MS2 Q3 CH 28 PT 2

The nurse is teaching a patient how to self-administer ipratropium via a metered-dose inhaler (MDI). Which instruction given by the nurse is most appropriate to help the patient learn the proper inhalation technique? "Avoid shaking the inhaler before use." "Breathe out slowly before positioning the inhaler." "Using a spacer should be avoided for this type of medication." "After taking a puff, hold the breath for 30 seconds before exhaling."

"Breathe out slowly before positioning the inhaler."

The physician has prescribed salmeterol (Serevent) for a patient with asthma. In reviewing the use of dry powder inhalers (DPIs) with the patient, what instructions should the nurse provide? "Close lips tightly around the mouthpiece and breathe in deeply and quickly." "To administer a DPI, you must use a spacer that holds the medicine so that you can inhale it." "You will know you have correctly used the DPI when you taste or sense the medicine going into your lungs." "Hold the inhaler several inches in front of your mouth and breathe in slowly, holding the medicine as long as possible."

"Close lips tightly around the mouthpiece and breathe in deeply and quickly."

The nurse teaches a 53-yr-old male patient with chronic obstructive pulmonary disease (COPD) how to administer fluticasone by metered-dose inhaler (MDI). Which statement by the patient to the nurse indicates correct understanding of the instructions? "I should not use a spacer device with this inhaler." "I will rinse my mouth each time after I use this inhaler." "I will feel my breathing improve over the next 2 to 3 days." "I should use this inhaler immediately if I have trouble breathing."

"I will rinse my mouth each time after I use this inhaler."

Which statement made by the patient with chronic obstructive pulmonary disease (COPD) indicates a need for further teaching regarding the use of an ipratropium inhaler? "I can rinse my mouth following the two puffs to get rid of the bad taste." "I should wait at least 1 to 2 minutes between each puff of the inhaler." "Because this medication is not fast acting, I cannot use it in an emergency if my breathing gets worse." "If my breathing gets worse, I should keep taking extra puffs of the inhaler until I can breathe more easily."

"If my breathing gets worse, I should keep taking extra puffs of the inhaler until I can breathe more easily."

The nurse determines that the patient understood medication instructions about the use of a spacer device when taking inhaled medications after hearing the patient state what as the primary benefit? "I will pay less for medication because it will last longer." "More of the medication will get down into my lungs to help my breathing." "Now I will not need to breathe in as deeply when taking the inhaler medications." "This device will make it so much easier and faster to take my inhaled medications."

"More of the medication will get down into my lungs to help my breathing."

Although a diagnosis of cystic fibrosis (CF) is most often made before age 2 years, an 18-yr-old patient at the student health center with a history of frequent lung and sinus infections has clinical manifestations consistent with undiagnosed CF. Which information would be accurate for the nurse to include when teaching the patient about a scheduled sweat chloride test? "Sweat chloride greater than 60 mmol/L is consistent with a diagnosis of CF." "The test measures the amount of sodium chloride in your postexercise sweat." "If sweating occurs after an oral dose of pilocarpine, the test result for CP is positive." "If the sweat chloride test result is positive on two occasions, genetic testing will be necessary."

"Sweat chloride greater than 60 mmol/L is consistent with a diagnosis of CF."

A patient has been receiving oxygen per nasal cannula while hospitalized for chronic obstructive pulmonary disease (COPD). The patient asks the nurse whether oxygen use will be needed at home. What is the most appropriate response by the nurse? "Long-term home oxygen therapy should be used to prevent respiratory failure." "Oxygen will not be needed until or unless you are in the terminal stages of this disease." "Long-term home oxygen therapy should be used to prevent heart problems related to COPD." "You will not need oxygen until your oxygen saturation drops to 88% and you have symptoms of hypoxia."

"You will not need oxygen until your oxygen saturation drops to 88% and you have symptoms of hypoxia."

A patient with asthma has a personal best peak expiratory flow rate (PEFR) of 400 L/minute. When explaining the asthma action plan, the nurse will teach the patient that a change in therapy is needed when the PEFR is less than ___ L/minute

320

Which test result identifies that a patient with asthma is responding to treatment? An increase in CO2 levels A decreased exhaled nitric oxide A decrease in white blood cell count An increase in serum bicarbonate levels

A decreased exhaled nitric oxide

A nurse is discharging a client who has COPD. Upon discharge, the client is concerned that he will never be able to leave his house now that he is on continuous oxygen. Which of the following is an appropriate response by the nurse? A. "There are portable oxygen delivery systems that you can take with you." B. "When you go out, you can remove the oxygen and then reapply it when you get home." C. "You probably will not be able to go out as much as you used to." D. "Home health services will come to you so you will not need to get out."

A. CORRECT: The nurse should inform the client that there are portable oxygen systems that he can use to leave the house. This should alleviate the client's anxiety.

A nurse is preparing to administer a dose of a new prescription of prednisone to a client who has COPD. The nurse should monitor for which of the following adverse effects of this medication? (Select all that apply.) A. Hypokalemia B. Tachycardia C. Fluid retention D. Nausea E. Black, tarry stools

A. CORRECT: The nurse should observe for hypokalemia. This is an adverse effect of prednisone. C. CORRECT: The nurse should observe for fluid retention. This is an adverse effect of prednisone. E. CORRECT: The nurse should monitor for black, tarry stools. This is an adverse effect of prednisone.

A nurse is caring for a client who is schedule for a thoracentesis. Prior to the procedure, which of the following actions should the nurse take? A. Position the client in an upright position, leaning over the bedside table B. Explain the procedure C. Obtain ABGs D. Administered benzocaine spray

A. Position the client in an upright position, leaning over the bedside table

The patient has an order for each of the following inhalers. Which one should the nurse offer to the patient at the onset of an asthma attack? Albuterol Ipratropium bromide Salmeterol (Serevent) Beclomethasone (Qvar)

Albuterol

A 45-yr-old man with asthma is brought to the emergency department by automobile. He is short of breath and appears frightened. During the initial nursing assessment, which clinical manifestation might be present as an early manifestation during an exacerbation of asthma? Anxiety Cyanosis Bradycardia Hypercapnia

Anxiety

A male patient with chronic obstructive pulmonary disease (COPD) becomes dyspneic at rest. His baseline blood gas results are PaO2 70 mm Hg, PaCO2 52 mm Hg, and pH 7.34. What updated patient assessment requires the nurse's priority intervention? Arterial pH 7.26 PaCO2 50 mm Hg Patient in tripod position Increased sputum expectoration

Arterial pH 7.26

A nurse is providing discharge teaching to a client who has COPD and a new prescription for albuterol. Which of the following statements by the client indicates an understanding of the teaching? A. "This medication can increase my blood sugar levels." B. "This medication can decrease my immune response." C. "I can have an increase in my heart rate while taking this medication." D. "I can have mouth sores while taking this medication."

C. CORRECT: Bronchodilators, such as albuterol, can cause tachycardia.

A nurse is planning to instruct a client on how to perform pursed‑lip breathing. Which of the following should the nurse include in the plan of care? A. Take quick breaths upon inhalation. B. Place your hand over your stomach. C. Take a deep breath in through your nose. D. Puff your checks upon exhalation.

C. CORRECT: The client should take a deep breath in through her nose while performing pursed‑lip breathing. This controls the client's breathing.

A nurse is instructing a client on the use of an incentive spirometer. Which of the following statements by the client indicates an understanding of the teaching? A. "I will place the adapter on my finger to read my blood oxygen saturation level." B. "I will lie on my back with my knees bent." C. "I will rest my hand over my abdomen to create resistance." D. "I will take in a deep breath and hold it before exhaling."

CORRECT: The client who is using the spirometer should take in a deep breath and hold it for 3 to 5 seconds

The nurse, who has administered a first dose of oral prednisone to a patient with asthma, writes on the care plan to begin monitoring for which patient parameters? Apical pulse Daily weight Bowel sounds Deep tendon reflexes

Daily weight

When teaching the patient with chronic obstructive pulmonary disease (COPD) about smoking cessation, what information should be included related to the effects of smoking on the lungs and the increased incidence of pulmonary infections? Smoking causes a hoarse voice. Cough will become nonproductive. Decreased alveolar macrophage function Sense of smell is decreased with smoking.

Decreased alveolar macrophage function

The nurse evaluates that nursing interventions to promote airway clearance in a patient admitted with chronic obstructive pulmonary disease (COPD) are successful based on which finding? Absence of dyspnea Improved mental status Effective and productive coughing PaO2 within normal range for the patient

Effective and productive coughing

The nurse is assigned to care for a patient who has anxiety and an exacerbation of asthma. What is the primary reason for the nurse to carefully inspect the chest wall of this patient? Allow time to calm the patient. Observe for signs of diaphoresis. Evaluate the use of intercostal muscles. Monitor the patient for bilateral chest expansion.

Evaluate the use of intercostal muscles.

When admitting a patient with a diagnosis of asthma exacerbation, the nurse will assess for what potential triggers (select all that apply.)? Exercise Allergies Emotional stress Decreased humidity

Exercise Allergies Emotional stress Upper respiratory infections

Nursing assessment findings of jugular venous distention and pedal edema would be indicative of what complication of chronic obstructive pulmonary disease (COPD)? Acute respiratory failure Secondary respiratory infection Fluid volume excess resulting from cor pulmonale Pulmonary edema caused by left-sided heart failure

Fluid volume excess resulting from cor pulmonale

when planning care for a client experiencing an asthma attack, the nurse needs to address the client shortness of breath. Which nursing intervention is most appropriate for this client? assess level of anxiety. Place head of bed in Fowler's position. reduce external stimuli. use relaxation techniques.

HOB in Fowler's position

Which position is most appropriate for the nurse to place a patient experiencing an asthma exacerbation? Supine Lithotomy High Fowler's Reverse Trendelenburg

High Fowler's

When planning teaching for the patient with chronic obstructive pulmonary disease (COPD), the nurse understands that what causes the manifestations of the disease? An overproduction of the antiprotease a1-antitrypsin Hyperinflation of alveoli and destruction of alveolar walls Hypertrophy and hyperplasia of goblet cells in the bronchi Collapse and hypoventilation of the terminal respiratory unit

Hyperinflation of alveoli and destruction of alveolar walls

a nurse is reinforcing teaching with a client on the purpose of taking a bronchodilator. Which of the following client statements indicates an understanding of the teaching? this medication can decrease my immune response. I take this medication to prevent asthma attacks. I need to take this medication with food. this medication has a slow onset to treat my symptoms.

I take this medication to prevent asthma attacks. a bronchodilator can prevent asthma attacks from occurring.

a nurse is providing discharge teaching to a client who has a new prescription of Prednisone for asthma. which of the following client statements indicates an understanding of the teaching? I will decrease my fluid intake while taking this medication. I will expect to have black tarry stools. I will take my medication with meals. I will monitor for weight loss while on this medication.

I will take my medication with meals. the client should take this medication with food. taking prednisone on an empty stomach can cause gastrointestinal distress.

A 68-yr-old patient with bronchiectasis has copious thick respiratory secretions. Which intervention should the nurse add to the plan of care for this patient? Use the incentive spirometer for at least 10 breaths every 2 hours. Administer prescribed antibiotics and antitussives on a scheduled basis. Increase intake to at least 12 eight-ounce glasses of fluid every 24 hours. Provide nutritional supplements that are high in protein and carbohydrates.

Increase intake to at least 12 eight-ounce glasses of fluid every 24 hours.

The nurse evaluates that a patient is experiencing the expected beneficial effects of ipratropium after noting which assessment finding? Decreased respiratory rate Increased respiratory rate Increased peak flow readings Decreased sputum production

Increased peak flow readings

When teaching the patient with bronchiectasis about manifestations to report to the health care provider, which manifestation should be included? Increasing dyspnea Temperature below 98.6°F Decreased sputum production Unable to drink 3 L of low-sodium fluids

Increasing dyspnea

The nurse supervises a team including another registered nurse (RN), a licensed practical/vocational nurse (LPN/LVN), and unlicensed assistive personnel (UAP) on a medical unit. The team is caring for many patients with respiratory problems. In what situation should the nurse intervene with teaching for a team member? LPN/LVN obtained a pulse oximetry reading of 94% but did not report it. RN taught the patient about home oxygen safety in preparation for discharge. UAP report to the nurse that the patient is complaining of difficulty breathing. LPN/LVN changed the type of oxygen device based on arterial blood gas results.

LPN/LVN changed the type of oxygen device based on arterial blood gas results.

During an assessment of a 45-yr-old patient with asthma, the nurse notes wheezing and dyspnea. The nurse interprets that these symptoms are related to what pathophysiologic change? Laryngospasm Pulmonary edema Narrowing of the airway Overdistention of the alveoli

Narrowing of the airway

When caring for a patient with chronic obstructive pulmonary disease (COPD), the nurse identifies a nursing diagnosis of imbalanced nutrition: less than body requirements after noting a weight loss of 30 lb. Which intervention should the nurse add to the plan of care for this patient? Order fruits and fruit juices to be offered between meals. Order a high-calorie, high-protein diet with six small meals a day. Teach the patient to use frozen meals at home that can be microwaved. Provide a high-calorie, high-carbohydrate, nonirritating, frequent feeding diet.

Order a high-calorie, high-protein diet with six small meals a day.

The nurse determines that a patient is experiencing common adverse effects from the inhaled corticosteroid beclomethasone after what occurs? Hypertension and pulmonary edema Oropharyngeal candidiasis and hoarseness Elevation of blood glucose and calcium levels Adrenocortical dysfunction and hyperglycemia

Oropharyngeal candidiasis and hoarseness

When teaching the patient with cystic fibrosis about the diet and medications, what is the priority information to be included in the discussion? Fat soluble vitamins and dietary salt should be avoided. Insulin may be needed with a diabetic diet if diabetes mellitus develops. Pancreatic enzymes and adequate fat, calories, protein, and vitamins are needed. Distal intestinal obstruction syndrome (DIOS) can be treated with increased water.

Pancreatic enzymes and adequate fat, calories, protein, and vitamins are needed.

The nurse teaches pursed-lip breathing to a patient who is newly diagnosed with chronic obstructive pulmonary disease (COPD). The nurse reinforces that this technique will assist respiration by which mechanism? Loosening secretions so that they may be coughed up more easily Promoting maximal inhalation for better oxygenation of the lungs Preventing bronchial collapse and air trapping in the lungs during exhalation Increasing the respiratory rate and giving the patient control of respiratory patterns

Preventing bronchial collapse and air trapping in the lungs during exhalation

The nurse determines that the patient is not experiencing adverse effects of albuterol (Proventil) after noting which patient vital sign? Temperature of 98.4°F Oxygen saturation 96% Pulse rate of 72 beats/min Respiratory rate of 18/ breaths/min

Pulse rate of 72 beats/min

The nurse is assisting a patient to learn self-administration of beclomethasone, two puffs inhaled every 6 hours. What should the nurse explain as the best way to prevent oral infection while taking this medication? Chew a hard candy before the first puff of medication. Rinse the mouth with water before each puff of medication. Ask for a breath mint after the second puff of medication. Rinse the mouth with water after the second puff of medication.

Rinse the mouth with water after the second puff of medication.

The nurse is assigned to care for a patient in the emergency department admitted with an exacerbation of asthma. The patient has received a â-adrenergic bronchodilator and supplemental oxygen. If the patient's condition does not improve, the nurse should anticipate what as the most likely next step in treatment? IV fluids Biofeedback therapy Systemic corticosteroids Pulmonary function testing

Systemic corticosteroids

The nurse is caring for a 48-yr-old male patient admitted for exacerbation of chronic obstructive pulmonary disease. The patient develops severe dyspnea at rest, with a change in respiratory rate from 26 breaths/min to 44 breaths/min. Which action by the nurse would be the most appropriate? Have the patient perform huff coughing. Perform chest physiotherapy for 5 minutes. Teach the patient to use pursed-lip breathing. Instruct the patient in diaphragmatic breathing.

Teach the patient to use pursed-lip breathing.

a client is newly diagnosed with asthma and needs information regarding possible asthma triggers. The nurse is preparing to teach the client to prevent asthma triggers. What information is appropriate for the nurse to educate the client to avoid? (select all that apply) cigarette smoke. tile floors in the house. indoor pets. stuffed animals. mattress covers.

Triggers to asthma that should be prevented include cigarette​ smoke, indoor​ pets, and stuffed animals.​ Carpeting, not tile​ floors, should be avoided. Mattress covers should be used to decrease dust​ mites, which are a trigger for asthma.

While teaching a patient with asthma about the appropriate use of a peak flow meter, what should the nurse instruct the patient to do? Keep a record of the peak flow meter numbers if symptoms of asthma are getting worse. Use the flow meter each morning after taking medications to evaluate their effectiveness. Increase the doses of the long-term control medication if the peak flow numbers decrease. Empty the lungs and then inhale quickly through the mouthpiece to measure how fast air can be inhaled.

Use the flow meter each morning after taking medications to evaluate their effectiveness.

A patient with an acute exacerbation of chronic obstructive pulmonary disease (COPD) needs to receive precise amounts of oxygen. Which equipment should the nurse prepare to use? Oxygen tent Venturi mask Nasal cannula Oxygen-conserving cannula

Venturi mask

Before discharge, the nurse discusses activity levels with a 61-yr-old patient with chronic obstructive pulmonary disease (COPD) and pneumonia. Which exercise goal is most appropriate once the patient is fully recovered from this episode of illness? Slightly increase activity over the current level. Swim for 10 min/day, gradually increasing to 30 min/day. Limit exercise to activities of daily living to conserve energy. Walk for 20 min/day, keeping the pulse rate less than 130 beats/min.

Walk for 20 min/day, keeping the pulse rate less than 130 beats/min.

The nurse is caring for a patient with an acute exacerbation of asthma. After initial treatment, what finding indicates to the nurse that the patient's respiratory status is improving? Wheezing becomes louder. Cough remains nonproductive. Vesicular breath sounds decrease. Aerosol bronchodilators stimulate coughing.

Wheezing becomes louder.

a nurse in the emergency department is caring for a client who is having an acute asthma attack. which of the following assessments indicates that the respiratory status is declining? (select all that apply). SaO2 95%. wheezing. retraction of sternal muscles. pink mucous membranes. premature ventricular complexes (PVCs)

Wheezing. retraction of sternal muscles. PVCs. all of the above are manifestations indicating the clients respiratory status is declining.

The nurse identifies the nursing diagnosis of activity intolerance for a patient with asthma. In patients with asthma, the nurse assesses for which etiologic factor for this nursing diagnosis? Work of breathing Fear of suffocation Effects of medications Anxiety and restlessness

Work of breathing

which state indicates the patient with asthma requires further teaching about self-care? a. "i use my corticosteroid inhaler when i feel short of breath" b. "i get a flu shot every year and see my hcp if i have an upper respiratory infection" c. "i use my inhaler before i visit my aunt who has a cat, but i only visit for a few minutes because of my allergies d. "i walk 30 minutes every day but sometimes i have to use my bronchodilator inhaler before walking to prevent me from getting short of breath"

a. "i use my coticosteroid inhaler when i feel short of breath" rationale: A rescue plan for patients with asthma includes taking 2 to 4 puffs of a shortacting bronchodilator (not a corticosteroid) every 20 minutes (3 times) to obtain rapid control of symptoms. All other patient statements identify to the nurse that the patient has accurate knowledge about his condition

A patient with bacterial pneumonia has rhonchi and thick sputum. What is the nurse's most appropriate action to promote airway clearance? a. Assist the patient to splint the chest when coughing. b. Teach the patient about the need for fluid restrictions. c. Encourage the patient to wear the nasal oxygen cannula. d. Instruct the patient on the pursed lip breathing technique.

a. Assist the patient to splint the chest when coughing.

A nurse is caring for a client following a thoracentesis. Which of the following manifestations should the nurse recognize as risks for complications? (Select all that apply.) a. Dyspnea b. Localized bloody drainage on the dressing c. Fever d. Hypotension e. Report of pain at the puncture site

a. Dyspnea c. Fever d. Hypotension

A nurse is caring for a client who is scheduled for a thoracentesis. Which of the following supplied should the nurse ensure are in the client's room? (Select all that apply.) a. Oxygen equipment b. Incentive spirometer c. Pulse oximeter d. Sterile dressing e. Suture removal kit

a. Oxygen equipment c. Pulse oximeter d. Sterile dressing

which findings indicate that a patient is developing status asthmaticus? (select all that apply) a. PEFR <300 L/min b. positive sputum culture c. unable to speak in complete sentences d. lack of response to conventional treatment e. chest x-ray show hyperinflated lungs and a flattened diaphragm

a. PEFR <300 L/min c. unable to speak in complete sentences d. lack of response to conventional treatment rationale: Status asthmaticus is characterized by a lack of response to conventional treatment. This is potentially a life-threatening medical emergency, which may require the insertion of an endotracheal tube and mechanical ventilation in the ICU. If the patient can speak in complete sentences, or, has a PEFR >300L/min, then there is no immediate threat to the respiratory system. A chest x-ray with hyperinflated lungs and a flattened diaphragm is strongly suggestive of COPD. A positive sputum culture indicates lung infection.

A nurse is caring for a client who is scheduled for a thoracentesis. Prior to the procedure, which of the following actions should the nurse take? a. Position the client in an upright position, leaning over the bedside table. b. Explain the procedure. c. Obtain ABGs. d. Administer benzocaine spray.

a. Position the client in an upright position, leaning over the bedside table.

Following assessment of a patient with pneumonia, the nurse identifies a nursing diagnosis of ineffective airway clearance. Which assessment data best supports this diagnosis? a. Weak, nonproductive cough effort b. Large amounts of greenish sputum c. Respiratory rate of 28 breaths/minute d. Resting pulse oximetry (SpO2) of 85%

a. Weak, nonproductive cough effort

A patients concerned that he may have asthma. Of the symptoms that he describes to the nurse, which one suggest asthma or risk factors of asthma? (Select all that apply) A. Allergic rhinitis B. Prolonged inhalation C. Cough, especially at night D. Gastric reflux or heartburn D. History of chronic sinusitis

a. allergic rhinitis c. cough, especially at night d. gastric reflux or heartburn e. history of chronic sinusitis rationale: Allergic rhinitis is a major predictor of adult asthma. Acute and chronic sinusitis, especially bacterial rhinosinusitis, may worsen asthma. The chronic inflammation of asthma leads to recurrent episodes of wheezing, breathlessness, chest tightness, and cough, particularly at night or in the early morning. GERD is more common in people with asthma than in the general population. GERD may worsen asthma symptoms because reflux may trigger bronchoconstriction and cause aspiration.

a patient who has bronchiectasis asks the nurse, "what conditions would warrant a call to the clinic?" a. blood clots in the sputum b. sticky sputum on a hot day c. increased shortness of breath after eating a large meal d. production of large amounts of sputum on a daily basis

a. blood clots in the sputum rationale: If hemoptysis occurs, patients should know when they should contact the HCP. In some patients, a spot of blood is usual. The HCP should give explicit instructions about when emergency contact is needed. The other indicators are to be expected in the patient with bronchiectasis, and do not need urgent medical attention

the plan of care for the patient with COPD should include... (select all that apply) a. exercise such as walking b. high flow rate of O2 administration c. low-dose chronic oral corticosteroid therapy d. use of peak flow meter to monitor the progression of COPD e. breathing exercises, such as pursed-lip breathing that focus on exhalation

a. exercises such as walking e. breathing exercises, such as pursed-lip breathing that focus on exhalation rationale: Breathing exercises may assist the patient during rest and activity (e.g., lifting, walking, stair climbing) by decreasing dyspnea, improving oxygenation, and slowing the respiratory rate. The main type of breathing exercise taught is pursed-lip breathing. Walking (or other endurance exercises, such as cycling), combined with strength training, when possible, are probably the best interventions to strengthen muscles and improve the endurance of a patient with chronic obstructive pulmonary disease (COPD).

a client with asthma is taking an inhaler that blocks parasympathetic input to bronchial smooth muscles. Which class of medication is a client taking for asthma control? leukotriene modifier. methylxanthine. adrenergic stimulant. anticholinergic

anticholinergic agent-an inhaler that blocks parasympathetic input to bronchial smooth muscle.

the intensive care nurse is caring for a client diagnosed with status asthmaticus who is currently not receiving medical treatment. What is the client at risk for developing? (select all that apply) hypercapnia. hyperresonance.. alkalosis. anxiety. hyporeflexia.

at risk for developing​ hypercapnia, hyperresonance, anxiety, and acidosis

A nurse in a provider's office is reviewing information with a client scheduled for pulmonary function tests (PFTs). Which of the following information should the nurse include? a. "Do not use inhaler medications for 6 hr following the test." b. "Do not smoke tobacco for 6 to 8 hr prior to the test." c. "You will be asked to bear down and hold your breath during the test." d. "The arterial blood flow to your hand will be evaluated as part of the test

b. "Do not smoke tobacco for 6 to 8 hr prior to the test."

a nurse is caring for a client 2 hours after admission. the client has a SaO2 of 91%, exhibits Audible wheezes, and is using accessory muscles when breathing. which of the following classes of medications should the nurse expect to administer? antibiotic. beta blocker. antiviral. beta 2 Agonist.

beta 2 Agonist. the nurse should administer beta 2 Agonist which cause dilation of the bronchioles.

The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD). Which information obtained from the patient would prompt the nurse to consult with the health care provider before administering the prescribed theophylline? a. The patient reports a recent 15-lb weight gain. b. The patient denies shortness of breath at present. c. The patient takes cimetidine (Tagamet HB) daily. d. The patient complains of coughing up green mucus.

c. The patient takes cimetidine (Tagamet HB) daily.

which medications would be MOST appropriate to administer to a patient experiencing an acute asthma attack? (select all that apply) a. montelukast (singulair) b. inhaled hypertonic saline c. albuterol (proventil HFA) d. ipratropium (atrovent HFA) e. salmeterol (serevent diskus)

c. albuterol (proventil HFA) d. iprotropium (atrovent HFA) rationale: The mainstay of acute asthmatic treatment is inhalation of short-acting β2- adrenergic agonist (SABA) bronchodilators, such as albuterol (ProAir HFA, Proventil HFA, Ventolin HFA). In patients with a moderate to severe attack, inhaled ipratropium (Atrovent) is used in conjunction with SABA. Salmeterol (Serevent Diskus) and montelukast (Singulair) are long-term control medications. Inhaled hypertonic saline is used in cystic fibrosis and bronchiectasis to help thin secretions.

A nurse is assessing a client following a bronchoscopy. Which of the following findings should the nurse report to the provider? a. Blood-tinged sputum b. Dry, nonproductive cough c. Sore throat d. Bronchospasms

d. Bronchospasms

Which information will the nurse include in the asthma teaching plan for a patient being discharged? a. Use the inhaled corticosteroid when shortness of breath occurs. b. Inhale slowly and deeply when using the dry powder inhaler (DPI). c. Hold your breath for 5 seconds after using the bronchodilator inhaler. d. Tremors are an expected side effect of rapidly acting bronchodilators.

d. Tremors are an expected side effect of rapidly acting bronchodilators.

which guideline should the nurse include when teaching a patient how to use a metered-dose inhaler (MDI)? a. after activating the MDI, breathe in as quickly as you can b. estimate the amount of remaining medicine in the MDI by floating the canister in water c. disassemble the plastic canister from the inhaler and rinse both pieces under running water every week d. to determine how long the canister will last, divide the total number of puffs in the canister by the puffs needed per day

d. to determine how long the canister will last, divide the total number of puffs in the canister by the puffs needed per day rationale: The patient needs to know the correct way to determine if the metered-dose inhaler (MDI) is empty. The patient should divide the total number of puffs in the canister by the puffs needed per day. The other statements are incorrect

a nurse is assessing a client who has a history of asthma. Which of the following factors should the nurse identify as a risk for asthma? gender. environmental allergies. alcohol use. race.

environmental allergens. environmental allergens are a risk factor associated with asthma. a client who has environmental allergies typically has other allergic problems, such as rhinitis or a skin rash.

a client with asthma reports I cannot catch my breath with the most simple of tasks, and I find the only thing I can do is sit in a chair most days. Based on these symptoms, what classification of asthma is the client experiencing? mild persistent mild intermittent moderate persistent severe persistent

severe persistent based on constant symptoms and limitations to physical activity

the major advantage of a venturi mask is that it can... a. deliver up to 80% O2 b. provide continuous 100% humidity c. deliver a precise concentration of O2 d. be used while a patient eats and sleeps

the major advantage of a venturi mask is that it can... a. deliver up to 80% O2 b. provide continuous 100% humidity c. deliver a precise concentration of O2 d. be used while a patient eats and sleeps