exam 2 respiratory NURS 1215
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? A. Lung sounds B. Skin color C. Heart rate D. Respiratory rate
A
A nurse is admitting a client with emphysema. What is a symptom diagnostic of emphysema? A. Dyspnea B. Copious sputum production C. Normal elastic recoil D. Occurrence of cor pulmonale
A
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? A. It helps prevent early airway collapse. B. It increases inspiratory muscle strength. C. It decreases use of accessory breathing muscles. D. It prolongs the inspiratory phase of respiration.
A
Which of the following is a leading cause of chronic obstructive pulmonary disease (COPD) exacerbation? A. Bronchitis B. Pneumonia C. Common cold D. Asthma
A
A nurse is discussing asthma complications with a client and family. What complications should the nurse include in the teaching? Select all that apply. A. Status asthmaticus B. Respiratory failure C. Pertussis D. Atelectasis E. Thoracentesis
A, B, D
The nurse is assigned to care for a patient in the ICU who is diagnosed with status asthmaticus. Why does the nurse include fluid intake as being an important aspect of the plan of care? (Select all that apply.) A. To combat dehydration B. To assist with the effectiveness of the corticosteroids C. To loosen secretions D. To facilitate expectoration E. To relieve bronchospasm
A, C, D
A client experiencing an asthmatic attack is prescribed methylprednisolone intravenously. What action should the nurse take? A. Aspirates for blood return before injecting the medication B. Assesses fasting blood glucose levels C. Encourages the client to decrease caloric intake due to increased appetite D. Informs the client to limit fluid intake due to fluid retention
B
A client has chronic obstructive pulmonary disease (COPD) and is exhibiting shallow respirations of 32 breaths per minute and a pulse oximetry of 93% despite receiving nasal oxygen at 2 L/minute. What action should the nurse take? A. Encourage the client to take deep breaths. B. Encourage the client to exhale slowly against pursed lips. C. Teach the client to perform upper chest breaths. D. Increase the flow of oxygen.
B
A client with chronic obstructive pulmonary disease (COPD) expresses a desire to quit smoking. The first appropriate response from the nurse is: A. "Nicotine patches would be appropriate for you." B. "Have you tried to quit smoking before?" C. "I can refer you to the American Lung Association." D. "Many options are available for you."
B
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 that apply. A. Chest tightness B. Crackles C. Bradypnea D. Wheezing E. Cough
A, D, E
A nurse is caring for a client who has been hospitalized with an acute asthma exacerbation. What drugs should the nurse expect to be ordered for this client to gain underlying control of persistent asthma? A. Rescue inhalers B. Anti-inflammatory drugs C. Antibiotics D. Antitussives
B
Although many signs and symptoms lead to a diagnosis of emphysema, one symptom stands as the primary presenting symptom. Which of the following is the primary presenting symptom? A. Chronic and persistent cough B. Dyspnea C. Tachypnea D. Wheezing
B
Which diagnostic test is most accurate in assessing acute airway obstruction? A. Arterial blood gases (ABGs) B. Pulmonary function studies C. Pulse oximetry D. Spirometry
B
A client admitted to the facility for treatment for tuberculosis receives instructions about the disease. Which statement made by the client indicates the need for further instruction? A. "I'll have to take the medication for up to a year." B. "This disease may come back later if I am under stress." C. "I'll stay in isolation for 6 weeks." D. "I'll always have a positive test for tuberculosis."
C
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: A. pleural effusion. B. pulmonary edema. C. atelectasis. D. oxygen toxicity.
C
A nurse is assisting a client with mild chronic obstructive pulmonary disease (COPD) to set a goal related to the condition. Which of the following is an appropriate goal for this client? A. Maintain activity level of walking to the mailbox. B. Continue with current level of mobility at home. C. Increase walking distance around a city block without shortness of breath. D. Relieve shortness of breath to a level as close as possible to tolerable.
C
A nurse is explaining to a client 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
The nurse at the beginning of the evening shift receives a report at 1900 on the following patients. Which patient would the nurse assess first? A. An 85 year old with COPD with wheezing and an O2 saturation of 89% on 2 L of oxygen B. A 62 year old with emphysema who has 300 mL of intravenous fluid remaining C. A 74 year old with chronic bronchitis who has BP 128/58, HR 104, and R 26 D. An 86 year old with COPD who arrived on the floor 30 minutes ago and is a direct admit from the doctor's office
D