Prep U Chapter 24

A client is diagnosed with a chronic respiratory disorder. After assessing the client's knowledge of the disorder, the nurse prepares a teaching plan. This teaching plan is most likely to include which nursing diagnosis? Imbalanced nutrition: More than body requirements Impaired swallowing Anxiety Unilateral neglect

Anxiety

A nurse is teaching a client with emphysema how to perform pursed-lip breathing. The client asks the nurse to explain the purpose of this breathing technique. Which explanation should the nurse provide? It increases inspiratory muscle strength. It helps prevent early airway collapse. It prolongs the inspiratory phase of respiration. It decreases use of accessory breathing muscles.

It helps prevent early airway collapse.

Which of the following is not a primary symptom of COPD? Cough Sputum production Weight gain Dyspnea upon exertion

Weight gain

A client with chronic obstructive pulmonary disease (COPD) is admitted to the medical-surgical unit. To help this client maintain a patent airway and achieve maximal gas exchange, the nurse should: instruct the client to drink at least 2 L of fluid daily. administer pain medication as ordered. maintain the client on bed rest. administer anxiolytics, as ordered, to control anxiety.

instruct the client to drink at least 2 L of fluid daily.

A patient is prescribed a mast cell stabilizer for the treatment of asthma. Which commonly used medication will the nurse educate the patient about? Albuterol Cromolyn sodium Budesonide Theophylline

Cromolyn sodium

Which of the following is a symptom diagnostic of emphysema? Dyspnea Copious sputum production The occurrence of corpulmonale Normal elastic recoil

Dyspnea

The classification of Stage II of COPD is defined as at risk for COPD. moderate COPD. very severe COPD. severe COPD. mild COPD.

moderate COPD.

A client with chronic obstructive pulmonary disease (COPD) is recovering from a myocardial infarction. Because the client is extremely weak and can't produce an effective cough, the nurse should monitor closely for: pleural effusion. pulmonary edema. oxygen toxicity. atelectasis.

atelectasis.

The classification of grade I COPD is defined as mild COPD. moderate COPD. severe COPD. very severe COPD.

mild COPD.

Asthma is cause by which type of response? IgM-mediated IgE-mediated IgA-mediated IgD-mediated

IgE-mediated

Which is the strongest predisposing factor for asthma? Allergy Congenital malformations Male gender Air pollution

Allergy

A nurse is developing a teaching plan for a client with asthma. Which teaching point has the highest priority? Avoid contact with fur-bearing animals. Take ordered medications as scheduled. Avoid goose down pillows. Change filters on heating and air conditioning units frequently.

Take ordered medications as scheduled.

A nurse is assisting with a subclavian vein central line insertion when the client's oxygen saturation drops rapidly. He complains of shortness of breath and becomes tachypneic. The nurse suspects the client has developed a pneumothorax. Further assessment findings supporting the presence of a pneumothorax include: paradoxical chest wall movement with respirations. muffled or distant heart sounds. diminished or absent breath sounds on the affected side. tracheal deviation to the unaffected side.

diminished or absent breath sounds on the affected side.

As status asthmaticus worsens, the nurse would expect which acid-base imbalance? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Respiratory acidosis

The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstruction that leads to the collapse of alveoli. This complication is known as Atelectasis Pneumonia Emphysema Pleurisy

Atelectasis

Which exposure acts as a risk factor for and accounts for the majority of cases of chronic obstructive pulmonary disease (COPD)? Passive smoking Ambient air pollution Occupational exposure Exposure to tobacco smoke

Exposure to tobacco smoke

Which vaccine should a nurse encourage a client with chronic obstructive pulmonary disease (COPD) to receive? Influenza Human papilloma virus (HPV) Hepatitis B Varicella

Influenza

A client has a history of chronic obstructive pulmonary disease (COPD). Following a coughing episode, the client reports sudden and unrelieved shortness of breath. Which of the following is the most important for the nurse to assess? Heart rate Lung sounds Skin color Respiratory rate

Lung sounds

A patient with asthma is prescribed a short acting beta-adrenergic (SABA) for quick relief. Which of the following is the most likely drug to be prescribed? Combivent Atrovent Flovent Proventil

Proventil

A patient is being treated for status asthmaticus. What danger sign does the nurse observe that can indicate impending respiratory failure? Metabolic acidosis Respiratory acidosis Metabolic alkalosis Respiratory alkalosis

Respiratory acidosis

Histamine, a mediator that supports the inflammatory process in asthma, is secreted by Mast cells Neutrophils Lymphocytes Eosiniphils

Mast cells

A client is being seen in the emergency department for exacerbation of chronic obstructive pulmonary disease (COPD). The first action of the nurse is to administer which of the following prescribed treatments? Intravenous methylprednisolone (Solu-Medrol) 120 mg Oxygen through nasal cannula at 2 L/minute Ipratropium bromide (Alupent) by metered-dose inhaler Vancomycin 1 gram intravenously over 1 hour

Oxygen through nasal cannula at 2 L/minute

A client with bronchiectasis is admitted to the nursing unit. The primary focus of nursing care for this client includes providing the client a low-calorie, high-fiber diet. teaching the family how to perform postural drainage. implementing measures to clear pulmonary secretions. instructing the client on the signs of respiratory infection.

implementing measures to clear pulmonary secretions.

The classification of Stage III of COPD is defined as severe COPD. moderate COPD. mild COPD. at risk for COPD. very severe COPD.

severe COPD.

The classification of Stage IV of COPD is defined as mild COPD. at risk for COPD. moderate COPD. very severe COPD. severe COPD.

very severe COPD.

The nurse is reviewing pressurized metered-dose inhaler (pMDI) instructions with a client. Which statement by the client indicates the need for further instruction? "I will shake the MDI container before I use it." "I can't use a spacer or holding chamber with the MDI." "Because I am prescribed a corticosteroid-containing MDI, I will rinse my mouth with water after use." "I will take a slow, deep breath in after pushing down on the MDI."

"I can't use a spacer or holding chamber with the MDI."

Upon assessment, the nurse suspects that a patient with COPD may have bronchospasm. What manifestations validate the nurse's concern? (Select all that apply.) Compromised gas exchange Ascites Wheezes Decreased airflow Jugular vein distention

Compromised gas exchange Wheezes Decreased airflow

Which statement describes emphysema? A disease of the airways characterized by destruction of the walls of overdistended alveoli Presence of cough and sputum production for at least a combined total of 2 to 3 months in each of two consecutive years A disease that results in reversible airflow obstruction, a common clinical outcome Chronic dilatation of a bronchus or bronchi

A disease of the airways characterized by destruction of the walls of overdistended alveoli

A client is being treated in the ED for respiratory distress coupled with pneumonia. The client has no medical history. However, the client works in a coal mine and smokes 10 cigarettes a day. The nurse anticipates which order based on the client's immediate needs? Completion of a 12-lead ECG Client education: avoidance of irritants like smoke and pollutants Administration of antibiotics Administration of corticosteroids and bronchodilators

Administration of antibiotics

In which statements regarding medications taken by a client diagnosed with COPD do the the drug name and the drug category correctly match? Select all that apply. Cotrimoxazole is a bronchodilator. Albuterol is a bronchodilator. Prednisone is a corticosteroid. Dexamethasone is an antibiotic. Ciprofloxacin is an antibiotic.

Albuterol is a bronchodilator. Prednisone is a corticosteroid. Ciprofloxacin is an antibiotic.

A client with chronic obstructive pulmonary disease (COPD) is admitted to an acute care facility because of an acute respiratory infection. When assessing the client's respiratory status, which finding should the nurse anticipate? An inspiratory-expiratory (I:E) ratio of 2:1 An oxygen saturation of 99% A transverse chest diameter twice that of the anteroposterior diameter A respiratory rate of 12 breaths/minute

An inspiratory-expiratory (I:E) ratio of 2:1

The nurse is assigned to care for a patient with COPD with hypoxemia and hypercapnia. When planning care for this patient, what does the nurse understand is the main goal of treatment? Increasing pH Providing sufficient oxygen to improve oxygenation Monitoring the pulse oximetry to assess need for early intervention when PCO2 levels rise Avoiding the use of oxygen to decrease the hypoxic drive

Providing sufficient oxygen to improve oxygenation

After reviewing the pharmacological treatment for pulmonary diseases, the nursing student knows that bronchodilators relieve bronchospasm in three ways. Choose the correct three of the following options. Reduce airway obstruction Decrease alveolar ventilation Alter smooth muscle tone Increase oxygen distribution

Reduce airway obstruction Alter smooth muscle tone Increase oxygen distribution

In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to which of the following acid-base imbalances? Respiratory alkalosis Respiratory acidosis Metabolic alkalosis Metabolic acidosis

Respiratory acidosis

The goal for oxygen therapy in COPD is to support tissue oxygenation, decrease the work of the cardiopulmonary system, and maintain the resting partial arterial pressure of oxygen (PaO2) of at least ______ mm Hg and an arterial oxygen saturation (SaO2) of at least ___%. 60 mm Hg; 90% 54 mm Hg; 84% 56 mm Hg; 86% 58 mm Hg; 88%

60 mm Hg; 90%

Which of the following is the most common chronic disease of childhood? Autism Cerebral palsy Asthma Obesity

Asthma

Which statement is true about both lung transplant and bullectomy? Both procedures treat patients with bullous emphysema. Both procedures treat end-stage emphysema. Both procedures cure COPD. Both procedures improve the overall quality of life of a client with COPD.

Both procedures improve the overall quality of life of a client with COPD.

A nurse administers albuterol (Proventil), as ordered, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect? Urine output of 40 ml/hour Dilated and reactive pupils Respiratory rate of 22 breaths/minute Heart rate of 100 beats/minute

Respiratory rate of 22 breaths/minute