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NURS 302: EXAM 3 QUESTIONS WITH
COMPLEETE SOLUTIONS
The patient with HIV is admitted to the hospital with a temperature of 99.6F, and reports bloody sputum, night sweats, feeling of tiredness, and shortness of breath. What are these assessment findings consistent with? correct answer: Tuberculosis Which statement about the transmission of TB is true? correct answer: The causative agent of TB is transmitted via aerosolization (airborne). Which patient is at the greatest risk for developing TB? correct answer: 42-year-old alcoholic homeless man who occasionally stays in a shelter. The most substantial impact of incidence of TB is from which high-risk population? correct answer: Those with immune dysfunction, particularly HIV. After several weeks of "not feeling well," the patient is seen in the physician's office for possible TB. If TB is present, which assessment findings does the nurse expect to observe? correct answer: Fatigue, night sweats, low- grade fever
Which test result indicates the patient has clinically active TB? correct answer: Induration of 12mm and positive sputum The patient has a positive skin test result for TB. What explanation does the nurse give to the patient? correct answer: "You have been infected but this does not mean active disease is present." What is the minimum time period for treatment of TB? correct answer: 6 months The patient has been compliant with drug therapy for TB and has returned as instructed for follow-up. Which result indicates that the patient is no longer infectious/communicable? correct answer: 3 negative sputum cultures The patient has an HIV infection, but the TB skin test shows an induration of less that 10mm and clinical symptoms of TB are present. Which medication does the patient receive for a period of 12 months to prevent TB? correct answer: Isoniazid (INH) The nurse is teaching the patient about the combination drug therapy that is used in the treatment of TB. Which patient statement indicates the nurse's
respiratory? correct answer: Asthma manifests as acute episodes of reversible airway distress The pt with chronic bronchitis often shows signs of hypoxia. Which clinical manifestation is the priority to look out for in this pt? correct answer: Large amounts of thick mucus The RN is taking a history for the pt with chronic pulmonary disease. The pt reports often sleeping in a chair that allows his head to be elevated rather than going to bed. The pt's behavior is a strategy to deal with which condition? correct answer: Orthopnea The patient has chronic bronchitis. The nurse plans interventions for impaired gas exchange based on which set of clinical manifestations? correct answer: Large amount of thick secretions and repeated infection The patient has COPD with chronic difficult breathing. In planning this patient's care, what condition must the nurse acknowledge is present in this patient? correct answer: Increased metabolism and the need for additional calories and protein supplements. In obtaining a history for the patient with chronic airflow limitation, which risk factor is not related to potentially causing or triggering the disease process? correct answer: Smokeless tobacco
Which statement is true about the relationship of smoking cessation to the pathophysiology of COPD? correct answer: Smoking cessation slows the rate of disease progression The patient has a history of COPD but is admitted for a surgical procedure that is unrelated to the respiratory system. Nevertheless, to prevent any complications related to the patient's COPD, what does the nurse do? correct answer: Monitor for signs and symptoms of pneumonia The nurse is instructing the patient regarding complications of COPD. Which statement by the patient indicated the need for additional teaching? correct answer: "My COPD is serious, but it can be reversed if I follow my doctor's orders." What is the pulmonary function testing (PFT)? correct answer: Distinguishes airway disease from restrictive lung disease Why is a high-liter flow of oxygen contraindicated in the pt with COPD? correct answer: The pt depends on a hypoxic drive to breathe In assisting the pt with chronic airway limitation to relieve dyspnea, which sitting position offers the pt no benefit? correct answer: In a low semi-reclining position with the shoulders back and the knees apart
A family member of the patient with COPD asks the nurse, "What is the purpose of making him cough on a routine basis?" What is the nurse's best response? correct answer: "It improves air exchange by increasing airflow in the larger airways." The patient has COPD and develops cor pulmonale. Which assessment finding does the nurse expect to observe with the condition? correct answer: Fatigue The patient has returned several times to the clinic for respiratory problems. Which action does the nurse preform first? correct answer: Obtain a history of the patient's previous respiratory problems and response to therapy. The nurse is working for a manufacturing company and is responsible for routine employee health issue. Which primary prevention is most important for those employees at high risk for occupational pulmonary disease? correct answer: Advise employees not to smoke and to use mask and ventilation equipment. The nurse has determined that the patient with COPD has a nursing diagnosis of impaired gas exchange related to reduced airway size, ventilator muscle fatigue and excessive mucous production. Which action is the best to delegate to the nursing assistant? correct answer: Report a respiratory rate of greater than 24/min at rest or 30/min after ambulating to the nurse's station.
If a pt has COPD would they be in respiratory alkalosis or acidosis? correct answer: respiratory acidosis Which blood pH value is within normal limits? correct answer: 7.37 (normal range: 7.35-7.45) May occur as result of anxiety correct answer: Respiratory alkalosis Results from bicarbonate loss correct answer: Metabolic acidosis Caused by hypoventilation correct answer: Respiratory acidosis May be a result of blood transfusions correct answer: Metabolic alkalosis May be caused by diarrhea correct answer: Metabolic acidosis Associated with Kussmaul respirations correct answer: Metabolic acidosis Associated with ingestion of antacids correct answer: Metabolic alkalosis Results in hypocalcemia correct answer: Respiratory and Metabolic alkalosis Compensation occurs through renal reabsorption of bicarbonate correct answer: Respiratory acidosis
