COPD practice questions

The term blue bloater is used to describe patients with? A. Pulmonary hypertension B. Left-sided heart failure C. Chronic Bronchitis D. Emphysema

C. Chronic Bronchitis

Which of the following is NOT a sign and symptom of chronic bronchitis? A. Productive cough B. Hyperventilation C. Cyanosis D. Barrel chest

D. Barrel chest

Which of the following statements are incorrect about discharge teaching that you would provide to a patient with COPD? Select-all-that-apply: A. "It is best to eat three large meals a day that are relatively low in calories." B. "Avoid going outside during extremely hot or cold days." C. "It is important to receive the Pneumovax vaccine annually." D. "Smoking cessation can help improve your symptoms."

A. "It is best to eat three large meals a day that are relatively low in calories." C. "It is important to receive the Pneumovax vaccine annually."

Which of the following is most commonly found in a patient with emphysema? A. Barrel chest B. Cyanosis C. V/Q mismatch D. Excessive productive cough

A. Barrel chest

An alarm beeps notifying you that one of your patient's oxygen saturation is reading 89%. You arrive to the patient's room, and see the patient comfortably resting in bed watching television. The patient is already on 2 L of oxygen via nasal cannula. The patient is admitted for COPD exacerbation. Your next nursing action would be: A. Continue to monitor the patient B. Increase the patient's oxygen level to 3 L C. Notify the doctor for further orders D. Turn off the alarm settings

A. Continue to monitor the patient

A patient with severe COPD is having an episode of extreme shortness of breath and requests their inhaler. Which type of inhaler ordered by the physician would provide the FASTEST relief for the patient based on this particular situation? A. Spiriva B. Salmeterol C. Symbicort D. Albuterol

D. Albuterol

In which of the following conditions below do the alveolar sacs lose elasticity which can lead to "air-trapping": A. Chronic Bronchitis B. Emphysema

B. Emphysema

In which of the following conditions below is there a matched V/Q defect? A. Chronic Bronchitis B. Emphysema

B. Emphysema

1. Select ALL the options that are TRUE about chronic bronchitis and emphysema: A. Patients with chronic bronchitis have the ability to fully exhale but have limited airflow. B. Emphysema and chronic bronchitis are irreversible. C. An incentive spirometer is used to diagnose both chronic bronchitis and emphysema. D. Patients with chronic bronchitis are sometimes referred to as "blue bloaters, while patients with emphysema are sometimes referred to as "pink puffers".

B. Emphysema and chronic bronchitis are irreversible. D. Patients with chronic bronchitis are sometimes referred to as "blue bloaters, while patients with emphysema are sometimes referred to as "pink puffers".

A patient is newly diagnosed with COPD due to chronic bronchitis. You're providing education to the patient about this disease process. Which statement by the patient indicates they understood your teaching about this condition? A. "If I stop smoking, it will cure my condition." B. "Complications from this condition can lead to pulmonary hypertension and right-sided heart failure." C. "I'm at risk for low levels of red blood cells due to hypoxia and may require blood transfusions during acute illnesses." D. "My respiratory system is stimulated to breathe due to high carbon dioxide levels rather than low oxygen levels, as with people who have healthy lungs.

C. "I'm at risk for low levels of red blood cells due to hypoxia and may require blood transfusions during acute illnesses."

A patient is presenting with chronic obstructive pulmonary disease. The patient has a chronic productive cough with dyspnea on excretion. Arterial blood gases show a low oxygen level and high carbon dioxide level in the blood. On assessment, the patient has cyanosis in the lips and edema in the abdomen and legs. Based on your nursing knowledge and the patient's symptoms, you suspect the patient suffers from what type of COPD? A. Emphysema B. Pneumonia C. Chronic bronchitis D. Pneumothorax

C. Chronic bronchitis

A patient with emphysema may present with all of the following symptoms EXCEPT? A. Barrel chest B. Hyperinflation of the lung C. Hypoventilation D. Hypercapnia

C. Hypoventilation

Patients with chronic bronchitis and emphysema can MOST COMMONLY experience what type of acid-base imbalance? A. High oxygen level and high carbon dioxide level B. Low oxygen level and low carbon dioxide level C. High oxygen level and low carbon dioxide level D. Low oxygen level and high carbon dioxide level

D. Low oxygen level and high carbon dioxide level

Which of the following is NOT a treatment for chronic bronchitis or emphysema? A. Albuterol B. Spirvia C. Theophylline D. Metoprolol

D. Metoprolol

You are providing teaching to a patient with chronic COPD on how to perform diaphragmatic breathing. This technique helps do the following: A. Increase the breathing rate to prevent hypoxemia B. Decrease the use of the abdominal muscles C. Encourages the use of accessory muscles to help with breathing D. Strengthen the diaphragm

D. Strengthen the diaphragm

True or False: COPD is reversible and tends to happens gradually.* True False

False

which factor causes the clinical manifestations of COPD a) decrease in respiratory drive b) inability to effectively expire air c) enhanced elastic recoil of airways d) diminished inflammatory response

b) inability to effectively expire air

which is the purpose of lung reduction surgery for the patient with chronic obstructive pulmonary disease (COPD) a) returns lung function to normal level of age b) allows more room for normal alveoli to expand c) permits discontinuation of medications for COPD d) replaces disease lung with healthy tissue from a donor

b) allows more room for normal alveoli to expand

how many minutes is the appropriate recovery period after activity for the patient with chronic obstructive pulmonary disease a) 5 b) 10 c) 15 d) 20

a) 5

which finding would confirm a diagnosis of COPD in a patient with dyspnea and a history of tobacco use a) FEV1/FVC ratio of 65% b) positive sputum culture c) flat diaphragm upon chest x-ray d) oxygen saturation of 86% at rest

a) FEV1/FVC ratio of 65%

What are common symptoms of chronic obstructive pulmonary disease (COPD)? Select all that apply. a) Increased shortness of breath b) Wheezing c) Fever with chills d) Frequent cough (with and without mucus) e) Chest tightness

a) Increased shortness of breath b) Wheezing d) Frequent cough (with and without mucus) e) Chest tightness

What clinical indications does a provider use to make a diagnosis of chronic obstructive pulmonary disease (COPD)? Select all that apply. a) Pulmonary function tests b) Chest x-ray c) History of symptoms d) Computed tomography (CT) scan e) Chest pain

a) Pulmonary function tests b) Chest x-ray c) History of symptoms d) Computed tomography (CT) scan

a young adult patient who denies any history of smoking is seen in the clinic with a few diagnosis of COPD. it is most appropriate for the nurse to teach the patient about a) alpha 1 antitrypsin testing b) use of the nicotine patch c) continuous pulse ox d) effects of leukotriene modifiers

a) alpha 1 antitrypsin testing

which findings will the nurse expect when assessing a clinic patient with chronic obstructive pulmonary disease (COPD) (SATA) a) barrel chest on inspection b) egophony on auscultation c) dullness on percussion d) wheezes on auscultation e) increased tactile fremitus on palpation

a) barrel chest on inspection d) wheezes on auscultation

which complication would the nurse expect in a patient with COPD who has alpha 1 antitrypsin (AAT) deficiency a) liver disease b) renal disease c) intestinal dysfunction d) urinary tract dysfunction

a) liver disease

when would the nurse schedule postural drainage for a patient who has chronic obstructive pulmonary disease a) one hour before a meal b) just prior to nebulizer treatment c) when the respiratory therapist is available d) after assisting the patient with huff coughing

a) one hour before a meal

the nurse is caring for a patient with cor pulmonale. the nurse should monitor the patient for which expected finding a) peripheral edema b) elevated temperature c) clubbing of the fingers d) complaints of chest pain

a) peripheral edema

which description best characterizes chronic obstructive pulmonary disease (COPD) a) progressive persistent expiratory airflow limitation b) airway obstruction due to increased mucus production c) difficulty clearing secretions due to dilated bronchioles d) variations in airflow over time with normal lung function in between

a) progressive persistent expiratory airflow limitation

A nurse plans care for a client with chronic obstructive pulmonary disease, knowing that the client is most likely to experience what type of acid-base imbalance? a) respiratory acidosis b) respiratory alkalosis c) metabolic acidosis d) metabolic alkalosis

a) respiratory acidosis

which physiologic effect of ongoing tobacco smoking leads to chronic obstructive pulmonary disease (COPD) a) respiratory tract cell hyperplasia b) impairment of the cough reflex c) increased protease levels d) reversible airway inflammation

a) respiratory tract cell hyperplasia

which diagnostic test for a patient with a chronic cough will be most useful in making a diagnosis of COPD a) spirometry b) chest x ray c) complete blood count d) CT

a) spirometry

which diagnostic test will the clinic nurse anticipate to confirm a diagnosis of chronic obstructive pulmonary disease in a patient with dyspnea a) spirometry b) chest x ray c) arterial blood gas d) ct scan of the chest

a) spirometry

which information about gender, cultural differences, and ethnic differences in patients with obstructive lung disease lung disease will the nurse use when planning care a) white have the highest incidence of cystic fibrosis b) before puberty more girls are affected with asthma than boys c) male african american have higher mortality rates from asthma than other groups d) hispanics have the highest incidence of chronic obstructive pulmonary disease (COPD)

a) white have the highest incidence of cystic fibrosis

which nursing actions will be included for a patient with COPD who is recieiving oxygen therapy through a mask (SATA) a) take a chest radiograph b) choose the optimal oxygen device c) assess the need to change IV fluids d) assess the need to adjust the oxygen flow rate e) monitor for signs of adverse effects of oxygen therapy

b) choose the optimal oxygen device d) assess the need to adjust the oxygen flow rate e) monitor for signs of adverse effects of oxygen therapy

which would the nurse identify as the pulmonary artery pressure at rest in a patient with pulmonary hypertension a) 15 mm Hg b) 25 mm Hg c) 30 mm Hg d) 45 mm Hg

b) 25 mm Hg

As chronic obstructive pulmonary disease (COPD) progresses, what changes will be seen when looking at a client's arterial blood gases (ABGs)? a) Low pH b) Increasing hypercapnia (CO2) c) Respiratory alkalosis d) Increasing oxygenation

b) Increasing hypercapnia (CO2)

Which criteria need to be met for a client to be diagnosed with chronic bronchitis? Select all that apply. a) Regular cigarette smoking b) Other causes ruled out c) X-ray showing enlarged lungs d) Chronic productive cough for 3 months in 2 successive years e) Chronic productive cough for at least 3 weeks in 2 successive months

b) Other causes ruled out d) Chronic productive cough for 3 months in 2 successive years

which of these is a clinical manifestation of early chronic obstructive pulmonary disease (COPD) a) dyspnea at rest b) a chronic intermittent cough c) the presence of chest breathing d) increased numbers of red blood cells

b) a chronic intermittent cough

which action may be beneficial to a patient with chronic obstructive pulmonary disease (COPD) to maximize food intake a) avoiding cold foods b) limiting fluids during mealtimes c) avoiding frequent meals and snacks d) performing physical activity before meals

b) limiting fluids during mealtimes

which complications in a patient with chronic obstructive pulmonary disorder (COPD) require acute intervention (SATA) a) atelectasis b) pneumonia d) cor pulmonale e) mucoid impact f) exacerbations

b) pneumonia d) cor pulmonale f) exacerbations

a patient with COPD has rhonchi throughout the lung fields and a chronic non productive cough. Which nursing intervention will be most effective a) change the oxygen flow rate to the highest prescribed b) teach the patient to use the flutter airway clearance device c) reinforce the ongoing use of pursed lip breathing technique d) teach the patient about consistent use of inhaled corticosteroids

b) teach the patient to use the flutter airway clearance device

which complication would the nurse monitor for when caring for a patient with COPD and cor pulmonale (SATA) a) leukopenia b) weight gain c) polycythemia d) hepatomegaly e) jugular vein distension

b) weight gain c) polycythemia d) hepatomegaly e) jugular vein distension

which discharge teaching about nutrition will the nurse include for a patient with chronic obstructive pulmonary disease and pneumonia a) increase intake of hot foods b) eat three large meals per day c) rest for 30 minutes before eating d) exercise before meals to increase appetite

c) rest for 30 minutes before eating

when caring for a patient diagnosed with cor pulmonale which finding will the nurse expect a) jaundice b) bradycardia c) ankle edema d) concave abdomen

c) ankle edema

A 58-year-old client with a 40-year history of smoking one to two packs of cigarettes a day has a chronic cough producing thick sputum, peripheral edema, and cyanotic nail beds. Based on this information, he most likely has which of the following conditions? a) adult respiratory distress syndrome b) asthma c) chronic obstructive bronchitis d) emphysema

c) chronic obstructive bronchitis

which are the predominant inflammatory cells in chronic obstructive pulmonary disease (SATA) a) mast cells b) eosinophils c) neutrophils d) lymphocytes e) macrophages

c) neutrophils d) lymphocytes e) macrophages

which delivery device is used for long term oxygen therapy a) nasal cannula b) simple face mask c) oxygen-conserving cannula d) partial and non-rebreather masks

c) oxygen-conserving cannula

which information about the purpose of pursed lip breathing will the nurse include when teaching a patient with chronic obstructive pulmonary disease about breathing exercises a) conserving energy b) relieving chest pain c) preventing air trapping d) increasing respiratory rate

c) preventing air trapping

which exercise will the nurse teach to improve expiratory effort and decrease air trapping for a patient with chronic obstructive pulmonary disease a) huff coughing b) diaphragmatic breathing c) pursed lip breathing d) chest physiotherapy

c) pursed lip breathing

The nurse interviews a patient with a new diagnosis of COPD. Which information is most helpful in confirming a diagnosis of chronic bronchitis a) the patient tells the nurse about a family history of bronchitis b) the patients history indicated a 30 pack year cigarette history c) the patient complains about a productive cough every winter for 3 months d) the patient denies having any respiratory problems until the last 12 months

c) the patient complains about a productive cough every winter for 3 months

A 66-year-old client has marked dyspnea at rest, is thin, and uses accessory muscles to breathe. He's tachypneic, with a prolonged expiratory phase. He has no cough. He leans forward with his arms braced on his knees to support his chest and shoulders for breathing. This client has symptoms of which of the following respiratory disorders? a) ARDS b) Asthma c) COPD d) Emphysema

d) Emphysema

when educating a patient which chronic obstructive pulmonary disease who continues to smoke cigarettes which complication of smoking would the nurse discuss with the patient a) cachexia b) osteoporosis c) metabolic syndrome d) cardiovascular disease

d) cardiovascular disease

postural drainage with percussion is ordered twice daily for a patient with chronic bronchitis. Which intervention should the nurse include in the plan of care a) schedule the procedure 1 hour after the patient ears b) maintain the patient in the lateral position for 20 minutes c) perform percussion before assisting the patient to the drainage position d) give the ordered albuterol (proventili) before the patient receives the therapy

d) give the ordered albuterol (proventili) before the patient receives the therapy

which explanation is likely when the nurse notes a hemoglobin level of 20 g/dl in a patient admitted with chronic obstructive pulmonary disease a) COPD has resolved b) patients diet is high in iron c) cardiac function has improved d) hypoxia has stimulated erythropoiesis

d) hypoxia has stimulated erythropoiesis

which factor contributes to loss of lung elastic recoil in a patient with COPD due to cigarette smoking a) increases in norepinephrine level b) erythropoiesis leading to polycuthemia c) suppression of inflammatory mediators d) imbalance of protease and antiprotease activity

d) imbalance of protease and antiprotease activity

True or False: Hyperinflation of the lungs leads to diaphragm flattening.

true