Quiz 19

The nurse is preparing the antitussive agent benzonatate (Tessalon Perles) for a patient with a dry cough and knows the action of this drug will: 1. dissolve thick sticky mucus. 2. suppress the cough reflex response in the brain. 3. stimulate an increase in bronchial gland secretions. 4. reduce the release of leukotrienes.

2. suppress the cough reflex response in the brain.

What are adverse effects of oxygen therapy?

A high concentration of O2 may raise the PaO2 level so that the patient's stimulus to breathe is lost and respiratory depression may result

What signs and symptoms does the nurse anticipate to find in a patient diagnosed with tuberculosis? Select all that apply. A. Lethargy B. Dyspnea C. Weight gain D. Night sweats E. Low-grade fever

A. Lethargy D. Night sweats E. Low-grade fever Expected assessment findings in a patient diagnosed with tuberculosis include lethargy, night sweats, and a low-grade fever. Dyspnea does not occur with tuberculosis. Weight loss and anorexia occur in patients with tuberculosis.

A home health nurse is planning care for a client who has COPD which of the following interventions should the nurse include in the plan of care?

Advise the client to keep snacks handy

A nurse is providing education to a patient taking rifampin as a result of an exposure to TB. What side effect of this drug should the nurse include? A. Extreme drowsiness B. Illness if aged cheese or smoked meats are consumed C. Body fluids to become red-orange D. Oral contraceptive pills to become ineffective

C. Body fluids to become red-orange Rifampin will color body fluids red-orange and will result in stained clothing and soft contact lenses.

A nurse is assessing a client who has COPD. The nurse should expect the client's chest to be which of the following shapes? A. Pigeon B. Funnel C. Kyphotic D. Barrel

D. Barrel Clients who have COPD use accessory muscles to assist with respiratory effort. The use of those accessory muscles causes the chest wall to eventually increase in anterior-posterior diameter, making it appear barrel shaped.

A home health nurse is visiting a client who has COPD & is receiving oxygen at 2 L/min via nasal cannula. The client tells the nurse she has been having difficulty breathing. Which of the following actions is the nurse's priority at this time?

Evaluate the client's respiratory status

Which of the following statements about ipratropium bromide (Atrovent), an anticholinergic bronchodilator, is true?

It may cause urinary retention

A nurse is reinforcing teaching about self-management strategies with a client with emphysema. which of the following statements indicates client understands the instructions? A. "I will follow a diet high in calories and protein." B. "I will inhale slowly through pursed lips to help me breathe better." C. "I will avoid flu shot." D. "I will lie on my stomach to practice abdominal breathing every day."

A. "I will follow a diet high in calories and protein."

A client has been prescribed ipratropium bromide to help treat stable chronic obstructive pulmonary disease (COPD). What discharge instructions will the nurse provide to reduce the risk of side effects? A. "Expect this medication will cause an increase in urination." B. "Take this medication 1 hour before meals or 2 hours after to decrease he risk of gastric upset." C. "Move positions slowly as this medication may cause a quick drop in blood pressure when you stand up." D. "Increase your fluid intake and use sugar-free gum to help with decreased salivation."

D. "Increase your fluid intake and use sugar-free gum to help with decreased salivation."

A nurse is assisting with the plan of care for a client who pneumonia and requires chest percussion, vibration, and postural drainage. Which of the following actions should the nurse plan to complete first? A. Auscultate lung fields. B. Provide mouth care.​ C. Cup hands and tap on the client's chest repeatedly. D. Position the client so that the lung area to be drained is above the client's trachea.

A. Auscultate lung fields

A patient with COPD has a nursing diagnosis of Activity intolerance, related to inability to meet O2 needs. Which intervention is inappropriate for this diagnosis? A. Bunch all nursing activities and treatments close together. B. Schedule rest periods during the day. C. Assist the patient only when needed to encourage independence. D. Provide daily ambulation to build tolerance.

A. Bunch all nursing activities and treatments close together.

A health care provider has prescribed codeine sulfate for a client with a nonproductive cough to suppress the cough reflex. The nurse reinforces instructions given to the client about the medication and tells the client to monitor for which side effect? A. Constipation B. Increased urination C. Difficulty coughing D. Difficulty swallowing

A. Constipation

A nurse is collecting data from a client who has emphysema. Which of the following findings should the nurse expect? (Select all that apply.) A. Dyspnea B. Barrel chest C. Clubbing of the fingers D. Shallow respirations E. Bradycardia

A. Dyspnea B. Barrel chest C. Clubbing of the fingers D. Shallow respirations

A nurse is assessing a client who has pulmonary tuberculosis. Which of the following findings should the nurse expect? A. Lethargy B. High-grade fever C. Weight gain D. Dry cough

A. Lethargy Manifestations of pulmonary tuberculosis include lethargy and fatigue.

What signs and symptoms are characteristic of a patient with chronic blue bloater bronchitis? (Select all that apply.) A. Productive cough B. Peripheral edema C. Discolored teeth D. Exertional dyspnea E. Elevated red blood cell count

A. Productive cough B. Peripheral edema D. Exertional dyspnea E. Elevated red blood cell count The blue bloater has a productive cough, peripheral edema, dyspnea, elevated RBCs, and cyanosis.

A nurse is providing care for a client who has COPD and is receiving supplemental oxygen which of the following findings should the nurse report to the RN immediately ​A. Speaks in short phrases B. Use of accessory muscles to breathe C. Increased sputum production D. Pulse oximetry reading of 90%

A. Speaks in short phrases

Which diagnostic test will the clinic nurse anticipate to confirm a diagnosis of chronic obstructive pulmonary disease (COPD) in a patient with dyspnea? A. Spirometry B. Chest x-ray C. Arterial blood gas (ABG) D. CT scan of the chest

A. Spirometry Spirometry is needed to confirm the presence of airflow obstruction and the severity of COPD. The patient is given a short-acting bronchodilator, and post-bronchodilator values are compared with a normal reference value. Chest x-rays are not diagnostic but can show a flat diaphragm caused by hyperinflated lungs. ABGs are used to determine gas exchange but are not diagnostic of COPD because many diseases can impact ABG results. CT scans are not used routinely to diagnose COPD.

When asked by a patient with TB how long he will have to take his TB medications,the nurse's best response would be: A. "Generally about 2 weeks." B. "Depending on the drug, it may be as long as 2 years." C. "TB drugs are usually taken throughout the lifespan." D. "People frequently ask that question. It depends on many things."

B. "Depending on the drug, it may be as long as 2 years." The usual course of therapy for active TB ranges from 6 to 24 months after sputum cultures become negative. Most drugs can be given in daily or twice-weekly doses. Neither MDR-TB nor XDR-TB is destroyed by INH or rifampin; therefore, various combinations of other drugs must be used over a 2-years period.

A patient has prescriptions for two inhalers. One inhaler is a bronchodilator, and the other is a corticosteroid. Which instruction regarding these inhalers will the nurse give to the patient? A. "Take the corticosteroid inhaler first." B. "Take the bronchodilator inhaler first." C. "Take these two drugs at least 2 hours apart." D. "It does not matter which inhaler you use first."

B. "Take the bronchodilator inhaler first." An inhaled bronchodilator is used before the inhaled corticosteroid to provide bronchodilation before administration of the antiinflammatory drug.

A nurse is collecting data from a client who has chronic bronchitis. Which of the following findings should the nurse expect? A. Pigeon chest B. Barrel chest C. Funnel chest D. Scoliosis

B. Barrel chest

When the nurse reads the diagnosis of centrilobar emphysema, the nurse recognizes that this type of emphysema is characterized by: A. No significant smoking history in the patient B. Enlarged and broken down bronchioles with intact alveoli C. Hypoelastic bronchi and bronchioles D. Deficiency of the enzyme inhibitor alpha1-antitrypsin.

B. Enlarged and broken down bronchioles with intact alveoli

A nurse recognizes that a patient diagnosed with COPD has a rising level of partial pressure of carbon dioxide (CO2) in arterial blood (PaCO2). How should the nurse interpret this assessment? A. More arterial O2 is available than is needed. B. The ventilation-perfusion ratio is becoming balanced. C. Respiratory acidosis has begun. D. The anticholinergic medications are effective.

C. Respiratory acidosis has begun. A rising PaCO2 level is acidic in nature and causes respiratory acidosis.

A nurse is contrary to the plan of care for a client who has COPD. Which of the following interventions should the nurse include in the plan of care? A. Restrict the client's fluid intake to less than 1 L/day. B. Encourage the client to use the upper chest for respiration. C. Plan to have the client lay down for 1 hr after meals. D. Instruct the client to use pursed-lip breathing.

D. Instruct the client to use pursed-lip breathing.

What is the purpose of a spacer or extender used with a metered-dose inhaler? A. It improves the speed of the inhaler. B. It delays the absorption of the medication. C. It decreases the amount of medication delivered over one minute. D. It improves the delivery and facilitates the absorption of the medication.

D. It improves the delivery and facilitates the absorption of the medication.

A nurse is reinforcing teaching with a client who is going to take an expectorant to manage a cough. The nurse should explain that this type of medication treats coughs by which of the following mechanisms? A. Reduces inflammation B. Suppresses the urge to cough C. Dries mucous membranes D. Stimulates secretions

D. Stimulates secretions

A client is receiving acetylcysteine (Mucomyst), 20% solution diluted in 0.9% normal saline by nebulizer. The nurse should have which item available for possible use after giving this medication? A. Ambu bag B. Intubation tray C. Nasogastric tube D. Suction equipment

D. Suction equipment Acetylcysteine can be given orally or by nasogastric tube to treat acetaminophen overdose, or it may be given by inhalation for use as a mucolytic. The nurse administering this medication as a mucolytic should have suction equipment available in case the client cannot manage to clear the increased volume of liquefied secretions.