INSTRUCTIONS : Use black pen. Read carefully and analyze your answer.
Circle the letter that corresponds to your correct answer. Erasures are not
allowed. ( Pls. write your name at the LEFT upper corner)
1. Which one of the following is NOT a function of the Upper airway?
A. For clearance mechanism such as coughing
B. Transport gases to the lower airways
C. Warming, Filtration and Humidification of inspired air
D. Protect the lower airway from foreign mater
2. This is the paranasal sinus found between the eyes and the nose that
extends backward into the skull
A. Ehtmoid
B. Sphenoid
C. Maxillary
D. Frontal
4. Which cell secretes mucus that help protect the lungs by trapping debris
in the respiratory tract?
A. Type I pneumocytes
B. Type II pneumocytes
C. Goblet cells
D. Adipose cells
5. Refers to the extra air that can be inhaled beyond the normal tidal
volume
A. Inspiratory reserve volume
B. Expiratory reserve volume
6. Casssandra, A 22 year old grade Agnostic, Asked you, how many spikes
of bones are there in my ribs? Your best response is which of the
following?
C. Diaphragm
D. Pectoralis major
C. Administer medications
D. Promote bronchoconstriction
10.
Ernest Arnold Hamilton, a 60 year old American client was mobbed
by teen gangsters near New york, Cubao. He was rushed to John Hopio
Medical Center and was Unconscious. You are his nurse and you are to
suction his secretions. In which position should you place Mr. Hamilton?
A. High fowlers
B. Semi fowlers
C. Prone
D. Side lying
11.
There are four catheter sizes available for use, which one of these
should you use for Mr. Hamilton?
A. Fr. 18
C. Fr. 10
B. B. Fr. 12
D. Fr. 5
12.
Which of the following is the initial sign of hypoxemia in an adult
client?
A. Tachypnea and Tachycardia
13.
Which of the following oxygen delivery method can deliver 100%
Oxygen at 15 LPM?
A. Nasal Cannula
14.
Roberto San Andres, A new nurse in the hospital is about to
administer oxygen on patient with Respiratory distress. As his senior
nurse, you should intervene if Roberto will:
A. Uses venture mask in oxygen administration
B. Put a non rebreather mask in the patient before opening the oxygen source
C. Use a partial rebreather mask to deliver oxygen
D. Check for the doctors order for Oxygen administration
15.
Which of the following will alert the nurse as an early sign of
hypoxia?
A. Client is tired and dyspneic
16.
Miguelito de balboa, An OFW presents at the admission with an A:P
Diameter ratio of 2:1, Which of the following associated finding should
the nurse expect?
A. Pancytopenia
B. Anemia
17.
The best method of oxygen administration for client with COPD
uses:
A. Cannula
D. Venturi mask
18.
Mang Dagul, a 50 year old chronic smoker was brought to the E.R
because of difficulty in breathing. Pleural effusion was the diagnosis and
CTT was ordered. What does C.T.T Stands for?
A. Chest tube thoracotomy
19.
Where will the CTT be inserted if we are to drain fluids
accumulated in Mang daguls pleura?
A. 2nd ICS
C. 5th ICS
B. 4th ICS
D. 8th ICS
20.
There is a continuous bubbling in the water sealed drainage
system with suction. And oscillation is observed. As a nurse, what
should you do?
A. Consider this as normal findings
B. Notify the physician
dressing
21.
An elderly client with pneumonia may appear with which of the
following symptoms first?
A. Altered mental status and dehydration
B. fever and chills
C. Hemoptysis and dyspnea
D. Pleuretic chest pain and cough
22.
Which of the following pathophysiological mechanisms that occurs
in the lung parenchyma allows pneumonia to develop?
A. Atelectasis
C. Effusion
B. Bronchiectasis
D. Inflammation
23. A 7-year-old client is brought to the E.R. Hes tachypneic and afebrile
and has a respiratory rate of 36 breaths/minute and a nonproductive
cough. He recently had a cold. From his history, the client may have which
of the following?
A. Acute asthma
C. Chronic obstructive pulmonary
disease (COPD)
B. Bronchial pneumonia
D. Emphysema
24. Which of the following assessment findings would help confirm a
diagnosis of asthma in a client suspected of having the disorder?
A. Circumoral cyanosis
C. Inspiratory and expiratory wheezing
B. Increased forced expiratory volume D. Normal breath sounds
25. Which of the following types of asthma involves an acute asthma attack
brought on by an upper respiratory infection?
A. Emotional
C. Intrinsic
B. Extrinsic
D. Mediated
26.
A client with acute asthma showing inspiratory and expiratory
wheezes and a decreased expiratory volume should be treated with
which of the following classes of medication right away?
a. Beta-adrenergic blockers
c. Inhaled steroids
b. Bronchodilators
d. Oral steroids
27.
A 19-year-old comes into the emergency department with acute
asthma. His respiratory rate is 44 breaths/minute, and he appears to be
in acute respiratory distress. Which of the following actions should be
taken first?
a. Take a full medication history
b. Give a bronchodilator by neubulizer
c. Apply a cardiac monitor to the client
d. Provide emotional support to the client.
28.
A 58-year-old client with a 40-year history of smoking one to two
packs of cigarettes a day has a chronic cough producing thick sputum,
peripheral edema, and cyanotic nail beds. Based on this information, he
most likely has which of the following conditions?
a. Adult respiratory distress syndrome (ARDS)
b. Asthma
c. Chronic obstructive bronchitis
d. Emphysema
29.
The term blue bloater refers to which of the following
conditions?
a. Adult respiratory distress syndrome (ARDS)
b. Asthma
c. Chronic obstructive bronchitis
d. Emphysema
30.
The term pink puffer refers to the client with which of the
following conditions?
a. ARDS
c. Chronic obstructive bronchitis
b. Asthma
d. Emphysema
31.
A 66-year-old client has marked dyspnea at rest, is thin, and uses
accessory muscles to breathe. Hes 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 shoulders for breathing.
This client has symptoms of which of the following respiratory
disorders?
a. ARDS
c. Chronic obstructive bronchitis
b. Asthma
d. Emphysema
32.
Its highly recommended that clients with asthma, chronic
bronchitis, and emphysema have Pneumovax and flu vaccinations for
which of the following reasons?
a. All clients are recommended to have these vaccines
b. These vaccines produce bronchodilation and improve oxygenation.
c. These vaccines help reduce the tachypnea these clients experience.
d. Respiratory infections can cause severe hypoxia and possibly death in these
clients.
33.
Exercise has which of the following effects on clients with asthma,
chronic bronchitis, and emphysema?
a. It enhances cardiovascular fitness.
b. It improves respiratory muscle strength.
52.When caring for a male patient who has just had a total laryngectomy, the
nurse should plan to:
A. Encourage oral feeding as soon as possible
B. Develop an alternative communication method
C. Keep the tracheostomy cuff fully inflated
D. Keep the patient flat in bed
53.A male patient has a sucking stab wound to the chest. Which action should
the nurse take first?
A. Drawing blood for a hematocrit and hemoglobin level
B. Applying a dressing over the wound and taping it on three sides
C. Preparing a chest tube insertion tray
D. Preparing to start an I.V. line
54.For a patient with advance chronic obstructive pulmonary disease (COPD),
which nursing action best promotes adequate gas exchange?
A. Encouraging the patient to drink three glasses of fluid daily
B. Keeping the patient in semi-fowlers position
C. Using a high-flow venture mask to deliver oxygen as prescribe
D. Administering a sedative, as prescribe
55.A male patients X-ray result reveals bilateral white-outs, indicating adult
respiratory distress syndrome (ARDS). This syndrome results from:
A. Cardiogenic pulmonary edema
B. Respiratory alkalosis
C. Increased pulmonary capillary permeability
D. Renal failure
56.For a female patient with chronic obstructive pulmonary disease, which
nursing intervention would help maintain a patent airway?
A. Restricting fluid intake to 1,000 ml per day
B. Enforcing absolute bed rest
C. Teaching the patient how to perform controlled coughing
D. Administering prescribe sedatives regularly and in large amounts
57.Nurse Lei caring for a client with a pneumothorax and who has had a chest
tube inserted notes continues gentle bubbling in the suction control
chamber. What action is appropriate?
A. Do nothing, because this is an expected finding
B. Immediately clamp the chest tube and notify the physician
C. Check for an air leak because the bubbling should be intermittent
D. Increase the suction pressure so that the bubbling becomes vigorous
58.Nurse Maureen has assisted a physician with the insertion of a chest tube.
The nurse monitors the client and notes fluctuation of the fluid level in the
water seal chamber after the tube is inserted. Based on this assessment,
which action would be appropriate?
A. Inform the physician
B. Continue to monitor the client
C. Reinforce the occlusive dressing
D. Encourage the client to deep-breathe
59.Nurse Reynolds caring for a client with a chest tube turns the client to the
side, and the chest tube accidentally disconnects. The initial nursing action
is to:
A. Call the physician
B. Place the tube in bottle of sterile water
C. Immediately replace the chest tube system
D. Place a sterile dressing over the disconnection site
60.A nurse is assisting a physician with the removal of a chest tube. The nurse
should instruct the client to:
A. Exhale slowly
B. Stay very still
C. Inhale and exhale quickly
D. Perform the Valsalva maneuver
61.While changing the tapes on a tracheostomy tube, the male client coughs
and tube is dislodged. The initial nursing action is to:
A. Call the physician to reinsert the tube
B. Grasp the retention sutures to spread the opening
A. Pallor
B. Low arterial PaO2
C. Elevated arterial PaO2
D. Decreased respiratory rate
71.A nurse is preparing to obtain a sputum specimen from a male client. Which
of the following nursing actions will facilitate obtaining the specimen?
A. Limiting fluid
B. Having the client take deep breaths
C. Asking the client to spit into the collection container
D. Asking the client to obtain the specimen after eating
72.Nurse Joy is caring for a client after a bronchoscopy and biopsy. Which of
the following signs, if noticed in the client, should be reported immediately
to the physician?
A. Dry cough
B. Hermaturia
C. Bronchospasm
D. Blood-streaked sputum
73.A nurse is suctioning fluids from a male client via a tracheostomy tube.
When suctioning, the nurse must limit the suctioning time to a maximum of:
A. 1 minute
B. 5 seconds
C. 10 seconds
D. 30 seconds
74.A nurse is suctioning fluids from a female client through an endotracheal
tube. During the suctioning procedure, the nurse notes on the monitor that
the heart rate is decreasing. Which if the following is the appropriate
nursing intervention?
A. Continue to suction
B. Notify the physician immediately
C. Stop the procedure and reoxygenate the client
D. Ensure that the suction is limited to 15 seconds
75.A male adult client is suspected of having a pulmonary embolus. A nurse
assesses the client, knowing that which of the following is a common
clinical manifestation of pulmonary embolism?
A. Dyspnea
B. Bradypnea
C. Bradycardia
D. Decreased respirations
76.A slightly obese female client with a history of allergy-induced
asthma,hypertension, and mitral valve prolapse is admitted to an acute
care facility for elective surgery. The nurse obtains a complete history and
performs a thorough physical examination, paying special attention to the
cardiovascular and respiratory systems. When percussing the clients chest
wall, the nurse expects to elicit:
A. Resonant sounds.
B. Hyperresonant sounds.
C. Dull sounds.
D. Flat sounds.
77.A male client who weighs 175 lb (79.4 kg) is receiving aminophylline
(Aminophyllin) (400 mg in 500 ml) at 50 ml/hour. The theophylline level is
reported as 6 mcg/ml. The nurse calls the physician who instructs the nurse
to change the dosage to 0.45 mg/kg/hour. The nurse should:
A. Question the order because its too low.
B. Question the order because its too high.
C. Set the pump at 45 ml/hour.
D. Stop the infusion and have the laboratory repeat the theophylline
measurement.
78.The nurse is teaching a male client with chronic bronchitis about breathing
exercises. Which of the following should the nurse include in the teaching?
A. Make inhalation longer than exhalation.
B. Exhale through an open mouth.
C. Pursed-lip breathing
D. Controlled breathing
88.A female client is undergoing a complete physical examination as a
requirement for college. When checking the clients respiratory status, the
nurse observes respiratory excursion to help assess:
A. Lung vibrations.
B. Vocal sounds.
C. Breath sounds.
D. Chest movements.
89.A male client comes to the emergency department complaining of sudden
onset of diarrhea, anorexia, malaise, cough, headache, and recurrent chills.
Based on the clients history and physical findings, the physician suspects
legionnaires disease. While awaiting diagnostic test results, the client is
admitted to the facility and started on antibiotic therapy. What is the drug
of choice for treating legionnaires disease?
A. Erythromycin (Erythrocin)
B. Rifampin (Rifadin)
C. Amantadine (Symmetrel)
D. Amphotericin B (Fungizone)
90.A male client with chronic obstructive pulmonary disease (COPD) is
recovering from a myocardial infarction. Because the client is extremely
weak and cant produce an effective cough, the nurse should monitor
closely for:
A. Pleural effusion.
B. Pulmonary edema.
C. Atelectasis.
D. Oxygen toxicity.
91.The nurse in charge is teaching a client with emphysema how to perform
pursed-lip breathing. The client asks the nurse to explain the purpose of
this breathing technique. Which explanation should the nurse provide?
A. It helps prevent early airway collapse.
B. It increases inspiratory muscle strength.
C. It decreases use of accessory breathing muscles.
D. It prolongs the inspiratory phase of respiration.
92.After receiving an oral dose of codeine for an intractable cough, the male
client asks the nurse, How long will it take for this drug to work? How
should the nurse respond?
A. In 30 minutes
B. In 1 hour
C. In 2.5 hours
D. In 4 hours
93.A male client suffers adult respiratory distress syndrome as a consequence
of shock. The clients condition deteriorates rapidly, and endotracheal (ET)
intubation and mechanical ventilation are initiated. When the high-pressure
alarm on the mechanical ventilator sounds, the nurse starts to check for the
cause. Which condition triggers the high-pressure alarm?
A. Kinking of the ventilator tubing
B. A disconnected ventilator tube
C. An ET cuff leak
D. A change in the oxygen concentration without resetting the oxygen level
alarm
94.A female client with chronic obstructive pulmonary disease (COPD) takes
anhydrous theophylline, 200 mg P.O. every 8 hours. During a routine clinic
visit, the client asks the nurse how the drug works. What is the mechanism
of action of anhydrous theophylline in treating a nonreversible obstructive
airway disease such as COPD?
A.It makes the central respiratory center more sensitive to carbon dioxide and
stimulates the respiratory drive.
B. It inhibits the enzyme phosphodiesterase, decreasing degradation of cyclic
adenosine monophosphate, a bronchodilator.
C. It stimulates adenosine receptors, causing bronchodilation.