nsg 121 COPD/Asthma
A nurse is caring for a patient who has been admitted with an exacerbation of chronic bronchiectasis. The nurse should expect to assess the patient for which of the following clinical manifestations? A) Copious sputum production B) Pain on inspiration C) Pigeon chest D) Dry cough
A) Copious sputum production
A nurse has been asked to give a workshop on COPD for a local community group. The nurse emphasizes the importance of smoking cessation because smoking has what pathophysiologic effect? A) Increases the amount of mucus production B) Destabilizes hemoglobin C) Shrinks the alveoli in the lungs D) Collapses the alveoli in the lungs
A) Increases the amount of mucus production
A pediatric nurse practitioner is caring for a child who has just been diagnosed with asthma. The nurse has provided the parents with information that includes potential causative agents for an asthmatic reaction. What potential causative agent should the nurse describe? A) Pets B) Lack of sleep C) Psychosocial stress D) Bacteria
A) Pets
A nurse is admitting a new patient who has been admitted with a diagnosis of COPD exacerbation. How can the nurse best help the patient achieve the goal of maintaining effective oxygenation? A) Teach the patient strategies from promoting diaphragmatic breathing. B) Administer supplementary oxygen by simple face mask. C) Teach the patient to perform airway suctioning. D) Assist the patient in developing an appropriate exercise program.
A) Teach the patient strategies from promoting diaphragmatic breathing.
A nurse is planning the care of a client with bronchiectasis. What goal of care should the nurse prioritize? A) the patient will successfully mobilize pulmonary secretions. B) The patient will maintain oxygen saturation level of 98%. C) The patients pulmonary blood pressure will decrease within reference ranges. D) The patient will resume prediagnosis level of function within 72 hours.
A) successfully mobilize pulmonary secretions.
A nurse is working with a child who is undergoing a diagnostic workup for suspected asthma. What are the signs and symptoms that are consistent with a diagnosis of asthma? Select all the apply. A) Chest tightness B) Crackles C) Bradypnea D) Wheezing E) Cough
A, D, E
A nurse is caring for a patient who has been hospitalized with an acute asthma exacerbation. What drugs should the nurse expect to be ordered for this patient to gain underlying control of persistent asthma? A) Rescue inhalers B) Anti-inflammatory drugs C) Antibiotics D) Antitussives
B) Anti-inflammatory drugs
A nurse is reviewing the pathophysiology of Cystic Fibrosis in anticipation of a new admission. The nurse should identify what characteristic aspects of CF? A) Alveolar mucus plugging, infection, and eventual bronchiectasis B) Bronchial mucus plugging, inflammation, and eventual bronchiectasis C) Atelectasis, infection, and eventual COPD D) Bronchial mucus plugging, infection, and eventual COPD
B) Bronchial mucus plugging, inflammation, and eventual bronchiectasis
A nurse is developing with the teaching portion of a care plan for a patient with COPD. What should be the most important component for the nurse to emphasize? A) smoking up to one-half a pack of cigarettes weekly is allowable B) Chronic inhalation of indoor toxins can cause lung damage C) Minor respiratory infections are considered to be self-limited and are not treated D0 Activities of daily living (ADLs) should be clustered in the early morning hours
B) Chronic inhalation of indoor toxins can cause lung damage
An asthma nurse educator is working with a group of adolescent asthma patients. What intervention is most likely to prevent asthma exacerbations among these patients? A) Encouraging patients to carry a corticosteroid rescue inhaler at all times B) Educating patients about recognizing and avoiding asthma triggers C) Teaching patients to utilize alternative therapies in asthma management D) Ensuring that patients keep their immunizations up to date
B) Educating patients about recognizing and avoiding asthma triggers
An asthma educator is teaching a patient newly diagnosed with asthma and her family about the use of a peak flow meter. The educator should teach the patient that a peak flow meter measures what value? A) Highest airflow during a forced inspiration B) Highest airflow during a forced expiration C) Airflow during a normal inspiration D) Airflow during a normal expiration
B) Highest airflow during a forced expiration
A nurse is caring for a young adult patient whose medical history includes Alpha1- antitrypsin deficiency. This deficiency predisposes the patient to what health problem? A) Pulmonary edema B) Lobular emphysema C) Cystic Fibrosis D) Empyema
B) Lobular emphysema
A patient with emphysema is experiencing shortness of breath. To relieve this patients symptoms, the nurse should assist her into what position? A) Low fowler, with the neck slightly hyperextended B) sitting upright leaning forward slightly C) Trendelenburg D) Prone
B) sitting upright leaning forward slightly
An older adult patient has been diagnosed with COPD. What characteristic of the patients current health status would preclude the safe and effective use of a metered-dose inhaler (MDI)? A) The patient has not yet quit smoking B) the patient has severe arthritis in her hands C) The patient requires both corticosteroids and beta2-agonists D) The patient has cataracts
B) the patient has severe arthritis in her hands
A nurse is assessing a patient who is suspected of having bronchiectasis. The nurse should consider which of the following potential causes? Select all the apply. A) Pulmonary hypertension B) Airway obstruction C) Pulmonary infections D) Genetic disorders E) Atelectasis
B, C, D
An interdisciplinary team is planning the care of a patient with bronchiectasis. What aspects of care should the nurse anticipate? Select all that apply. A) Occupational therapy B) Antimicrobial therapy C) Positive pressure isolation D) Chest physiotherapy E) Smoking cessation
B, D, E
The nurse is assessing a patient whose respiratory disease in characterized by chronic hyperinflation of the lungs. What would the nurse most likely assess in this patient? A) Signs of oxygen toxicity B) Chronic chest pain C) A barrel chest D) Long thin fingers
C) A barrel chest
A nurse is completing a focused respiratory assessment of a child with asthma. What assessment finding is most likely associated with the characteristic signs and symptoms of asthma? A) Shallow respirations B) Increased anterior-posterior (A-P) diameter C) Bilateral wheezes D) Bradypnea
C) Bilateral wheezes
A nurse is teaching a patient with asthma about Azmacort, an inhaled corticosteroid. Which adverse effects should the nurse be sure to address in patient teaching? A) Dyspnea and increased respiratory secretions. B) Nausea and vomiting C) Cough and oral thrush D) fatigue and decreased level of consciousness
C) Cough and oral thrush
A nurse is evaluating the diagnostic study data of a patient with Cystic Fibrosis. Which of the following test results is associated with a diagnosis of Cystic Fibrosis? A) Presence of protein in the urine B) Positive phenylketonuria C) Elevated sweat chloride concentration D) Malignancy on lung biopsy
C) Elevated sweat chloride concentration
A nurse is creating a health promotion intervention focused on COPD. What should the nurse identify as a complication of COPD? A) Lung Cancer B) Cystic Fibrosis C) Respiratory failure D) Hemothorax
C) Respiratory failure
A nurse is providing discharge teaching for a client with COPD. When teaching the client about breathing exercises, what should the nurse include in the teaching? A) Lie supine to facilitate air entry B) Avoid pursed lip breathing C) Use diaphragmatic breathing D) Use chest breathing
C) Use diaphragmatic breathing
A clinic nurse is caring for a patient who has just been diagnosed with COPD. The patient asks the nurse what he could have done to minimize the risk of contracting this disease. What would the nurses best answer? A) the most important risk factor is inadequate exercise. B)"..." exposure to dust and pollen. C)"..." cigarette smoking. D)".." exposure to occupational toxins.
C) cigarette smoking
A patients severe asthma has necessitated the use of a long-acting beta2-agonist (LABA). Which of the patients statements suggests a need for further education? A) I know that these drugs can sometimes make my heart beat faster. B) Ive heard that this drug is particularly good at preventing asthma attacks during exercise. C) I'll make sure to use this each time I feel an asthma attack coming on. D) I've heard that this drug sometimes get less effective over time.
C) make sure to use this each time I feel an asthma attack coming on.
A school nurse is caring for a 10 year old girl who is having an asthma attack. What is the preferred intervention to alleviate this clients airflow obstruction? A) Utilize a peak flow monitoring device B) Administer corticosteroids by meter dose inhalers C) Administer inhaled anticholinergics D) Administer an inhaled beta-adrenergic agonist
D) Administer an inhaled beta-adrenergic agonist
A nurse is documenting the results of assessment of a patient with bronchiectasis. What should the nurse most likely include in documentation? A) Sudden onset of pleuritic chest pain B) Wheezes on auscultation C) Increased anterior-posterior (A-P) diameter D) Clubbing of the fingers
D) Clubbing of the fingers
A patient is having pulmonary-function studies performed. The patient performs a spirometry test, revealing an FEV1/FVC ratio of 60%. How should the nurse interpret this assessment finding? A) Strong exercise tolerance B) Exhalation volume is normal C) Respiratory infection D) Obstructive lung disease
D) Obstructive lung disease
A nurse is planning the care of a patient with emphysema who will soon be discharged. What teaching should the nurse prioritize in the plan of care? A) Taking prophylactic antibiotics as ordered B) Adhering to the treatment regimen in order to cure the disease C) Avoiding airplanes, buses, and other crowded public places D) Setting realistic short term and long range goals
D) Setting realistic short term and long range goals
A nurse is preparing to perform an admission assessment on a patient with COPD. It is most important for the nurse to review which of the following? A) Social work assessment B) Insurance coverage C) Chloride levels D) available diagnostic tests
D) available diagnostic tests
A nurse is providing health education to the family of a patient with bronchiectasis. What should the nurse teach the patients family member? A) The correct technique for the chest palpation and auscultation. B) Techniques for assessing the patients fluid balance. C) The technique for providing deep nasotracheal suctioning. D) The correct technique for providing postural drainage.
D) the correct technique for providing postural drainage.
A nurse is explaining to a patient with asthma what her new prescription for prednisone is used for. What would be the most accurate explanation that the nurse could give? A) To ensure long term prevention of asthma exacerbations B) To cure any systemic infection underlying asthma attacks. C) To prevent recurrent pulmonary infections D) To gain prompt control of inadequately controlled, persistent asthma
D) to gain prompt control of inadequately controlled, persistent asthma