Breathe In, Breathe Out
During a respiratory assessment, the nurse notes unequal chest expansion. Which finding is most likely responsible?
What is pneumothorax or atelectasis? – Unequal expansion indicates one lung isn’t inflating properly due to collapse or obstruction.
Which oxygen delivery device provides the lowest concentration of oxygen and allows the patient to eat and talk while wearing it?
What is a nasal cannula? – Delivers 1–6 L/min of oxygen (24–44% FiO₂) and is comfortable for long-term use.
A patient with asthma develops wheezing and shortness of breath after exercise. Which pathophysiologic change causes this
What is bronchoconstriction triggered by airway hyperreactivity? – Exercise-induced asthma causes smooth muscle constriction and airway narrowing.
What type of isolation is required for a patient with suspected tuberculosis (TB)?
What is airborne isolation? – Requires a negative-pressure room, N95 respirator, and closed door at all times
What is the nurse’s first action when a patient suddenly becomes short of breath?
What is assess the airway and check oxygen saturation? – Always assess before intervening; airway is the top priority in all respiratory distress.
Which breath sound is characterized by high-pitched, continuous musical tones heard mainly during expiration?
What are wheezes? – Caused by air passing through narrowed airways, commonly heard in asthma or COPD.
Which oxygen delivery system provides precise oxygen concentration and is commonly used for COPD patients?
What is a Venturi mask? – Delivers controlled FiO₂ (24–50%) using interchangeable color-coded adapters.
A nurse recognizes that thick mucus plugs and Curschmann spirals in the airways are characteristic of what condition?
What is chronic asthma? – Chronic inflammation leads to mucus hypersecretion and airway remodeling.
A patient is newly diagnosed with TB. Which statement by the patient indicates the need for further teaching?
What is “I can stop taking my medication once I feel better”? – TB treatment lasts 6–12 months; stopping early can cause drug resistance.
A nurse is preparing to suction a patient with a tracheostomy. Which nursing action ensures safety during the procedure?
What is pre-oxygenate the patient with 100% oxygen before suctioning? – Prevents hypoxemia and maintains oxygenation.
Which diagnostic test evaluates arterial oxygenation and ventilation by analyzing blood pH, PaCO₂, and PaO₂ levels?
What is an arterial blood gas (ABG)? – ABGs assess gas exchange and acid-base balance in respiratory disorders
A nurse notes condensation in the tubing of a patient’s humidified oxygen system. What is the appropriate action?
What is drain the condensation away from the patient? – Prevents aspiration and maintains consistent oxygen flow.
In COPD, what chronic structural change leads to air trapping and hyperinflation?
What is loss of alveolar elasticity and destruction of alveolar walls? – Seen in emphysema; impairs expiratory airflow and gas exchange.
Which test confirms the diagnosis of active tuberculosis?
What is a sputum culture for Mycobacterium tuberculosis? – The culture is definitive; chest x-ray and skin test are screening tools only.
The nurse is caring for a patient on a mechanical ventilator. The high-pressure alarm sounds. What should the nurse check first?
What is assess for kinks, secretions, or biting of the tube? – Obstruction increases airway pressure; always assess before adjusting settings.
The nurse hears coarse crackles at the lung bases during auscultation. What does this finding most likely indicate?
What is fluid in the airways or alveoli (e.g., pneumonia or heart failure)? – Crackles result from air moving through fluid-filled spaces.
What is the maximum flow rate for a simple face mask before the patient risks rebreathing CO₂?
What is 5 L/min? – Flow must be at least 5 L/min to flush exhaled CO₂ from the mask.
A patient with pneumonia reports productive cough and pleuritic chest pain. What key finding helps confirm this diagnosis?
What are crackles, dullness on percussion, and chest x-ray infiltrates? – These findings confirm fluid and consolidation in the lungs.
A nurse obtains a tuberculin skin test result showing 12 mm induration. The patient is HIV-positive. How should this be interpreted?
What is a positive result? – ≥5 mm induration is considered positive in immunocompromised individuals.
A nurse is teaching about preventing hospital-acquired pneumonia in immobile patients. Which intervention is most effective?
What is encourage coughing, deep breathing, and repositioning every 2 hours? – Promotes lung expansion and secretion clearance.
During percussion of the chest, the nurse notes hyperresonance. This sound is consistent with which condition?
What is emphysema or pneumothorax? – Hyperresonance occurs when the lungs are overinflated or contain trapped air.
A patient on 100% non-rebreather mask suddenly shows decreased O₂ saturation. What is the nurse’s first action?
What is check that the reservoir bag is inflated and valves are functioning? – A collapsed bag or faulty valve reduces oxygen delivery.
A COPD patient’s oxygen saturation drops from 92% to 86% on 6 L nasal cannula. What is the nurse’s priority action?
What is assess the patient’s respiratory effort and consider reducing oxygen flow? – Excess O₂ can suppress hypoxic drive in CO₂ retainers; assess before adjusting therapy.
Which medication combination is typically used for initial TB treatment?
What is isoniazid, rifampin, pyrazinamide, and ethambutol (RIPE)? – Multi-drug therapy prevents resistance and ensures full eradication.
A patient receiving oxygen via nasal cannula reports dryness and nosebleeds. What should the nurse do?
What is add humidification to the oxygen delivery system? – Prevents mucosal irritation while maintaining oxygen therapy effectiveness.