NSG 202 EXAM 2 - Questions & Answers (Multiple Choice, Graded A)

1. The nurse begins her shift. Which of the following clients should be assessed first? 2. The nurse is monitoring drug levels for a client who is receiving theophylline. The most recent level was 13 mcg/mL, and the n ...

1. The nurse begins her shift. Which of the following clients should be assessed first? 2. The nurse is monitoring drug levels for a client who is receiving theophylline. The most recent level was 13 mcg/mL, and the nurse evaluates this level to be which one of the following? 3. The nurse is reviewing the client's ABG results. The PaO2 is 80 mm Hg, pH is 7.50, PaCO2 is 25 mm, HCO3 is 25 mEq/L. What would the nurse expect to observe on assessment of this client? 4. After teaching a client who is prescribed salmeterol (Serevent), the nurse assesses the client's understanding. Which statement by the client indicates a need for additional teaching? 5. The nurse reviews the MAR for a client having an acute asthma attack. Which medication should the nurse administer first? 6. The nurse completes an admission assessment on a client with asthma. Which information given by the client is most indicative of a need for change in therapy? 7. A pulmonary nurse cares for clients who have COPD. Which client should the nurse assess first? 8. A client newly diagnosed with asthma is being discharged. The nurse anticipates including which topic in the discharge teaching? 9. When a pulse ox monitor indicates a client has a drop in spo2 from 96% to 85% over 4 hours, which one of the following will the nurse do first? 10. A nurse cares for a client with a 40-year smoking history who is experiencing distended neck veins and dependent edema. Which physiologic process should the nurse correlate with this client's history and clinical manifestations? 11. After the nurse has received change-of-shift report, which client should the nurse assess first? 12. Which nursing action for a client with COPD could the nurse delegate to experienced UAP? 13. The nurse develops a teaching plan to help increase activity tolerance at home for an older adult with severe COPD. Which instructions would be most appropriate for the nurse to include in the plan of care? 14. A client with chronic cough has a bronchoscopy. After the procedure, which intervention by the nurse is most appropriate? 15. The nurse is working on a medical surgical unit with clients that are having difficulty with gas exchange. Which client is acceptable to assign to the LPN? 16. A nurse evaluates the following ABG and vital sign results for a client with COPD. VITAL SIGNS: ABG RESULTS: HR 110 bpm pH 7.32 RR 12 breaths/min PaCO2 62 mm Hg BP 145/65 mm Hg PaO2 46 mm Hg Oxygen sat 76% HCO3 28 mEq/L Which action should the nurse take first? 17. The nurse is caring for a client who is prescribed a long acting beta2 agonist. The client states, "the medication is too expensive to use every day. I only use my inhaler when I have an attack." How should the nurse respond? 18. A client with severe COPD tells the nurse, "I wish I were dead! I'm just a burden on everybody." Based on this information, which nursing diagnosis is most appropriate? 19. A client with COPD has a nursing diagnosis of impaired breathing pattern related to anxiety. Which nursing action is most appropriate to include in the plan of care? 20. The nurse is caring for a client with a cough, the nurse knows which of the following would contribute to a diagnosis for chronic bronchitis for this client? 21. A nurse teaches a client who has COPD. Which statements related to nutrition should the nurse include in this client's teaching? (Select all that apply) 22. A nurse assesses a client with COPD. Which questions should the nurse ask to determine the client's activity tolerance? (Select all that apply) 23. Which information will the nurse include in the asthma teaching plan for a client being discharged? 24. The nurse is caring for a client with late-stage COPD. The nurse will expect which of the following ABG results to be characteristic of this client's disease state? 25. A client who is experiencing an asthma attack develops bradycardia and a decrease in wheezing. Which action should the nurse take first? 26. A nurse assesses a client with asthma and notes bilateral wheezing, decreased pulse ox, and suprasternal retraction on inhalation. Which actions should the nurse take? (Select all that apply) 27. A client who is experiencing an acute asthma attack is admitted to the emergency department. Which assessment should the nurse complete first? 28. The nurse is caring for a client with cor pulmonale. The nurse should monitor the client for which expected finding? 29. After the nurse has received change of shift report, which if the following clients should the nurse assess first? 30. A nurse cares for a client with COPD. The client states that he no longer enjoys going out with his friends. How should the nurse respond? 31. Which finding by the nurse for a client with a nursing diagnosis of impaired gas exchange will be most useful in evaluating the effectiveness of treatment? 32. A client with COPD has a nursing diagnosis of imbalanced nutrition: less than body requirements. Which intervention would be most appropriate for the nurse to include in the plan of care? 33. A client with COPD has poor gas exchange. Which action by the nurse would be most appropriate? 34. A nurse cares for a client with COPD who appears thin and disheveled. Which question should the nurse ask first? 35. The nurse is admitting a client diagnosed with an acute exacerbation of COPD. What is the best way for the nurse to determine the appropriate oxygen flow rate? 36. The nurse in the emergency department receives ABG results for four recently admitted clients with COPD. Which client will require the most rapid action by the nurse? 37. The nurse teaches a client with chronic bronchitis about a new prescription for Advair Diskus (combined fluticasone and salmeterol). Which action by the client would indicate to the nurse that teaching about medication administration has been successful? 38. The nurse teaches a client who has asthma about peak flow meter use. Which action by the client indicates that teaching was successful? 39. A client is scheduled for pulmonary function testing. Which action should the nurse take to prepare the client for this procedure? 40. A client with COPD has rhonchi throughout the lung fields and a chronic nonproductive cough. Which nursing intervention will be most effective? 41. A client with acute shortness of breath is admitted to the hospital. Which action should the nurse take during the initial assessment of the client? 42. The client is admitted for impaired gas exchange. The nurse anticipates the labs to reveal which one of the following results? 43. After receiving a nebulizer treatment with a beta agonist, the client complains of feeling slightly nervous and wonders if her asthma's getting worse. What is the nurse's best response? 44. The nurse is assessing a client for the adequacy of ventilation. What assessment findings would indicate the client has good ventilation? (Select all that apply) 45. The nurse is providing instructions to a client who has a new prescription for a corticosteroid metered dose inhaler. Which statement by the client indicates that further instruction is needed? (Select all that apply) 46. A nurse assesses several clients who have a history of asthma. Which client should the nurse assess first? 47. A client is ordered dexamethasone (Decadron) IV push for management of asthma. The physician orders the client's dose of 9 mg. The pharmacy sends a vial of 4 mg/mL. How many mL should the nurse draw up? 48. The nurse analyzes the results of a client's ABGs. Which finding would require immediate action? 49. A client has prescriptions for two inhalers. One inhaler is a bronchodilator, and the other is a corticosteroid. Which instruction regarding these inhalers will the nurse give to the client? 50. The nurse is teaching a client with COPD who has been prescribed continuous oxygen therapy at home. Which statement indicates the client correctly understands the teaching? 51. After teaching a client who is prescribed a long-acting beta2 agonist medication, a nurse assesses the client's understanding. Which statement indicates the client comprehends the teaching? 52. Which of the following nursing diagnoses is the highest priority for a client with a new onset of status asthmaticus? 53. The nurse admits a client who has a diagnosis of an acute asthma attack. Which statement indicates that the client may need teaching regarding medication use? 54. A nurse plans care for a client who has COPD and thick, tenacious secretions. Which interventions should the nurse include in this client's plan of care? (Select all that apply) 55. A client is taking aminophylline for a severe exacerbation of COPD. The nurse will assess for which therapeutic response? 56. The nurse identifies which of the following as a strategy to meet the nutritional needs of a client with COPD? 57. The acid-base status of a client is dependent on normal gas exchange. Which client would the nurse identify as having an increased risk for the development of respiratory acidosis? 58. The nurse receives a change of shift report on the following clients with COPD. Which client should the nurse assess first? 59. A client who has a history of COPD was hospitalized for increasing SOB and chronic hypoxemia (SaO2 levels of 89% to 90%). In planning for discharge, which action by the nurse will be most effective in improving compliance with discharge teaching? 60. Your client is admitted with acute exacerbation of asthma. He/she is ordered Methylprednisolone (Solumedrol) 40 mg IVP q8 hours. The client is ordered to have AC and HS blood glucose monitoring with Lispro (Humalog) insulin coverage for elevated blood glucose. The client states, "I am not diabetic, I don't want any insulin." What's your best response?