Question

28. A nurse is assisting a physician to remove a chest tube. The nurse should instruct the client to A. Exhale slowly C. stay very still B. Inhale and exhale quickly D. perform the valsava maneuvevr 29. While changing the taping of a tracheostomy tube, the male client coughs and the tube dislodges. The initial action is to A. Call the physician to reinsert the tube B. Call the respiratory therapy department to reinsert the tracheostomy C. Cover the tracheostomy site with a sterile dressing to prevent infection D. Grasp the retention suture to spread the opening 30. When assessing a patient who has sustained a blunt injury to the chest wall, which of the following signs would indicate the present of a pneumothorax in the client? A. A low respiratory rate C. Diminished breath sounds B. A sucking sound at the site of injury D. presence of barrel sounds 31. A nurse is caring for a male client with emphysema who is receiving oxygen. The nurse assesses the oxygen flow rate to ensure that it does not exceed? A, IL/min C.6L/min C.2L/min D. 10L/min 32. The nurse is caring for a patient after bronchoscopy and biopsy. Which of the following signs, if noticed shold be reported immediately to the physician A Blood-streaked sputum C. Dry cough B. Bronchospasm D. Haematuria 33. A nurse is suctioning fluid from a mle client via a tracheostomy tube. When suctioning, the nurse must limit the suctioning time to a maximum of A. 1 minute C. 10 seconds B. 5 seconds D. 30 seconds 34. When suctioning fluids from a female client with an endotracheal tube, the nurse notes on the monitor that the heart rate is decreasing. Which of the following inteventions would be appropriate A. Continue to suction B. Ensure that the suction is limited to 15seconds C. Notify the physician immediately D.D. stop the procedure and reoxygenate the client 35. Which phrase is used to describe the volume of air inspired and expired with a normal breath? A. Forced vital capacity C. Tidal volume B. Residual volume D. Total lung capacity 36. A male client abruptly sits up in bed, reports having difficulty in breathin and has an arterial oxygen saturation of 88%. Which mode of oxygen delivery would most likely reverse the manifestation? A. Face tent C. Non-rebreather mask B. Nasal cannula D. Simple mask

Answer 1

28. A chest tube is inserted in many lung pathologies to drain excess fluid accumulated in pleural cavity.
When removing the chest tube, the nurse should ask the patient to perform valsava maneuver i.e. inhale and then exhale forcefully. This prevents pneumothorax.
All other options given are wrong instructions and can result in complications while removing chest tube.
Answer : option D.
29. When the tube gets dislodged the patient may find difficulty in breathing and the situation demands emergency response.
Calling the physician or respiratory therapist will delay the treatment, this options A and B are incorrect.
If the tracheostomy opening is covered by sterile dressing it will block the airway resulting in difficulty breathing. So option C is incorrect.
Grasping the retention suture to spread the opening will help in patient to breath easily. This is the correct option.
Answer : option D

30. Pneumothorax is the filling of air in the pleural cavity. Presence of air around the lungs causes reduced breath sounds.
Answer : option B.
31.  In Emphysema patient, the oxygen should be administered carefully. In emphysema long standing hypercapnia occurs and respiratory drive is stimulated in response to low oxygen levels instead of hogh CO2 levels.
The oxygen flow rate should not exceed over 2L/ min.
Answer : option C