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CHAPTER 25: ASSESSMENT OF RESPIRATORY SYSTEM LEWIS: MEDICAL-SURGICAL NURSING, 10TH EDITION QUESTIONS AND ANSWERS WITH SOLUTIONS 2024 $12.49   Add to cart
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CHAPTER 25: ASSESSMENT OF RESPIRATORY SYSTEM LEWIS: MEDICAL-SURGICAL NURSING, 10TH EDITION QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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CHAPTER 25: ASSESSMENT OF RESPIRATORY SYSTEM LEWIS: MEDICAL-SURGICAL NURSING, 10TH EDITION QUESTIONS AND ANSWERS WITH SOLUTIONS 2024

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  • August 31, 2024
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CHAPTER 25: ASSESSMENT OF
RESPIRATORY SYSTEM LEWIS:
MEDICAL-SURGICAL NURSING, 10TH
EDITION QUESTIONS AND ANSWERS
WITH SOLUTIONS 2024
A patient with acute shortness of breath is admitted to the hospital. Which action should the nurse take
during the initial assessment of the patient?

a. Ask the patient to lie down to complete a full physical assessment.

b. Briefly ask specific questions about this episode of respiratory distress.

c. Complete the admission database to check for allergies before treatment.

d. Delay the physical assessment to first complete pulmonary function tests. - ANSWER b. Briefly ask
specific questions about this episode of respiratory distress.



The nurse prepares a patient with a *left-sided pleural effusion* for a *thoracentesis*. How should the
nurse position the patient?

a. High-Fowler's position with the left arm extended

b. Supine with the head of the bed elevated 30 degrees

c. On the right side with the left arm extended above the head

d. Sitting upright with the arms supported on an over bed table - ANSWER d. Sitting upright with the
arms supported on an over bed table



The upright position with the arms supported increases lung expansion, allows fluid to collect at the lung
bases, and expands the intercostal space so that access to the pleural space is easier. The other positions
would increase the work of breathing for the patient and make it more difficult for the health care
provider performing the thoracentesis.



A diabetic patient's arterial blood gas (ABG) results are *pH 7.28*; PaCO2 34 mm Hg; PaO2 85 mm Hg;
*HCO3- 18* mEq/L. The nurse would expect which finding?

a. Intercostal retractions

c. Low oxygen saturation (SpO2)

, b. Kussmaul respirations

d. Decreased venous O2 pressure - ANSWER b. Kussmaul respirations



Kussmaul (deep and rapid) respirations are a compensatory mechanism for metabolic acidosis.



The *low pH and low bicarbonate* result indicate *metabolic acidosis*.



Intercostal retractions, a low oxygen saturation rate, and a decrease in venous O2 pressure would not be
caused by acidosis.



On auscultation of a patient's lungs, the nurse hears *low-pitched, bubbling sounds* during inhalation in
the *lower third of both lungs*. How should the nurse document this finding?

a. Inspiratory crackles at the bases

b. Expiratory wheezes in both lungs

c. Abnormal lung sounds in the apices of both lungs

d. Pleural friction rub in the right and left lower lobes - ANSWER a. Inspiratory crackles at the bases



*Crackles* are *low-pitched, bubbling sounds* usually heard on inspiration.



*Wheezes* are *high-pitched* sounds.

They can be heard during the expiratory or inspiratory phase of the respiratory cycle.



The lower third of both lungs are the bases, not apices.



*Pleural friction rubs* are *grating sounds* that are usually heard during both inspiration and
expiration.



The nurse palpates the posterior chest while the patient says "99" and notes absent fremitus
(=vibration). Which action should the nurse take NEXT?

a. Palpate the anterior chest and observe for barrel chest.

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