscitation. Later, the physician suspects that the client has aspirated stomach contents. The nurse knows that this client is at highest risk for:

a) acute respiratory distress syndrome (ARDS).
b) chronic obstructive pulmonary disease (COPD).
c) bronchial asthma.
d) renal failure.


Answer: a) acute respiratory distress syndrome (ARDS).

An emergency room nurse is assessing a patient who is complaining of dyspnea. Which of these signs would indicate the presence of a pleural effusion?

An emergency room nurse is assessing a patient who is complaining of dyspnea. Which of these signs would indicate the presence of a pleural effusion?

a) Mottling of the skin upon inspection
b) Resonance upon percussion
c) Wheezing upon auscultation
d) Decreased chest wall excursion upon palpation


Answer: d) Decreased chest wall excursion upon palpation

A 68-year-old male client who underwent thoracic surgery to remove a lung tumor had a chest tube placed anteriorly. The nurse knows that the surgical team places this catheter:

A 68-year-old male client who underwent thoracic surgery to remove a lung tumor had a chest tube placed anteriorly. The nurse knows that the surgical team places this catheter:

a) To administer IV medication
b) To ventilate the client
c) To remove fluid from the lungs
d) To remove air from the pleural space


Answer: d) To remove air from the pleural space

A patient involved in a motor vehicle crash suffered a blunt injury to the chest wall and was brought to the emergency department. The nurse assesses the patient for which clinical manifestation that would indicate the presence of a pneumothorax?

A patient involved in a motor vehicle crash suffered a blunt injury to the chest wall and was brought to the emergency department. The nurse assesses the patient for which clinical manifestation that would indicate the presence of a pneumothorax?

a) Bloody, productive cough
b) Diminished breath sounds
c) Decreased respiratory rate
d) Sucking sound at the site of injury


Answer: d) Sucking sound at the site of injury

The nursing instructor is discussing pulmonary arterial hypertension with the nursing students. What would the instructor describe as the pathophysiology of secondary pulmonary arterial hypertension?

The nursing instructor is discussing pulmonary arterial hypertension with the nursing students. What would the instructor describe as the pathophysiology of secondary pulmonary arterial hypertension?

a) Bronchial thickening causes increased resistance and pressure in the pulmonary vascular bed.
b) Chronic lung disease causes scaring in the bronchioles raising pressure in the pulmonary vascular bed.
c) Left-sided heart failure causes increased resistance and pressure in the pulmonary vascular bed.
d) Alveolar destruction causes increased resistance and pressure in the pulmonary vascular bed.


Answer: d) Alveolar destruction causes increased resistance and pressure in the pulmonary vascular bed.

Which of the following actions is most appropriate for the nurse to take when the patient demonstrates subcutaneous emphysema along the suture line or chest dressing 2 hours after chest surgery?

Which of the following actions is most appropriate for the nurse to take when the patient demonstrates subcutaneous emphysema along the suture line or chest dressing 2 hours after chest surgery?

a) Measure the patient's pulse oximetry
b) Record the observation
c) Report the finding to the physician immediately
d) Apply a compression dressing to the area


Answer: b) Record the observation

The nursing instructor is teaching students about the types of lung cancer. Which type of lung cancer is characterized as fast growing and can arise peripherally?

The nursing instructor is teaching students about the types of lung cancer. Which type of lung cancer is characterized as fast growing and can arise peripherally?

a) Large cell carcinoma
b) Squamous cell carcinoma
c) Bronchoalveolar carcinoma
d) Adenocarcinoma


Answer: a) Large cell carcinoma

The nurse is interpreting blood gases for a patient with acute respiratory distress syndrome (ARDS). Which set of blood gas values indicates respiratory acidosis?

The nurse is interpreting blood gases for a patient with acute respiratory distress syndrome (ARDS). Which set of blood gas values indicates respiratory acidosis?

a) pH 7.47, PaCO2 28, HCO3 30
b) pH 7.25, PaCO2 48, HCO3 24
c) pH 7.87, PaCO2 38, HCO3 28
d) pH 7.49, PaCO2 34, HCO3 25


Answer: b) pH 7.25, PaCO2 48, HCO3 24

A 62-year-old female client arrives at the office complaining of dyspnea and fatigue. She tells the nurse that she's had a persistent productive cough for the last few months, which she attributes to a bout with the flu. The nurse suspects that this client may have which of the following?

A 62-year-old female client arrives at the office complaining of dyspnea and fatigue. She tells the nurse that she's had a persistent productive cough for the last few months, which she attributes to a bout with the flu. The nurse suspects that this client may have which of the following?

a) Pleurisy
b) Lung abscess
c) Pleural effusion
d) Lung cancer


Answer: d) Lung cancer

Which of the following community-acquired pneumonias demonstrates the highest occurrence during summer and fall?

Which of the following community-acquired pneumonias demonstrates the highest occurrence during summer and fall?

a) Viral pneumonia
b) Mycoplasmata pneumonia
c) Legionnaires' disease
d) Streptococcal (pneumococcal) pneumonia


Answer: c) Legionnaires' disease

Which of the following types of lung cancer is characterized as fast growing and tending to arise peripherally?

Which of the following types of lung cancer is characterized as fast growing and tending to arise peripherally?

a) Bronchoalveolar carcinoma
b) Adenocarcinoma
c) Squamous cell carcinoma
d) Large cell carcinoma


Answer: d) Large cell carcinoma

A 29-year-old client presents to the ED complaining of dyspnea on exertion and overall weakness. Her pulmonary arterial pressure is 40/15 mm Hg. These symptoms indicate that the client may have which of the following conditions?

A 29-year-old client presents to the ED complaining of dyspnea on exertion and overall weakness. Her pulmonary arterial pressure is 40/15 mm Hg. These symptoms indicate that the client may have which of the following conditions?

a) Atelectasis
b) Restrictive lung disease
c) Asthma
d) Pulmonary arterial hypertension


Answer: d) Pulmonary arterial hypertension

A mechanically ventilated patient is receiving a combination of atracurium (Tracrium) and an opioid analgesic morphine. The nurse monitors the patient for which potential complication?

A mechanically ventilated patient is receiving a combination of atracurium (Tracrium) and an opioid analgesic morphine. The nurse monitors the patient for which potential complication?

a) Pulmonary hypertension
b) Cor pulmonale
c) Venous thromboemboli
d) Pneumothorax


Answer: c) Venous thromboemboli

A client with unresolved hemothorax is febrile, with chills and sweating. He has a nonproductive cough and chest pain. His chest tube drainage is turbid. A possible explanation for these findings is:

A client with unresolved hemothorax is febrile, with chills and sweating. He has a nonproductive cough and chest pain. His chest tube drainage is turbid. A possible explanation for these findings is:

a) empyema.
b) Pneumocystis carinii pneumonia.
c) infected chest tube wound site.
d) lobar pneumonia.


Answer: a) empyema.

You've been invited to speak to the Hospital Guild of the hospital where you practice nursing. You've been asked to address "Communicable Diseases of Winter" and are speaking to a large group of volunteer women, most of whom are older than 60 years. What practices should you encourage in these women, who are at the risk of pneumococcal and influenza infections? Select all that apply.

You've been invited to speak to the Hospital Guild of the hospital where you practice nursing. You've been asked to address "Communicable Diseases of Winter" and are speaking to a large group of volunteer women, most of whom are older than 60 years. What practices should you encourage in these women, who are at the risk of pneumococcal and influenza infections? Select all that apply.

a) Receiving vaccinations
b) Techniques for incentive spirometry
c) Hand antisepsis
d) Using prescribed opioids


Answer:


a) Receiving vaccinations
c) Hand antisepsis
b) Techniques for incentive spirometry

Which of the following should a nurse encourage in patients who are at the risk of pneumococcal and influenza infections?

Which of the following should a nurse encourage in patients who are at the risk of pneumococcal and influenza infections?

a) Receiving vaccination
b) Using prescribed opioids
c) Using incentive spirometry
d) Mobilizing early


Answer: a) Receiving vaccination

Following thoracic surgery, the care plan for a client at risk for impaired gas exchange would include which of the following? Select all that apply.

Following thoracic surgery, the care plan for a client at risk for impaired gas exchange would include which of the following? Select all that apply.

a) Elevate head of bed 30°-40° as tolerated.
b) Reinforce preoperative breathing exercises.
c) Administer pain medications.
d) Maintain accurate record of intravenous intake.
e) Monitor vital signs frequently.

Answer:

e) Monitor vital signs frequently.
b) Reinforce preoperative breathing exercises.
a) Elevate head of bed 30°-40° as tolerated.

What are the conditions that make up Virchow's triad? Select all that apply.

What are the conditions that make up Virchow's triad? Select all that apply.

a) Hypocoagulability
b) Disruption of the vessel lining
c) Edema
d) Hypercoagulability
e) Venostasis


Answer:

a) Hypercoagulability
b) Disruption of the vessel lining
e) Venostasis

Approximately what percentage of people who are initially infected with TB develop active disease?

Approximately what percentage of people who are initially infected with TB develop active disease?

a) 10%
b) 40%
c) 20%
d) 30%


Answer: a) 10%

Influenza, an annual epidemic in the U.S., creates a significant increase in hospitalizations and an increase in the death rates of pneumonia and cardiovascular disease. Besides death, what is the most serious complication of influenza?

Influenza, an annual epidemic in the U.S., creates a significant increase in hospitalizations and an increase in the death rates of pneumonia and cardiovascular disease. Besides death, what is the most serious complication of influenza?

a) Tracheobronchitis
b) Viral pneumonia
c) Cardiovascular disease
d) Staphylococcal pneumonia


Answer: d) Staphylococcal pneumonia

A client is admitted to the emergency department with a stab wound and is now presenting dyspnea, tachypnea, and sucking noise heard on inspiration and expiration. The nurse should care for the wound in which manner?

A client is admitted to the emergency department with a stab wound and is now presenting dyspnea, tachypnea, and sucking noise heard on inspiration and expiration. The nurse should care for the wound in which manner?

a) Apply vented dressing.
b) Apply airtight dressing.
c) Apply direct pressure to the wound.
d) Clean the wound and leave open to the air.


Answer: b) Apply airtight dressing.

The nursing instructor is talking with the junior class of nursing students about lung cancer. What would be the best rationale the instructor could give for the difficulty of early diagnosis of lung cancer?

The nursing instructor is talking with the junior class of nursing students about lung cancer. What would be the best rationale the instructor could give for the difficulty of early diagnosis of lung cancer?

a) Symptoms are often minimized by clients.
b) There are no early symptoms of lung cancer.
c) Symptoms often mimic other infectious diseases.
d) Symptoms often do not appear until the disease is well established.


Answer: d) Symptoms often do not appear until the disease is well established.

A client admitted to the facility for treatment for tuberculosis receives instructions about the disease. Which statement made by the client indicates the need for further instruction?

A client admitted to the facility for treatment for tuberculosis receives instructions about the disease. Which statement made by the client indicates the need for further instruction?

a) "I'll stay in isolation for 6 weeks."
b) "This disease may come back later if I am under stress."
c) "I'll have to take the medication for up to a year."
d) "I'll always have a positive test for tuberculosis."


Answer: a) "I'll stay in isolation for 6 weeks."

The nurse is obtaining data from a client with a respiratory disorder. Which information would be considered a part of the functional assessment and assist in the diagnosis of an occupational lung disease?

The nurse is obtaining data from a client with a respiratory disorder. Which information would be considered a part of the functional assessment and assist in the diagnosis of an occupational lung disease?

a) Cough and dyspnea
b) Black-streaked sputum
c) Tenacious secretions
d) Barrel chest


Answer: b) Black-streaked sputum

Which of the following comfort techniques does a nurse teach to a patient with pleurisy to assist with splinting the chest wall?

Which of the following comfort techniques does a nurse teach to a patient with pleurisy to assist with splinting the chest wall?

a) Elevate the head of the bed
b) Use a prescribed analgesic
c) Use a heat application
d) Turn onto the affected side


Answer: d) Turn onto the affected side

A client with lung cancer develops pleural effusion. During chest auscultation, which breath sound should the nurse expect to hear?

A client with lung cancer develops pleural effusion. During chest auscultation, which breath sound should the nurse expect to hear?

a) Crackles
b) Wheezes
c) Rhonchi
d) Decreased breath sounds


Answer: d) Decreased breath sounds

A victim of a motor vehicle accident has been brought to the emergency room. The patient is exhibiting paradoxical chest expansion and respiratory distress. Which of the following chest disorders should be suspected?

A victim of a motor vehicle accident has been brought to the emergency room. The patient is exhibiting paradoxical chest expansion and respiratory distress. Which of the following chest disorders should be suspected?

a) Cardiac tamponade
b) Flail chest
c) Simple pneumothorax
d) Pulmonary contusion


Answer: b) Flail chest

A patient diagnosed with acute respiratory distress syndrome (ARDS) is restless and has a low oxygen saturation level. If the patient's condition does not improve and the oxygen saturation level continues to decrease what procedure will the nurse expect to assist with in order to assist the patient to breathe easier?

A patient diagnosed with acute respiratory distress syndrome (ARDS) is restless and has a low oxygen saturation level. If the patient's condition does not improve and the oxygen saturation level continues to decrease what procedure will the nurse expect to assist with in order to assist the patient to breathe easier?

a) Administer a large dose of furosemide (Lasix) IVP stat
b) Intubate the patient and control breathing with mechanical ventilation
c) Schedule the patient for pulmonary surgery
d) Increase oxygen administration


Answer: b) Intubate the patient and control breathing with mechanical ventilation

A client has hypoxemia of pulmonary origin. What portion of arterial blood gas results is most useful in distinguishing between acute respiratory distress syndrome and acute respiratory failure?

A client has hypoxemia of pulmonary origin. What portion of arterial blood gas results is most useful in distinguishing between acute respiratory distress syndrome and acute respiratory failure?

a) Partial pressure of arterial carbon dioxide (PaCO2)
b) pH
c) Partial pressure of arterial oxygen (PaO2)
d) Bicarbonate (HCO3-)


Answer: c) Partial pressure of arterial oxygen (PaO2)

The client, with a lower respiratory airway infection, is presenting with the following symptoms: fever, chills, dry hacking cough, and wheezing. Which nursing diagnosis best supports the assessment by the nurse?

The client, with a lower respiratory airway infection, is presenting with the following symptoms: fever, chills, dry hacking cough, and wheezing. Which nursing diagnosis best supports the assessment by the nurse?

a) Risk for Infection
b) Ineffective Airway Clearance
c) Ineffective Breathing Pattern
d) Impaired Gas Exchange


Answer: b) Ineffective Airway Clearance

You are caring for a client who has just been diagnosed with lung cancer. What is a cardinal sign of lung cancer?

You are caring for a client who has just been diagnosed with lung cancer. What is a cardinal sign of lung cancer?

a) Pain on inspiration
b) Mucopurulent sputum
c) Obvious trauma
d) Shortness of breath


Answer: b) Mucopurulent sputum

Arterial blood gas analysis would reveal which of the following related to acute respiratory failure?

Arterial blood gas analysis would reveal which of the following related to acute respiratory failure?

a) pH 7.35
b) pH 7.28
c) PaCO 32 mm Hg
d) PaO 80 mm Hg


Answer: b) pH 7.28

A physician determines that a client has been exposed to someone with tuberculosis. The nurse expects the physician to order which treatment?

A physician determines that a client has been exposed to someone with tuberculosis. The nurse expects the physician to order which treatment?

a) Daily oral doses of isoniazid (Nydrazid) and rifampin (Rifadin) for 6 months to 2 years
b) Daily doses of isoniazid, 300 mg for 6 months to 1 year
c) Isolation until 24 hours after antitubercular therapy begins
d) Nothing, until signs of active disease arise


Answer: b) Daily doses of isoniazid, 300 mg for 6 months to 1 year

A client diagnosed with tuberculosis (TB) is taking medication for the treatment of TB. The nurse should instruct the client that he will be safe from infecting others approximately how long after initiation of the chemotherapy regimen?

A client diagnosed with tuberculosis (TB) is taking medication for the treatment of TB. The nurse should instruct the client that he will be safe from infecting others approximately how long after initiation of the chemotherapy regimen?

a) Within 48 hours after initiation of bacteriocidal drugs
b) Results vary with each client, so it is difficult to predict
c) After completion of 6 months of bacteriocidal drugs
d) Two to 3 weeks after initiation of bacteriocidal drugs


Answer: d) Two to 3 weeks after initiation of bacteriocidal drugs

Which type of pneumonia has the highest incidence in AIDS patients and patients receiving immunosuppressive therapy for cancer?

Which type of pneumonia has the highest incidence in AIDS patients and patients receiving immunosuppressive therapy for cancer?

a) Fungal
b) Streptococcal
c) TB
d) Pneumocystis


Answer: d) Pneumocystis

The client asks the nurse to explain the reason for a chest tube insertion in treating a pneumothorax. Which is the best response by the nurse?

The client asks the nurse to explain the reason for a chest tube insertion in treating a pneumothorax. Which is the best response by the nurse?

a) "Chest tube will allow air to be restored to the lung."
b) "Chest tubes provide a route for medication instillation to the lung."
c) "The tube will drain air from the space around the lung."
d) "The tube will drain secretions from the lung."


Answer: c) "The tube will drain air from the space around the lung."

For a patient with pleural effusion, what does chest percussion over the involved area reveal?

For a patient with pleural effusion, what does chest percussion over the involved area reveal?

a) Dullness over the involved area
b) Absent breath sounds
c) Fluid presence
d) Friction rub


Answer: a) Dullness over the involved area

A mediastinal shift occurs in which type of chest disorder?

A mediastinal shift occurs in which type of chest disorder?

a) Traumatic pneumothorax
b) Tension pneumothorax
c) Cardiac tamponade
d) Simple pneumothorax


Answer: b) Tension pneumothorax

A client, who is at risk for pneumonia, has been ordered influenza vaccine. Which statement from the nurse best explains the rationale for this vaccine?

A client, who is at risk for pneumonia, has been ordered influenza vaccine. Which statement from the nurse best explains the rationale for this vaccine?

a) "Getting the flu can complicate pneumonia."
b) "Influenza vaccine will prevent typical pneumonias."
c) "Influenza is the major cause of death in the United States."
d) "Viruses, like influenza, are the most common cause of pneumonia."


Answer: d) "Viruses, like influenza, are the most common cause of pneumonia."

You are a clinic nurse caring for a client with acute bronchitis. The client asks what may have caused the infection. What may induce acute bronchitis?

You are a clinic nurse caring for a client with acute bronchitis. The client asks what may have caused the infection. What may induce acute bronchitis?

a) Aspiration
b) Direct lung damage
c) Chemical irritation
d) Drug ingestion


Answer: c) Chemical irritation

A client who is diagnosed with chronic respiratory failure will have which of the following symptoms?

A client who is diagnosed with chronic respiratory failure will have which of the following symptoms?

a) Dyspnea
b) Hypercapnia
c) Hypoxemia
d) Ventilatory failure


Answer: a) Dyspnea

A nurse is caring for a patient after a thoracentesis. Which of the following signs if noted in the patient should be reported to the physician immediately?

A nurse is caring for a patient after a thoracentesis. Which of the following signs if noted in the patient should be reported to the physician immediately?

a) "Patient has subcutaneous emphysema around needle insertion site."
b) "Patient is becoming agitated and complains of pleuritic pain."
c) "Patient is drowsy and complains of headache."
d) "Patient has an oxygen saturation level of 93%."


Answer: b) "Patient is becoming agitated and complains of pleuritic pain."

Which of the following techniques does a nurse suggest to a patient with pleurisy while teaching about splinting the chest wall?

Which of the following techniques does a nurse suggest to a patient with pleurisy while teaching about splinting the chest wall?

a) Use a prescribed analgesic
b) Use a heat or cold application
c) Turn onto the affected side
d) Avoid using a pillow while splinting


Answer: c) Turn onto the affected side

A nurse is reviewing a client's X-ray. The X-ray shows an endotracheal (ET) tube placed 3/4? (2 cm) above the carina and reveals nodular lesions and patchy infiltrates in the upper lobe. Which interpretation of the X-ray is accurate?

A nurse is reviewing a client's X-ray. The X-ray shows an endotracheal (ET) tube placed 3/4? (2 cm) above the carina and reveals nodular lesions and patchy infiltrates in the upper lobe. Which interpretation of the X-ray is accurate?

a) The X-ray is inconclusive.
b) A disease process is present.
c) The ET tube must be pulled back.
d) The ET tube must be advanced.


Answer: b) A disease process is present.

A client who has just had a triple-lumen catheter placed in his right subclavian vein complains of chest pain and shortness of breath. His blood pressure is decreased from baseline and, on auscultation of his chest, the nurse notes unequal breath sounds. A chest X-ray is immediately ordered by the physician. What diagnosis should the nurse suspect?

A client who has just had a triple-lumen catheter placed in his right subclavian vein complains of chest pain and shortness of breath. His blood pressure is decreased from baseline and, on auscultation of his chest, the nurse notes unequal breath sounds. A chest X-ray is immediately ordered by the physician. What diagnosis should the nurse suspect?

a) Pulmonary embolism
b) Pneumothorax
c) Heart failure
d) Myocardial infarction (MI)


Answer: b) Pneumothorax

Which statement would indicate that the parents of child with cystic fibrosis understand the disorder?

Which statement would indicate that the parents of child with cystic fibrosis understand the disorder?

a) "There are fibrous cysts in the lungs."
b) "Early treatment can stop the progression of the disease."
c) "The mucus-secreting glands are abnormal."
d) "Allergic reactions cause inflammation in the lungs."


Answer: c) "The mucus-secreting glands are abnormal."

The nurse knows the mortality rate is high in lung cancer clients due to which factor?

The nurse knows the mortality rate is high in lung cancer clients due to which factor?

a) Increased exposure to industrial pollutants
b) Increase in women smokers
c) Few early symptoms
d) Increased incidence among the elderly


Answer: c) Few early symptoms

A 73-year-old client is admitted to the pulmonology unit of the hospital. She was admitted with a pleural effusion and was "tapped" to drain the fluid to reduce her mediastinal pressure. How much fluid is typically present between the pleurae, which surround the lungs, to prevent friction rub?

A 73-year-old client is admitted to the pulmonology unit of the hospital. She was admitted with a pleural effusion and was "tapped" to drain the fluid to reduce her mediastinal pressure. How much fluid is typically present between the pleurae, which surround the lungs, to prevent friction rub?

a) No fluid normally is present
b) 5 - 15 ml
c) 15 - 25 ml
d) 20 - 30 ml


Answer: b) 5 - 15 ml

The nurse identifies which finding to be most consistent prior to the onset of acute respiratory distress?

The nurse identifies which finding to be most consistent prior to the onset of acute respiratory distress?

a) Chronic lung disease
b) Normal lung function
c) Loss of lung function
d) Slow onset of symptoms


Answer: b) Normal lung function

A positive Mantoux test indicates that a client:

A positive Mantoux test indicates that a client:

a) has produced an immune response.
b) has an active case of tuberculosis.
c) will develop full-blown tuberculosis.
d) is actively immune to tuberculosis.


Answer: a) has produced an immune response.

You are a clinic nurse caring for a client with acute tracheobronchitis. The client asks what may have caused the infection. Which of the following responses from the nurse would be most accurate?

You are a clinic nurse caring for a client with acute tracheobronchitis. The client asks what may have caused the infection. Which of the following responses from the nurse would be most accurate?

a) Drug ingestion
b) Chemical irritation
c) Direct lung damage
d) Aspiration


Answer: b) Chemical irritation

The new client on the unit was admitted with acute respiratory failure. What are the signs and symptoms of acute respiratory failure?

The new client on the unit was admitted with acute respiratory failure. What are the signs and symptoms of acute respiratory failure?

a) Sudden onset in client who had normal lung function
b) Insidious onset in client who had normal lung function
c) Insidious onset in client who had compromised lung function
d) Sudden onset in client who had compromised lung function


Answer: a) Sudden onset in client who had normal lung function

A nurse recognizes that a client with tuberculosis needs further teaching when the client states:

A nurse recognizes that a client with tuberculosis needs further teaching when the client states:

a) "I'll have to take these medications for 9 to 12 months."
b) "The people I have contact with at work should be checked regularly."
c) "I'll need to have scheduled laboratory tests while I'm on the medication."
d) "It won't be necessary for the people I work with to take medication."


Answer: b) "The people I have contact with at work should be checked regularly."

An elderly client is diagnosed with pulmonary tuberculosis. Upset and tearful, he asks the nurse how long he must be separated from his family. Which nursing diagnosis is most appropriate for this client?

An elderly client is diagnosed with pulmonary tuberculosis. Upset and tearful, he asks the nurse how long he must be separated from his family. Which nursing diagnosis is most appropriate for this client?

a) Social isolation
b) Deficient knowledge (disease process and treatment regimen)
c) Impaired social interaction
d) Anxiety


Answer: b) Deficient knowledge (disease process and treatment regimen)

The nurse is assessing a patient who, following an extensive surgical procedure, is at risk for developing acute respiratory distress syndrome (ARDS). The nurse assesses for which early, most common sign of ARDS?

The nurse is assessing a patient who, following an extensive surgical procedure, is at risk for developing acute respiratory distress syndrome (ARDS). The nurse assesses for which early, most common sign of ARDS?

a) Rapid onset of severe dyspnea
b) Cyanosis
c) Inspiratory crackles
d) Bilateral wheezing


Answer: a) Rapid onset of severe dyspnea

A client asks a nurse a question about the Mantoux test for tuberculosis. The nurse should base her response on the fact that the:

A client asks a nurse a question about the Mantoux test for tuberculosis. The nurse should base her response on the fact that the:

a) area of redness is measured in 3 days and determines whether tuberculosis is present.
b) test stimulates a reddened response in some clients and requires a second test in 3 months.
c) presence of a wheal at the injection site in 2 days indicates active tuberculosis.
d) skin test doesn't differentiate between active and dormant tuberculosis infection.


Answer: d) skin test doesn't differentiate between active and dormant tuberculosis infection.

A nurse assesses arterial blood gas results for a patient in acute respiratory failure (ARF). Which of the following results are consistent with this disorder?

A nurse assesses arterial blood gas results for a patient in acute respiratory failure (ARF). Which of the following results are consistent with this disorder?

a) pH 7.35, PaCO2 48 mm Hg
b) pH 7.28, PaO2 50 mm Hg
c) pH 7.46, PaO2 80 mm Hg
d) pH 7.36, PaCO2 32 mm Hg



Answer: b) pH 7.28, PaO2 50 mm Hg

A nurse is caring for a client who was admitted with pneumonia, has a history of falls, and has skin lesions resulting from scratching. The priority nursing diagnosis for this client should be:

A nurse is caring for a client who was admitted with pneumonia, has a history of falls, and has skin lesions resulting from scratching. The priority nursing diagnosis for this client should be:

a) Risk for falls.
b) Ineffective breathing pattern.
c) Ineffective airway clearance.
d) Impaired tissue integrity.


Answer: c) Ineffective airway clearance.

The ICU nurse caring for a 2-year-old near drowning victim monitors for what possible complication?

The ICU nurse caring for a 2-year-old near drowning victim monitors for what possible complication?

a) Atelectasis
b) Acute respiratory distress syndrome
c) Metabolic alkalosis
d) Respiratory acidosis


Answer: b) Acute respiratory distress syndrome

A nurse is caring for a group of clients on a medical-surgical floor. Which client is at greatest risk for developing pneumonia?

A nurse is caring for a group of clients on a medical-surgical floor. Which client is at greatest risk for developing pneumonia?

a) A client with a nasogastric tube
b) A client who is receiving acetaminophen (Tylenol) for pain
c) A client who ambulates in the hallway every 4 hours
d) A client with a history of smoking two packs of cigarettes per day until quitting 2 years ago


Answer: a) A client with a nasogastric tube

What is the reason for chest tubes after thoracic surgery?

What is the reason for chest tubes after thoracic surgery?

a) Draining secretions, air, and blood from the thoracic cavity is necessary.
b) Chest tubes allow air into the pleural space.
c) Chest tubes indicate when the lungs have re-expanded by ceasing to bubble.
d) Draining secretions and blood while allowing air to remain in the thoracic cavity is necessary.


Answer: a) Draining secretions, air, and blood from the thoracic cavity is necessary.

A nurse is assessing a client who comes to the clinic for care. Which findings in this client suggest bacterial pneumonia?

A nurse is assessing a client who comes to the clinic for care. Which findings in this client suggest bacterial pneumonia?

a) Sore throat and abdominal pain
b) Nonproductive cough and normal temperature
c) Hemoptysis and dysuria
d) Dyspnea and wheezing


Answer: d) Dyspnea and wheezing

Which of the following is a key characteristic of pleurisy?

Which of the following is a key characteristic of pleurisy?

a) Blood-tinged secretions
b) Pain
c) Dyspnea
d) Anxiety


Answer: b) Pain

A Class 1 with regards to TB indicates

A Class 1 with regards to TB indicates

a) disease that is not clinically active.
b) exposure and no evidence of infection.
c) no exposure and no infection.
d) latent infection with no disease.


Answer: b) exposure and no evidence of infection.

Which vitamin is usually administered with isoniazid (INH) to prevent INH-associated peripheral neuropathy?

Which vitamin is usually administered with isoniazid (INH) to prevent INH-associated peripheral neuropathy?

a) Vitamin E
b) Vitamin D
c) Vitamin C
d) Vitamin B6


Answer: d) Vitamin B6

After diagnosing a client with pulmonary tuberculosis, the physician tells family members that they must receive isoniazid (INH [Laniazid]) as prophylaxis against tuberculosis. The client's daughter asks the nurse how long the drug must be taken. What is the usual duration of prophylactic isoniazid therapy?

After diagnosing a client with pulmonary tuberculosis, the physician tells family members that they must receive isoniazid (INH [Laniazid]) as prophylaxis against tuberculosis. The client's daughter asks the nurse how long the drug must be taken. What is the usual duration of prophylactic isoniazid therapy?

a) 1 to 3 weeks
b) 6 to 12 months
c) 2 to 4 months
d) 3 to 5 days


Answer: b) 6 to 12 months

A victim has sustained a blunt force trauma to the chest. A pulmonary contusion is suspected. Which of the following clinical manifestations correlate with a moderate pulmonary contusion?

A victim has sustained a blunt force trauma to the chest. A pulmonary contusion is suspected. Which of the following clinical manifestations correlate with a moderate pulmonary contusion?

a) Respiratory alkalosis
b) Productive cough
c) Blood-tinged sputum
d) Bradypnea


Answer: c) Blood-tinged sputum

You are an ICU nurse caring for a client who was admitted with a diagnosis of smoke inhalation. You know that this client is at increased risk for which of the following?

You are an ICU nurse caring for a client who was admitted with a diagnosis of smoke inhalation. You know that this client is at increased risk for which of the following?

a) Bronchitis
b) Lung cancer
c) Tracheobronchitis
d) Acute respiratory distress syndrome


Answer: d) Acute respiratory distress syndrome

A nurse is caring for a client with chest trauma. Which nursing diagnosis takes the highest priority?

A nurse is caring for a client with chest trauma. Which nursing diagnosis takes the highest priority?

a) Decreased cardiac output
b) Anxiety
c) Ineffective tissue perfusion (cardiopulmonary)
d) Impaired gas exchange


Answer: d) Impaired gas exchange

A 65-year-old client who works construction, and has been demolishing an older building,is diagnosed with pneumoconiosis. The nurse is aware that his lung inflammation is most likely caused by exposure to which of the following?

A 65-year-old client who works construction, and has been demolishing an older building,is diagnosed with pneumoconiosis. The nurse is aware that his lung inflammation is most likely caused by exposure to which of the following?

a) Silica
b) Coal dust
c) Pollen
d) Asbestos


Answer: d) Asbestos

You are caring for a client who has been diagnosed with viral pneumonia. You are making a plan of care for this client. What nursing interventions would you put into the plan of care for a client with pneumonia?

You are caring for a client who has been diagnosed with viral pneumonia. You are making a plan of care for this client. What nursing interventions would you put into the plan of care for a client with pneumonia?

a) Place client on bed rest.
b) Offer nutritious snacks 2 times a day.
c) Encourage increased fluid intake.
d) Give antibiotics as ordered.



Answer: c) Encourage increased fluid intake.

A nurse reading a chart notes that the patient had a Mantoux skin test result with no induration and a 1-mm area of ecchymosis. How does the nurse interpret this result?

A nurse reading a chart notes that the patient had a Mantoux skin test result with no induration and a 1-mm area of ecchymosis. How does the nurse interpret this result?

a) Uncertain
b) Positive
c) Borderline
d) Negative


Answer: d) Negative

After 48 hours, a Mantoux test is evaluated. At the site, there is a 10 mm induration. This finding would be considered:

After 48 hours, a Mantoux test is evaluated. At the site, there is a 10 mm induration. This finding would be considered:

a) Significant
b) Negative
c) Nonreactive
d) Not significant


Answer: a) Significant

A client has been hospitalized for treatment of acute bacterial pneumonia. Which outcome indicates an improvement in the client's condition?

A client has been hospitalized for treatment of acute bacterial pneumonia. Which outcome indicates an improvement in the client's condition?

a) The client has a partial pressure of arterial oxygen (PaO2) value of 90 mm Hg or higher.
b) The client exhibits bronchial breath sounds over the affected area.
c) The client exhibits restlessness and confusion.
d) The client has a partial pressure of arterial carbon dioxide (PaCO2) value of 65 mm Hg or higher.


Answer: a) The client has a partial pressure of arterial oxygen (PaO2) value of 90 mm Hg or higher.

A recent immigrant is diagnosed with pulmonary tuberculosis (TB). Which intervention is the most important for the nurse to implement with this client?

A recent immigrant is diagnosed with pulmonary tuberculosis (TB). Which intervention is the most important for the nurse to implement with this client?

a) Client teaching about the cause of TB
b) Developing a list of people with whom the client has had contact
c) Client teaching about the importance of TB testing
d) Reviewing the risk factors for TB


Answer: b) Developing a list of people with whom the client has had contact

When caring for a client with acute respiratory failure, the nurse should expect to focus on resolving which set of problems?

When caring for a client with acute respiratory failure, the nurse should expect to focus on resolving which set of problems?

a) Hyperventilation, hypertension, and hypocapnia
b) Hypercapnia, hypoventilation, and hypoxemia
c) Hypotension, hyperoxemia, and hypercapnia
d) Hyperoxemia, hypocapnia, and hyperventilation


Answer: b) Hypercapnia, hypoventilation, and hypoxemia

A nurse is caring for a patient diagnosed with empyema. Which of the following interventions does a nurse implement for patients with empyema?

A nurse is caring for a patient diagnosed with empyema. Which of the following interventions does a nurse implement for patients with empyema?

a) Institute droplet precautions.
b) Do not allow visitors with respiratory infection.
c) Encourage breathing exercises.
d) Place suspected patients together.


Answer: c) Encourage breathing exercises.

On auscultation, which finding suggests a right pneumothorax?

On auscultation, which finding suggests a right pneumothorax?

a) Inspiratory wheezes in the right thorax
b) Absence of breath sounds in the right thorax
c) Bilateral pleural friction rub
d) Bilateral inspiratory and expiratory crackles


Answer: b) Absence of breath sounds in the right thorax

During discharge teaching, a nurse is instructing a client about pneumonia. The client demonstrates his understanding of relapse when he states that he must:

During discharge teaching, a nurse is instructing a client about pneumonia. The client demonstrates his understanding of relapse when he states that he must:

a) follow up with the physician in 2 weeks.
b) turn and reposition himself every 2 hours.
c) maintain fluid intake of 40 oz (1,200 ml) per day.
d) continue to take antibiotics for the entire 10 days.


Answer: d) continue to take antibiotics for the entire 10 days.

The patient with a chest tube is being transported to X-ray. Which complication may occur if the chest tube is clamped during transportation?

The patient with a chest tube is being transported to X-ray. Which complication may occur if the chest tube is clamped during transportation?

a) Flail chest
b) Cardiac tamponade
c) Pulmonary contusion
d) Tension pneumothorax


Answer: d) Tension pneumothorax

Which of the following types of lung cancer is the most prevalent carcinoma of the lung for both men and women?

Which of the following types of lung cancer is the most prevalent carcinoma of the lung for both men and women?

a) Large cell carcinoma
b) Squamous cell carcinoma
c) Small cell carcinoma
d) Adenocarcinoma


Answer: d) Adenocarcinoma

Resistance to one of the first-line antituberculotic agents in people who have not had previous treatment is

Resistance to one of the first-line antituberculotic agents in people who have not had previous treatment is

a) tertiary drug resistance.
b) secondary drug resistance.
c) primary drug resistance.
d) multidrug resistance.


Answer: c) primary drug resistance.

The nurse is providing discharge instructions to a patient with pulmonary sarcoidosis. The nurse concludes that the patient understands the information if the patient correctly states which of the following early signs of exacerbation?

The nurse is providing discharge instructions to a patient with pulmonary sarcoidosis. The nurse concludes that the patient understands the information if the patient correctly states which of the following early signs of exacerbation?

a) Fever
b) Headache
c) Weight loss
d) Shortness of breath


Answer: d) Shortness of breath

A nurse is administering a purified protein derivative (PPD) test to a client. Which statement concerning PPD testing is true?

A nurse is administering a purified protein derivative (PPD) test to a client. Which statement concerning PPD testing is true?

a) A negative reaction always excludes the diagnosis of TB.
b) The PPD can be read within 12 hours after the injection.
c) A positive reaction indicates that the client has active tuberculosis (TB).
d) A positive reaction indicates that the client has been exposed to the disease.


Answer: d) A positive reaction indicates that the client has been exposed to the disease.

A physician stated to the nurse that the patient has fluid noted in the pleural space and will need a thoracentesis. The nurse would expect that the physician will document this fluid as which of the following?

A physician stated to the nurse that the patient has fluid noted in the pleural space and will need a thoracentesis. The nurse would expect that the physician will document this fluid as which of the following?

a) Pneumothorax
b) Hemothorax
c) Pleural effusion
d) Consolidation


Answer: c) Pleural effusion

What dietary recommendations should a nurse provide a patient with a lung abscess?

What dietary recommendations should a nurse provide a patient with a lung abscess?

a) A diet low in calories
b) A carbohydrate-dense diet
c) A diet rich in protein
d) A diet with limited fat


Answer: c) A diet rich in protein

You are an occupational nurse completing routine assessments on the employees where you work. What might be revealed by a chest radiograph for a client with occupational lung diseases?

You are an occupational nurse completing routine assessments on the employees where you work. What might be revealed by a chest radiograph for a client with occupational lung diseases?

a) Fibrotic changes in lungs
b) Hemorrhage
c) Damage to surrounding tissues
d) Lung contusion


Answer: a) Fibrotic changes in lungs

A nurse is preparing instructions for a patient with a lung abscess regarding dietary recommendations. Which of the following statements would be included in the plan of care?

A nurse is preparing instructions for a patient with a lung abscess regarding dietary recommendations. Which of the following statements would be included in the plan of care?

a) "You must consume a diet low in calories, such as skim milk, fresh fruits, and vegetables."
b) "You must consume a diet rich in protein, such as chicken, fish, and beans."
c) "You must consume a diet high in carbohydrates, such as bread, potatoes, and pasta."
d) "You must consume a diet low in fat by limiting dairy products and concentrated sweets."


Answer: b) "You must consume a diet rich in protein, such as chicken, fish, and beans."

A client with acquired immunodeficiency syndrome (AIDS) develops Pneumocystis carinii pneumonia. Which nursing diagnosis has the highest priority?

A client with acquired immunodeficiency syndrome (AIDS) develops Pneumocystis carinii pneumonia. Which nursing diagnosis has the highest priority?

a) Activity intolerance
b) Impaired oral mucous membranes
c) Imbalanced nutrition: Less than body requirements
d) Impaired gas exchange


Answer: d) Impaired gas exchange

A client who underwent surgery 12 hours ago has difficulty breathing. He has petechiae over his chest and complains of acute chest pain. What action should the nurse take first?

A client who underwent surgery 12 hours ago has difficulty breathing. He has petechiae over his chest and complains of acute chest pain. What action should the nurse take first?

a) Perform nasopharyngeal suctioning.
b) Initiate oxygen therapy.
c) Administer a heparin bolus and begin an infusion at 500 units/hour.
d) Administer analgesics as ordered.


Answer: b) Initiate oxygen therapy.

The nurse is collaborating with a community group to develop plans to reduce the incidence of lung cancer in the community. Which of the following would be most effective?

The nurse is collaborating with a community group to develop plans to reduce the incidence of lung cancer in the community. Which of the following would be most effective?

a) Classes at community centers to teach about smoking cessation strategies
b) Advertisements in public places to encourage cigarette smokers to have yearly chest x-rays
c) Legislation that requires homes and apartments be checked for asbestos leakage
d) Public service announcements on television to promote the use of high-efficiency particulate air (HEPA) filters in homes


Answer: a) Classes at community centers to teach about smoking cessation strategies

A client who has started therapy for drug-resistant tuberculosis demonstrates understanding of tuberculosis transmission when he says:

A client who has started therapy for drug-resistant tuberculosis demonstrates understanding of tuberculosis transmission when he says:

a) "My tuberculosis isn't contagious after I take the medication for 24 hours."
b) "I'll stop being contagious when I have a negative acid-fast bacilli test."
c) "I'm contagious as long as I have night sweats."
d) "I'm clear when my chest X-ray is negative."


Answer: b) I'll stop being contagious when I have a negative acid-fast bacilli test."

A 67-year-old female client is being discharged postoperative following pelvic surgery. The patient care instructions to prevent the development of a pulmonary embolus would include which of the following?

A 67-year-old female client is being discharged postoperative following pelvic surgery. The patient care instructions to prevent the development of a pulmonary embolus would include which of the following?

a) Consume majority of fluid intake prior to bed.
b) Wear tight-fitting clothing.
c) Begin estrogen replacement.
d) Tense and relax muscles in lower extremities.


Answer: d) Tense and relax muscles in lower extremities.

While caring for a client with a chest tube, which nursing assessment would alert the nurse to a possible complication?

While caring for a client with a chest tube, which nursing assessment would alert the nurse to a possible complication?

a) Bloody drainage is seemed in the collection chamber.
b) Crackling is heard when skin around tube is touched.
c) Skin around tube is pink.
d) Absence of bloody drainage in the anterior/upper tube


Answer: b) Crackling is heard when skin around tube is touched.

Which of the following interventions does a nurse implement for patients with empyema?

Which of the following interventions does a nurse implement for patients with empyema?

a) Institute droplet precautions
b) Do not allow visitors with respiratory infections
c) Place suspected patients together
d) Encourage breathing exercises


Answer: d) Encourage breathing exercises

You are an occupational health nurse in a large ceramic manufacturing company. How would you intervene to prevent occupational lung disease in the employees of the company?

You are an occupational health nurse in a large ceramic manufacturing company. How would you intervene to prevent occupational lung disease in the employees of the company?

a) Provide employees with smoking cessation materials.
b) Insist on adequate breaks for each employee.
c) Fit all employees with protective masks.
d) Give workshops on disease prevention.


Answer: c) Fit all employees with protective masks.

Which of the following is a true statement regarding severe acute respiratory syndrome (SARS)?

Which of the following is a true statement regarding severe acute respiratory syndrome (SARS)?

a) Constipation usually develops
b) It is spread by fecal contamination
c) Hypothermia will occur
d) It is the most contagious during the second week of illness


Answer: d) It is the most contagious during the second week of illness

You are assessing a client's potential for pulmonary emboli. What finding indicates possible deep vein thrombosis?

You are assessing a client's potential for pulmonary emboli. What finding indicates possible deep vein thrombosis?

a) Negative Homan's sign
b) Pain in the feet
c) Pain in the calf
d) Inability to dorsiflex


Answer: c) Pain in the calf

You are caring for a client with chronic respiratory failure. What are the signs and symptoms of chronic respiratory failure?

You are caring for a client with chronic respiratory failure. What are the signs and symptoms of chronic respiratory failure?

a) Progressive loss of lung function associated with chronic disease
b) Sudden loss of lung function associated with chronic disease
c) Progressive loss of lung function with history of normal lung function
d) Sudden loss of lung function with history of normal lung function


Answer: a) Progressive loss of lung function associated with chronic disease

You are caring for a client status post lung resection. When assessing your client you find that the bubbling in the water-seal chamber for the chest tubes is more than you expected. What should you check when bubbling in the water-seal chamber is excessive?

You are caring for a client status post lung resection. When assessing your client you find that the bubbling in the water-seal chamber for the chest tubes is more than you expected. What should you check when bubbling in the water-seal chamber is excessive?

a) See if the chest tube is clogged.
b) See if the wall suction unit has malfunctioned.
c) See if there are leaks in the system.
d) See if a kink has developed in the tubing.


Answer: c) See if there are leaks in the system.

A client is brought to the emergency department following a motor vehicle accident. Which of the following nursing assessment is significant in diagnosing this client with flail chest?

A client is brought to the emergency department following a motor vehicle accident. Which of the following nursing assessment is significant in diagnosing this client with flail chest?

a) Clubbing of fingers and toes
b) Respiratory acidosis
c) Paradoxical chest movement
d) Chest pain on inspiration


Answer: c) Paradoxical chest movement

A client is admitted to the health care facility with active tuberculosis (TB). The nurse should include which intervention in the care plan?

A client is admitted to the health care facility with active tuberculosis (TB). The nurse should include which intervention in the care plan?

a) Keeping the door to the client's room open to observe the client
b) Instructing the client to wear a mask at all times
c) Putting on an individually fitted mask when entering the client's room
d) Wearing a gown and gloves when providing direct care


Answer: c) Putting on an individually fitted mask when entering the client's room