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NSG 201H -Assessment of Respiratory Function
NSG 201H -Assessment of Respiratory Function
Chapter 23: Assessment of Respiratory Function
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. The nurse educator is teaching a student nurse how to auscultate the lungs. Which action by the student nurse indicates the need for further education?
| 1) | Listening to sound over the bony structures |
| 2) | Asking the client to sit in an upright position |
| 3) | Instructing the client to breathe slowly through mouth |
| 4) | Beginning auscultation from lung apices and moving toward intercostal spaces |
NSG 201H -Assessment of Respiratory Function
____ 2. The nurse is providing care to a patient who will need a bronchoscopy. Which patient statement indicates appropriate understanding of the information presented?
| 1) | “I will be awake and aware during the procedure.” |
| 2) | “I will require mechanical ventilation after the procedure.” |
| 3) | “I will need to have my prothrombin time drawn after the test.” |
| 4) | “I will abstain from eating or drinking for eight hours prior to the procedure.” |
____ 3. The nurse is conducting a respiratory assessment for a patient who is diagnosed with asthma. Which assessment finding indicates the patient is experiencing airway irritation?
| 1) | Hemoptysis |
| 2) | Dry, hacking cough |
| 3) | Harsh, barky cough |
| 4) | Loose-sounding cough |
____ 4. The nurse is assessing a patient who is admitted with a persistent cough and is diagnosed with pulmonary edema. Which assessment finding supports the patient’s diagnosis?
| 1) | Foul smelling sputum |
| 2) | Clear, whitish, or yellow sputum |
| 3) | Large amounts of frothy, pink tinged sputum |
| 4) | Clear to gray with occasional specks of brown sputum |
NSG 201H -Assessment of Respiratory Function
____ 5. The nurse is assessing a patient who is diagnosed with tuberculosis. Which assessment finding supports this diagnosis?
| 1) | Wheezing |
| 2) | Hemoptysis |
| 3) | Grey sputum |
| 4) | Slightly whitish sputum |
____ 6. When percussing the patient’s lung fields, the nurse notes a moderately low-pitched sound over the chest. Which term does the nurse use to describe these sounds?
| 1) | Dull |
| 2) | Tympany |
| 3) | Resonance |
| 4) | Hyperresonance |
NSG 201H -Assessment of Respiratory Function
____ 7. Which diagnostic procedure is used to remove pleural fluid for analysis?
| 1) | Lung biopsy |
| 2) | Bronchoscopy |
| 3) | Thoracentesis |
| 4) | Sputum studies |
____ 8. The nurse is providing care to a patient who undergoes a sputum study. Which will the sputum study help to diagnose?
| 1) | Asthma |
| 2) | Lung cancer |
| 3) | Bacterial lung infection |
| 4) | Chronic obstructive pulmonary disease |
____ 9. While auscultating a patient’s chest, the nurse notes wheezing. Based on this data, which diagnosis does the nurse anticipate?
| 1) | Bronchiectasis |
| 2) | Pleural effusion |
| 3) | Pulmonary edema |
| 4) | Chronic obstructive pulmonary disease |
____ 10. The nurse is conducting a health history interview for a patient who is diagnosed with chronic obstructive pulmonary disease (COPD). Which question is appropriate when assessing the patient’s nutrition-metabolic pattern?
| 1) | “Have you lost any weight recently?” |
| 2) | “Do you have trouble getting to the toilet?” |
| 3) | “Does your breathing wake you up in the night?” |
| 4) | “Do you have any pain associated with breathing?” |
____ 11. The nurse assesses a patient who presents with tachypnea and clubbing of the fingers. Based on this data, which diagnosis does the nurse anticipate for this patient?
| 1) | Asthma |
| 2) | Chest trauma |
| 3) | Chronic hypoxemia |
| 4) | Chronic pulmonary obstructive disease |
NSG 201H -Assessment of Respiratory Function
____ 12. A patient is admitted to the emergency department (ED) with dyspnea. Upon assessment, the nurse notes a bluish discoloration of the patient’s lips, fine crackles on auscultation, and dullness upon percussion of the lung fields. Based on this data, which diagnosis does the nurse anticipate?
| 1) | Asthma |
| 2) | Pleural effusion |
| 3) | Pulmonary edema |
| 4) | Pulmonary fibrosis |
____ 13. Which is the term used to describe abnormal breath sounds?
| 1) | Vesicular |
| 2) | Bronchial |
| 3) | Adventitious |
| 4) | Bronchovesicular |
____ 14. Which would the nurse assess when using palpation during the respiratory assessment?
| 1) | Tracheal position |
| 2) | Bronchovesicular sounds |
| 3) | Lung density |
| 4) | Adventitious sounds |
____ 15. The nurse is performing pulmonary function testing on a patient. Which nursing action is beneficial to the patient?
| 1) | Assessing for respiratory distress |
| 2) | Scheduling the test after a meal |
| 3) | Providing rest before the procedure |
| 4) | Administering an inhaled bronchodilator six hours before procedure |
____ 16. The nurse is caring for a patient with a suspected pulmonary embolism. Which radiology study does the nurse anticipate to be beneficial for the patient?
| 1) | Chest x-ray |
| 2) | Pulmonary angiogram |
| 3) | Computed tomography |
| 4) | Magnetic resonance imaging |
____ 17. The nurse is caring for a patient with shortness of breath and respiratory rate of 28 breaths per minute. Which is the most preferred method to auscultate the chest of the patient with this condition?
| 1) | Listening at the apices |
| 2) | Listening at the lung bases |
| 3) | Listening by comparing opposite areas of the chest |
| 4) | Listening to each cycle of inspiratory and expiratory cycle |
____ 18. What is the function of the epiglottis?
| 1) | To aid in the sensation of smell |
| 2) | To conduct gases to the alveoli |
| 3) | To filter small particles before air enters the lungs |
| 4) | To prevent the entry of solids and liquids into the lungs |
____ 19. Which interconnected structure allows the movement of air between the alveoli?
| 1) | Bronchioles |
| 2) | Pores of Kohn |
| 3) | Visceral pleura |
| 4) | Parietal pleura |
____ 20. The nurse is providing care to a patient who is diagnosed with asthma. Which noninvasive method will the nurse use to assess the patient’s oxygenation status?
| 1) | Pulse oximetry |
| 2) | Arterial blood gas |
| 3) | Venous blood gas |
| 4) | Cardiopulmonary monitor |
____ 21. The nurse is conducting a respiratory assessment. Which respiratory manifestation indicates inadequate oxygenation?
| 1) | Mild hypertension |
| 2) | Cool, clammy skin |
| 3) | Dyspnea on exertion |
| 4) | Unexplained apprehension |
____ 22. The nurse is providing care to a patient who is diagnosed with pneumonia. The patient admits to smoking one pack of cigarettes per day. Which respiratory defense mechanism may have failed to cause the patient’s diagnosis?
| 1) | Cough reflex |
| 2) | Filtration of air |
| 3) | Alveolar macrophages |
| 4) | Mucociliary clearance system |
____ 23. What is the location of central chemoreceptors?
| 1) | Lungs |
| 2) | Pores of Kohn |
| 3) | Roof of the nose |
| 4) | Medulla oblongata |
____ 24. Which structure is located in the lower respiratory tract?
| 1) | Alveoli |
| 2) | Larynx |
| 3) | Trachea |
| 4) | Pharynx |
____ 25. Which is the major muscle of respiration?
| 1) | Accessory muscle |
| 2) | Intercostal muscle |
| 3) | Diaphragm muscle |
| 4) | Abdominal muscle |
NSG 201H -Assessment of Respiratory Function
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 26. The nurse is providing care to a patient who is diagnosed with chronic obstructive pulmonary disease (COPD). Which laboratory values will the nurse monitor when planning care for this client? Select all that apply.
| 1) | Elevated eosinophils count |
| 2) | Decreased neutrophils count |
| 3) | Elevated red blood cells count |
| 4) | Decreased partial pressure of arterial oxygen |
| 5) | Decreased partial pressure of arterial carbon dioxide |
____ 27. Which questions are appropriate when assessing the effects of the patient’s respiratory diagnosis on activity-exercise patterns? Select all that apply.
| 1) | “Are you ever incontinent of urine when you cough?” |
| 2) | “Do you have trouble walking due to shortness of breath?” |
| 3) | “Does your spouse wake you in the middle of the night due to snoring?” |
| 4) | “How many flights of stairs can you walk before you are short of breath?” |
| 5) | “Do you ever feel full very quickly when eating due to your breathing issues?” |
____ 28. During the respiratory assessment, the nurse notes coarse crackles upon auscultation of the lung fields. Which diagnoses presents with this assessment finding? Select all that apply.
| 1) | Pneumonia |
| 2) | Heart failure |
| 3) | Cystic fibrosis |
| 4) | Bronchospasm |
| 5) | Interstitial edema |
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____ 29. Which are age-related changes to the respiratory system’s defense mechanisms? Select all that apply.
| 1) | Decreased cilia function |
| 2) | Decreased chest wall compliance |
| 3) | Decreased response to hypoxemia |
| 4) | Decreased cell-mediated immunity |
| 5) | Decreased respiratory muscle strength |
____ 30. Which are age-related changes to respiratory control that may be observed when assessing the older adult patient? Select all that apply.
| 1) | Less forceful cough |
| 2) | Calcification of costal cartilage |
| 3) | Decreased response to hypoxemia |
| 4) | Decrease in number of functional alveoli |
| 5) | Decreased response to hypercapnia |
NSG 201H -Assessment of Respiratory Function