Vision: A PREMIER UNIVERSITY delivering

“Excellent nursing education that

world-class education that promotes
sustainable development amidst climate
change.
Benguet State University provides graduates with self-
direction, competence and

Mission: To provide quality education to

COLLEGE OF NURSING compassion.”

enhance food security, sustainable La Trinidad, Benguet “The College of Nursing is committed
communities, industry innovation, climate www.bsu.edu.ph/ 422- 2127 to provide a strong academic and
resilience, gender equality, institutional professional foundation for the
development and partnerships. practice of nursing.”

NCM 112
Care of clients with problems in Oxygenation, Fluid and Electrolytes, Infectious, Inflammatory
and immunologic response, Cellular Aberrations, Acute and Chronic.

WORKSHEET 2
NAME: [ ] SCORE:________
SECTION: [ ] DATE: _________

Part 1: MULTIPLE CHOICE

1. Choose the initial part of the respiratory tract that is not considered part of the gas-exchange airways.
a. Bronchioles
b. Respiratory bronchioles
c. Alveolar ducts
d. Alveolar sacs

2. Choose the alveolar cells that secrete surfactant.

a. Type I cells
b. Type II cells
c. Type III cells
d. Type I and II cells

3. The pulmonary circulation is considered a:

a. High-pressure, high-resistance system
b. Low-pressure, low-resistance system
c. High-pressure, low-resistance system
d. Low-pressure, high-resistance system

4. A nurse is caring for a patient with a pulmonary embolism understands that a high ventilation-perfusion ratio exists.
This means that:
a. Perfusion exceeds ventilation
b. There is an absence of perfusion and ventilation
c. Ventilation exceeds perfusion
d. Ventilation matches perfusion

5. A nurse understands that a safe but low level of oxygen saturation provides for adequate tissue saturation. The
normal oxygen saturation is:
a. 40 and above mmHg
b. 75 and above mmHg
c. 80 and above mmHg
d. 95 and above mmHg

6. The nurse inspects the thorax of a patient with advanced emphysema. The nurse expects chest configuration change
consistent with a deformity known as:
a. Barrel chest
b. Funnel chest
c. Kyphoscoliosis
d. Pigeon chest

7. Breath sounds that originate in the smaller bronchi and bronchioles and are high-pitched, sibilant, and musical are
called:
a. Wheezes
b. Rhonchi
c. Rales
d. Crackles

8. Crackles, noncontiguous breath sounds, would be assessed for a patient with:

a. Asthma
b. Bronchospasm
c. Pulmonary congestion
d. Pulmonary fibrosis

9. During a preadmission assessment, the nurse would expect to find decreased tactile fremitus and hyperresonant
percussion sounds with a diagnosis of:
 Vision: A PREMIER UNIVERSITY delivering
“Excellent nursing education that
world-class education that promotes
sustainable development amidst climate
change.
Benguet State University provides graduates with self-
direction, competence and

Mission: To provide quality education to

COLLEGE OF NURSING compassion.”

enhance food security, sustainable La Trinidad, Benguet “The College of Nursing is committed
communities, industry innovation, climate www.bsu.edu.ph/ 422- 2127 to provide a strong academic and
resilience, gender equality, institutional professional foundation for the
development and partnerships. practice of nursing.”

a. Bronchitis
b. Emphysema
c. Atelectasis
d. Pulmonary edema

10. Nursing directions to a patient from whom a sputum specimen is to be obtained should include all of the following
except directing the patient to: 30
a. Initially clear his or her nose and throat.
b. Spit surface mucus and saliva into a sterile specimen container.
c. Take a few deep breaths before coughing.
d. Use diaphragmatic contractions to aid in the expulsion of sputum.

11. The nurse should advise the patient who is scheduled for bronchoscopy that he or she will:
a. Have his or her throat sprayed with a topical anesthetic.
b. Be required to fast for 12 hours before the procedure.
c. Receive postoperative anesthesia after the procedure.
d. Experience all of the above.
Part 2:
SHORT ANSWER
Read each statement carefully. Write your response in the space provided.
1. Distinguish between the terms ventilation and respiration.
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________

2. Describe the function of the epiglottis.

____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________

3. List four conditions that cause low compliance or distensibility of the lungs: _______________________,
_______________________, _____________________, and _____________________________.

4. Define the term partial pressure.

____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________.

5. Name two centers in the brain that are responsible for the neurologic control of ventilation:
_____________________________ and _____________________________.

6. The alveoli begin to lose elasticity at about age _______ years, resulting in decreased gas diffusion.

7. List six major signs and symptoms of respiratory disease.

_______________________ __________________________
_______________________ __________________________
_______________________ __________________________

8. List four conditions that are influenced by genetic factors that affect respiratory function: _________________,
__________________, ___________________, and ________________________.

9. Explain the breathing pattern characterized as Cheyne–Stokes respirations.

____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________.

Part 3: Clinical Situations

CASE STUDY: Bronchoscopy
Mr. Beacon is scheduled for a bronchoscopy for the diagnostic purpose of locating a pathologic process.
1. Because a bronchoscopy was ordered, the nurse knows that the suspected lesion was not in the:
 Vision: A PREMIER UNIVERSITY delivering
“Excellent nursing education that
world-class education that promotes
sustainable development amidst climate
change.
Benguet State University provides graduates with self-
direction, competence and

Mission: To provide quality education to

COLLEGE OF NURSING compassion.”

enhance food security, sustainable La Trinidad, Benguet “The College of Nursing is committed
communities, industry innovation, climate www.bsu.edu.ph/ 422- 2127 to provide a strong academic and
resilience, gender equality, institutional professional foundation for the
development and partnerships. practice of nursing.”

a. bronchus.
b. larynx.
c. pharynx.
d. trachea.

2. Nursing measures before the bronchoscopy include:

a. obtaining an informed consent.
b. supplying information about the procedure.
c. withholding food and fluids for 6 hours before the test.
d. all of the above.

3. The nurse is aware that possible complications of bronchoscopy include all of the following except:
a. aspiration.
b. gastric perforation.
c. infection.
d. pneumothorax.

4. After the bronchoscopy, Mr. Beacon must be observed for:

a. dyspnea.
b. hemoptysis.
c. tachycardia.
d. all of the above.

5. After the bronchoscopy, Mr. Beacon:

a. can be given ice chips and fluids after he demonstrates that he can perform the gag reflex.
b. should immediately be given a house diet to alleviate the hunger resulting from the required fast.
c. should initially be given iced ginger ale to prevent vomiting and possible aspiration of stomach contents.
d. will need to remain NPO for 6 hours to prevent pharyngeal irritation.

CASE STUDY:Thoracentesis
Mrs. Abad is admitted to the clinical area for a thoracentesis. The physician wants to remove excess air from the pleural
cavity (see figure below).

1. Nursing responsibilities before the thoracentesis should include:

a. informing Mrs. Abad about pressure sensations that will be experienced during the procedure.
b. making sure that chest radiograms ordered in advance have been completed.
c. seeing that the consent form has been explained and signed.
d. all of the above.

2. For the thoracentesis, the patient is assisted to any of the following positions except:
a. lying on the unaffected side with the bed elevated 30 to 40 degrees.
b. lying prone with the head of the bed lowered 15 to 30 degrees.
c. sitting on the edge of the bed with her feet supported and her arms and head on a padded overbed table.
d. straddling a chair with her arms and head resting on the back of the chair.
Vision: A PREMIER UNIVERSITY delivering
“Excellent nursing education that
world-class education that promotes
sustainable development amidst climate
change.
Benguet State University provides graduates with self-
direction, competence and

Mission: To provide quality education to

COLLEGE OF NURSING compassion.”

enhance food security, sustainable La Trinidad, Benguet “The College of Nursing is committed
communities, industry innovation, climate www.bsu.edu.ph/ 422- 2127 to provide a strong academic and
resilience, gender equality, institutional professional foundation for the
development and partnerships. practice of nursing.”

3. Nursing intervention includes exposing the entire chest even though the thoracentesis site is normally in the
midclavicular line between the:
a. first and second intercostal spaces.
b. second and third intercostal spaces.
c. third and fourth intercostal spaces.
d. fourth and fifth intercostal spaces.

4. Nursing observations after the thoracentesis include assessment for:

a. blood-tinged mucus.
b. signs of hypoxemia.
c. tachycardia.
d. all of the above.

5. A chest x-ray film is usually ordered after the thoracentesis to rule out:
a. pleurisy.
b. pneumonia.
c. pneumothorax.
d. pulmonary edema.