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A 55-year-old patient with increasing dyspnea is being evaluated for a possible diagnosis of chronic obstructive pulmonary disease (COPD). When teaching a patient about pulmonary function testing (PFT) for this condition, what is the most important question the nurse should ask? "Have you taken any bronchodilators in the past 6 hours?" "Are you claustrophobic?" "Are you allergic to shellfish?" "Do you have any metal implants or prostheses?"

"Have you taken any bronchodilators in the past 6 hours?"

The nurse provides dietary teaching for a patient with chronic obstructive pulmonary disease (COPD) who has a low body mass index (BMI). Which patient statement indicates that the teaching has been effective? "I can have ice cream as a snack every day." "I will drink lots of fluids with my meals." "I will decrease my intake of meat and poultry." "I will exercise for 15 minutes before meals."

"I can have ice cream as a snack every day."

Which instruction should the nurse include in an exercise teaching plan for a patient with chronic obstructive pulmonary disease (COPD)? "Upper body exercise should be avoided to prevent dyspnea." "Stop exercising if you start to feel short of breath." "Breathe in and out through the mouth while you exercise." "Use the bronchodilator before you start to exercise."

"Use the bronchodilator before you start to exercise."

The nurse in the emergency department receives arterial blood gas results for four recently admitted patients with obstructive pulmonary disease. Which patient will require the most rapid action by the nurse? 65-year-old with ABG results: pH 7.31, PaCO2 58 mm Hg, and PaO2 64 mm Hg 22-year-old with ABG results: pH 7.28, PaCO2 60 mm Hg, and PaO2 58 mm Hg 34-year-old with ABG results: pH 7.48, PaCO2 30 mm Hg, and PaO2 65 mm Hg 45-year-old with ABG results: pH 7.34, PaCO2 33 mm Hg, and PaO2 80 mm Hg

22-year-old with ABG results: pH 7.28, PaCO2 60 mm Hg, and PaO2 58 mm Hg

The nurse receives a change-of-shift report on the following patients with chronic obstructive pulmonary disease (COPD). Which patient should the nurse assess first? A patient with a respiratory rate of 38/minute A patient with jugular venous distention and peripheral edema A patient who has a cough productive of thick, green mucus A patient with loud expiratory wheezes

A patient with a respiratory rate of 38/minute

The nurse notes thick, white secretions in the endotracheal tube (ET) of a patient who is receiving mechanical ventilation. Which intervention will be most effective in addressing this problem? Increase suctioning to every hour. Instill 5 mL of sterile saline into the ET before suctioning. Reposition the patient every 1 to 2 hours. . Add additional water to the patient's enteral feedings.

Add additional water to the patient's enteral feedings.

A patient seen in the asthma clinic has recorded daily peak flows that are 75% of the baseline. Which action will the nurse plan to take next? Instruct the patient to keep the next scheduled follow-up appointment. Increase the dose of the leukotriene inhibitor. Teach the patient about the use of oral corticosteroids. Administer a bronchodilator and recheck the peak flow.

Administer a bronchodilator and recheck the peak flow.

The nurse reviews the medication administration record (MAR) for a patient having an acute asthma attack. Which medication should the nurse administer first? Salmeterol (Serevent) 50 mcg per dry-powder inhaler (DPI) Methylprednisolone (Solu-Medrol) 60 mg IV Albuterol (Ventolin) 2.5 mg per nebulizer Triamcinolone (Azmacort) 2 puffs per metered-dose inhaler (MDI)

Albuterol (Ventolin) 2.5 mg per nebulizer

While family members are visiting, a patient has a respiratory arrest and is being resuscitated. Which action by the nurse is best? Tell the family members that watching the resuscitation will be very stressful. Take the family members quickly out of the patient room and remain with them. Ask family members if they wish to remain in the room during the resuscitation. Assign a staff member to wait with family members just outside the patient room.

Ask family members if they wish to remain in the room during the resuscitation.

Which finding in a patient hospitalized with bronchiectasis is most important to report to the health care provider? Scattered rhonchi and wheezes heard bilaterally Complaint of sharp chest pain with deep breathing Respiratory rate 28 breaths/minute while ambulating in hallway Cough productive of bloody, purulent mucus

Cough productive of bloody, purulent mucus

A patient with chronic obstructive pulmonary disease (COPD) has poor gas exchange. Which action by the nurse would be most appropriate? Ask the patient to rest in bed in a high-Fowler's position with the knees flexed. Encourage the patient to sit up at the bedside in a chair and lean slightly forward. Have the patient rest in bed with the head elevated to 15 to 20 degrees. Place the patient in the Trendelenburg position with several pillows behind the head.

Encourage the patient to sit up at the bedside in a chair and lean slightly forward.

Which assessment finding in a patient who has received omalizumab (Xolair) is most important to report immediately to the health care provider? Flushing and dizziness Respiratory rate 22 breaths/minute Peak flow reading 75% of normal Pain at injection sit

Flushing and dizziness

The clinic nurse makes a follow-up telephone call to a patient with asthma. The patient reports having a baseline peak flow reading of 600 L/minute and the current peak flow is 420 L/minute. Which action should the nurse take first? Ask about recent exposure to any new allergens or asthma triggers. Question the patient about use of the prescribed inhaled corticosteroids. Tell the patient to go to the hospital emergency department. Instruct the patient to use the prescribed albuterol (Proventil).

Instruct the patient to use the prescribed albuterol (Proventil).

A patient who is experiencing an acute asthma attack is admitted to the emergency department. Which assessment should the nurse complete first? Determine when the dyspnea started. Listen to the patient's breath sounds. Obtain the forced expiratory volume (FEV) flow rate. Ask about inhaled corticosteroid use.

Listen to the patient's breath sounds.

The nurse is admitting a patient diagnosed with an acute exacerbation of chronic obstructive pulmonary disease (COPD).What is the best way for the nurse to determine the appropriate oxygen flow rate? Avoid administration of oxygen at a rate of more than 2 L/minute Maintain the pulse oximetry level at 90% or greater. Minimize oxygen use to avoid oxygen dependency. Administer oxygen according to the patient's level of dyspnea.

Maintain the pulse oximetry level at 90% or greater.

A patient who is experiencing an asthma attack develops bradycardia and a decrease in wheezing. Which action should the nurse take first? Notify the health care provider. Document changes in respiratory status. Administer IV methylprednisolone (Solu-Medrol). Encourage the patient to cough and deep breathe.

Notify the health care provider.

Which nursing action for a patient with chronic obstructive pulmonary disease (COPD) could the nurse delegate to experienced unlicensed assistive personnel (UAP)? Adjust oxygen to keep saturation in prescribed parameters. Obtain oxygen saturation using pulse oximetry. Teach the patient about safe use of oxygen at home. Monitor for increased oxygen need with exercise.

Obtain oxygen saturation using pulse oximetry.

A patient with chronic obstructive pulmonary disease (COPD) has a nursing diagnosis of imbalanced nutrition: less than body requirements. Which intervention would be most appropriate for the nurse to include in the plan of care? Offer high-calorie snacks between meals and at bedtime. Increase the patient's intake of fruits and fruit juices. Encourage increased intake of whole grains. Assist the patient in choosing foods with high vegetable and mineral content.

Offer high-calorie snacks between meals and at bedtime.

The emergency department nurse is evaluating the effectiveness of therapy for a patient who has received treatment during an asthma attack. Which assessment finding is the best indicator that the therapy has been effective? Respiratory rate is 16 breaths/minute. Oxygen saturation is >90%. Accessory muscle use has decreased. No wheezes are audible.

Oxygen saturation is >90%.

A young adult patient with cystic fibrosis (CF) is admitted to the hospital with increased dyspnea. Which intervention should the nurse include in the plan of care? Arrange for a hospice nurse visit. Perform chest physiotherapy every 4 hours. Place the patient on a low-sodium diet. Schedule a sweat chloride test.

Perform chest physiotherapy every 4 hours.

The nurse is caring for a patient with cor pulmonale. The nurse should monitor the patient for which expected finding? Complaints of chest pain Elevated temperature Peripheral edema Clubbing of the fingers

Peripheral edema

Which finding by the nurse for a patient with a nursing diagnosis of impaired gas exchange will be most useful in evaluating the effectiveness of treatment? Absence of wheezes, rhonchi, or crackles Respiratory rate of 18 breaths/minute Even, unlabored respirations Pulse oximetry reading of 92%

Pulse oximetry reading of 92%

A patient newly diagnosed with asthma is being discharged. The nurse anticipates including which topic in the discharge teaching? Self-administration of inhaled corticosteroids Side effects of sustained-release theophylline Use of long-acting b-adrenergic medications Complications associated wit oxygen therapy

Self-administration of inhaled corticosteroids

A patient with chronic obstructive pulmonary disease (COPD) has a nursing diagnosis of impaired breathing pattern related to anxiety. Which nursing action is most appropriate to include in the plan of care? Titrate oxygen to keep saturation at least 90%. Teach the patient how to effectively use pursed lip breathing. Suggest the use of over-the-counter sedative medications. Discuss a high-protein, high-calorie diet with the patient.

Teach the patient how to effectively use pursed lip breathing.

The nurse educator is evaluating the care that a new registered nurse (RN) provides to a patient receiving mechanical ventilation. Which action by the new RN indicates the need for more education? The RN increases the FIO2 to 100% before suctioning. The RN positions the patient with the head of bed at 10 degrees. The RN secures a bite block in place using adhesive tape. The RN asks for assistance to reposition the endotracheal tube.

The RN positions the patient with the head of bed at 10 degrees.

The nurse educator is evaluating the performance of a new registered nurse (RN) who is providing care to a patient who is receiving mechanical ventilation with 15 cm H2O of peak end-expiratory pressure (PEEP). Which action indicates that the new RN is safe? The RN changes the ventilator circuit tubing routinely every 48 hours. The RN tapes connection between the ventilator tubing and the ET. The RN plans to suction the patient every 1 to 2 hours. The RN uses a closed-suction technique to suction the patient.

The RN uses a closed-suction technique to suction the patient.

The nurse interviews a patient with a new diagnosis of chronic obstructive pulmonary disease (COPD). Which information is most helpful in confirming a diagnosis of chronic bronchitis? The patient's history indicates a 30 pack-year cigarette history. The patient denies having any respiratory problems until the last 12 months. The patient tells the nurse about a family history of bronchitis. The patient complains about a productive cough every winter for 3 months.

The patient complains about a productive cough every winter for 3 months.

The nurse teaches a patient about pursed lip breathing. Which action by the patient would indicate to the nurse that further teaching is needed? The patient practices by blowing through a straw. The patient inhales slowly through the nose. The patient puffs up the cheeks while exhaling. The patient's ratio of inhalation to exhalation is 1:3.

The patient puffs up the cheeks while exhaling.

The nurse teaches a patient with chronic bronchitis about a new prescription for Advair Diskus (combined fluticasone and salmeterol). Which action by the patient would indicate to the nurse that teaching about medication administration has been successful? The patient shakes the device before use. The patient attaches a spacer to the Diskus. The patient performs huff coughing after inhalation. The patient rapidly inhales the medication.

The patient rapidly inhales the medication.

The nurse teaches a patient how to administer formoterol (Perforomist) through a nebulizer. Which action by the patient indicates good understanding of the teaching? The patient coughs vigorously after using the inhaler. The patient attaches a spacer before using the inhaler. The patient activates the inhaler at the onset of expiration. The patient removes the facial mask when misting has ceased.

The patient removes the facial mask when misting has ceased.

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? The patient takes cimetidine (Tagamet) 150 mg daily. The patient complains about coughing up green mucus. The patient denies any shortness of breath at present. The patient reports a recent 15-pound weight gain.

The patient takes cimetidine (Tagamet) 150 mg daily.

The nurse takes an admission history on a patient with possible asthma who has new-onset wheezing and shortness of breath. Which information may indicate a need for a change in therapy? The patient takes propranolol (Inderal) for hypertension. The patient has a history of pneumonia 6 months ago. The patient uses acetaminophen (Tylenol) for headaches. The patient has chronic inflammatory bowel disease.

The patient takes propranolol (Inderal) for hypertension.

The nurse teaches a patient who has asthma about peak flow meter use. Which action by the patient indicates that teaching was successful? The patient takes montelukast (Singulair) for peak flows in the red zone. The patient uses albuterol (Proventil) metered dose inhaler (MDI) for peak flows in the yellow zone. The patient inhales rapidly through the peak flow meter mouthpiece. The patient calls the health care provider when the peak flow is in the green zone.

The patient uses albuterol (Proventil) metered dose inhaler (MDI) for peak flows in the yellow zone.

The nurse completes an admission assessment on a patient with asthma. Which information given by patient is most indicative of a need for a change in therapy? The patient's heart rate increases after using the albuterol (Proventil) inhaler. The patient uses albuterol (Proventil) before any aerobic exercise. The patient's only medications are albuterol (Proventil) and salmeterol (Serevent). The patient says that the asthma symptoms are worse every spring.

The patient's only medications are albuterol (Proventil) and salmeterol (Serevent).

Which assessment finding obtained by the nurse when caring for a patient receiving mechanical ventilation indicates the need for suctioning? The patient's oxygen saturation is 93%. The patient's respiratory rate is 32 breaths/minute. The patient was last suctioned 6 hours ago. The patient has occasional audible expiratory wheezes.

The patient's respiratory rate is 32 breaths/minute.

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

Tremors are an expected side effect of rapidly acting bronchodilator

The nurse assesses a patient with a history of asthma. Which assessment finding indicates that the nurse should take immediate action? Use of accessory muscles in breathing Pulse oximetry reading of 91% Peak expiratory flow rate of 240 L/minute Respiratory rate of 26 breaths/minute

Use of accessory muscles in breathing

A patient is scheduled for pulmonary function testing. Which action should the nurse take to prepare the patient for this procedure? Administer oral corticosteroids 2 hours before the procedure. Give the rescue medication immediately before testing. Withhold bronchodilators for 6 to 12 hours before the examination. Ensure that the patient has been NPO for several hours before the test.

Withhold bronchodilators for 6 to 12 hours before the examination.

An 81-year-old patient who has been in the intensive care unit (ICU) for a week is now stable and transfer to the progressive care unit is planned. On rounds, the nurse notices that the patient has new onset confusion. The nurse will plan to notify the health care provider and postpone the transfer. obtain an order for restraints as needed and transfer the patient. inform the receiving nurse and then transfer the patient. give PRN lorazepam (Ativan) and cancel the transfe

inform the receiving nurse and then transfer the patient.

To verify the correct placement of an oral endotracheal tube (ET) after insertion, the best initial action by the nurse is to auscultate for the presence of bilateral breath sounds. use an end-tidal CO2 monitor to check for placement in the trachea. observe the chest for symmetric chest movement with ventilation. obtain a portable chest x-ray to check tube placement.

use an end-tidal CO2 monitor to check for placement in the trachea.