A nurse cares for a client who has developed esophagitis after undergoing radiation therapy for lung cancer. Which diet selection should the nurse provide for this client?

Omelet, soft whole wheat bread

The nurse is caring for a client with lung cancer who states, I dont want any pain medication because I am afraid Ill become addicted. How should the nurse respond?

It is unlikely you will become addicted when taking medicine for pain.

After teaching a client who is prescribed salmeterol (Serevent), the nurse assesses the clients understanding. Which statement by the client indicates a need for additional teaching?

I will use the drug when I have an asthma attack.

A nurse cares for a client with chronic obstructive pulmonary disease (COPD). The client states that he no longer enjoys going out with his friends. How should the nurse respond?

Share any thoughts and feelings that cause you to limit social activities.

A nurse is teaching a client who has cystic fibrosis (CF). Which statement should the nurse include in this clients teaching?

Eat a well-balanced, nutritious diet.

While assessing a client who is 12 hours postoperative after a thoracotomy for lung cancer, a nurse notices that the lower chest tube is dislodged. Which action should the nurse take first?

Cover the insertion site with sterile gauze.

A nurse assesses a client who is prescribed fluticasone (Flovent) and notes oral lesions. Which action should the nurse take?

Encourage oral rinsing after fluticasone administration.

A nurse cares for a client who is infected with Burkholderia cepacia. Which action should the nurse take first when admitting this client to a pulmonary care unit?

Keep the client isolated from other clients with cystic fibrosis.

A nurse cares for a client who had a chest tube placed 6 hours ago and refuses to take deep breaths because of the pain. Which action should the nurse take?

Administer pain medication and encourage the client to take deep breaths.

A nurse cares for a client who has a chest tube. When would this client be at highest risk for developing a pneumothorax?

When the tube becomes disconnected from the drainage system

A nurse cares for a client with a 40-year smoking history who is experiencing distended neck veins and dependent edema. Which physiologic process should the nurse correlate with this clients history and clinical manifestations?

Increased pulmonary pressure creating a higher workload on the right side of the heart

A nurse cares for a client with chronic obstructive pulmonary disease (COPD) who appears thin and disheveled. Which question should the nurse ask first?

Do you experience shortness of breath with basic activities?

The nurse is caring for a client who is prescribed a long-acting beta2 agonist. The client states, The medication is too expensive to use every day. I only use my inhaler when I have an attack. How should the nurse respond?

It is important to use this type of inhaler every day. Lets identify potential community services to help you.

A pulmonary nurse cares for clients who have chronic obstructive pulmonary disease (COPD). Which client should the nurse assess first?

A 52-year-old in a tripod position using accessory muscles to breathe

The nurse is teaching a client with chronic obstructive pulmonary disease who has been prescribed continuous oxygen therapy at home. Which statement indicates the client correctly understands the teaching?

I plan to use cotton balls to cushion the oxygen tubing on my ears.

A nurse cares for a client who has a pleural chest tube. Which action should the nurse take to ensure safe use of this equipment?

Keep padded clamps at the bedside for use if the drainage system is interrupted.

A nurse cares for a client who tests positive for alpha1-antitrypsin (AAT) deficiency. The client asks, What does this mean? How should the nurse respond?

Your risk for chronic obstructive pulmonary disease is higher, especially if you smoke.

A nurse cares for a female client who has a family history of cystic fibrosis. The client asks, Will my children have cystic fibrosis? How should the nurse respond?

Since you have a family history of cystic fibrosis, I would encourage you and your partner to be tested.

A nurse administers medications to a client who has asthma. Which medication classification is paired correctly with its physiologic response to the medication?

Cholinergic antagonist Causes bronchodilation by inhibiting the parasympathetic nervous system

A nurse auscultates a clients lung fields. Which pathophysiologic process should the nurse associate with this breath sound?
(Click the media button to hear the audio clip.)

Inflammation of the pleura

A nurse auscultates a clients lung fields. Which action should the nurse take based on the lung sounds? (Click the media button to hear the audio clip.)

Assess for airway obstruction.

The nurse instructs a client on the steps needed to obtain a peak expiratory flow rate. In which order should these steps occur?

4, 2, 1, 3, 5, 6, 7

The nurse instructs a client on how to correctly use an inhaler with a spacer. In which order should these steps occur?

4, 3, 5, 1, 2, 6

A nurse evaluates the following arterial blood gas and vital sign results for a client with chronic obstructive pulmonary disease (COPD):
Arterial Blood Gas Results Vital Signs
pH = 7.32

PaCO2 = 62 mm Hg
PaO2 = 46 mm Hg
HCO3 = 28 mEq/L Heart rate = 110 beats/min
Respiratory rate = 12 breaths/min
Blood pressure = 145/65 mm Hg
Oxygen saturation = 76%

Initiate oxygenation therapy to increase saturation to 92%.

A nurse assesses a client with asthma and notes bilateral wheezing, decreased pulse oxygen saturation, and suprasternal retraction on inhalation. Which actions should the nurse take? (Select all that apply.)
a. Administer prescribed salmeterol (Serevent) inhaler.

Administer oxygen to keep saturations greater than 94%.

Administer prescribed albuterol (Proventil) inhaler.

A nurse assesses a client who has a mediastinal chest tube. Which symptoms require the nurses immediate intervention? (Select all that apply.)

Tracheal deviation

Sudden onset of shortness of breath

Drainage greater than 70 mL/hr
Disconnection at Y site

A nurse teaches a client who has chronic obstructive pulmonary disease. Which statements related to nutrition should the nurse include in this clients teaching? (Select all that apply.)

Avoid drinking fluids just before and during meals.

Rest before meals if you have dyspnea.

Have about six small meals a day.

A nurse assesses a client with chronic obstructive pulmonary disease. Which questions should the nurse ask to determine the clients activity tolerance? (Select all that apply.)

Do you have any difficulty sleeping?

How long does it take to perform your morning routine?

Have you lost any weight lately?

A nurse assesses a client who has a chest tube. For which manifestations should the nurse immediately intervene? (Select all that apply.)

Tracheal deviation

Sudden onset of shortness of breath

A nurse plans care for a client who has chronic obstructive pulmonary disease and thick, tenacious secretions. Which interventions should the nurse include in this clients plan of care? (Select all that apply.)

Ask the client to drink 2 liters of fluids daily.
Add humidity to the prescribed oxygen.

Use a vibrating positive expiratory pressure device.

A nurse cares for a client who is prescribed an intravenous prostacyclin agent. Which actions should the nurse take to ensure the clients safety while on this medication? (Select all that apply.)

Keep an intravenous line dedicated strictly to the infusion.

Ensure that there is always a backup drug cassette available.

Use strict aseptic technique when using the drug delivery system.