Question

Hello. Please help with these questions. I tried but I'm getting no answer. Thanks

Question 1

How do you select the appropriate size airway when inserting an oropharyngeal airway?

1. Measure from corner of mouth to corner of ear tragus
2. Measure from the center of the lips to the front of the ear
3. There is no need to measure for placing an oropharyngeal airway
4. Measure from the tip of the nose to the top of the trachea

Question 2

Pursed-lip breathing creates a resistance to air flowing out of the lungs, increasing pressure within the bronchi and minimizing collapse of smaller airways.

True

False

Question 3

Which is most effective for maintaining a patent airway?

1. Incentive spirometry
2. Nebulizer treatments
3. Abdominal breathing
4. Active coughing

Question 4

The nurse is preparing to suction a patient. The nurse should plan to limit the suctioning time to a maximum of which time?

1. 10 seconds
2. 5 seconds
3. 1 minute
4. 30 seconds

Question 5

The nurse observes a client use an incentive spirometer. Which action indicates that the client would benefit from additional instruction about the use of the device?

1. Takes a brisk low-volume breath
2. Exhales normally
3. Seals lips around the mouthpiece
4. The client should exhale normally. This is correct procedure.

Question 6

After connecting a sterile suction catheter to the suction tubing in preparation for performing nasopharyngeal suctioning, the sterile catheter tip accidentally touches the client’s chin. What should the nurse do first?

1. Dip the tip in sterile water
2. Hyperoxygenate the client
3. Obtain another sterile catheter
4. Relubricate the tip

Question 7

The nurse auscultates a client’ breath sounds. Which sounds should the nurse report to the healthcare provider?

1. Low-pitched, continuous snoring heard over the trachea
2. Moderate-pitched blowing sounds heard between the scapulae
3. Soft, low-pitched sounds heard at the lung bases
4. High-pitched loud sounds heard over the trachea

Question 8

The nurse in reinforcing instructions to a hospitalized client with a diagnosis of emphysema about positions that will enhance the effectiveness of breathing during dyspneic episodes. Which position should the nurse instruct the client to assume?

1. Sitting in a recliner chair
2. Side-lying in bed
3. Sitting up in bed at a 90-degree angle
4. Sitting on the side of the bed, leaning on an overbed table

Question 9

A client with a diagnosis of asthma is admitted to the hospital with respiratory distress. Which type of adventitious lung sounds should the nurse expect to note documented in the health record when collecting data related to the respiratory system for this client?

1. Diminished
2. Wheezes
3. Pleural friction rub
4. Stridor

Question 10

Which goal is written correctly for the nursing diagnosis of activity intolerance related to imbalance between oxygen supply and demand?

1. Patient will walk 1 mile without shortness of breath.
2. Patient will ambulate 100 feet with no shortness of breath on third day after treatment.
3. Patient will climb stairs without shortness of breath by day 2 of hospital stay
4. Patient will tolerate activity.

Answer 1

Answer: Measure from corner of mouth to corner of ear tragus.

( The size is measured from the end of the mouth to the ear lobe or tragus.)

Answer: True

( Pursed-lip breathing increases pressure within the bronchi and minimizing collapse of smaller airways.)

Answer: Nebulizer treatments

( In the case of providing oxygen, it is important to provide nebulizer that directly enable patient to inhale oxygen.)

Answer: 10 seconds.

( The nurse plan to limit the suctioning time to a maximum of 10seconds)