Med/Surg 3 Chapter 11 NCLEX Style Questions
The nurse is reviewing pressurized metered-dose inhaler (pMDI) instructions with a client. Which statement by the client indicates the need for further instruction?
"I can't use a spacer or holding chamber with the MDI."
A client newly diagnosed with COPD tells the nurse, "I can't believe I have COPD; I only had a cough. Are there other symptoms I should know about?" Which is the best response by the nurse?
"Other symptoms you may develop are shortness of breath upon exertion and sputum production."
A nurse is administering supplemental oxygen to a client with COPD. The nurse assesses the oxygen saturation level to evaluate the client's status. Which reading would the nurse identify as being appropriate to reduce the risk of vital organ damage in this client?
92%
Which statement describes emphysema?
A disease of the airways characterized by destruction of the walls of overdistended alveoli.
What is the strongest predisposing factor for asthma?
Allergy
What type of chest configuration is typical of a client with COPD?
Barrel chest
Which statement is truth both about lung transplant surgery and bullectomy?
Both procedures improve the overall quality of life of a client with COPD.
Which is the most important risk factor for development of chronic obstructive pulmonary disease (COPD)?
Cigarette smoking
What symptoms are considered primary symptoms of COPD?
Cough
A client is being admitted to the medical-surgical unit for the treatment of an exacerbation of acute asthma. Which medication is contraindicated in the treatment of asthma exacerbation?
Cromolyn sodium
Which exposure acts as a risk factor and accounts for the majority of the cases of COPD?
Exposure to tobacco smoke
A client diagnosed with asthma is preparing for discharge. The nurse is educating the client on the proper use of a peak flow meter. The nurse instructs the client to complete which action?
If coughing occurs during the procedure, repeat it.
A client with bronchiectasis is admitted to the nursing unit. The primary focus of nursing care for this client includes:
Implementing measures to clear pulmonary secretions.
Which measure may increase complications for a client with COPD?
Increased oxygen supply.
Why would a client with COPD report feeling fatigued?
Lung function gradually decreases over time in clients with COPD. The client is using all expendable energy just to breathe.
A nurse is preparing a discharge teaching plan for a client diagnosed with asthma and prescribed a leukotriene modifier. Which medication would the nurse most likely include when teaching the client about this group of medications?
Montelukast
In which statements regarding medications taken by a client diagnosed with COPD do the drug name and the drug category correctly match?
Prednisone is a corticosteroid. Albuterol is a bronchodilator. Ciprofloxacin is an antibiotic.
A client presents to the ED experiencing symptoms of COPD exacerbation. The nurse understands that goals of therapy should be achieved to improve the client's condition. Which statements reflect therapy goals?
Provide medical support for the current exacerbation. Provide long-term support for medical management. Return the client to their original functioning abilities. Treat the underlying cause of the event.
What diagnostic test is most accurate in assessing acute airway obstruction?
Pulmonary function studies
A nurse is caring for a client with COPD. While reviewing breathing exercises, the nurse instructs the client to breathe in slowly through the nose, taking a normal breath. Then the nurse asks the client to pucker his lips as if preparing to whistle. Finally, the client is told to exhale slowly and gently through the puckered lips. The nurse teaches the client this breathing exercise to accomplish which goals?
Release air trapped by the lungs. Control the rate and depth of respirations. Prevent airway collapse.
A nurse is reviewing the medical records of several clients who have been diagnosed with COPD. When reviewing pulmonary function test results, the client with which postbronchodilator FEV1/FVC result would be considered to have the most severe disease?
The client with the lowest percentage result.
A client is receiving theophylline for long-term control and prevention of asthma symptoms. Client education related to this medication will include:
The importance of blood tests to monitor serum concentrations.
A client with advanced COPD is admitted for treatment of exacerbation. Oxygen therapy is prescribed. Which delivery device would the nurse use to administer the oxygen to the client?
Venturi mask
A nurse is assessing a client with COPD and suspects that the client may be developing respiratory failure. Which assessment finding would support the nurse's suspicion?
Worsening hypercapnia. Alternating tachypnea and bradypnea. Change in mental status. Hypoxemia despite oxygen therapy.
A client with COPD is being referred to a pulmonary rehabilitation program. When explaining this program to the client, which information would the nurse most likely include as a reason for it?
Symptom reduction. Improved quality of life.
