Respiratory Disorders NCLEX Quiz
Respiratory Disorders NCLEX Practice Question.
The respiratory system functions primarily to maintain the exchange of oxygen and carbon dioxide in the lungs and tissues and to regulate acid-base balance. Any change in this system affects every other body system. Conversely, changes in other body systems may reduce the lungs’ ability to provide oxygen and eliminate carbon dioxide.
Following 10 Practice Questions are based on Respiratory Disorders.
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Respiratory Disorders NCLEX Quiz
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- Question 1 of 7
1. Question
A10-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?
CorrectAnswer: Option 2 is the correct answer.
Rationale: Asthma is a chronic inflammatory disease of the airways. Decreased wheezing in a child with asthma may be interpreted incorrectly as a positive sign when it may actually signal an inability to move air. A “silent chest” is an ominous sign during an asthma episode.With treatment, increased wheezing actually may signal that the child’s condition is improving. Warm, dry skin indicates an improvement in the child’s condition because the child is normally diaphoretic during exacerbation.
The normal pulse rate in a 10-year-old is 70 to 110 beats/ minute. The normal respiratory rate in a 10-year-old is 16 to 20 breaths/minute.
Test-Taking Strategy: Note the word worsening in the question. Options 3 and 4 can be eliminated because they are comparable or alike in that they are normal vital signs. From the remaining options, recall that a “silent chest” is an ominous sign during an asthma episode and indicates severe bronchial spasm or obstruction.IncorrectAnswer: Option 2 is the correct answer.
Rationale: Asthma is a chronic inflammatory disease of the airways. Decreased wheezing in a child with asthma may be interpreted incorrectly as a positive sign when it may actually signal an inability to move air. A “silent chest” is an ominous sign during an asthma episode.With treatment, increased wheezing actually may signal that the child’s condition is improving. Warm, dry skin indicates an improvement in the child’s condition because the child is normally diaphoretic during exacerbation.
The normal pulse rate in a 10-year-old is 70 to 110 beats/ minute. The normal respiratory rate in a 10-year-old is 16 to 20 breaths/minute.
Test-Taking Strategy: Note the word worsening in the question. Options 3 and 4 can be eliminated because they are comparable or alike in that they are normal vital signs. From the remaining options, recall that a “silent chest” is an ominous sign during an asthma episode and indicates severe bronchial spasm or obstruction. - Question 2 of 7
2. Question
A new parent expresses concern to the nurse regarding sudden infant death syndrome (SIDS). She asks the nurse how to position her new infant for sleep. In which position should the nurse tell the parent to place the infant?
CorrectAnswer: Option 4 is correct answer.
Rationale: SIDS is the unexpected death of an apparently healthy infant younger than 1 year for whom an investigation of the death and a thorough autopsy fail to show an adequate cause of death. Several theories are proposed regarding the cause, but the exact cause is unknown. Nurses should encourage parents to place the infant on the back (supine) for sleep. Infants in the prone position (on the stomach) may be unable to move their heads to the side, increasing the risk of suffocation. The infant may have the ability to turn to a prone position from the side-lying position.
Test-Taking Strategy: Eliminate options 1, 2, and 3 because they are comparable or alike. Remember that the infant needs to be placed on his or her back.
IncorrectAnswer: Option 4 is correct answer.
Rationale: SIDS is the unexpected death of an apparently healthy infant younger than 1 year for whom an investigation of the death and a thorough autopsy fail to show an adequate cause of death. Several theories are proposed regarding the cause, but the exact cause is unknown. Nurses should encourage parents to place the infant on the back (supine) for sleep. Infants in the prone position (on the stomach) may be unable to move their heads to the side, increasing the risk of suffocation. The infant may have the ability to turn to a prone position from the side-lying position.
Test-Taking Strategy: Eliminate options 1, 2, and 3 because they are comparable or alike. Remember that the infant needs to be placed on his or her back.
- Question 3 of 7
3. Question
The emergency department nurse is caring for a child diagnosed with epiglottitis. In assessing the child, the nurse should monitor for which indication that the child may be experiencing airway obstruction?
CorrectAnswer: Option 2 is the correct answer.
Rationale: Epiglottitis is a bacterial form of croup. A primary concern is that it can progress to acute respiratory distress. Clinical manifestations suggestive of airway obstruction include tripod positioning (leaning forward while supported by arms, chin thrust out, mouth open), nasal flaring, the use of accessory muscles for breathing, and the presence of stridor. Option 4 is an incorrect position.Options 1 and 3 are incorrect because epiglottitis causes tachycardia and a high fever.
Test-Taking Strategy: Focus on the subject, manifestations of airway obstruction in a child with epiglottitis. Eliminate option 1 first because tachycardia rather than bradycardiawould occur in a child experiencing respiratory distress. Eliminate option 3 next, knowing that a high fever occurs with epiglottitis. From the remaining options, visualize the descriptions in each and determine which position would best assist a child experiencing respiratory distress.
IncorrectAnswer: Option 2 is the correct answer.
Rationale: Epiglottitis is a bacterial form of croup. A primary concern is that it can progress to acute respiratory distress. Clinical manifestations suggestive of airway obstruction include tripod positioning (leaning forward while supported by arms, chin thrust out, mouth open), nasal flaring, the use of accessory muscles for breathing, and the presence of stridor. Option 4 is an incorrect position.Options 1 and 3 are incorrect because epiglottitis causes tachycardia and a high fever.
Test-Taking Strategy: Focus on the subject, manifestations of airway obstruction in a child with epiglottitis. Eliminate option 1 first because tachycardia rather than bradycardiawould occur in a child experiencing respiratory distress. Eliminate option 3 next, knowing that a high fever occurs with epiglottitis. From the remaining options, visualize the descriptions in each and determine which position would best assist a child experiencing respiratory distress.
- Question 4 of 7
4. Question
The clinic nurse reads the results of a tuberculin skin test (TST) on a 3-year-old child. The results indicate an area of induration measuring 10 mm. The nurse should interpret these results as which finding?
CorrectAnswer: Option 1 is the correct answer.
Rationale: Induration measuring 10 mm or more is considered to be a positive result in children younger than 4 years of age and in children with chronic illness or at high risk for exposure to tuberculosis. Areaction of 5 mm or more is considered to be a positive result for the highest risk groups, such as a child with an immunosuppressive condition or a child with human immunodeficiency virus (HIV) infection. A reaction of 15 mm or more is positive in children 4 years or older without any risk factors. Test-Taking Strategy: Options 3 and 4 are comparable or alike and can be eliminated first. From the remaining options, focus on the data in the question and note the child’s age to assist in directing you to the correct option.
IncorrectAnswer: Option 1 is the correct answer.
Rationale: Induration measuring 10 mm or more is considered to be a positive result in children younger than 4 years of age and in children with chronic illness or at high risk for exposure to tuberculosis. Areaction of 5 mm or more is considered to be a positive result for the highest risk groups, such as a child with an immunosuppressive condition or a child with human immunodeficiency virus (HIV) infection. A reaction of 15 mm or more is positive in children 4 years or older without any risk factors. Test-Taking Strategy: Options 3 and 4 are comparable or alike and can be eliminated first. From the remaining options, focus on the data in the question and note the child’s age to assist in directing you to the correct option.
- Question 5 of 7
5. Question
The mother of a hospitalized 2-year-old child with viral laryngotracheobronchitis (croup) asks the nurse why the health care provider did not prescribe antibiotics. Which response should the nurse make?
CorrectAnswer: Option 3 is the correct answer.
Rationale: Laryngotracheobronchitis (croup) is the inflammation of the larynx, trachea, and bronchi and is the most common type of croup. It can be viral or bacterial. Antibiotics are not indicated in the treatment of croup unless a bacterial infection is present. Options 1, 2, and 4 are incorrect. In addition, no supporting data in the question indicate that the child may be allergic to antibiotics.
Test-Taking Strategy: Focus on the subject, indications for the use of antibiotics. Eliminate option 1 because there are no supporting data in the question regarding the potential for allergies. Noting the word viral in the question and noting the age of the child will assist in eliminating options 2 and 4.
IncorrectAnswer: Option 3 is the correct answer.
Rationale: Laryngotracheobronchitis (croup) is the inflammation of the larynx, trachea, and bronchi and is the most common type of croup. It can be viral or bacterial. Antibiotics are not indicated in the treatment of croup unless a bacterial infection is present. Options 1, 2, and 4 are incorrect. In addition, no supporting data in the question indicate that the child may be allergic to antibiotics.
Test-Taking Strategy: Focus on the subject, indications for the use of antibiotics. Eliminate option 1 because there are no supporting data in the question regarding the potential for allergies. Noting the word viral in the question and noting the age of the child will assist in eliminating options 2 and 4.
- Question 6 of 7
6. Question
The nurse is caring for an infant with bronchiolitis, and diagnostic tests have confirmed respiratory syncytial virus (RSV). On the basis of this finding, which is the most appropriate nursing action?
CorrectAnswer: Option 2 is the correct answer.
Rationale: RSV is a highly communicable disorder and is not transmitted via the airborne route. The virus usually is transferred by the hands. Use of contact and standard precautions during care is necessary. Using good hand-washing technique and wearing gloves and gowns are also necessary.Masks are not required. An infant with RSV is isolated in a single room or placed in a room with another child with RSV. Enteric precautions are unnecessary.
Test-Taking Strategy: Note the strategic words, most appropriate. Focus on the subject, the method of transmission of RSV. Remember that the virus is not transmitted via the airborne route and is usually transferred by the hands. An infant with RSV is isolated in a single room or placed in a room with another child with RSV.
IncorrectAnswer: Option 2 is the correct answer.
Rationale: RSV is a highly communicable disorder and is not transmitted via the airborne route. The virus usually is transferred by the hands. Use of contact and standard precautions during care is necessary. Using good hand-washing technique and wearing gloves and gowns are also necessary.Masks are not required. An infant with RSV is isolated in a single room or placed in a room with another child with RSV. Enteric precautions are unnecessary.
Test-Taking Strategy: Note the strategic words, most appropriate. Focus on the subject, the method of transmission of RSV. Remember that the virus is not transmitted via the airborne route and is usually transferred by the hands. An infant with RSV is isolated in a single room or placed in a room with another child with RSV.
- Question 7 of 7
7. Question
The nurse is preparing for the admission of an infant with a diagnosis of bronchiolitis caused by respiratory syncytial virus (RSV). Which interventions should the nurse include in the plan of care?
CorrectAnswer: Option 1,6 are correct answer.
Rationale: RSV is a highly communicable disorder and is not transmitted via the airborne route. The virus usually is precautions during care (wearing gloves and a gown) reduces nosocomial transmission ofRSV.Amask is unnecessary. In addition, it is important to ensure that nurses caring for a child with RSV do not care for other high-risk children to prevent the transmission of the infection. An infant with RSVshould be isolated in a private room or in a room with another infant with RSV infection. The infant should be positioned with the head and chest at a 30- to 40-degree angle and the neck slightly extended to maintain an open airway and decrease pressure on the diaphragm. Cool humidified oxygen is delivered to relieve dyspnea, hypoxemia, and insensible water loss from tachypnea.
Test-Taking Strategy: Focus on the subject, care of the child with bronchiolitis and RSV. Recalling the mode of transmission of RSV will assist in answering correctly. Remember that RSV is highly communicable and is transmitted via contact such as by the hands.
IncorrectAnswer: Option 1,6 are correct answer.
Rationale: RSV is a highly communicable disorder and is not transmitted via the airborne route. The virus usually is precautions during care (wearing gloves and a gown) reduces nosocomial transmission ofRSV.Amask is unnecessary. In addition, it is important to ensure that nurses caring for a child with RSV do not care for other high-risk children to prevent the transmission of the infection. An infant with RSVshould be isolated in a private room or in a room with another infant with RSV infection. The infant should be positioned with the head and chest at a 30- to 40-degree angle and the neck slightly extended to maintain an open airway and decrease pressure on the diaphragm. Cool humidified oxygen is delivered to relieve dyspnea, hypoxemia, and insensible water loss from tachypnea.
Test-Taking Strategy: Focus on the subject, care of the child with bronchiolitis and RSV. Recalling the mode of transmission of RSV will assist in answering correctly. Remember that RSV is highly communicable and is transmitted via contact such as by the hands.
Respiratory Disirder includes the following.
- Tonsillitis
- Laryngitis
- Common coldBronchitis
- Pneumonia
- Pleurisy
- Emphysema
- Cystic fibrosis
- Asthma
- Lung cancer
The respiratory system consists of the airways, lungs, bony thorax, and respiratory muscles and functions in conjunction with the central nervous system (CNS).
Airways:
The airways are divided into the upper and lower airways. The upper airways include the nasopharynx (nose), oropharynx (mouth), laryngopharynx, and larynx. Their purpose is to warm, filter, and humidify inhaled air. They also help make sound and send air to the lower airways.
Lungs:
Each lung is wrapped in a lining called the visceral pleura. The larger of the two lungs, the right lung has three lobes: upper, middle, and lower. The smaller left lung has only an upper and a lower lobe.
Thorax:
The bony thorax includes the clavicles, sternum, scapula, 12 sets of ribs, and 12 thoracic vertebrae. You can use specific parts of the thorax, along with some imaginary vertical lines drawn on the Ribs are made of bone and cartilage and allow the chest to expand and contract during each breath. All ribs attach to the vertebrae.
The first seven ribs also attach directly to the sternum. The 8th, 9th, and 10th ribs attach to the costal cartilage of the ribs above. The 11th and 12th ribs are called floating ribs because they don’t attach to anything in the front.
Respiratory muscles:
The diaphragm and the external intercostal muscles are the primary muscles used in breathing. They contract when the patient inhales and relax when the patient exhales. The respiratory center in the medulla initiates each breath by sending messages to the primary respiratory muscles over the phrenic nerve. Impulses from
the phrenic nerve adjust the rate and depth of breathing, depending on the carbon dioxide and pH levels in the cerebrospinal fluid (CSF).