chronic pulmonary disease PrepU

A client is prescribed metaproterenol 20 mg four times each day. How many mg of metaproterenol does the client take each day? Enter the correct number ONLY.

80

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 symptoms of mild persistent asthma is now initiating treatment. Which of the following is the preferred therapy that the nurse will teach the client to use at home?

Inhaled beclomethasone (Beconase)

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?

Lung sounds

Histamine, a mediator that supports the inflammatory process in asthma, is secreted by

Mast cells

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

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.

The classification of Stage I of COPD is defined as

mild COPD.

A client is being admitted to an acute healthcare facility with an exacerbation of chronic obstructive pulmonary disease (COPD). The client had been taking an antibiotic at home with poor relief of symptoms and has recently decided to stop smoking. The nurse is reviewing at-home medications with the client. The nurse is placing this information on the Medication Reconciliation Record. Which of the following is incomplete information?

salmeterol/fluticasone (Seretide) MDI daily at 0800

The classification of Stage III of COPD is defined as

severe COPD.

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:

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

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."

A male patient 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 of the following is the nurse's best response?

"Other symptoms you may develop are shortness of breath on exertion, and sputum production."

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."

For a client with advanced chronic obstructive pulmonary disease (COPD), which nursing action best promotes adequate gas exchange?

Using a Venturi mask to deliver oxygen as ordered

Nursing students are gathered for a study session about the pulmonary system. One student asks the others to name the primary causes for an acute exacerbation of COPD. Which of the following responses should be in the reply? Choose all that apply.

• Air pollution • Tracheobronchial infection

A patient with end-stage COPD and heart failure asks the nurse about lung reduction surgery. What is the best response by the nurse?

"You and your physician should discuss the options that are available for treatment."

Emphysema is described by which of the following statements?

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

Which of the following is accurate regarding status asthmaticus?

A severe asthma episode that is refractory to initial therapy

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

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

The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstruction that leads to the collapse of alveoli. This complication is known as

Atelectasis

Asthma is cause by which type of response?

IgE-mediated

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 home health nurse sees a client with end-stage chronic obstructive pulmonary disease. An outcome identified for this client is preventing infection. Which finding indicates that this outcome has been met?

Decreased oxygen requirements

Which of the following is a symptom diagnostic of emphysema?

Dyspnea

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 most of the risk factors for COPD?

Exposure to tobacco smoke

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

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

III

A patient with bronchiectasis is admitted to the nursing unit. The primary focus of nursing care for this patient includes which of the following?

Implementing measures to clear pulmonary secretions

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 caring for a patient with COPD. In COPD, the body attempts to improve oxygen-carrying capacity by increasing the amounts of red blood cells. Which of the following is the term for this process?

Polycythemia

A child is having an asthma attack and the parent can't remember which inhaler to use for quick relief. The nurse accesses the child's medication information and tells the parent to use which inhalant?

Proventil

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

Which diagnostic is the most accurate in assessing acute airway obstruction?

Pulmonary function studies

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 a productive cough

A nurse is developing a teaching plan for a client with asthma. Which teaching point has the highest priority?

Take ordered medications as scheduled.

The nurse is instructing the patient with asthma in the use of a newly prescribed leukotriene receptor antagonist. What should the nurse be sure to include in the education?

The patient should take the medication an hour before meals or 2 hours after a meal.

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

Weight gain

At 11 p.m., a client is admitted to the emergency department. He has a respiratory rate of 44 breaths/minute. He's anxious, and wheezes are audible. The client is immediately given oxygen by face mask and methylprednisolone (Depo-medrol) I.V. At 11:30 p.m., the client's arterial blood oxygen saturation is 86%, and he's still wheezing. The nurse should plan to administer:

albuterol (Proventil).

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

• Cough • Dyspnea • Wheezing

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

• Decreased airflow • Wheezes • Compromised gas exchange

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

After reviewing the pharmacological treatment for pulmonary diseases, the nursing student knows that bronchodilators relieve bronchospasm in three ways. Choose the correct three of the following options.

• Reduce airway obstruction • Increase oxygen distribution • Alter smooth muscle tone

Which of the following is a clinical manifestation of a pneumothorax? Select all that apply.

• Sudden chest pain • Asymmetry of chest movement • Unilateral retractions • Oxygen desaturation

The nurse is teaching the client about use of the pictured item with a metered-dose inhaler (MDI). The nurse instructs the client as follows: (Select all that apply.)

• Take a slow, deep inhalation from the device. • Activate the MDI once. • The device may increase delivery of the MDI medication.

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."

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%

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

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