Chapter 28: Nursing Management: Lower Respiratory Problems

Chapter 28: Nursing Management: Lower Respiratory Problems

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. Following assessment of a patient with pneumonia, the nurse identifies a nursing
diagnosis of ineffective airway clearance. Which information best supports this
diagnosis?
a. Weak, nonproductive cough effort
b. Large amounts of greenish sputum
c. Respiratory rate of 28 breaths/minute
d. Resting pulse oximetry (SpO2) of 85%
ANS: A
The weak, nonproductive cough indicates that the patient is unable to clear the airway
effectively. The other data would be used to support diagnoses such as impaired gas
exchange and ineffective breathing pattern.
DIF: Cognitive Level: Application REF: 551-552 TOP: Nursing Process:
Diagnosis
MSC: NCLEX: Physiological Integrity
2. During assessment of the chest in a patient with pneumococcal pneumonia, the nurse
would expect to find
a. vesicular breath sounds.
b. increased tactile fremitus.
c. dry, nonproductive cough.
d. hyperresonance to percussion.
ANS: B
Increased tactile fremitus over the area of pulmonary consolidation is expected with
bacterial pneumonias. Dullness to percussion would be expected. Pneumococcal
pneumonia typically presents with a loose, productive cough. Adventitious breath sounds
such as crackles and wheezes are typical.
DIF: Cognitive Level: Application REF: 549
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
3. A patient with bacterial pneumonia has rhonchi and thick sputum. Which action will the
nurse use to promote airway clearance?
a. Assist the patient to splint the chest when coughing.
b. Educate the patient about the need for fluid restrictions.
c. Encourage the patient to wear the nasal oxygen cannula.
d. Instruct the patient on the pursed lip breathing technique.
ANS: A
Test Bank 28-2
Coughing is less painful and more likely to be effective when the patient splints the chest
during coughing. Fluids should be encouraged to help liquefy secretions. Nasal oxygen
will improve gas exchange, but will not improve airway clearance. Pursed lip breathing is
used to improve gas exchange in patients with COPD, but will not improve airway
clearance.
DIF: Cognitive Level: Application REF: 552-553
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
4. Which statement by a patient who has been hospitalized for pneumonia indicates a good
understanding of the discharge instructions given by the nurse?
a. “I will call the doctor if I still feel tired after a week.”
b. “I will need to use home oxygen therapy for 3 months.”
c. “I will continue to do the deep breathing and coughing exercises at home.”
d. “I will schedule two appointments for the pneumonia and influenza vaccines.”
ANS: C
Patients should continue to cough and deep breathe after discharge. Fatigue for several
weeks is expected. Home oxygen therapy is not needed with successful treatment of
pneumonia. The pneumovax and influenza vaccines can be given at the same time.
DIF: Cognitive Level: Application REF: 552 TOP: Nursing Process:
Evaluation
MSC: NCLEX: Physiological Integrity