NURSING 1102 Med Surg HESI EXAM

NURSING 1102 Med Surg HESI EXAM

• The nurse is reviewing the arterial blood gas results for a patient with a respiratory

disorder. What should the nurse recognize as being the most important chemical regulator of respiration?

• The blood level of oxygen
• The blood level of nitrogen
• The blood level of carbon dioxide
• The amount of hemoglobin in red blood cells
• The nurse is reviewing the results of a patients pulmonary function tests. Which

result describes the air remaining in lungs after normal expiration?

• Tidal volume
• Expiratory reserve
• Forced vital capacity
• Functional residual capacity
• The nurse is reviewing the exchange of gases in the blood stream with a patient

prescribed oxygen therapy. How should the nurse explain the transport of carbon dioxide in the blood?

• As CO2 in plasma
• As bicarbonate ions in plasma
• As hydrogen ions in red blood cells
• As part of hemoglobin in red blood cells
• A patient is having problems with oxygenation of body tissues. What is important

for the nurse to consider about the transport of oxygen in the blood?

• It is in blood plasma as free oxygen.
• It travels on red blood cell membranes.
• It is bonded to hemoglobin in blood plasma. d. It is

bonded to hemoglobin in red blood cells.

• The nurse is reviewing the physiology of the respiratory system with a patient being

treated for pneumonia. What structure should the nurse identify as sweeping mucus and pathogens from the nasal cavities and trachea to the pharynx?

• Ciliated epithelium
• Alveolar macrophages
• Elastic connective tissue
• Simple squamous epithelium
• The nurse is coaching a patient to empty the lungs of all air before using a metered-

dose inhaler. What air that is expired beyond tidal volume in a forceful exhalation is the nurse coaching the patient to remove from the lungs?

• Tidal volume
• Expiratory reserve
• Forced vital capacity
• Peak expiratory flow rate
• A patient has a low oxygen level. Which body structure should the nurse consider as

being responsible for this low level?

• Larynx b.

Alveoli

• Bronchi
• Nasal passages

NURSING 1102 Med Surg HESI EXAM

• The nurse is providing care to a patient who experienced an ischemic stroke and

now requires respiratory support with mechanical ventilation. The nurse realizes that the stroke most likely occurred in which part of the brain? a. Medulla

• Cerebrum
• Cerebellum
• Hypothalamus
• A nurse is providing care for a patient who complains of difficulty breathing. Which

assessment will best help the nurse determine the severity of the patients dyspnea?

• Count the patients respiratory rate.
• Ask the patient to describe the dyspnea.
• Have the patient rate the dyspnea on a 0-to-10 scale.
• Observe the patient throughout two to three respirations.
• While providing care for a patient with asthma, the nurse notes the patients

shoulders are rising with each breath. What should the nurse realize this action represents?

• Hyperinflation of the chest
• The use of accessory muscles to aid breathing
• Shoulder muscle fatigue related to difficulty breathing
• Effective use of a breathing exercise to increase ventilation
• During the admission assessment of an individual admitted to the medical

respiratory unit, the nurse notes the patient has a barrel-shaped chest. Which assessment should the nurse perform next?

• Assess the patients rate and character of respirations.
• Ask the patient about presence of a productive cough.
• Palpate the patients thorax to determine presence of tenderness.
• Obtain a blood sample for arterial blood gas (ABG) to detect respiratory acidosis.
• The nurse is auscultating a patients chest and hears an adventitious sound in the

left lower lobe. What is the first step in determining whether this is an abnormality?

• Call another nurse to listen to the patients lungs.
• Ask the patient if this has ever occurred in the past.
• Have the physician listen and verify what the nurse is hearing. d. Listen

to the corresponding area in the patients right lower lobe.

• The nurse is auscultating a patients lungs but is unable to hear much air movement.

What should the nurse do to most effectively hear the lung sounds?

• Try another stethoscope.
• Have the patient rest between breaths.
• Have the patient assume a side-lying position.
• Ask the patient to breathe deeply through the mouth.
• The nurse observes a patient who has periods of fast, deep respirations alternating

with periods of apnea. What term should the nurse use to describe this pattern?

• Tachypnea
• Kussmauls
• Cheyne-Stokes

NURSING 1102 Med Surg HESI EXAM

• Hyperventilation
• An adult patient has a respiratory rate of 36 breaths per minute. Which term

should the nurse use to document this finding?

• Apnea
• Bradypnea
• Tachypnea
• Within normal limits
• A patient with pulmonary edema has moist, bubbling lung sounds. How should the

nurse describe this finding?

• Wheezing
• Fine crackles c.

Coarse crackles

• Pleural friction rub
• A patient is making a loud crowing sound caused by an obstruction of the

airways by a foreign body. How should the nurse document this patients lung sound?

• Stridor
• Wheeze
• Crackles
• Pleural friction rub
• The nurse is providing care for a patient diagnosed with asthma. Which adventitious

sound should the nurse expect when auscultating this patients lung sounds?

• Crackles b.

Wheezes

• Pleural friction rub
• Diminished breath sounds
• A patient with pneumonia is having difficulty raising secretions for a sputum

culture. Which action should the nurse take first?

• Administer a bronchodilator.
• Suction the patient to obtain a specimen. c.

Encourage the patient to take deep breaths.

• Obtain the specimen with a cotton-tipped swab.
• A laboratory technician has just completed drawing arterial blood gases from a

patient. What action should the nurse take first?

• Increase the patients oxygen to 4 L/min.
• Hold pressure on the puncture site for 5 minutes.
• Have the patient hold his or her hand in a fist for 2 to 3 minutes.
• Notify the physician that the blood is in the laboratory for analysis.
• A patients arterial blood gas analysis shows a PaCO2 of 68 mm Hg. What

action should the nurse take first?

• Notify the physician.
• Remove the patients oxygen mask.
• Have the patient breathe into a paper bag.
• Place the patient in a left side-lying position.
• A patients arterial blood gas analysis shows a pH of 7.28. The PaCO2 is high. Which

acidbase imbalances is the patient experiencing?

• Metabolic acidosis

NURSING 1102 Med Surg HESI EXAM

• Metabolic alkalosis c.

Respiratory acidosis

• Respiratory alkalosis
• A patients oxygen saturation value is 92% on room air. What does this value mean

to the nurse?

• The percentage of oxygen in the lungs
• The partial pressure of the oxygen in the blood
• The amount of oxygen saturating the lymphocytes
• The percentage of hemoglobin that is saturated with oxygen
• A patients oxygen saturation is 89%. Which actions should the nurse take first?
• Raise the head of the patients bed.
• Call the respiratory therapist STAT.
• Place the patient in a supine position.
• No action; this is a normal oxygen saturation.
• A patient returns to the medical unit after a pulmonary angiogram. Which

instructions by the nurse would help prevent complications from the test? a. Lie flat for 8 hours so the injection site does not bleed.

• Stay in Fowlers position to help excrete the radioactive gas.
• Try not to cough for 6 hours because this could cause irritation and bleeding.
• Dont eat or drink anything for 6 hours after the test, because your gag reflex may not be

intact.

• After a bronchoscopic examination, the patient must remain NPO (nothing

by mouth) until the return of the gag reflex. How can the nurse determine when the gag reflex has returned?

• Ask the patient to swallow.
• Give the patient a sip of water.
• Touch the back of the throat with a cotton swab.
• Touch the roof of the mouth with a gloved finger.
• The nurse is caring for a patient experiencing dyspnea. What should the nurse

instruction the patient to breathe more effectively?

• Use deep breathing, and exhale as forcefully as you are able.
• Take four quick, panting breaths, and then blow out for 6 seconds.
• Hold your breath for 3 seconds after each exhalation to empty all the alveoli. d. Breathe

using your abdominal muscles, and blow out slowly through pursed lips.

• The nurse places a patient who is experiencing dyspnea in the Fowlers position.

What is the rationale for the nurse to use this position?

• Fowlers position helps dilate diseased bronchioles. b.

Fowlers position allows maximum lung expansion.

• Fowlers position increases use of accessory muscles.
• Fowlers position relieves stress on the back and chest.
• A patient with cancer in the left lung is acutely short of breath. Which position

should the nurse suggest the patient assume?

• Prone
• Supine
• Left side-lying d.

Right side-lying