Chapter 28 Respiratory Care

Chapter 28  Respiratory Care

Complete Chapter Questions And Answers
 

Sample Questions

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____ 1. Which of the following mechanisms results in inhalation?
A.
The intercostal muscles relax.
B.
The ribs move inward.
C.
The diaphragm contracts.
D.
Pressure within the lungs raises above atmospheric pressure.

____ 2. The nurse is caring for a patient with a high blood level of carbon dioxide. The nurse would expect which of the following responses by the body’s respiratory system?
A.
The breathing rate increases.
B.
The breathing rate slows.
C.
The breathing rate will not be affected.
D.
The breathing stops.

____ 3. The nurse is caring for an African American individual with a long history of lung disease. The nurse would be most concerned if
A.
The patient’s respiratory rate is 22.
B.
The patient’s nailbeds are curved.
C.
The patient’s skin is warm and moist.
D.
The patient’s mucous membranes are ashen.

____ 4. The student nurse is providing care for a patient who becomes short of breath while ambulating to the bathroom. The best way for the student to document this finding is
A.
“Patient cyanotic with ambulation.”
B.
“Dyspnea noted after walking 15 feet.”
C.
“Patient complains that he can’t catch his breath.”
D.
“Hypoxemia present after walking to the bathroom.”

____ 5. While reviewing charts, a student nurse reads, “Patient resting in orthopneic position.” The student expects to find the patient
A.
Sitting on the side of the bed and leaning forward with arms across the bedside table.
B.
Lying on the left side with the head of the bed elevated to 45 degrees.
C.
Sitting in a chair with pillows under the knees and behind his or her head.
D.
Lying in the bed with his or her head and shoulder lower than the trunk of his or her body.

Chapter 28. Respiratory Care
Answer Section

MULTIPLE CHOICE

1. ANS: C

Feedback
A
The intercostal muscles relax during expiration.
B
The ribs move inward during expiration.
C
When the diaphragm contracts in response to stimulus from the phrenic nerves, it moves downward, which increases the size of the chest cavity, resulting in inspiration/inhalation. Chapter Objective: Explain the mechanics of inhalation and exhalation.
D
Pressure within the lungs raises above atmospheric pressure during expiration.

PTS: 1 REF: Chapter: 28 | Page: 612 OBJ: Chapter Objective: 28-2
KEY: Content Area: Alterations in Body Systems | Integrated Process: Nursing Process/Evaluation | Client Need: Physiological Adaptation | Cognitive Level: Knowledge

2. ANS: A

Feedback
A
When carbon dioxide increases above normal amounts, it causes the blood to become more acidic. The chemoreceptors respond by sending the message to the medulla, which, in turn, causes the respiratory rate to increase to “blow off” or remove excess carbon dioxide, returning the blood pH to normal levels. Chapter Objective: Describe chemical and nervous regulation of respirations.
B
The breathing rate will increase, not slow.
C
The breathing rate will increase.
D
The breathing rate will increase, not stop.

PTS: 1 REF: Chapter: 28 | Page: 613 OBJ: Chapter Objective: 28-3
KEY: Content Area: Alterations in Body Systems | Integrated Process: Nursing Process/Evaluation | Client Need: Physiological Adaptation | Cognitive Level: Analysis

3. ANS: D

Feedback
A
This is not the biggest concern.
B
Clubbing is often seen with long-term lung disease.
C
This is a normal finding.
D
When the patient has dark skin, the color may appear more ashen than cyanotic and the nurse will depend more on the color of the mucous membranes. The nurse should check the palms of the hands and soles of the feet for color changes as well. Safety: This is a late sign of hypoxia. The nurse should take action immediately and notify the health care provider stat. Chapter Objective: List inspection points in the assessment of a patient with impaired oxygenation.

PTS: 1 REF: Chapter: 28 | Page: 615 OBJ: Chapter Objective: 28-9
KEY: Content Area: Alterations in Body Systems | Integrated Process: Nursing Process/Implementation | Client Need: Physiological Adaptation | Cognitive Level: Application

4. ANS: B

Feedback
A
Cyanosis refers to skin discoloration.
B
When the patient is having difficulty moving air in and out of the lungs, it is referred to as dyspnea. Charting should be as specific as possible and use correct terminology. Chapter Objective: Define key terms associated with respiratory rate.
C
This is not specific.
D
Hypoxemia refers to decreased oxygenation and would require measurement of oxygen saturation to determine.

PTS: 1 REF: Chapter: 28 | Page: 615 OBJ: Chapter Objective: 28-1
KEY: Content Area: Alterations in Body Systems | Integrated Process: Communication and Documentation | Client Need: Physiological Adaptation | Cognitive Level: Application

5. ANS: A

Feedback
A
A patient with impaired oxygenation often assumes a position of sitting upright and leaning slightly forward with his or her arms and head over a table. This is the orthopneic position. Chapter Objective: Explain nursing interventions to use for patients with impaired oxygenation.
B
This position is not most conducive to breathing.
C
This position is not most conducive to breathing.
D
This position is not most conducive to breathing.

PTS: 1 REF: Chapter: 28 | Page: 615 OBJ: Chapter Objective: 28-12
KEY: Content Area: Alterations in Body Systems | Integrated Process: Nursing Process/Evaluation | Client Need: Physiological Adaptation | Cognitive Level: Analysis