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Q:
Which vessel is the most commonly associated with massive hemorrhage following a tracheostomy?a. innominate artery b. carotid artery c. pulmonary arteryd. subclavian artery
Q:
What is the recommended "safe range" for endotracheal tube cuff pressures?a. 20-25 mm Hg b. 30-35 mm Hg c. 35-40 mm Hgd. 45-50 mm Hg
Q:
In an adult, at what angle does the left mainstem bronchus branch from the trachea?a. 40-60 degrees b. 60-75 degrees c. 25-40 degreesd. 10-15 degrees
Q:
What is the term for the bifurcation of the trachea?a. carina b. hilum c. choanad. concha
Q:
In cm, what is the average diameter of the adult trachea?a. 1.5 - 2.5 cm b. 2.0-3.5 cm c. 0.75 - 1.0 cmd. 0.5 - 1.5 cm
Q:
What is the term for the cartilaginous airways?a. conducting zone b. respiratory unit c. acinusd. tracheobronchial tree
Q:
When degranulation of mast cells occurs and chemical mediators are released, which of the following would occur in the lungs?I. Increased vascular permeabilityII. Increased mucus productionIII. Smooth muscle relaxationIV. Vasodilation with edemaa. I, II, and IV only b. I, II, III and IV c. I, II, and III onlyd. I and IV only
Q:
Approximately how many IgE receptor sites are present on a single mast cell?a. 100,000 - 500,000 b. 1,000 - 5,000 c. 100 - 500d. 1,000,000 - 5,000,000
Q:
Where are mast cells located in the tracheobronchial tree?I. Lamina propriaII. Intra-alveolar septaIII. Sub-mucosal glandsa. I, II, and III b. I only c. I and III onlyd. I and II only
Q:
Which of the following factors can alter the mucociliary transport mechanism?I. Excessive bronchial secretionsII. Tobacco smokeIII. HypoxiaIV. Air pollutiona. I, II, III, and IV b. I, II, and IV only c. I, II, and III onlyd. I and II only
Q:
When excessive secretions are present in the lungs, what term describes the sound heard by ascultation over large airways during exhalation?a. rhonchi b. wheeze c. cracklesd. stridor
Q:
How many times per minute do the cilia in the tracheobronchial tree move?a. 1500 times b. 2500 times c. 500 timesd. 50 times
Q:
What is the term for the viscous layer of the mucous blanket?a. gel b. sol c. basald. epoxic
Q:
Which cranial nerve innervates the submucosal glands?a. tenth b. ninth c. eighthd. seventh
Q:
At what level in the tracheobronchial tree are cilia completely absent?a. respiratory bronchioles b. lobar bronchi c. mainstem bronchid. bronchioles
Q:
What is the primary component of the mucous blanket in the tracheobronchial tree?a. water b. lipids c. glycoproteinsd. DNA
Q:
What type of epithelium extends from the trachea to the respiratory bronchioles?a. pseudostratified ciliates columnar b. cuboidal c. pseudostratified squamousd. stratified squamous
Q:
What is the secondary vital function of the larynx?a. Valsalva's maneuver b. Gag reflex c. Babinski reflexd. Moro maneuver
Q:
Which of the following muscles pull the larynx and hyoid downward?a. infrahyoid group b. suprahyoid group c. cricothyroid musclesd. posterior cricoarytenoid muscles
Q:
Which laryngeal muscles are primarily responsible for adduction of the vocal cords?a. lateral cricoarytenoid b. posterior cricoarytenoid c. transverse arytenoidd. thyroarytenoid
Q:
Which type of epithelium is present in the larynx above the vocal cords?a. stratified squamous b. cuboidal c. pseudostratified squamousd. pseudostratified ciliated columnar
Q:
What is causative agent in the majority of cases of acute epiglottitis?a. Haemophilus influenzae type B b. Parainfluenza virus c. MRSAd. Streptococcus
Q:
Which of the following is a subglottic airway obstruction usually caused by the parainfluenza virus?a. laryngotracheobronchitis (LTB) b. epiglottitis c. tonsillitisd. pharyngitis
Q:
What is the treatment of choice for post-extubation laryngeal edema?a. aerosolized alpha adrenergic agent such as racemic epinephrineb. antibioticsc. cough medicined. long-acting bronchodilators
Q:
What is the space between the true vocal cords called?a. rima glottidis b. vestibule c. valleculad. choana
Q:
Which of the laryngeal cartilages are paired?I. CuneiformII. ArytenoidIII. CorniculateIV. Cricoida. I, II, and III only b. I, II, III, and IV c. I, II, and IV onlyd. II, III, and IV only
Q:
Which laryngeal cartilage is shaped like a signet ring and forms a large portion of the posterior laryngeal wall?a. cricoid b. cuneiform c. corniculated. epiglottis
Q:
Which laryngeal cartilage is primarily responsible for preventing food, liquids, and foreign bodies from entering the lower airways?a. epiglottis b. thyroid c. cricoidd. corniculate
Q:
To what structure does the upper portion of the thyroid cartilage attach by a membrane?a. hyoid bone b. tongue c. epiglottisd. mandible
Q:
Which of the cartilages of the larynx are unpaired?a. thyroid, epiglottis, and cricoidb. thyroid, cricoid, and cuneiformc. artyenoid, cuneiform, and corniculated. thyroid, epiglottis, and arytenoid
Q:
Which of the following are functions of the larynx?I. Passageway for gasII. Protects against aspirationIII. Generation of sounds for speechIV.Warming and filtration of inspired gasa. I, II, and III only b. I and II only c. I and III onlyd. I, III, and IV only
Q:
Which structure extends from the base of the tongue to the upper end of the trachea?a. larynx b. laryngopharynx c. thyroid glandd. rima glottidis
Q:
What is a common site for misplacement of endotracheal tubes during emergency intubation?a. esophagus b. left mainstem bronchus c. stomachd. left upper lobar bronchus
Q:
Which type of epithelium lines the laryngopharynx?a. stratified squamous b. pseudostratified squamous c. pseudostratified ciliated columnard. cuboidal
Q:
What structure is located between the glossoepiglottic folds in the posterior oropharynx?a. vallecula epiglottica b. lingual tonsils c. palatine tonsilsd. rima glottidis
Q:
What type of epithelium is found in the oropharynx?a. stratified squamous b. pseudostratified squamous c. pseudostratified ciliated columnard. cuboidal
Q:
Which structure extends from the soft palate to the base of the tongue?a. oropharynx b. nasopharynx c. laryngopharynxd. uvula
Q:
What is the most frequent cause of hearing loss in young children?a. otitis media b. sinusitis c. tonsillitisd. pharyngitis
Q:
What is another name for the pharyngotympanic tubes?a. auditory b. adenoids c. fauciald. conchae
Q:
What is another name for pharyngeal tonsils?a. adenoids b. palatine tonsils c. lingual tonsilsd. faucial tonsils
Q:
Which epithelium is present in the nasopharynx?a. pseudostratified ciliated columnar b. cuboidal c. stratified squamousd. pseudostratified squamous
Q:
Which structure extends from the posterior nares to the superior portion of the soft palate?a. nasopharynx b. oropharynx c. tongued. palatine tonsils
Q:
What is another name for the palatine tonsils?a. faucial b. pharyngeal c. linguald. adenoids
Q:
To what structure is the uvula attached?a. soft palate b. hard palate c. palatopharyngeal archd. palatoglossal arch
Q:
Which epithelium lines the oral cavity?a. stratified squamous b. cuboidal c. pseudostraified ciliated columnard. pseudostratified squamous
Q:
What is the name of the structure that secures the tongue to the floor of the mouth?a. lingual frenulum b. extrinsic lingual muscles c. instrinsic lingual musclesd. uvula
Q:
In the oral cavity, what is the term for the space between the teeth and lips?a. vestibule b. vallecula c. vibrissaed. ventricle
Q:
Which of the following can cause sinusitis?I. Upper respiratory infectionII. Dental infectionIII. Air travelIV. Scuba divinga. I, II, III, and IV b. I and II only c. I, II, and III onlyd. I, II, and IV only
Q:
Approximately what portion of the sense of taste is reliant upon the sense of smell?a. 80% b. 60% c. 40%d. 20%
Q:
Among pediatric patients, in which age range is epistaxis most prevalent?a. 2-10 years b. newborn -2 years c. 8-16 yearsd. 10-14 years
Q:
What effect, if any, would be expected from the topical application of phenylephrine on the nasal mucosa?a. vasoconstriction b. vasodilation c. bronchospasmd. no known effect
Q:
Which of the following sinuses are considered to be paranasal sinuses?I. MaxillaryII. FrontalIII. EthmoidIV. Sphenoida. I. II. III, and IV b. I, II, and III only c. I. III, and IV onlyd. I and II only
Q:
Where is the olfactory region located in the nasal cavity?a. superior and middle turbinates b. middle and inferior turbinates c. choanad. vestibule
Q:
What is another term for conchae?a. turbinates b. choana c. vestibuled. alae
Q:
What type of epithelium is present in the posterior two-thirds of the nasal cavity?a. pseudostratified ciliated columnar b. cuboidal c. stratified squamousd. pseudostratified squamous
Q:
In which structure would vibrissae normally be found?a. nasal cavity b. oropharynx c. laryngopharynxd. trachea
Q:
What type of epithelium lines the anterior third of the nasal cavity?a. stratified squamousb. pseudostratified ciliated squamousc. pseudostratified ciliated columnard. cuboidal
Q:
What is the term for the openings created by the alae nasi and septal cartilage?a. nares b. glottis c. vestibuled. choana
Q:
Which structures form the posterior section of the floor of the nasal cavity?I. Nasal bonesII. Cribriform plate of the ethmoid boneIII. Palatine process of maxillaIV. Superior portion of soft palatea. IV only b. III and IV only c. II, III, and IV onlyd. 1, II, III only
Q:
Which of the following structures form the anterior nasal septum?I. Septal cartilageII. VomerIII. Perpendicular plate of ethmoid boneIV. Frontal process of maxillaa. I only b. I and II only c. II, III, and IV onlyd. I, II, and III only
Q:
What is the term for widening of the nostrils that can occur during respiratory distress?a. nasal flaring b. alar collapse c. retractionsd. grunting
Q:
Which structure form the lower two-thirds of the nose?I. Lateral nasal cartilageII. Lesser and greater alar cartilagesIII. Septal cartilageIV. Fibrous fatty tissuea. I, II, III, and IV b. I, II, and III only c. I, II, and IV onlyd. I. III, and IV only
Q:
Which structures form the upper third of the nose?I. Nasal bonesII. Frontal process of maxillaIII. Lateral nasal cartilageIV. Greater alar cartilagea. I and II only b. I , II, and III only c. I. II, and IV onlyd. I, II, III, and IV
Q:
Which of the following are functions of the upper airway?I. Conduction of gas to lower airwayII. Prevent foreign materials from entering lower airwayIII. Warm, filter, and humdify inspired gasIV. Aid in speech and smella. I, II, III, and IV b. I, II, and III only c. I, III, and IV onlyd. I, II, and IV only
Q:
Which of the following is NOT a primary function of the nose?a. conduct gas and food to lower airwayb. humidfy inspired gasc. filter the inspired gasd. warm the inspired gas
Q:
Which of the following are primary components of the upper airway?a. nose, oral cavity, pharynxb. larynx, trachea, and bronchic. nose, oral cavity, larynx and trachead. nose, oral cavity, pharynx, larynx, and trachea
Q:
On the first day of clinical rotation on an inpatient psychiatric unit, nursing student A complains of nausea, sweaty palms, and stomach butterflies. Nursing student B attempts to console student A by saying, "You just can"t take anything these clients say personally; don"t listen to a word they say." Having observed this exchange, the nursing instructor should be most concerned about:1. Student B's lack of appropriate fear towards this potentially dangerous environment.2. Student B's perception that listening to the client is unnecessary.3. Student A's fear about the psychiatric setting.4. Student A's symptoms of an impending panic attack.
Q:
Following a particularly violent incident which resulted in a client being placed in four-point restraints, the nurse recognizes feeling fearful of having to work with the client again. How should the nurse handle this emotion?1. Recognize that feeling fear and getting into physical confrontations is "part of the job."2. Accept the fear, process the event with other staff, and continue working with the client.3. Ignore feelings of fear as it would impede the nurse's ability to manage the client effectively.4. Engage in debriefing with the client to clear up hard feelings.
Q:
An inpatient psychiatric unit has been operating at an unusually high acuity level over the past week resulting in numerous incidents of seclusion or restraint. A review of each violent event reveals that appropriate crisis management strategies were implemented and unit policy followed. What action is most appropriate?1. No action is necessary; the staff is following policy appropriately.2. Create a rotating schedule to allow staff to leave the unit for frequent brief breaks to alleviate stress.3. Identify the characteristics of the aggressive clients so that admission criteria can be adjusted to reduce risk of violence.4. Have an expert speak to staff about seclusion and restraint reduction strategies.
Q:
The mother of an 8-year-old client being treated for conduct disorder says that the child often threatens to "kung-fu" (kick and strike) the client's sister just like a favorite cartoon character does on TV. Based on behavioral theory, the nurse would suspect that the child's aggressive behavior could best be reduced by:1. Administering a medication that will increase the neurotransmitter serotonin.2. Engaging the client and sister in family therapy.3. Providing positive reinforcement when the child exhibits nonaggressive behavior.4. Identifying and reframing the negative thoughts that the child has toward the sister.
Q:
A client is standing in the hallway on the phone arguing with the caller. As the client becomes increasing loud and argumentative, an appropriate action for the nurse to take would be to:1. Move the other clients away from the area providing the client privacy to continue the conversation.2. Stand next to the client and say in a calm, firm voice, "If you cannot lower your voice, you will lose your phone privileges indefinitely."3. Walk up to the client and softly say, "This conversation appears to be getting you upset, tell this person that you will talk later and come sit with me to discuss what is bothering you."4. Do nothing. The client does not pose any danger as the person the client is angry with is not physically present.
Q:
A client has been placed in seclusion. Which client behavior would have warranted this intervention?1. The client is manic, has been flirtatious towards staff and refused morning medication, and has verbalized a plan to leave2. The client is psychotic, sits in the corner with hands over ears, and displays increased suspiciousness of and agitation towards others despite recently receiving 1mg risperidone (Risperdal) PRN3. The client is depressed and wants to be left alone to rest4. The client is suicidal, has been banging head against the table in the day room, and was unresponsive to staff's verbal redirection
Q:
A client with paranoid schizophrenia is experiencing visual hallucinations of people jumping out of nowhere. The client keeps striking the wall. Repeated attempts by the nurse to orient the client to reality and reassure the client of safety have failed. What would be the nurse's next de-escalation approach?1. Offer the client a PRN medication2. Apply soft limb restraints on client's wrists3. Have several staff demobilize the client so that forcible injection can be administered4. Call security to assist in placing the client in seclusion
Q:
The nurse manager of an inpatient psychiatric unit is providing an orientation session for new staff. Which of the following statements reflect strategies used to promote a safe, therapeutic milieu?Standard Text: Select all that apply.1. Staff should provide frequent, short, individualized contacts with clients.2. Management of potentially dangerous items such as belts, shoelaces, and electrical appliances is based on unit policy and clinical judgment.3. A nurse:client ratio of at least one nurse for every four clients is required at all times.4. Staff should take their breaks during client mealtimes because there is a lower risk of behavioral problems at this time.5. When a client is becoming disruptive, staff should intervene by engaging the client in a structured group activity.
Q:
A new nurse is being oriented to work on the psychiatric unit. Which of the following statements reflect general principles for maintaining unit safety?Standard Text: Select all that apply.1. Staff should be sensitive to a client's need for privacy and personal space.2. The staff should schedule their breaks during client mealtimes.3. The nurse:client ratio should be at least one nurse for every four clients.4. Staff should lock up clients' potentially dangerous items and permit use only under direct staff supervision.5. Staff should provide frequent, short individualized contacts with clients.
Q:
During the morning community meeting, a client with psychosis becomes agitated, making loud threats to no one in particular, but the other clients appear increasingly uncomfortable. What action should the nurse facilitator take?1. Address the client by name and say, "It sounds as if you are experiencing something very disturbing. Please go see the nurse who may be able to help you."2. Direct the client by saying, "You need to sit quietly and listen until it's your turn to talk."3. Accompany the client to his or her room so that the client can de-escalate.4. Say to the group, "You all appear frightened by this behavior. What should we do about it?"
Q:
After a nurse addresses an agitated client by setting limits in a calm, direct manner, the client begins pacing, exhibiting a clenched jaw and fists. The nurse would evaluate the approach as ineffective because:1. The nurse lacks rapport with the client.2. The nurse lacks adequate de-escalation and limit setting skills.3. Some clients have limited control, so verbal interventions may not work, but this is not reflective of the nurse's skill.4. In some cases verbal de-escalation and limit setting will not work and the nurse should start with a more restrictive measure.
Q:
A client was admitted for psychosis and aggressive behavior. The client has been noncompliant with the antipsychotic medication because the client says it makes the client's jaw tight and neck stiff. The client is becoming increasingly agitated and needs a quick-acting medication. Which medication would the nurse expect to give?1. Benztropine (Cogentin)2. Fluphenazine (Prolixin)3. Risperidone (Risperdal)4. Zolpidem (Ambien)
Q:
A client who is being treated for psychosis has begun exhibiting signs of increasing agitation and has started repetitively opening and slamming the door to the client's room. Which of the following nursing interventions address and redirect the client's behavior?Standard Text: Select all that apply.1. "You need to stop slamming your door and go down the hall to the group meeting."2. "How about taking a walk with me so we can find a place for you to let go of some of your nervous energy."3. "I can see that you have some excess energy that you need to get out, but you cannot continue to slam this door."4. "You seem upset, would you like some medication to help you with your agitation?"5. "If you don"t stop slamming the door, I will lock it for the rest of the day."
Q:
Staff have made several verbal attempts to de-escalate a client, however, the client's level of agitation continues to increase and it becomes necessary to administer a fast-acting pharmacological intervention. Which medication would the nurse most likely provide?1. Haloperidol (Haldol)2. Methylphenidate (Ritalin)3. Lithium carbonate (Lithobid)4. Amitriptyline (Elavil)