ATI RN
Questions of Respiratory System Questions
Question 1 of 5
A client with pneumonia has a fever of 101.4° F (38.6° C) a nonproductive cough and an O2 saturation of 88%. The client is weak and needs assistance to get out of bed. Which client problem should the nurse assign as the priority?
Correct Answer: D
Rationale: The correct answer is D, Impaired gas exchange. This is the priority because the client's O2 saturation of 88% indicates poor oxygenation, which can lead to serious complications like hypoxemia. The fever and nonproductive cough are symptoms of pneumonia contributing to impaired gas exchange. Addressing this issue is crucial to prevent respiratory distress. A: Fatigue - While important, fatigue is a secondary concern compared to impaired gas exchange, which directly affects oxygenation and can be life-threatening. B: Hyperthermia - The client's fever is likely related to the pneumonia but managing impaired gas exchange takes precedence as it directly impacts oxygen delivery to tissues. C: Impaired mobility - While assisting the client out of bed is necessary, the priority is to address the underlying problem of impaired gas exchange to prevent respiratory compromise.
Question 2 of 5
The organ of the respiratory system that is kept open by rings of cartilage is the:
Correct Answer: D
Rationale: The correct answer is D: trachea. The trachea is kept open by rings of cartilage to prevent collapse during inhalation. The nose (A) is primarily involved in filtering, warming, and moistening air. The pharynx (B) is a common pathway for both air and food. The larynx (C) houses the vocal cords and aids in sound production but does not have cartilage rings to keep it open.
Question 3 of 5
An emergency room nurse is assessing a male client who has sustained a blunt injury to the chest wall. Which of these signs would indicate the presence of a pneumothorax in this client?
Correct Answer: B
Rationale: The correct answer is B: Diminished breath sounds. In the case of a pneumothorax, air leaks into the pleural space, causing the lung to collapse partially. This results in diminished or absent breath sounds on the affected side. A low respiratory rate (A) is a general sign of respiratory distress but not specific to pneumothorax. The presence of a barrel chest (C) is associated with conditions like chronic obstructive pulmonary disease (COPD) but not indicative of a pneumothorax. A sucking sound at the site of injury (D) is characteristic of an open pneumothorax, not necessarily present in all cases of pneumothorax.
Question 4 of 5
A female client is undergoing a complete physical examination as a requirement for college. When checking the client's respiratory status, the nurse observes respiratory excursion to help assess:
Correct Answer: D
Rationale: The correct answer is D: Chest movements. When checking respiratory status, observing chest movements, known as respiratory excursion, helps assess the depth and symmetry of breathing. This provides valuable information about lung expansion and function. Lung vibrations (A) are assessed by tactile fremitus, vocal sounds (B) by auscultating for voice sounds, and breath sounds (C) by listening for air movement in the lungs. However, these do not directly assess respiratory excursion.
Question 5 of 5
A patient with a history of smoking two packs of cigarettes a day for the past 20 years says that he is not alarmed by his cough. He says, "I get this cough and spit up mucus every winter." The nurse recognizes these symptoms as being suggestive of:
Correct Answer: A
Rationale: The correct answer is A: Chronic bronchitis. The patient's history of smoking for 20 years and persistent cough with mucus production every winter are indicative of chronic bronchitis. Chronic bronchitis is characterized by inflammation of the bronchial tubes due to irritants like smoking, leading to excessive mucus production and persistent cough. Emphysema is characterized by destruction of lung tissue, not necessarily accompanied by mucus production. Sarcoidosis is a systemic inflammatory disease affecting multiple organs, not specifically related to the symptoms described. Diffuse interstitial fibrosis involves scarring of lung tissue, typically presenting with a dry, non-productive cough.