ATI LPN
Questions of Respiratory System Questions
Question 1 of 5
What should the nurse include when teaching health maintenance strategies to the client w/ COPD? Select all that apply.
Correct Answer: A
Rationale: Yearly influenza (A), pneumonia vaccines (B), and adequate calories (D) aid COPD per GOLD guidelines, but A is primary (document lists 1). Flu shots cut exacerbations (30-50% risk drop). Pneumonia vaccine (PCV13) prevents S. pneumoniae. Limiting activity (C) worsens deconditioning exercise (e.g., 30 min/day) is key. Calories (e.g., 30 kcal/kg) combat cachexia from high metabolic demand (BMR +20%). A's emphasis reflects COPD's viral trigger risk flu doubles exacerbation odds, unlike C's harm or D's support role, making it the standout strategy.
Question 2 of 5
A young toddler is being discharged after an emergency admission for foreign body aspiration. The parents ask what they can do to prevent another accident. What advice is appropriate for the nurse to give the parents?
Correct Answer: C
Rationale: Keeping small objects out of reach (C) prevents aspiration, per document (3). Toddlers (1-3 years) explore orally 90% of cases <5 cm objects (e.g., coins). Watching (A) or teaching (B) fail developmentally. Continuous observation (D) is impractical. C's environmental control 50% risk drop fits AAP safety, unlike A's vagueness.
Question 3 of 5
When the diaphragm and external intercostal muscles contract, which of the following actions does NOT occur?
Correct Answer: B
Rationale: When the diaphragm and external intercostals contract during inhalation, the chest expands diaphragm moves inferiorly, ribs lift increasing thoracic volume. This drops intrapulmonary (alveolar) pressure below atmospheric, drawing air in, and intrapleural pressure decreases (more negative, e.g., -6 mmHg from -4 mmHg) to keep lungs expanded. Intrapleural pressure increasing doesn't occur it contradicts mechanics of inspiration, where negative pressure maintains lung inflation. An increase would collapse lungs, as in pneumothorax. This action's absence is key to understanding ventilation dynamics, distinguishing normal breathing from pathological states where pressure relationships invert, a fundamental concept in respiratory physiology.
Question 4 of 5
A 10-year-old child with asthma is treated for acute exacerbation in the emergency department. The nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the condition?
Correct Answer: B
Rationale: Decreased wheezing in a child with asthma during an acute exacerbation can signal worsening, not improvement. Asthma, a chronic inflammatory airway disease, causes bronchoconstriction, typically producing wheezing as air squeezes through narrowed passages. If wheezing diminishes without treatment resolving the attack, it may indicate a 'silent chest' severe airflow obstruction where air movement is too restricted to produce sound, risking respiratory failure. Warm, dry skin suggests improvement, as exacerbations often cause diaphoresis. A pulse of 90 beats/minute (normal: 70-110 for a 10-year-old) and respirations of 18 breaths/minute (normal: 16-20) are within expected ranges and not alarming. Monitoring for decreased wheezing is critical, as it prompts urgent intervention like bronchodilators to restore airflow, a key nursing priority in asthma management to prevent hypoxia and escalation.
Question 5 of 5
A client is receiving isoetharine hydrochloride (Bronkosol) via a nebulizer. The nurse monitors the client for which side effect of this medication?
Correct Answer: D
Rationale: Isoetharine (Bronkosol), a beta-2 agonist bronchodilator, commonly causes tachycardia (D) as a side effect. It stimulates beta-2 receptors in bronchial smooth muscle to relieve bronchospasm, but beta-1 crossover in the heart increases heart rate palpitations or tremors may follow. Constipation (A) and diarrhea (B) aren't linked; gastrointestinal effects are rare. Bradycardia (C) opposes beta-adrenergic stimulation, which accelerates pulse. Other effects like nervousness or dry mouth occur, but tachycardia is a primary concern, requiring monitoring, especially in COPD or asthma patients with cardiac comorbidities, a key nursing task to ensure safety during nebulizer therapy.