Chapter 24 (Test 3)

A nurse administers albuterol (Proventil), as ordered, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect?

Respiratory rate of 22 breaths/minute

The classification of Stage II of COPD is defined as

Moderate COPD

Which of the following terms means an increase in the red blood cell concentration in the blood?

Polycythemia

A patient is being treated for status asthmaticus. What danger sign does the nurse observe that can indicate impending respiratory failure?

Respiratory acidosis

A client is being sent home with oxygen therapy. The nurse instructs that

Smoking or a flame is dangerous near oxygen.

The wife of a patient who was admitted 3 days ago with an exacerbation of chronic obstructive pulmonary disease (COPD) states that she is worried about her husband because he appears to be breathing "really hard." The nurse performs a respiratory assessment. Which of the following findings would indicate a need for further interventions? (Select all that apply.)

• BP 122/80, HR 116, R 24, pale and clammy skin, temp 101.3 degrees F

Upon assessment, the nurse suspects that a patient with COPD may have bronchospasm. What manifestations validate the nurse's concern? (Select all that apply.)

• Compromised gas exchange • Wheezes • Decreased airflow

A nursing student knows that there are three most common symptoms of asthma. Choose the three that apply.

• Cough • Wheezing • Dyspnea

The nurse is reviewing metered-dose inhaler (MDI) instructions with a patient. Which of the following patient statements indicates the need for further instruction?

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

A nurse has just completed teaching with a patient who has been prescribed a meter-dosed inhaler for the first time. Which of the following statements would the nurse use to initiate further teaching and follow-up care?

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

The goal for oxygen therapy in COPD is to support tissue oxygenation, decrease the work of the cardiopulmonary system, and maintain the resting partial arterial pressure of oxygen (PaO2) of at least ______ mm Hg and an arterial oxygen saturation (SaO2) of at least ___%.

60 mm Hg; 90%

Which of the following is accurate regarding status asthmaticus?

A severe asthma episode that is refractory to initial therapy

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?

Atelectasis

Which of the following is true about both lung transplant and bullectomy?

Both are aimed at improving the overall quality of life of a patient with COPD.

A nurse consulting with a nutrition specialist knows it's important to consider a special diet for a client with chronic obstructive pulmonary disease (COPD). Which diet is appropriate for this client?

High-protein

A client with chronic obstructive pulmonary disease (COPD) and cor pulmonale is being prepared for discharge. The nurse should provide which instruction?

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

Emphysema is described by which of the following statements?

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

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?

Anxiety

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?

Emphysema

Which of the following exposures accounts for the majority of cases with regard to risk factors for chronic obstructive pulmonary disease (COPD)?

Exposure to tobacco smoke

A nurse evaluates the results of a spirometry test to help confirm a diagnosis of obstructive lung disease. Which one of the following results indicates an initial early stage of COPD? (FEV1 refers to forced expired volume in 1 second.)

FEV1 > 80%

In which stage of COPD is the forced expiratory volume (FEV) less than 30%?

III

A nursing student just learned that the primary presenting symptom of emphysema is dyspnea. During the clinical rotation that same week, the student is assigned to a patient diagnosed with emphysema. In prioritizing the care for the shift, the student would choose which of the following interventions first?

Monitor vital signs every 2 hours, including respiratory rate and characteristics.

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?

Oxygen through nasal cannula at 2 L/minute

The nurse is assigned the care of a 30-year-old female patient diagnosed with cystic fibrosis (CF). Which of the following nursing interventions will be included in the patient's plan of care?

Performing chest physiotherapy as ordered

A patient 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?

Proventil

As status asthmaticus worsens, the nurse would expect which acid-base imbalance?

Respiratory acidosis

In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to which of the following acid-base imbalances?

Respiratory acidosis

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?

Sputum and productive cough

Which of the following would not be considered a primary symptom of COPD?

Weight gain

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:

diminished or absent breath sounds on the affected side.

Following are statements regarding medications taken by a patient diagnosed with COPD. Choose which statements correctly match the drug name to the drug category. Select all that apply.

• Prednisone is a corticosteroid. • Albuterol is a bronchodilator. • Ciprofloxacin is an antibiotic.