COPD Practice NCLEX Test
47. An oxygen delivery system is prescribed for a client with COPD to deliver precise oxygen concentration. Which of the following types of delivery systems would the nurse anticipate to be prescribed? A) Face tent B) Venturi mask C) Aerosol mask D) Tracheostomy collar
b
14. When teaching a client with COPD to conserve energy, the nurse should teach the client to lift objects: A) While inhaling through an open mouth B) While exhaling through pursed lips C) After exhaling but before inhaling D) While taking a deep breath and holding it
b
18. A client with COPD is experiencing dyspnea and has a low PaO2 level. The nurse plans to administer oxygen as ordered. Which of the following statements is true concerning oxygen administration to a client with COPD? A) High oxygen concentrations will cause coughing and dyspnea B) High oxygen concentrations may inhibit the hypoxic stimulus to breathe C) Increased oxygen use will cause the client to become dependent on the oxygen D) Administration of oxygen is contraindicated in clients who are using bronchodilators
b
24. The exercise that would be most beneficial for a client with COPD is A) Controlled coughing B) Whistling while exhaling C) Deep breathing D) Use of incentive spirometer
b
25. A client with COPD has developed secondary polycythemia. Which nursing diagnosis would be included in the care plan because of the polycythemia? A) Fluid volume deficit related to blood loss B) Impaired tissue perfusion related to thrombosis C) Activity intolerance related to dyspnea D) Risk for infection related to suppressed immune response
b
26. For a client with advanced COPD, which nursing action best promotes adequate gas exchange? A) Encouraging the client to drink three glasses of fluid daily B) Keeping the client in semi-fowler's position C) Using a high-flow venture mask to deliver oxygen as prescribed D) Administering a sedative as prescribed
b
36. A home care nurse assesses a client with COPD who is complaining of increased dyspnea. The client is on home oxygen via a concentrator at 2 liters per minute, and the client's respiratory rate is 22 breaths per minute. The appropriate nursing action is to: A) Determine the need to increase the oxygen B) Conduct further assessment of the client's respiratory status C) Call the emergency services to take the client to the emergency room D) Reassure the client that there is no need to worry
b
39. A nurse is planning to obtain an arterial blood gas from a client with COPD. To prevent bleeding following the procedure, the nurse plans time for which activity after the arterial blood gas is drawn? A) Holding a warm compress over the puncture site for 5 minutes B) Applying pressure to the puncture site by applying a 2 X 2 gauze for 5 minutes C) Encouraging the client to open and close the hand rapidly for 2 minutes D) Having the client keep the radial pulse puncture site in a dependent position for 5 minutes
b
4. Clients with chronic obstructive pulmonary disease may be bedridden at home and get a little exercise. Which of the following is a normal physiologic reaction to prolonged periods of bed rest and inactivity? A) Increased sodium retention B) Increased calcium excretion C) Increased insulin use D) Increased red blood cell production
b
42. A nurse has been preparing a client with COPD for discharge to home. Which statement made by the client indicates a need for further teaching in relation to nutrition? A) "I will certainly try to dink 3 liters of fluid per day?" B) "It's best to eat three large meals a day so I will get all my nutrients" C) "I will not eat as much cabbage as I once did?" D) "I will rest a few minutes before I eat
b
45. A home care nurse visits a client with COPD who is on home oxygen at 2 liters/minute. The client's respiratory rate is 22 breaths per minute, and the client is complaining of increased dyspnea. The nurse would initially: A) Determine the need to increase the oxygen B) Collect additional information regarding the client's respiratory status C) Call emergency services to come to the home D) Reassure the client that there is no need to worry
b
46. A nurse is caring for a client hospitalized with an acute exacerbation of COPD. Which of the following would the nurse expect to note on assessment? A) Hypocapnia B) A hyperinflated chest noted on chest x-ray C) Increased oxygen saturation with exercise D) A widened diaphragm noted on chest x-ray
b
50. A 68 year old man has a long history of COPD and is admitted to the hospital with cor pulmonale. Which clinical manifestations noted by the nurse is consistent with cor pulmonale diagnosis? A) Audible crackles at both lung bases B) 3+ edema in the lower extremities C) Loud murmur at the mitral valve D) High systolic BP
b
23. The arterial blood gases of a client with COPD deteriorate, and respiratory failure is impending. The nurse should first assess the client for: A) Cyanosis B) Bradycardia C) Mental confusion D) Distended neck veins
c
27. A client with chronic COPD is recovering from myocardial infarction. Because the client is extremely weak and can't produce an effective cough, the nurse should monitor for: A) Pleural effusion B) Pulmonary edema C) Atelectasis D) Oxygen toxicity
c
3. For a client with chronic obstructive pulmonary disease who has trouble raising respiratory secretions, which of the following nursing measures would help reduce the tenacity of secretions? A) Ensuring the client's diet is low in salt B) Ensuring that the client's oxygen therapy is continuous C) Helping the client maintain a high fluid intake D) Keeping the client in a semi-sitting position as much as possible
c
41. A client with COPD has a knowledge deficit related to the positions used to breathe more easily. The nurse teaches the client to: A) Lie on the side with the head of the bed at 45 degree angle B) Sit bolt upright in bed with the arms crossed over the chest C) Sit on the edge of the bed with the arms leaning on an over bed table D) Sit in the reclining chair tilted slightly back with the feet elevated
c
11. Which of the following is a priority goal for the client with COPD? A) Maintaining functional ability B) Minimizing chest pain C) Increasing carbon dioxide levels in the blood D) Treating infectious agents
a
17. Which of the following blood gas abnormalities should the nurse anticipate in the client with advanced COPD? A) Increased PaCO2 B) Increased PaO2 C) Increased pH D) Increased oxygen saturation
a
28. A home health nurse sees a client with end stage COPD. An outcome identified for this client is preventing infection. Which finding indicates that this outcome has been met? A) Decreased oxygen requirements B) Increased sputum prevention C) Decreased activity tolerance D) Normothermia
a
19. Which of the following diets would be most appropriate for a client with COPD? A) Low fat, low cholesterol B) Bland, soft diet C) Low sodium diet D) High calorie, high protein
d
32. A client with COPD is being evaluated for a lung transplant. The nurse performs the initial physical assessment. Which signs and symptoms should the nurse expect to find? Select all that apply. A) Decreased respiratory rate B) Dypnea on exertion C) Barrel chest D) Shortened expiratory phase E) Clubbed fingers and toes F) Fever
b,c,e
43. A client is newly diagnosed with COPD. The client returns home after a short hospitalization. The home care nurse visits the client and most importantly plans teaching strategies that are designed to: A) Encourage the client to become more active person B) Improve oxygenation and minimize carbon dioxide retention C) Identify irritants in the home that interfere with breathing D) Promote membership in support groups
b
38. A nurse monitors the respiratory status of the client being treated for an acute exacerbation of COPD. Which assessment finding would indicate a deterioration in ventilation? A) Cyanosis B) Rapid, shallow respirations C) Hyperinflated chest D) Coarse crackles bilaterally
b
21. The nurse is planning to teach a client with COPD how to cough effectively. Which of the following instructions should be included? A) Take a deep abdominal breath, bend forward, and cough three or four times on exhalation B) Lie flat on the back, splint the thorax, take two deep breaths, and cough C) Take several rapid, shallow breaths and then cough forcefully D) Assume a side-lying position, extend the arm over the head, and alternate deep breathing with coughing
a
29. The nurse is teaching a client with COPD how to perform pursed-lip breathing. The client asks the nurse to explain the purpose of this breathing. 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
31. A 63 year old client with an exacerbation of COPD is admitted to the hospital. Which nursing diagnosis requires the nurse to collaborate with other health care members t achieve the best outcome for the client? A) Impaired gas exchange B) Impaired skin integrity C) Activity intolerance D) Imbalanced nutrition: less than body requirements
a
12. A client's arterial blood gas values are as follows: pH 7.31, PaO2 80 mm Hg, PaCO2 65 mm Hg, HCO3 36 mEq/L. Which of the following signs and symptoms should the nurse expect? A) Cyanosis B) Flushed skin C) Irritability D) Anxiety
b
13. When performing postural drainage, which of the following promotes the movement of secretions from the lower to the upper respiratory tract? A) Friction between the cilia B) Force of gravity C) Sweeping motion of the cilia D) Involuntary muscle contraction
b
22. When a client has a history of COPD, the nurse should be aware of complication involving: A) Kidney function B) Cardiac function C) Joint inflammation D) Peripheral neuropathy
b
1. Which of the following interventions is most helpful in determining the need for oxygen therapy in a client with chronic obstructive pulmonary disease? A) Ask the client to tell the nurse when oxygen is needed B) Assess the client's fatigue level C) Use a pulse oximeter to determine oxygen saturation D) Evaluate the client's hemoglobin level
c
15. The nurse teaches a client with COPD to assess signs and symptoms of right sided heart failure. Which of the following signs and symptoms should be included in the teaching plan? A) Clubbing of nails B) Hypertension C) Peripheral edema D) Increased appetite
c
20. The nurse administers theophylline (Theo-dur) to a client. To evaluate the effectiveness of this medication, which of the following drug actions should the nurse anticipate? A) Suppression of the client's respiratory rate B) Decrease in bronchial secretions C) Relaxation of bronchial smooth muscle D) Thinning of tenacious, purulent sputum
c
10. Which of the following is the primary reason to teach purse-lip breathing to clients with emphysema? A) To promote oxygen intake B) To strengthen the diaphragm C) To strengthen the intercostal muscles D) To promote carbon dioxide elimination
d
16. The nurse assesses the respiratory status of a client experiencing an exacerbation of COPD secondary to a upper respiratory tract infection. Which of the following findings would be expected? A) Normal breath sounds B) Prolonged inspiration C) Normal chest movement D) Coarse crackles and rhonchi
d
2. Oxygen is at the rate of 2 liters/minute through the nasal cannula is prescribed for a client with chronic obstructive pulmonary disease. Which of the following best describes why the oxygen therapy is maintained at relatively low concentration? A) The oxygen will be lost at the client's nostrils if given at a higher level with a nasal cannula B) The client's long history of respiratory problems indicates that he would unable to absorb oxygen at a higher rate C) The cells in the alveoli are so damaged by the client's long history of respiratory problems that increased oxygen levels and reduced carbon dioxide levels likely will cause the cells to burst D) The client's respiratory center is used to high carbon dioxide and low oxygen levels that changing these levels may eliminate his stimulus to breathe
d
33. A client with COPD tells the nurse that he feels short of breath. The client's respiratory rate is 36 breaths/minute and the nurse auscultates diffuse wheezes. His arterial saturation is 84%. The nurse calls the assigned respiratory therapist to administer a prescribed nebulizer treatment. The therapist says, "I have several more nebulizer treatments to do on the unit where I am now. As soon as I'm done, I'll come assess the client." The nurse's most appropriate action is to: A) Notify the primary physician immediately B) Stay with the client until the therapist arrives C) Administer the treatment by meter-dose inhaler D) Administer the nebulizer treatment
d
37. A client with end stage COPD is admitted to the hospital with acute exacerbation. Which of the following blood gas results would the nurse most likely expect to note? A) PO2 of 68 and PCO2 of 40 B) PO2 of 55 and PCO2 of 40 C) PO2 of 70 and PCO2 of 50 D) PO2 of 60 and PCO2 of 50
d
34. A client with COPD and cor pulmonale is being prepared for discharge. The nurse should provide which instruction? A) "Weigh yourself daily and report loss of 1 pound in 1 day" B) "Eat a high sodium diet" C) "Weigh yourself daily and report a gain of 2 pounds un 1 day" D) "Maintain bed rest."
c
49. Which of the following assessment data is most important for a nurse to report to the primary care provider? A) SaO2 90% on room air B) Pulse 110 beats/min C) Clubbing of fingers and cyanotic lips D) Blood pressure 159/88 mm Hg
c
35. A client with COPD is admitted to the medical-surgical unit. To help this client maintain a patent airway and achieve maximal gas exchange, the nurse should: A) Instruct the client to drink 2 L of fluid daily B) Maintain the client on bed rest C) Administer anxiolytics, as prescribed, to control anxiety D) Administer pain medication as prescribed
a
40. A nurse is preparing to administer oxygen to a client who has COPD and is at risk for carbon dioxide narcosis. The nurse checks to see that the oxygen flow rate is prescribed at: A) 2 to 3 liters per minute B) 4 to 5 liters per minute C) 6 to 8 liters per minute D) 8 to 10 liters per minute
a
44. A nurse is interviewing a client with COPD who has a respiratory rate of 35 breaths per minute and is experiencing extreme dyspnea. Which nursing diagnosis would be appropriate for the client? A) Impaired verbal communication related to physical behavior B) Ineffective coping, related to the client's inability to handle a situational crisis C) Disturbed body image, related to neurological deficit D) Deficient knowledge, related to COPD
a
48. When discharging a client with home oxygen therapy, which of the following is most important for nurse to teach? A) Smoking cessation B) Equipment maintenance C) Incorporating rest into ADLs D) Anger management
a
5. A client with chronic obstructive disease (COPD) reports steady weight loss and being "too tired from just breathing to eat." Which of the following nursing diagnosis would be most appropriate when planning nutritional interventions for this client? A) Imbalanced nutrition: less than body requirements related to fatigue B) Activity intolerance related to dyspnea C) Weight loss related to COPD D) Ineffective breathing pattern related to alveolar hypoventilation
a
6. When developing a discharge plan to manage a patient with COPD, the nurse should anticipate that the client will do which of the following? A) Develop respiratory infections easily B) Maintain current status C) Require less supplemental oxygen D) Show permanent improvement
a
8. Which of the following physical assessment findings would the nurse expect to find in a client with advanced COPD? A) Increased anteroposterior chest diameter B) Underdeveloped neck muscles C) Collapsed neck veins D) Increased chest excursion with respiration
a
30. For a client with COPD, which nursing intervention would help maintain a patent airway? A) Restricting fluid intake to 1000 ml/day B) Enforcing absolute bedrest C) Teaching the client how to perform controlled breathing D) Administering prescribed sedatives regularly in small amounts
c
7. Which of the following outcomes would be appropriate for a client with COPD who has been discharged home? A) The client promises to do purse-lip breathing at home B) The client states actions to reduce pain C) The client states that he will use oxygen via a nasal cannula at 5 L/min D) The client agrees to call the physician f dyspnea on exertion increases
d
9. When instructing clients on how to decrease the risk of COPD, the nurse should emphasize which of the following behaviors? A) Participate regularly in aerobic exercises B) Maintain a high protein diet C) Avoid exposure to people with known respiratory infections D) Abstain from cigarette smoking
d
