Chapter 22 Respiratory Function

Chapter 22  Respiratory Function

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. The nurse best maximizes an older adult’s potential to avoid developing a postsurgical respiratory infection by:
a.
walking the patient to the bathroom instead of using the bedside commode.
b.
encouraging compliance with prescribed antibiotic therapy.
c.
evaluating the patient’s ability to effectively cough and deep breathe.
d.
offering fluids every hour while the patient is awake.

ANS: C
Older adults have a decrease in the number and effectiveness of cilia in the tracheobronchial tree, which results in increasing difficulty clearing secretions. The other activities also help avoid atelectasis and infection, but evaluating the patient’s ability to cough and deep breathe can indicate that other treatment measures may be needed postoperatively.

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2. An older adult’s pulmonary function studies indicate that his vital capacity is reduced and his residual volume is increased. The nurse recognizes that these test results are observed in the patient’s:
a.
ineffective cough reflex.
b.
shallow breathing.
c.
slow respiratory rate.
d.
frequent respiratory infections.

ANS: B
Normal aging results in the progressive loss of elastic recoil of the lung parenchyma and conducting airways as well as reduced elastic recoil of the lung and the opposing forces of the chest wall. The lung becomes less elastic as collagenic substances surrounding the alveoli and alveolar ducts stiffen and form cross-linkages that interfere with the elastic properties of the lungs. Any and all of these structural changes make it more difficult for the older person to ventilate.

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3. The nurse is concerned about an older adult patient developing toxic levels of the prescribed theophylline when it is determined that the patient has a(n):
a.
one pack a day smoking habit.
b.
elevated serum potassium level.
c.
history of chronic bronchitis.
d.
chronic, nonproductive cough.

ANS: A
Theophylline is a medication that is affected by smoking, which increases serum drug levels. The other factors do not affect the pharmacokinetics of this drug.

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4. The nurse is aware of the typical occurrence of comorbidities in the older adult. Motivated by this knowledge, the nurse assesses a patient with diagnosed respiratory dysfunction for possible:
a.
poor wound healing of the legs and feet.
b.
ineffective absorption of vitamins and minerals.
c.
abnormal urine protein levels.
d.
visual problems including retinal detachment.

ANS: A
In addition, older patients are more likely to have comorbidities involving the cardiovascular and respiratory systems. Peripheral circulation is a possible cardiovascular problem that would result in poor wound healing. The other options are not related to having a respiratory dysfunction.

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5. Because the older adult is not as likely to exhibit the typical signs of ineffective gas exchange, the nurse is particularly suspicious of:
a.
a nonproductive cough in an afebrile patient.
b.
irritability in a usually pleasant patient.
c.
pale nail beds in a patient of color.
d.
an elevated white blood cell (WBC) count in an 82-year-old patient.

ANS: B
An early sign of respiratory problems is a change in mental status. Because the physiologic responses to hypoxemia and hypercapnia are blunted in older patients, compensatory changes in heart rate, respiratory rate, and blood pressure may be delayed and cerebral perfusion may suffer. Mental status changes may include subtle increases in forgetfulness and irritability.

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