Resp. Ch. 24

The nurse assesses a patient with a heart rate of 42 and a blood pressure of 70/46. What type of hypoxia does the nurse determine this patient is displaying?

Circulatory hypoxia

A client with chronic obstructive pulmonary disease (COPD) expresses a desire to quit smoking. The first appropriate response from the nurse is: A. "Have you tried to quit smoking before?" B. "I can refer you to the American Lung Association." C. "Nicotine patches would be appropriate for you." D. "Many options are available for you."

A. "Have you tried to quit smoking before?"

Which of the following is accurate regarding status asthmaticus? A. A severe asthma episode that is refractory to initial therapy B. Usually occurs with warning C. Usually does not progress to severe obstruction D. Patients have a productive cough.

A. A severe asthma episode that is refractory to initial therapy

A nurse has just completed teaching with a client who has been prescribed a meter-dosed inhaler for the first time. Which statement if made by the client would indicate to the nurse that further teaching and follow-up care is necessary? A. "I will make sure to take a slow, deep breath as I push on my inhaler." B. "I do not need to rinse my mouth with this type of inhaler." C. "After I breathe in, I will hold my breath for 10 seconds." D. "If I use the spacer, I know I am only supposed to push on the inhaler once."

B. "I do not need to rinse my mouth with this type of inhaler."

A nurse is admitting a client with emphysema. What are presenting findings the nurse should assess? Select all that apply. A. Chest pain B. Dyspnea C. Chronic cough D. Wheezing E. Tachypnea

B. Dyspnea C. Chronic cough

A nurse is caring for a client experiencing an acute asthma attack. The client stops wheezing and breath sounds aren't audible. This change occurred because: A. the attack is over. B. the swelling has decreased. C. the airways are so swollen that no air can get through. D. crackles have replaced wheezes.

C. the airways are so swollen that no air can get through.

A nursing student is taking a pathophysiology examination. Which of the following factors would the student correctly identify as contributing to the underlying pathophysiology of chronic obstructive pulmonary disease (COPD)? Choose all that apply. A. Dry airways that obstruct airflow B. Inflamed airways that obstruct airflow C. Decreased numbers of goblet cells D. Overinflated alveoli that impair gas exchange E. Mucus secretions that block airways

B. Inflamed airways that obstruct airflow D. Overinflated alveoli that impair gas exchange E. Mucus secretions that block airways

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

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

The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstruction and that leads to the collapse of alveoli. What complication should the nurse monitor for? A. Pneumonia B. Pleurisy C. Emphysema D. Atelectasis

D. Atelectasis

The nurse has instructed the client to use a peak flow meter. The nurse evaluates client learning as satisfactory when the client

Exhales hard and fast with a single blow

The nurse is assessing a client's potential for pulmonary emboli. What finding indicates possible deep vein thrombosis?

Localized calf tenderness

A client has a nursing diagnosis of "ineffective airway clearance" as a result of excessive secretions. An appropriate outcome for this client would be which of the following?

Lungs are clear on auscultation

the nurse is reviewing the blood gas results for a patient with pneumonia. What arterial blood gas measurement best reflects the adequacy of alveolar ventilation?

PaCO2

The nurse is admitting a patient with COPD. The decrease of what substance in the blood gas analysis would indicate to the nurse that the patient is experiencing hypoxemia?

PaO2

The nurse is providing discharge instructions to a client with pulmonary sarcoidosis. The nurse concludes that the client understands the information if the client correctly mentions which early sign of exacerbation?

SOB

The nurse receives an order to obtain a sputum sample from a client with hemoptysis. When advising the client of the physician's order, the client states not being able to produce sputum. Which suggestion, offered by the nurse, is helpful in producing the sputum sample?

Take deep breaths and cough forcefully.

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

A. Take ordered medications as scheduled.

Upon assessment, the nurse suspects that a client with COPD may have bronchospasm. What manifestations validate the nurse's concern? Select all that apply. A. Wheezes B. Decreased airflow C. Jugular vein distention D. Compromised gas exchange E. Ascites

A. Wheezes B. Decreased airflow D. Compromised gas exchange

A client is being sent home with oxygen therapy. The nurse instructs that A. The client should raise the flow of oxygen if shortness of breath increases. B. The client will not be able to travel with oxygen. C. Smoking or a flame is dangerous near oxygen. D. Oxygen is addictive and its use must be decreased.

C. Smoking or a flame is dangerous near oxygen.

For air to enter the lungs (process of ventilation), the intrapulmonary pressure must be less than atmospheric pressure so air can be pulled inward. Select the movement of respiratory muscles that makes this happen during inspiration.

Diaphragm contracts and elongates the chest cavity.

Which of the following is the key underlying feature of asthma? A. Shortness of breath B. Inflammation C. Productive cough D. Chest tightness

B. Inflammation

As status asthmaticus worsens, the nurse would expect which acid-base imbalance? A. Metabolic alkalosis B. Respiratory acidosis C. Respiratory alkalosis D. Metabolic acidosis

B. Respiratory acidosis

The classification of Stage IV of COPD is defined as A. at risk for COPD. B. mild COPD. C. moderate COPD. D. severe COPD. E. very severe COPD.

E. very severe COPD.

Pink, frothy sputum may be an indication of

pulmonary edema

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? A. Anxiety B. Impaired swallowing C. Unilateral neglect D. Imbalanced nutrition: More than body requirements

A. Anxiety

A client experiencing an asthmatic attack is prescribed methylprednisolone intravenously. What action should the nurse take? A. Assesses fasting blood glucose levels B. Informs the client to limit fluid intake due to fluid retention C. Aspirates for blood return before injecting the medication D. Encourages the client to decrease caloric intake due to increased appetite

A. Assesses fasting blood glucose levels

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? A. Providing sufficient oxygen to improve oxygenation B. Monitoring the pulse oximetry to assess need for early intervention when PCO2 levels rise C. Increasing pH D. Avoiding the use of oxygen to decrease the hypoxic drive

A. Providing sufficient oxygen to improve oxygenation

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

A. Respiratory acidosis

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. Respiratory failure B. Atelectasis C. Pertussis D. Thoracentesis E. Status asthmaticus

A. Respiratory failure B. Atelectasis E. Status asthmaticus

A pneumothorax is a possible complication of COPD. Symptoms will depend on the suddenness of the attack and the size of the air leak. The most common, immediate symptom that should be assessed is: A. Sharp, stabbing chest pain B. Dyspnea C. A dry, hacking cough D. Tachycardia

A. Sharp, stabbing chest pain

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. Skin color B. Lung sounds C. Respiratory rate D. Heart rate

B. Lung sounds

For a client with chronic obstructive pulmonary disease, which nursing intervention helps maintain a patent airway? A. Administering ordered sedatives regularly and in large amounts B. Teaching the client how to perform controlled coughing C. Restricting fluid intake to 1,000 ml/day D. Enforcing absolute bed rest

B. Teaching the client how to perform controlled coughing

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

B. implementing measures to clear pulmonary secretions.

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

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

A client 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? A. Ipratropium bromide and albuterol sulfate B. Ipratropium bromide C. Albuterol D. Fluticasone propionate

C. Albuterol

Which exposure accounts for most cases of COPD? A. Ambient air pollution B. Occupational exposure C. Exposure to tobacco smoke D. Passive smoking

C. Exposure to tobacco smoke

What is histamine, a mediator that supports the inflammatory process in asthma, secreted by? A. Neutrophils B. Lymphocytes C. Mast cells D. Eosinophils

C. Mast cells

A patient comes to the clinic for the third time in 2 months with chronic bronchitis. What clinical symptoms does the nurse anticipate assessing for this patient? A. Tachypnea and tachycardia B. Fever, chills, and diaphoresis C. Sputum and a productive cough D. Chest pain during respiration

C. Sputum and a productive cough

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. oxygen toxicity. C. atelectasis. D. pulmonary edema.

C. atelectasis.

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: A. paradoxical chest wall movement with respirations. B. tracheal deviation to the unaffected side. C. diminished or absent breath sounds on the affected side. D. muffled or distant heart sounds.

C. diminished or absent breath sounds on the affected side.

A physician orders metaproterenol by metered-dose inhalation four times daily for a client with acute bronchitis. Which statement by the client indicates effective teaching about this medication? A. "I should use this inhaler whenever I get short of breath." B. "I can stop using this drug when I begin to feel better." C. "I need to call the physician right away if I feel my heart beating fast after using the drug." D. "I need to hold my breath as long as possible after I take a deep inhalation."

D. "I need to hold my breath as long as possible after I take a deep inhalation."

A client with chronic obstructive pulmonary disease (COPD) and cor pulmonale is being prepared for discharge. The nurse should provide which instruction? A. "Limit yourself to smoking only 2 cigarettes per day." B. "Eat a high-sodium diet." C. "Maintain bed rest." D. "Weigh yourself daily and report a gain of 2 lb in 1 day."

D. "Weigh yourself daily and report a gain of 2 lb in 1 day."

A junior-level nursing class has just finished learning about the management of clients with chronic pulmonary diseases. They learned that a new definition of COPD leaves only one disorder within its classification. Which of the following is that disorder? A. Bronchiectasis B. Cystic fibrosis C. Asthma D. Emphysema

D. Emphysema

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

D. Heart rate of 100 beats/minute

Asthma is cause by which type of response? A. IgA-mediated B. IgD-mediated C. IgM-mediated D. IgE-mediated

D. IgE-mediated

The classification of Stage II of COPD is defined as A. moderate COPD. B. mild COPD. C. severe COPD. D. very severe COPD. E. at risk for COPD.

A. moderate COPD.

The classification of Stage III of COPD is defined as A. severe COPD. B. moderate COPD. C. mild COPD. D. at risk for COPD. E. very severe COPD.

A. severe COPD.

The ICU nurse is caring for a client who was admitted with a diagnosis of smoke inhalation. The nurse knows that this client is at increased risk for which of the following?

Acute respiratory distress syndrome

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? A. Ipratropium bromide (Alupent) by metered-dose inhaler B. Oxygen through nasal cannula at 2 L/minute C. Vancomycin 1 gram intravenously over 1 hour D. Intravenous methylprednisolone (Solu-Medrol) 120 mg

B. Oxygen through nasal cannula at 2 L/minute

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

C. Ciprofloxacin is an antibiotic. D. Prednisone is a corticosteroid. E. Albuterol is a bronchodilator

A client is admitted to a health care facility for treatment of chronic obstructive pulmonary disease. Which nursing diagnosis is most important for this client? A. Anxiety related to actual threat to health status B. Risk for infection related to retained secretions C. Activity intolerance related to fatigue D. Impaired gas exchange related to airflow obstruction

D. Impaired gas exchange related to airflow obstruction