This is not a risk factor in developing respiratory disorder.

Risk factors in developing respiratory disorders are: Age, Genetics,

Smoking and Environmental exposure such as exposure to radon
gas(radioactive gas that can cause CA), asbestos, arsenic, and other
harmful substance 

 
Asbestos exposure

 
Cholesterol diet

This is not a risk factor in developing respiratory disorder.

Risk factors in developing respiratory disorders are: Age, Genetics,

Smoking and Environmental exposure such as exposure to radon
gas(radioactive gas that can cause CA), asbestos, arsenic, and other
harmful substance 

 
Genetics

Risk factors in developing respiratory disorders are: Age, Genetics,

Smoking and Environmental exposure such as exposure to radon
gas(radioactive gas that can cause CA), asbestos, arsenic, and other
harmful substance 

 
Radioactive gas

Incorrect Question 2 0
/ 1 pts

Inside each of your lungs there are tubes called bronchi. These branches into
even smaller tubes much like the branches of tree. What are at the ends of
these tubes?

 
Alveoli

 
Primary Bronchi

 
Bronchi

 
Bronchioles

Alveoli are the balloon-like air sacs located at  the distal ends of the
bronchial tube .

Question 3 1
/ 1 pts
 The group 1 of JRU nursing students were assigned at Medical Ward of Cardinal
Santos Medical Center to take care of patients with respiratory disorders. Which
of the following lists of airway structures is in order from largest to smallest?

 
Larynx - Pharynx - Trachea - Bronchioles

 
Trachea - Bronchioles - Alveoli - Bronchi

 
Trachea - Pharynx - larynx - Bronchial

 
Trachea - Bronchi -Bronchioles - Alveoli

Lower Respiratory from largest to smallest start with Trachea -then split into
Main stem Bronchi which has a Left main stem Bronchus and right Main
stem Bronchus to smaller branches of Bronchiole up to smallest branches 
located at the distal end which is the Alveoli 

Incorrect Question 4 0
/ 2 pts

Nurse Sian is assessing another female client who has sustained blunt injury to
the chest wall. Which of these signs would indicate the presence of a
Pneumothorax in this client?

 
Increased respiratory rate

 
increase tactile fremitus

 
A decrease Respiratory rate

 
A sucking sounds @ the site of injury

The most common symptoms of Pneumothorax are chest pain and

shortness of breath. The chest pain is pleuritic, sharp, severe, and radiates
to the ipsilateral shoulder and on examination, the following findings are
noted:

Respiratory discomfort
Increased respiratory rate
Asymmetrical lung expansion
Decreased tactile fremitus
Decreased intensity of breath sounds or absent breath sounds

 
Diminished breath sounds

 The most common symptoms of Pneumothorax are chest pain and

shortness of breath. The chest pain is pleuritic, sharp, severe, and radiates
to the ipsilateral shoulder and on examination, the following findings are
noted:

Respiratory discomfort
Increased respiratory rate
Asymmetrical lung expansion

Decreased tactile fremitus

Decreased intensity of breath sounds or absent breath sounds

Question 5 1
/ 1 pts

A 76-year-old client has marked dyspnea at rest, is thin, and uses accessory
muscles to breathe. He’s tachypneic, with a prolonged expiratory phase. He has
no cough. He leans forward with his arms braced on his knees to support his
chest and shoulder for breathing. This client has symptoms of which of the
following respiratory disorders?

 
Asthma

 
Pleural Effusion

 
Emphysema

When emphysema develops, the alveoli and lung tissue are destroyed. With
this damage, the alveoli cannot support the bronchial tubes. The tubes
collapse and cause an “obstruction” (a blockage), which traps air inside the
lungs. Too much air trapped in the lungs can give some patients a barrel-
chested appearance. Also, because there are fewer alveoli, less oxygen will
be able to move into the bloodstream.

Symptoms of emphysema may include coughing, wheezing, shortness of

breath, chest tightness, tachypneic ,uses accessory muscles to breathe 
and an increased production of mucus.

 
Pneumothorax

Incorrect Question 6 0
/ 2 pts

The following are the causes of Epistaxis. except :

 
Hypotension

 Local causes

Local causes of epistaxis can include local trauma caused by nose-picking,

a foreign body in the nose, anatomic irregularities such as a deviated
septum, facial trauma, incorrect or excessive use of topical nasal sprays,
inflammatory reactions, and rarely intranasal tumors. Smoking and snorting
illicit drugs such as cocaine can also cause frequent nosebleeds due to
irritation of the nasal mucosa, and can lead to further nasal damage in
come cases.

Common environmental causes of epistaxis include changes in temperature

or humidity, as nose vessels are more prone to rupture in cold weather and
dry environments. 

Hypertension , Vascular malformation, Bleeding disorder and Hypertension

are the Systemic Causes of Epistaxis.

 
Moist mucosal lining

 
Excessive use of topical nasal spray

 
Hypertension

 
Smoking and snorting illicit drugs such as cocaine

 
Cold weather environment

 
Vascular malformation

 
Dry mucosal lining

Local causes

Local causes of epistaxis can include local trauma caused by nose-picking,

a foreign body in the nose, anatomic irregularities such as a deviated
septum, facial trauma, incorrect or excessive use of topical nasal sprays,
inflammatory reactions, and rarely intranasal tumors. Smoking and snorting
illicit drugs such as cocaine can also cause frequent nosebleeds due to
irritation of the nasal mucosa, and can lead to further nasal damage in
come cases.

Common environmental causes of epistaxis include changes in temperature

or humidity, as nose vessels are more prone to rupture in cold weather and
dry environments. 

Hypertension , Vascular malformation, Bleeding disorder and Hypertension

are the Systemic Causes of Epistaxis.

Incorrect Question 7 0
/ 2 pts

The following are symptoms indicative of Acute Sinusitis, except: (2 pts)

 
fullness in the ear

  
purulent discharge

 
Facial pain

Sign  and Symptoms of Acute Sinusitis are:

Facial pain or pressure over the sinus area; purulent nasal discharge ;fever
;headache and  ear pain 

Sign and Symptoms of Chronic Sinusitis are:

Chronic hoarseness; Chronic HA in the periorbital area; Facial pain; Fatigue

;Nasal stuffiness ;Decrease in smell and taste ; Fullness in the ears 

 
Decrease in smell and taste

Sign  and Symptoms of Acute Sinusitis are:

Facial pain or pressure over the sinus area; purulent nasal discharge ;fever
;headache and  ear pain 

Sign and Symptoms of Chronic Sinusitis are:

Chronic hoarseness; Chronic HA in the periorbital area; Facial pain; Fatigue

;Nasal stuffiness ;Decrease in smell and taste ; Fullness in the ears 

 
ear pain

 
Repetitive sneezing

 
Rhinorrhea 

Question 8 1
/ 1 pts

 Nurse Kohreen is teaching a male patient with Chronic bronchitis about

breathing exercise. Which of the following should the nurse include in the
teaching?

 
Breathe in through the nose then make inhalation longer than exhalation

 
Breathe in through the nose then take short, shallow breaths into their chest

 
Breathe in through the nose then exhale through an open mouth

 
Breathe in through your nose. Let your belly fill with air then breathe out through
your nose
 With this technique, you'll learn how to take bigger breaths, all the way into
your belly.

1. Get comfortable. You can lie on your back in bed or on the floor with a
pillow under your head and knees. Or you can sit in a chair with your
shoulders, head, and neck supported against the back of the chair.
2. Breathe in through your nose. Let your belly fill with air.
3. Breathe out through your nose.
4. Place one hand on your belly. Place the other hand on your chest.
5. As you breathe in, feel your belly rise. As you breathe out, feel your
belly lower. The hand on your belly should move more than the one
that's on your chest.
6. Take three more full, deep breaths. Breathe fully into your belly as it
rises and falls with your breath.

Incorrect Question 9 0
/ 2 pts

A patient is being discharged from the Emergency Department after being

treated for Epistaxis. In teaching a family first aid measures in the event the
epistaxis would recur, what measure should the nurse suggest?

 
Partially insert small gauze into the bleeding nostril

Nosebleeds usually aren’t serious. You can treat most by yourself at home
by doing the following:
Stay calm. If you start to get nervous, it can actually make you bleed
more. Try to relax.
Sit up, don’t lie down. Keep your head above your heart.
Lean a little bit forward. This keeps the blood from draining down the
back of your throat.
Pinch your nostrils closed. Use your thumb and index finger to hold
your nostrils closed for 5 to 10 minutes while you breathe through your
mouth. This puts pressure on the part of your nose that’s bleeding and
can make the blood stop flowing.
Apply cold compress .To promote vasodilation and stop the bleeding.
Avoid spraying the midline septum to avoid irritation.

 
Apply cold compress to the nose

 
Pinch the entire soft lower portion of the nose

 Nosebleeds usually aren’t serious. You can treat most by yourself at home
by doing the following:

Stay calm. If you start to get nervous, it can actually make you bleed
more. Try to relax.
Sit up, don’t lie down. Keep your head above your heart.
Lean a little bit forward. This keeps the blood from draining down the
back of your throat.
Pinch your nostrils closed. Use your thumb and index finger to hold
your nostrils closed for 5 to 10 minutes while you breathe through your
mouth. This puts pressure on the part of your nose that’s bleeding and
can make the blood stop flowing.
Apply cold compress .To promote vasodilation and stop the bleeding.
Avoid spraying the midline septum to avoid irritation.

 
Apply warm compress to the nose

 
Tilt the patient's head backward

 
direct the nasal spray to the midline septum

Question 10 1
/ 1 pts

A patient with Pleural effusion is scheduled to have a Thoracentesis. The nurse

on duty will assists the patient to which position during the procedure?

 
Sim's position

 
Supine position with both arms extended

 
Lying in bed on the affected side with head of the bed elevated about 45 degrees

 
Dorsal position

 
Trendelenburg position

 
sit at the edge of the bed while leaning forward with their arms in the bedside
table

During a thoracentesis a needle is inserted into the intercostal space, so the

nurse should assist the client to sit at the edge of the bed while leaning
forward with their arms supported on a bedside table and a pillow or
folded towel.
Question 11 1
/ 1 pts

Pleural effusion is also known as Hydrothorax. A client has a left Pleural effusion
that has not been treated. Nurse Leuvy Ruth plans to have which of the following
items available for immediate use to remove fluid in the thorax cavity?

 
Thoracentesis Set tray

Thoracentesis is a procedure to remove fluid or air from around the lungs. A

needle is put through the chest wall into the pleural space. The pleural
space is the thin gap between the pleura of the lung and of the inner chest
wall. Prepare Thoracentesis Set use to remove fluid in the thorax cavity.

A paracentesis, or an abdominal tap, is a procedure that removes ascites

(build-up of fluid) from your abdomen (belly)

Dressing Set is mainly used to clean wound and injury by doctors or nurses.
This set was sterilized by  Sterilization. It consist of usable forceps with
center lock and made of hard material so it can hold strongly while in the
process.

Equipment is needed for a tracheostomy are: 

Cuffed tracheostomy tube. Obturator, inner cannula, cuff, tracheostomy
tube Velcro tie, gauze and hydrogen peroxide; syringe, forceps, scissors,
lubricant; soft suction catheter; gloves, gown, and mask.

 
Paracentesis Set tray

 
Dressing Set tray

 
Tracheostomy Set tray

Question 12 1
/ 1 pts

What condition wherein a blood clot ( embolus) travels and gets stuck in the
artery in the lungs?

 
Cor Pulmonale

 
Pulmonary Hypertension

 
Pulmonary Edema

 
Pulmonary Embolism

 Pulmonary embolism (PE) occurs when a blood clot gets stuck in an

artery in the lung, blocking blood flow to part of the lung.
Causes a Pulmonary Embolism are:
A fat embolus (often due to the breaking of a large bone)
Amniotic fluid embolus
Air bubbles
Deep vein thrombosis in the upper body
Clots on an indwelling (IV) intravenous catheter that break off and travel
to the lungs

Incorrect Question 13 0
/ 2 pts

Nurse Miguel is teaching a patient how to prevent DVT. Select ALL that apply:

 
avoid walking around as much as possible

 
wear Compression stockings

If you’ve been inactive for a long time, your chance of getting a pulmonary
embolism increases. This is because when you’re inactive, blood tends to
collect in the lower parts of your body, particularly in your lower legs.

This isn’t usually a problem because when you start to move, your blood
flow increases, and blood begins to move more evenly round your body. But
if you’re immobile for a long time, the flow of blood around your body can
slow and clot, causing a DVT that can break off and cause a pulmonary
embolism.

 
avoid becoming dehydrated

 
wear fitting, comfortable clothes

 
bend and straighten your legs, feet and toes every 60 minutes when you’re sitting

If you’ve been inactive for a long time, your chance of getting a pulmonary
embolism increases. This is because when you’re inactive, blood tends to
collect in the lower parts of your body, particularly in your lower legs.

This isn’t usually a problem because when you start to move, your blood
flow increases, and blood begins to move more evenly round your body. But
if you’re immobile for a long time, the flow of blood around your body can
slow and clot, causing a DVT that can break off and cause a pulmonary
embolism.

 
encourage long periods of bed rest

 Question 14 1
/ 1 pts

A client with pneumonia develops dyspnea with a respiratory rate of 32

breaths/minute and difficulty expelling his secretions. The nurse auscultates his
lung fields and hears bronchial sounds in the left lower lobe. The nurse
determines that the client requires which of the following treatments first?

 
Suctioning

 
Oxygen

The client is having difficulty breathing and is probably becoming hypoxic.

As an emergency measure, the nurse can provide oxygen without waiting
for a physician’s order. Anticipate the need for supplemental oxygen first
and intubation later if the patient’s condition deteriorates. These measures
are needed to correct hypoxemia. Intubation is needed for deep suctioning
efforts and provides a source for augmenting oxygenation.

 
CXR

 
Intubation

Incorrect Question 15 0
/ 1 pts

A pulse oximetry gives what type of information about the client?

 
Amount of Oxygen in the blood

A blood oxygen level test is used to check how well the lungs are working
and measure the acid-base balance in the blood. A blood oxygen level test
also checks the balance of acids and bases, known as pH balance, in the
blood. Too much or too little acid in the blood can mean there is a problem
with the lungs or kidneys.

 
Respiratory rate

 
Percentage of hemoglobin carrying oxygen

 
Amount of carbon dioxide in the blood

Question 16 1
/ 1 pts

Continuous positive airway pressure (CPAP) can be provided through an oxygen

mask to improve oxygenation in hypoxic patients by which of the following
methods? 
  
The mask pressurizes at the end of expiration to open collapsed alveoli

 
The mask provides 100% oxygen to the client

 
The mask provides pressurized oxygen so the client can breathe more easily

The mask provides pressurized oxygen continuously through both

inspiration and expiration. Continuous positive airway pressure (CPAP) is a
type of positive airway pressure that is used to deliver a set pressure to the
airways that is maintained throughout the respiratory cycle, during both
inspiration and expiration.

 
The mask provides continuous air that the client can breathe

Question 17 1
/ 1 pts

Which of the following best describes Pleural effusion?

 
The fluid in the alveolar space

 
the collapse of bronchiole

 
the collapse of alveoli

 
The fluid  between the linings of the pleural space

The pleural fluid normally seeps continually into the pleural space from the
capillaries lining the parietal pleura and is reabsorbed by the visceral pleural
capillaries and lymphatics. Any condition that interferes with either the
secretion or drainage of this fluid will lead to a pleural effusion.

Incorrect Question 18 0
/ 2 pts

A patient is about to have their chest tube removed by the physician. As the
nurse assisting with the removal, which of the following actions will you perform?
Select-all-that-apply: (2 pts)

 
Gather supplies needed which will include a petroleum gauze dressing per
physician preference
 Have the patient take a deep breath, exhale, and bear down during removal
of the tube(Valsalva maneuver)

Pre-medicate prior to removal as ordered by the physician.

Gather supplies needed which will include a petroleum gauze dressing per
physician preference.

Fowler's position is best after removal.

 
Place the patient is prone position after removal

 
Educate the patient how to take a deep breath out and inhale rapidly while the
tube in being removed

 
Give extra fluid prior to removal of chest tube

 
NPO prior to removal as ordered by the physician

 
Place the patient in Semi-Fowler's position

Have the patient take a deep breath, exhale, and bear down during removal
of the tube(Valsalva maneuver)

Pre-medicate prior to removal as ordered by the physician.

Gather supplies needed which will include a petroleum gauze dressing per
physician preference.

Fowler's position is best after removal.

 
Have the patient take a deep breath, exhale, and bear down during removal of the
tube

Question 19 1
/ 1 pts

Nurse Eliza observes constant bubbling in the water-seal chamber of a closed

chest drainage system. What should the nurse conclude?

 
The chest tube is obstructed

 
The system has an air leak

Constant bubbling in the chamber indicates an air leak and requires

immediate intervention. With suction applied, this indicates a persistent air
leak that may be from a large pneumothorax at the chest insertion site
(patient-centered) or chest drainage unit (system-centered).

 
The client has a pneumothorax

  
The system is functioning normally

Question 20 1
/ 1 pts

A patient is receiving treatment for Infective Endocarditis. The client has a

history of intravenous drug use and underwent mitral valve replacement a year
ago. The client is scheduled for a trans-esophageal echocardiogram tomorrow
morning. Nurse Sian performed an assessment and he find a tender, red lesions
on the client’s hand and feet. He knows that is a common finding in a client with
infective endocarditis and is known as:

 
Janeway Lesion

 
Osler's node

other signs of Infective Endocarditis :

Osler nodes - red, painful nodules in the pads of the fingers and toes

Janeway lesions - red, painless skin spots on the palms and soles

Roth spots - small, pinpoint areas of bleeding on the surface of the eye or
the eyelids 

Splinter hemorrhages - small areas of bleeding under the nails 

 
Splinter hemorrhage

 
Roth spots

Question 21 1
/ 1 pts

Which of the following blood tests is most indicative of cardiac damage?

 
ESR

 
CRP

 
Troponin I

A troponin test measures the levels of troponin T or troponin I proteins

in the blood. These proteins are released when the heart muscle has been
damaged, such as occurs with a heart attack. The more damage there is to
the heart, the greater the amount of troponin T and I there will be in the
blood.

 
Lactate dehydrogenase

Partial Question 22 1
/ 3 pts

The following are the preparation for patients to undergo Coronary Angioplasty.
Select ALL that apply (3 pts)

 
You may get a sedative before the procedure to help you relax.

 
Let you doctor know if you have any kidney problems

 
Tell your doctor that you are allergic to iodine

 
You will be advised fasting is not needed

 
Your doctor may request a blood test for liver before the procedure

Question 23 1
/ 1 pts

A patient is scheduled for a cardiac catheterization using a radiopaque dye.

Which of the following assessments is most critical before the procedure?

 
Height & weight

 
Liver test

 
Intake & Output

 
Allergy to iodine

Iodine is a nutrient that is essential for thyroid function and an allergy to it

would be life-threatening.

Iodine can be found in fish, shellfish, iodine-based contrast agents used in

medical imaging (substances taken into your body to enhance images,
making them easier to read), and some disinfectant products. 

Tell your doctor if you have ever had a reaction to any contrast dye; if you
are allergic to iodine; or if you are sensitive to or are allergic to any
medicines, latex, tape, and anesthetic agents (local and general).

Question 24 1
/ 1 pts

Intravenous Heparin therapy is ordered for a patient. While implementing this

order, a nurse ensures that which of the following medications is available on the
nursing unit?
  
Coumadin

 
activated charcoal

 
Vit K

 
Protamine Sulfate

Heparin injection is an anticoagulant.  This medicine is sometimes called a

blood thinner, although it does not actually thin the blood. Heparin will not
dissolve blood clots that have already formed, but it may prevent the clots
from becoming larger and causing more serious problems.

Protamine sulfate is the Antidote for Heparin overdose and is usually

administered to reverse the large dose of heparin administered during
certain surgeries, especially heart surgery where anti-coagulation is
necessary to prevent clot formation within the cardiopulmonary bypass
pump apparatus. 

Incorrect Question 25 0
/ 1 pts

Which of the following is the first line of treatment for Coronary Artery  Disease
(CAD)  ?

 
Oral medication therapy

 
Angioplasty

Angioplasty is a procedure used to open blocked coronary arteries

caused by coronary artery disease. It restores blood flow to the heart
muscle without open-heart surgery. Angioplasty can be done in an
emergency setting such as a heart attack.

β‐blockers should be first line treatment in patients with established CAD. 

 
CABG

 
Pacemaker

Question 26 1
/ 1 pts

What is the most  common Aneurysm of the aorta that runs through the
abdomen ?

 
Femoral Artery Aneurysm

 
Thoracic Aortic aneurysm

  
Abdominal Aortic aneurysm

the most common aneurysm of the aorta that runs through the abdomen is
AAA

Less common  affect the part of the aorta running through the chest which
is the Thoracic Aneurysm

Artery junction points at the Circle of Willis  may become weak, causing a
ballooning of the blood vessel wall to potentially form a small sac or
aneurysm is called Cerebral Aneurysm

 
Cerebral Aneurysm

Incorrect Question 27 0
/ 1 pts

A 70-year old male patient comes into the Emergency Room with complains of
crushing chest pain that radiates to his shoulder and left arm. The admitting
diagnosis is Acute Myocardial Infarction. Immediate admission orders include
oxygen by nasal cannula at 4 L/minute, blood works, CXR, an ECG and 2 grams
of Morphine to be given intravenously. What is the drug of choice to be given first
for chest pain?

 
Heparin

 
Morphine 2 to 4 mg IV

Morphine is indicated for the relief of severe acute and severe chronic pain.

Chest pain can be treated with nitroglycerin or

sometimes morphine. Nitroglycerin is preferable to morphine, which
should be used judiciously (eg, if a patient has a contraindication
to nitroglycerin or is in pain despite nitroglycerin therapy). Nitroglycerin is
initially given sublingually, followed by continuous IV drip if
needed. Morphine 2 to 4 mg IV, repeated every 15 minutes as needed, is
highly effective but can depress respiration, can reduce myocardial
contractility, and is a potent venous vasodilator. 

 
Aspirin

 
Nitroglycerin is initially given sublingually

Question 28 1
/ 1 pts

The accumulation of blood in the pleural space is called:

 
Hemothorax

 Hemothorax is when blood collects between your chest wall and your
lungs. This area where blood can pool is known as the pleural cavity. The
buildup of the volume of blood in this space can eventually cause your lung
to collapse as the blood pushes on the outside of the lung.

 
Pleural effusion

 
Pneumothorax

 
Empyema

Question 29 1
/ 1 pts

Presence of overdistented and non-functional alveoli is a condition called:

 
Bronchitis

 
Empyema

 
Emphysema

An over distented and non-functional alveoli is a condition called

Emphysema.

Empyema is the presence of pus in the lungs.

Bronchitis is an infection of the main airways of the lungs (bronchi), causing
them to become irritated and inflamed.

Pneumonia is an infection that inflames the air sacs in one or both lungs. 

 
Pneumonia

Question 30 1
/ 1 pts

The most important action Nurse Jerusalem should do before and after
suctioning a patient is:

 
Hyperventilating the patient with 100% O2

 Hyper-oxygenation pre suction:

May reduce the incidence of suction related hypoxaemia and
bradycardia
The 2001 CPG recommended that hyperoxygenation should be used
before and after suctioning to prevent oxygen desaturation in
mechanically ventilated patients who underwent trauma, or had
cardiac or chronic obstructive pulmonary disease (COPD) 

In general, give oxygen for 30-60 seconds prior to suctioning. If you

must suction them repeatedly or the first suctioning attempt fails, withdraw
the catheter and oxygenate the patient again.

 
Making sure that suctioning takes only 10-15 seconds

 
Place the patient in a supine position

 
Evaluating for clear breath sounds

Question 31 1
/ 1 pts

Nurse Jeremie position the patient during suctioning is in:

 
Prone

 
Supine

 
Trendelenburg

 
semi-Fowlers

Position patient in semi-Fowler’s position with head turned to the side. This
facilitates ease of suctioning. Unconscious patients should be in the lateral
position.

Question 32 1
/ 1 pts

The patient in room 25 calls on the call light to tell you something is wrong with
his chest tube. When you arrive to the room you note that the drainage system
has fallen on its side and is leaking drainage onto the floor from a crack in the
system. What is your next PRIORITY?*

 
Notify the physician immediately

 
Disconnect the tubing from the drainage system and insert the tubing 1 inch into a
bottle of sterile water and obtain a new system
 A new system needs to be obtained, however, in order to maintain a
water seal until the new system arrives you will need to place the
tubing 1 inch in sterile water or sterile saline to regain a water seal.

 
Place the patient in supine position and clamp the tubing

 
Disconnect the drainage system and get a new one

Incorrect Question 33 0
/ 1 pts

Nurse Jhon Rey is assessing a patient who is post-operative from a chest tube
insertion. On assessment, he noted there is 50 cc of serosanguinous fluid in the
drainage chamber, fluctuation of water in the water seal chamber when the
patient breathes in and out, and bubbling in the suction control chamber. Which
of the following is the most appropriate nursing intervention?*

 
Assess for an air leak due to bubbling noted in the suction chamber

The assessment findings are normal(50 cc of serosanguinous fluid in

the drainage chamber, fluctuation of water in the water seal chamber
when the patient breathes in and out, and bubbling in the suction
control chamber)

All the other options are incorrect.

 
Notify the physician about the drainage

 
Milk the tubing to ensure patency of the tubes

 
Document the findings as normal.

Question 34 1
/ 1 pts

Aminophylline (Theophylline) is prescribed for a client with Acute Bronchitis. A

nurse administers the medication, knowing that the primary action of this
medication is to:

 
Promote expectoration

 
Prevent infection

 
Suppress the cough

 
Relax smooth muscles of the bronchial airway

 Aminophylline is a bronchodilator that directly relaxes the smooth muscles

of the bronchial airway. Theophylline causes non-selective inhibition of type
III and type IV isoenzymes of phosphodiesterase, which leads to increased
tissue cyclic adenosine monophosphate (cAMP) and cyclic  guanosine
monophosphate concentrations, resulting in smooth muscle relaxation in
lungs and pulmonary vessels, diuresis, CNS and cardiac stimulation.

Question 35 1
/ 1 pts

What test involves compressing the radial and ulnar arteries and asking the
client to close and open the fist. This should cause the hand to become pale.
The nurse then releases pressure on one artery and observes whether
circulation is restored quickly. The nurse repeats the process, releasing the other
artery. The blood sample may be taken safely if collateral circulation is adequate:

 
Ankle Brachial Index Test

 
Allen's Test

The Allen test is used to assess collateral blood flow to the hands,
generally in preparation for a procedure that has the potential to disrupt
blood flow in either the radial or the ulnar artery. These procedures include
arterial puncture or cannulation and the harvest of the artery alone or as
part of a forearm flap

 
Contrast Venography

 
.Capillaroscopy Test

Question 36 1
/ 1 pts

A female client is scheduled to have a chest Radiograph (CXR). Which of the

following questions is of most importance to the nurse assessing this client?

 
“Can you hold your breath easily?”

 
“Are you wearing any metal chains or jewelry?”

 
“Are you able to hold your arms below your head?”

 
“Is there any possibility that you could be pregnant?”

The most important item to ask about is the client’s pregnancy status
because pregnant women should not be exposed to radiation. The risk of
side effects of an X-ray while the client is pregnant is extremely minimal, but
it is always important to protect the developing fetus from harm.
Question 37 1
/ 1 pts

Which of the following individuals would the nurse consider to have the highest
priority for receiving an influenza vaccination?

 
A 60-year-old man with a Hiatal hernia

 
A 60-year-old woman with osteoarthritis

 
A 50-year-old woman caring for a spouse with cancer

Individuals who are household members or home care providers for high-
risk individuals are high-priority targeted groups for immunization against
influenza to prevent transmission to those who have a decreased capacity
to deal with the disease. The wife who is caring for a husband with cancer
has the highest priority of the clients described.

 
A 36-year-old pregnant woman with 3 children

Question 38 1
/ 1 pts

Client has just returned to a nursing unit following B A nurse would implement
which of the following nursing interventions for this client?

 
Ensuring the return of the gag reflex before offering foods or fluids

After bronchoscopy, the nurse keeps the client on NPO status until the gag
reflex returns because the preoperative sedation and the local anesthesia
impair swallowing and the protective laryngeal reflexes for a number of
hours. Although bronchoscopy can be done without sedation, most
procedures are done under moderate conscious sedation with the use of
various sedatives based on the clinician’s preference (e.g.,
benzodiazepines, opioids, dexmedetomidine).

 
Encouraging additional fluids for the next 24 hours

 
Administering Atropine intravenously

 
Administering small doses of Midazolam

Question 39 1
/ 1 pts
A nurse is assessing a client with chronic airflow limitation and notes that the
client has a “barrel chest.” The nurse interprets that this client has which of the
following forms of chronic airflow limitation?

 
Emphysema

The client with emphysema has hyperinflation of the alveoli and flattening of
the diaphragm. These lead to increased anteroposterior diameter, which is
referred to as “barrel chest.” The client also has dyspnea with prolonged
expiration and has hyperresonant lungs to percussion.

 
Acute Bronchitis

 
Chronic Obstructive Bronchitis

 
Bronchial Asthma

Question 40 1
/ 1 pts

Nurse Angela teaches a client about the use of a respiratory inhaler. Which
action by the client indicated a need for further teaching?

 
Inhales the mist and quickly exhales

Take the inhaler out of the mouth. If the client can, he should hold his breath
as he slowly counts to 10. This lets the medicine reach deep into the lungs.
The client should be instructed to hold his or her breath at least 10 to 15
seconds before exhaling the mist.

 
Press the canister down with your finger as he breathes in

 
Removes the cap and shakes the inhaler well before use

 
Waits 1 to 2 minutes between puffs if more than one puff has been prescribed

Question 41 2
/ 2 pts

Nurse Chesca is teaching the client on how to use a metered-dose inhaler (MDI)
to administer a Corticosteroid drug. Which of the following client actions
indicates that he is using the MDI correctly? Select all that apply.(2pts)

 
Head is tilted down while inhaling the medication

 
Mouth is rinsed with water following administration

 Inhaled respiratory medications are often taken by using a device called a

metered-dose inhaler, or MDI. The MDI is a pressurized canister of
medicine in a plastic holder with a mouthpiece. When sprayed, it gives a
reliable, consistent dose of medication.

Remove the cap and hold the inhaler upright. Each inhaler consists of a
small canister of medicine connected to a mouthpiece. The canister is
pressurized. As the client presses down on the inhaler, it releases a mist of
medicine. The client breathes that mist into the lungs. It’s important to use
the inhaler correctly.

Some inhalers (steroid) also recommend rinsing the mouth out with water
and gargling with water (spit out the water) after use. If using this inhaler for
a corticosteroid preventer medication, with or without a spacer, rinse the
mouth with water and spit after inhaling the last dose to reduce the risk of
side-effects

 
The inhaler is held upright

Inhaled respiratory medications are often taken by using a device called a

metered-dose inhaler, or MDI. The MDI is a pressurized canister of
medicine in a plastic holder with a mouthpiece. When sprayed, it gives a
reliable, consistent dose of medication.

Remove the cap and hold the inhaler upright. Each inhaler consists of a
small canister of medicine connected to a mouthpiece. The canister is
pressurized. As the client presses down on the inhaler, it releases a mist of
medicine. The client breathes that mist into the lungs. It’s important to use
the inhaler correctly.

 
Client lies supine for 15 minutes following administration

 
Client waits 5 minutes between puffs

Question 42 1
/ 1 pts

A 34-year-old woman with a history of asthma is admitted to the Emergency

Department. The nurse notes that the client is dyspneic, with a respiratory rate
of 35 breaths/minute, nasal flaring, and use of accessory muscles. Auscultation
of the lung fields reveals greatly diminished breath sounds. Based on these
findings, what action should the nurse take to initiate care of the client?

 
Encourage the client to relax and breathe slowly through the mouth

 
Administer bronchodilators

In an acute asthma attack, diminished or absent breath sounds can be an

ominous sign indicating lack of air movement in the lungs and impending
respiratory failure. The client requires immediate intervention with inhaled
bronchodilators, intravenous corticosteroids, and possibly intravenous
theophylline.
  
Draw blood for an ABG analysis and send the client for a chest x-ray

 
Initiate oxygen therapy and reassess the client in 10 minutes

Question 43 1
/ 1 pts

Which of the following would be an expected outcome for a client recovering

from an upper respiratory tract infection? The client will:

 
Experience less nasal obstruction and discharge

A client recovering from an URI should report decreasing or no nasal

discharge and obstruction. Decongestants and combination
antihistamine/decongestant medications can limit cough, congestion, and
other symptoms in adults. Avoid cough preparations in children. H1-
receptor antagonists may offer a modest reduction of rhinorrhea and
sneezing during the first 2 days of a cold in adults.

 
Experience chills only once a day

 
Cough productively without chest discomfort

 
Maintain a fluid intake of 800 ml every 24 hours

Question 44 1
/ 1 pts

The client with asthma should be taught which of the following is one the most
common precipitating factors of an acute asthma attack?

 
Exercising in cold temperatures

 
Viral respiratory infections

The most common precipitator of asthma attacks is viral respiratory

infection. Clients with asthma should avoid people who have the flu or a
cold and should get yearly flu vaccinations. Asthma is a condition of acute,
fully reversible airway inflammation, often following exposure to an
environmental trigger. The pathological process begins with the inhalation of
an irritant (e.g., cold air) or an allergen (e.g., pollen), which then, due to
bronchial hypersensitivity, leads to airway inflammation and an increase in
mucus production. This leads to a significant increase in airway resistance,
which is most pronounced on expiration.

 
Occupational exposure to toxins

 
Exposure to cigarette smoke

Question 45 1
/ 1 pts

On auscultation, which finding suggests a right Pneumothorax?

 
Bilateral pleural friction rub

 
Inspiratory wheezes in the right thorax

 
Absence of breaths sound in the right thorax

In pneumothorax, the alveoli are deflated and no air exchange occurs in the
lungs. Therefore, breath sounds in the affected lung field are absent. A
pneumothorax is defined as a collection of air outside the lung but within the
pleural cavity. It occurs when air accumulates between the parietal and
visceral pleura inside the chest. The air accumulation can apply pressure on
the lung and make it collapse. The degree of collapse determines the
clinical presentation of pneumothorax. None of the other options are
associated with pneumothorax.

 
Bilateral inspiratory and expiratory crackles

Question 46 1
/ 1 pts

A female client comes into the Emergency Room complaining of SOB and pain
in the lung area. She states that she started taking birth control pills 3 weeks ago
and that she smokes. Her VS are: BP - 140/80, P- 110, RR- 40. The physician
orders ABG’s, results are as follows: pH: 7.50; PaCO2 29 mm Hg; PaO2 60 mm
Hg; HCO3- 24 mEq/L; SaO2 86%. Considering these results, the first
intervention is to:

 
Monitor for pulmonary embolism

 
Place the client on oxygen

The pH (7.50) reflects alkalosis, and the low PaCO2 indicates the lungs are
involved. The client should immediately be placed on oxygen via mask so
that the SaO2 is brought up to 95%. Encourage slow, regular breathing to
decrease the amount of CO2 she is losing.

 
Begin mechanical ventilation

 
Give the client sodium bicarbonate

Question 47 1
/ 1 pts
After undergoing a left Pneumonectomy, a female patient has a chest tube in
place for drainage. When caring for this patient, the nurse must:

 
Clamp the chest tube once every shift

 
Encourage coughing and deep breathing

When caring for a patient who is recovering from a pneumonectomy, the

nurse should encourage coughing and deep breathing to prevent
pneumonia in the unaffected lung. Assist the patient with splinting painful
areas when coughing, deep breathing. Supporting chest and abdominal
muscles makes coughing more effective and less traumatic.

 
Milk the chest tube every 2 hours

 
Monitor fluctuations in the water-seal chamber

Question 48 1
/ 1 pts

When caring for a male patient who has just had a Total Laryngectomy, Nurse
Rica should plan to:

 
Develop an alternative communication method

A patient with a laryngectomy cannot speak, yet still needs to communicate.

Therefore, the nurse should plan to develop an alternative communication
method. Assess the effectiveness of nonverbal communication methods.
The client may use hand signals, facial expressions, and changes in body
posture to communicate with others. However, others may have difficulty in
interpreting these nonverbal techniques. Each new method needs to be
assessed for effectiveness and altered as necessary.

 
Encourage oral feeding as soon as possible

 
Keep the tracheostomy cuff fully inflated

 
Keep the patient flat in bed

Question 49 1
/ 1 pts

Before administering Ephedrine, Nurse Apple assesses the patient’s history.

Because of Ephedrine’s central nervous system (CNS) effects, it is not
recommended for:

 
Elderly patients

 Ephedrine is not recommended for elderly patients, who are particularly

susceptible to CNS reactions (such as confusion and anxiety) and to
cardiovascular reactions (such as increased systolic blood pressure,
coldness in the extremities, and anginal pain). Ephedrine is also
arrhythmogenic, and caution should be used during administration to
patients who are predisposed to arrhythmias or taking other arrhythmogenic
medications, particularly digitalis

 
Patients with an acute asthma attack

 
Patients with narcolepsy

 
Patients under age

Question 50 1
/ 1 pts

Nurse Mariel performs an Admission assessment on a female client with a

diagnosis of Tuberculosis. She reviews the result of which Diagnosis test that
will confirm this diagnosis?

 
Chest Xray

 
Sputum culture

Tuberculosis is definitively diagnosed through culture and isolation of

Mycobacterium tuberculosis. Mycobacterial culture is the gold standard for
diagnosis. Mycobacterial culture should be performed on both the solid and
liquid medium. Liquid media culture can detect very low bacterial load and
is considered a gold standard. Culture essential for drug susceptibility
testing. A presumptive diagnosis is made based on a tuberculin skin test, a
sputum smear that is positive for acid-fast bacteria, a chest x-ray, and
histological evidence of granulomatous disease on biopsy. Active
tuberculosis is diagnosed by isolating Mycobacterium tuberculosis complex
bacilli from bodily secretions.

 
Bronchoscopy

 
Tuberculin Test

Question 51 1
/ 1 pts

A male adult client is suspected of having a Pulmonary embolism. Nurse

Jermhie  assesses the client, knowing that which of the following is a common
clinical manifestation of Pulmonary embolism?

 
Bradycardia

  
Dyspnea

The common clinical manifestations of pulmonary embolism are tachypnea,

tachycardia, dyspnea, and chest pain. PE leads to impaired gas exchange
due to obstruction of the pulmonary vascular bed leading to a mismatch in
the ventilation to perfusion ratio because alveolar ventilation remains the
same, but pulmonary capillary blood flow decreases, effectively leading to
dead space ventilation and hypoxemia.

 
Decreased respirations

 
Bradypnea

Question 52 1
/ 1 pts

Nurse Roselle is caring for a client with a Pneumothorax and who has had a
chest tube inserted. She observes a continues gentle bubbling in the Suction
Control chamber. What action is appropriate?

 
Immediately clamp the chest tube and notify the physician

 
Do nothing, because this is an expected finding

Continuous gentle bubbling should be noted in the suction control chamber.

Bubbling during expiration reflects venting of pneumothorax (desired
action). Bubbling usually decreases as the lung expands or may occur only
during expiration or coughing as the pleural space diminishes.

 
Check for an air leak because the bubbling should be intermittent

 
Increase the suction pressure so that the bubbling becomes vigorous

Incorrect Question 53 0
/ 1 pts

Nurse Geriza is suctioning a fluids from a female client through an Endotracheal

tube (ET). During the suctioning procedure, she noted on the monitor that the
heart rate is decreasing. Which of the following is the appropriate nursing
intervention?

 
Notify the physician immediately

 
Ensure that the suction is limited to 15 seconds

Brief, 10-second suction duration is usually recommended to avoid mucosal

damage and prolonged hypoxia. Hypoxia can be profound from occlusion,
interruption of oxygen supply, and prolonged suctioning.
  
Stop the procedure and reoxygenate the client

 
Continue to suction

Question 54 1
/ 1 pts

Student nurse Mohammed is preparing to obtain a sputum specimen from a

male client. Which of the following nursing actions will facilitate obtaining the
specimen?

 
Limiting fluid

 
Asking the client to spit into the collection containe

 
Having the client take deep breaths

To obtain a sputum specimen, the client should rinse the mouth to reduce
contamination, breathe deeply, and then cough into a sputum specimen
container. To cough deeply from the lungs, the client might need to take
three deep breaths before he coughs forcefully.

 
Asking the client to obtain the specimen after eating

Question 55 1
/ 1 pts

A Fil-Am black client with Asthma seeks emergency care for Acute Respiratory
distress. Because of this client’s dark skin, the nurse should assess for cyanosis
by inspecting the:

 
Nailbeds

 
Lips

 
Ear lobes

 
Mucous membranes

Skin color doesn’t affect the mucous membranes. When the oxygen level
has dropped only a small amount, cyanosis may be hard to detect. In dark-
skinned people, cyanosis may be easier to see in the mucous membranes
(lips, gums, around the eyes) and nails. The lips, nail beds, and earlobes
are less reliable indicators of cyanosis because they’re affected by skin
color.
Question 56 1
/ 1 pts

An 87-year-old client requires long-term ventilator therapy. He has a

tracheostomy in place and requires frequent suctioning. Which of the following
techniques is correct?

 
Using continuous suction while advancing the catheter

 
Using intermittent suction while withdrawing the catheter

Intermittent suction should be applied during catheter withdrawal. To

prevent hypoxia, suctioning shouldn’t last more than 10-seconds at a time.
Suction shouldn’t be applied while the catheter is being advanced. Ensure
preoxygenation with 100% FiO2 was done with adequate pulse oximetry
measurements. Preoxygenation is required because airway suctioning
procedure may be associated with significant hypoxemia.

 
Using intermittent suction while advancing the catheter

 
Using continuous suction while withdrawing the catheter

Question 57 1
/ 1 pts

An elderly client has been ill with the flu, experiencing headache, fever, and
chills. After 3 days, she developed a cough productive of yellow sputum. The
nurse auscultates her lungs and hears diffuse crackles. How would the
nurse best interpret these assessment findings?

 
The client has not been taking her decongestants and bronchodilators as
prescribed

 
It is likely that the client is developing a secondary bacterial pneumonia.

Pneumonia is the most common complication of influenza, especially in the

elderly. The development of a purulent cough and crackles may be
indicative of a bacterial infection that is not consistent with a diagnosis of
influenza.

 
The assessment findings are consistent with influenza and are to be expected

 
The client is getting dehydrated and needs to increase her fluid intake to
decrease secretions
Question 58 1
/ 1 pts

A client with COPD reports steady weight loss and being “too tired from just
breathing to eat.” Which of the following nursing diagnoses would
be most appropriate when planning nutritional interventions for this client?

 
Activity intolerance related to dyspnea

 
Altered nutrition: Less than body requirements related to fatigue

The client’s problem is altered nutrition—specifically, less than required.

The cause, as stated by the client, is the fatigue associated with the disease
process. Instruct the patient to frequently eat high caloric foods in smaller
portions. COPD patients expend an extraordinary amount of energy simply
on breathing and require high caloric meals to maintain body weight and
muscle mass.

 
Weight loss related to COPD

 
Ineffective breathing pattern related to alveolar hypoventilation

Question 59 1
/ 1 pts

A client with acute asthma is prescribed short-term Corticosteroid therapy. What

is the rationale for the use of steroids in clients with asthma?

 
Corticosteroids promote bronchodilation

 
Corticosteroids have an anti-inflammatory effect

Corticosteroids have an anti-inflammatory effect and act to decrease edema

in the bronchial airways and decrease mucus secretion. At a physiologic
level, steroids reduce airway inflammation and mucus production and
potentiate beta-agonist activity in smooth muscles and reduce beta-agonists
tachyphylaxis in patients with severe asthma. Corticosteroids do not have a
bronchodilator effect, act as expectorants, or prevent respiratory infections.

 
Corticosteroids prevent development of respiratory infections

 
Corticosteroids act as an expectorant

Question 60 1
/ 1 pts

A client has been taking flunisolide (Aerobid), two inhalations a day, for
treatment of asthma. He tells the nurse that he has painful, white patches in his
mouth. Which response by the nurse would be the most appropriate?
  
“You are using your inhaler too much and it has irritated your mouth.”

 
“This is an anticipated side-effect of your medication. It should go away in a
couple of weeks.”

 
“You have developed a fungal infection from your medication. It will need to be
treated with an antifungal.”

Use of oral inhalant corticosteroids, such as flunisolide, can lead to the

development of oral thrush, a fungal infection. Oral candidiasis (thrush) is
another common complaint among users of inhaled corticosteroids (ICS).
This risk increases in elderly patients and patients who are also taking oral
steroids, high dose ICS, or antibiotics.

 
“Be sure to brush your teeth and floss daily. Good oral hygiene will treat this
problem.”

Question 61 1
/ 1 pts

A cyanotic client with an unknown diagnosis is admitted to the E.R. In relation to

oxygen, the first nursing action would be to:

 
Not administer oxygen unless ordered by the physician

 
Administer oxygen at 2 L flow per minute

Administer oxygen at 2 L/minute and no more, for if the client is

emphysemic and receives too high a level of oxygen, he will develop CO2
narcosis and the respiratory system will cease to function. With prolonged
oxygen therapy there is an increase in blood oxygen level, which
suppresses peripheral chemoreceptors; depresses ventilator drive and
increase in PCO2. high blood oxygen level may also disrupt the ventilation:
perfusion balance (V/Q) and cause an increase in dead space to tidal
volume ratio and increase in PCO2.

 
Administer oxygen at 10 L flow per minute and check the client’s nail beds

 
Wait until the client’s lab work is done

Question 62 1
/ 1 pts

Dr Jonas prescribes Albuterol Sulfate (Proventil) for a patient with newly

diagnosed Asthma. When teaching the patient about this drug, the nurse should
explain that it may cause:

 
Nasal Congestion

 
Lethargy

 
Nervousness

Albuterol may cause nervousness. The primary adverse effects of albuterol

therapy are tremors and nervousness, mostly seen in children who are 2 to
6 years of age, though can be seen at any age. Tremors are the result of
activation of the beta-2 receptors found on the motor nerve terminals which
increases intracellular cAMP. These side effects occur in approximately one
in every five patients. Other adverse effects of albuterol include tremor,
dizziness, headache, tachycardia, palpitations, hypertension, heartburn,
nausea, vomiting and muscle cramps.

 
Hyperkalemia

Question 63 1
/ 1 pts

Which assessment data would the nurse identify as the most characteristic sign
of Thrombocytopenia?

 
petechiae

 
melena

 
hemostasis

 
hemarthrosis

Question 64 1
/ 1 pts

Which blood component would the nurse expect to administer to therapeutically

provide all the coagulation factors?

 
Cryoprecipitate

 
Random donor platelets

 
Fresh frozen plasma

 
Stored whole blood

Incorrect Question 65 0
/ 1 pts

A patient is diagnosed with Iron Deficiency Anemia and is currently under

management. Which statement by the patient indicates the needs for further
teaching about ferrous sulfate therapy?

 
"I know that the metallic taste is a side effects and is common"

 
"I take Vitamin C tablets to enhance iron absorption"

 
"I eat organic means weekly because they are a good dietary source of iron"

 
"I take iron supplements only whenever I feel fatigue during the day"

Incorrect Question 66 0
/ 1 pts

During complete blood count, a female patient revealed a decreased in

erythrocytes and hemoglobin. Which of the clinical manifestations would suggest
Anemia secondary to Vitamin B12 deficiency rather than Folic acid deficiency?

 
Palpitations

 
Paresthesias

 
Dizziness

 
Smooth, sore tongue

Question 67 1
/ 1 pts

Which nursing intervention would you include in the plan of care for a client
diagnosed with a bleeding disorder?

 
Inspecting the skin for petechiae and ecchymosis

 
Administering enteric-coated aspirin

 
Administering ferrous sulfate daily

 
Encourage contact sports to promote physical activity and exercise

 Question 68 1
/ 1 pts

Which instruction would be included in a client teaching plan about self-

management of fatigue associated with anemia?

 
"Continue bed rest to conserve energy."

 
"Participate in all usual activities of daily living."

 
"Follow a progressive ambulatory program."

 
"Exercise to increase cardiopulmonary function"

Incorrect Question 69 0
/ 1 pts

Which action by the parents indicates ineffective adjustment to their infant son's
diagnosis of Hemophilia?

 
Requesting family planning and counseling information

 
Verbalizing feelings about shame and guilt

 
Demonstrating IV administration of factor VIII

 
Discouraging the child's participation in sports

Incorrect Question 70 0
/ 1 pts

Which of the following nursing intervention should be included in the care plan
for a client experiencing a Sickle cell crisis?

 
Administering vitamin B12 thru IV

 
Administering round-the-clock analgesics

 
Apply cold compresses to joints

 
Encouraging active range-of-motion exercises

Question 71 1
/ 1 pts
 While providing discharge instructions to a patient admitted due to Sickle cell
crisis, which of the following activities should he avoid?

 
Passing by an overpass in the street

 
Walking in the beach

 
Riding a helicopter

 
Performing exercise through brisk walking

Incorrect Question 72 0
/ 1 pts

Which statement by the patient indicates a successful teaching plan about the
disease process for the client diagnosed with Pernicious Anemia?

 
"I should eat lots of iron-rich foods and take my iron supplements"

 
"The nurse has to give my folic acid injection via Z-track method."

 
"When my hemoglobin returns to normal, I can stop my folic acid."

 
"I will have to take vitamin B12 replacement therapy for the rest of my life."

Incorrect Question 73 0
/ 1 pts

A patient diagnosed with Pernicious anemia asked you for food recommendation
as part of his diet plan. Which of the following foods will you suggest as having a
high cobalamin content?

 
Green fruits

 
Red meat

 
Dairy Products

 
Salt Water Fish

Incorrect Question 74 0
/ 1 pts
 Pancytopenia is the common manifestation associated with patients diagnosed
with Aplastic Anemia. Which of the following interventions will you keep in mind
in managing a patient diagnosed with such disease?

 
Encourage the patient to avoid crowded places

 
Check kidney function to monitor any complications that may be caused by
hemolysis of the blood vessels

 
Submit the patient to fecal occult blood test (FOBT) to know if RBC deposits are
present

 
Administer anti-coagulant to prevent clotting of the blood

Incorrect Question 75 0
/ 1 pts

Aside from manifestations of anemia which is prominent in hematologic

disorders. Which of the following is the most common complication of patients
suffering from Thalassemia?

 
Fatigue

 
Difficulty of breathing

 
Fractures

 
Bleeding

Incorrect Question 76 0
/ 1 pts

A client receiving a unit of packed Red blood cells (pRBC) has the following
baseline vital signs, temperature of 36.7 C, blood pressure of 130/70 mmHg,
pulse rate of 100 and respiratory rate of 22. Fifteen minutes later, the client's
temperature is 38.3 C, blood pressure of 140/80 mmHg, pulse of 104 and
respiratory rate of 24. Which intervention should the nurse implement first?

 
Stop the transfusion immediately and notify the physician.

 
Continuing the transfusion and administering aspirin for the client's fever.

  
Continue the transfusion, monitoring the patient every 15 minutes for further
findings.

 
Slowing the rate of transfusion and continuing to monitor the client.

Question 77 1
/ 1 pts

Which sign and symptom would lead the nurse to suspect that the client who is
receiving a blood transfusion was experiencing circulatory overload?

 
complaints of severe abdominal pain and dark urine

 
anxiety and complaints if shortness of breath

 
red splotches on the face with complaints of itching

 
fever and complains of low back pain

Incorrect Question 78 0
/ 1 pts

Which assessment finding indicates a positive response to Heparin therapy in

the client diagnosed with Disseminated Intravascular Coagulation?

 
increased fibrinogen

 
increased platelet count

 
decreased fibrin splint products

 
reduced bleeding

Question 79 1
/ 1 pts

A patient is receiving treatment for Infective Endocarditis. The client has a

history of intravenous drug use and underwent mitral valve replacement a year
ago. The client is scheduled for a Trans-esophageal Echocardiogram (TEE) the
following day. Nurse Maritony performed an assessment and she find a tender,
painful red lesions on the client’s hand and feet. She knows that this is a
common finding in a client with Infective endocarditis and is known as:

 
Osler's node

 other signs of Infective Endocarditis :

Osler nodes - red, painful nodules in the pads of the fingers and toes

Janeway lesions - red, painless skin spots on the palms and soles

Roth spots - small, pinpoint areas of bleeding on the surface of the eye or
the eyelids 

Splinter hemorrhages - small areas of bleeding under the nails 

 
Splinter hemorrhage

 
Janeway Lesion

 
Roth spots

Question 80 1
/ 1 pts

A patient is scheduled for a cardiac catheterization using a radiopaque dye.

Which of the following assessments is most critical before the procedure?

 
Allergy to iodine

Iodine is a nutrient that is essential for thyroid function and an allergy to it

would be life-threatening.

Iodine can be found in fish, shellfish, iodine-based contrast agents used in

medical imaging (substances taken into your body to enhance images,
making them easier to read), and some disinfectant products. 

Tell your doctor if you have ever had a reaction to any contrast dye; if you
are allergic to iodine; or if you are sensitive to or are allergic to any
medicines, latex, tape, and anesthetic agents (local and general).

 
Height & weight

 
Intake & Output

 
Liver test

Incorrect Question 81 0
/ 1 pts

Which of the following is the first line of treatment for Coronary Artery  Disease
(CAD)  ?

 
Angioplasty

 Angioplasty is a procedure used to open blocked coronary arteries

caused by coronary artery disease. It restores blood flow to the heart
muscle without open-heart surgery. Angioplasty can be done in an
emergency setting such as a heart attack.

β‐blockers should be first line treatment in patients with established CAD. 

 
CABG

 
Oral medication therapy

 
Pacemaker

Question 82 1
/ 1 pts

What is the most  common aneurysm of the aorta that runs through the
abdomen ?

 
Femoral Artery Aneurysm

 
Abdominal Aortic aneurysm

the most common aneurysm of the aorta that runs through the abdomen is
AAA

Less common  affect the part of the aorta running through the chest which
is the Thoracic Aneurysm

Artery junction points at the Circle of Willis  may become weak, causing a
ballooning of the blood vessel wall to potentially form a small sac or
aneurysm is called Cerebral Aneurysm

 
Cerebral Aneurysm

 
Thoracic Aortic aneurysm

Incorrect Question 83 0
/ 1 pts

A 60-year old male patient comes into the Emergency Room with complains of
crushing chest pain that radiates to his shoulder and left arm. The admitting
diagnosis is Acute Myocardial Infarction. Immediate admission orders include
oxygen by nasal cannula at 4 L/minute, blood works, CXR, an ECG and 2 grams
of Morphine to be given intravenously. What is the drug of choice to be given first
for chest pain?

 
Aspirin

  
Nitroglycerin is initially given sublingually

 
Heparin

 
Morphine 2 to 4 mg IV

Morphine is indicated for the relief of severe acute and severe chronic pain.

Chest pain can be treated with nitroglycerin or

sometimes morphine. Nitroglycerin is preferable to morphine, which
should be used judiciously (eg, if a patient has a contraindication
to nitroglycerin or is in pain despite nitroglycerin therapy). Nitroglycerin is
initially given sublingually, followed by continuous IV drip if
needed. Morphine 2 to 4 mg IV, repeated every 15 minutes as needed, is
highly effective but can depress respiration, can reduce myocardial
contractility, and is a potent venous vasodilator. 

Question 84 1
/ 1 pts

Nurse Eliza observes constant bubbling in the water-seal chamber of a closed

chest drainage system. What should the nurse conclude?

 
The chest tube is obstructed

 
The system has an air leak

Constant bubbling in the chamber indicates an air leak and requires

immediate intervention. With suction applied, this indicates a persistent air
leak that may be from a large pneumothorax at the chest insertion site
(patient-centered) or chest drainage unit (system-centered).

 
The client has a pneumothorax

 
The system is functioning normally

Incorrect Question 85 0
/ 1 pts

How do you check placement of a chest tube?

 
Fluoroscopy

 The doctor may take x-rays after the procedure to check the placement of
the chest tube. The chest tube is like a catheter.

Fluoroscopy exam is painless and typically takes 15 to 20 minutes to

complete. You will be given a liquid contrast medium to drink during the
exam. The contrast medium is a flavored mixture of barium sulfate and
water. In addition, you may be given effervescent crystals with the contrast
material to further improve the images.

 
Ultrasound

 
Xray

 
MRI

Question 86 1
/ 1 pts

How much pleural fluid is normal?

 
30 to 40 ml

 
50 to 60 ml

 
70 to 80 ml

 
10 to 20 ml

In a healthy human, the pleural space contains a small amount of fluid

(about 10 to 20 mL), with a low protein concentration (less than 1.5 g/dL)

Question 87 1
/ 1 pts

How much fluid is considered a large pleural effusion in an adult?

 
6-7 liters

 
3-4 liters

 
1- 2 liters

 
4-5 liters

The pleural space is usually filled with a very small amount of fluid(10-20
ml). However, large amounts (4–5 liters in an adult) of fluid can
accumulate in the pleural space under pathological conditions.
Question 88 1
/ 1 pts

What procedure is done to remove fluid or air from around the lungs?

 
Thoracentesis

Thoracentesis is a procedure to remove fluid or air from around the

lungs. A needle is put through the chest wall into the pleural space. The
pleural space is the thin gap between the pleura of the lung and of the inner
chest wall. The pleura is a double layer of membranes that surrounds the
lungs.

 
Chest Tube insertion

 
Pleurodesis

 
Pericardiocentesis

Question 89 1
/ 1 pts

What do you call the main component of the blood that carry oxygen to the cells
& tissues and contain millions of hemoglobin molecules 

 
Thrombocytes

 
Leukocytes

 
Erythrocytes

Red blood cells-Erythrocytes   (41%) carry oxygen to the cells & tissues
contain millions of hemoglobin molecules RBC pick up CO2 for
transportation to the  lungs where the CO2 is expelled from the body .

Red blood cells, also known as erythrocytes, deliver oxygen to the

tissues in your body. Oxygen turns into energy and your tissues release
carbon dioxide. Your red blood cells also transport carbon dioxide to your
lungs for you to exhale.

 
Plasma

Quiz Score:
64 out of 100