Adult Health II Respiratory NCLEX Questions
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Question 1 of 5.
A client uses a metered-dose inhaler (MDI) to aid in management of his asthma. Which action by the client indicates to the nurse that he needs further instruction regarding its use? Select all that apply.
A. Activation of the MDI is not coordinated with inspiration.
B. The client inspires rapidly when using the MDI.
C. The client holds his breath for 3 seconds after inhaling with the MDI.
D. The client shakes the MDI after use.
E. The client performs puffs in rapid succession.
Explanation: Incorrect MDI use includes not coordinating activation with inspiration (A), rapid inspiration (B), holding breath for only 3 seconds (C; should be 10 seconds), and rapid successive puffs (E; wait 1 minute between puffs). Shaking after use (D) is incorrect but less critical.
Question 2 of 5.
When administering a thrombolytic drug to the client experiencing a myocardial infarction (MI), the nurse explains that the purpose of the drug is to:
A. Help keep him well hydrated.
B. Dissolve clots that he may have.
C. Prevent kidney failure.
D. Treat potential cardiac arrhythmias.
Explanation: Thrombolytic drugs dissolve clots in coronary arteries, restoring blood flow to the myocardium during an MI, reducing infarct size and improving outcomes.
Question 3 of 5.
Alteplase recombinant, or tissue plasminogen activator (t-PA), is administered during the first 6 hours after onset of myocardial infarction (MI) to:
A. Control chest pain.
B. Reduce coronary artery vasospasm.
C. Control the arrhythmias associated with MI.
D. Revascularize the blocked coronary artery.
Explanation: t-PA dissolves clots in the coronary artery, restoring blood flow (revascularization) to the ischemic myocardium, critical within the first 6 hours of MI.
Question 4 of 5.
As an initial step in treating a client with angina, the physician prescribes nitroglycerin tablets, 0.3 mg given sublingually. This drug's principal effects are produced by:
A. Antispasmodic effects on the pericardium.
B. Causing an increased myocardial oxygen demand.
C. Vasodilation of peripheral vasculature.
D. Improved conductivity in the myocardium.
Explanation: Nitroglycerin causes vasodilation of peripheral and coronary vasculature, reducing preload and myocardial oxygen demand, relieving angina.
Question 5 of 5.
When teaching a client with heart failure about preventing complications and future hospitalizations, which problems stated by the client as reasons to call the physician would indicate to the nurse that the client has understood the teaching? Select all that apply.
A. Becoming increasingly short of breath at rest.
B. Weight gain of 2 lb or more in 1 day.
C. High intake of sodium for breakfast.
D. Having to sleep sitting up in a reclining chair.
E. Weight loss of 2 lb in 1 day.
Explanation: Shortness of breath at rest (A), weight gain of 2 lb or more in 1 day (B), and sleeping sitting up (D) indicate worsening heart failure, requiring physician notification.
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