COPD, Asthma, Pneumonia- PREP U

Which of the following would be LEAST likely to contribute to a case of hospital-acquired pneumonia? A. A nurse washes her hands before beginning patient care. B. Host defenses are impaired. C. A highly virulent organism is present. D. Inoculum of organisms reaches the lower respiratory tract and overwhelms the host's defenses.

A. A nurse washes her hands before beginning patient care.

Which of the following is the strongest predisposing factor for asthma? A. Allergy B. Air pollution C. Male gender D. Congenital malformations

A. Allergy

A nurse provides care for a client receiving oxygen from a nonrebreather mask. Which nursing intervention has the highest priority? A. Assessing the client's respiratory status, orientation, and skin color B. Changing the mask and tubing daily C. Posting a "No smoking" sign over the client's bed D. Applying an oil-based lubricant to the client's mouth and nose

A. Assessing the client's respiratory status, orientation, and skin color

Which of the following is the most common chronic disease of childhood? A. Asthma B. Obesity C. Cerebral palsy D. Autism

A. Asthma

A patient with bronchiectasis is admitted to the nursing unit. The primary focus of nursing care for this patient includes which of the following? A. Implementing measures to clear pulmonary secretions B. Teaching the family how to perform postural drainage C. Instructing the patient on the signs of respiratory infection D. Providing the patient with a low-calorie, high-fiber diet

A. Implementing measures to clear pulmonary secretions

During a community health fair, a nurse is teaching a group of seniors about health promotion and infection prevention. Which intervention would best promote infection prevention for senior citizens who are at risk of pneumococcal and influenza infections? A. Receive vaccinations B. Take all prescribed medications C. Exercise daily D. Drink six glasses of water daily

A. Receive vaccinations

For a client with chronic obstructive pulmonary disease, which nursing intervention helps maintain a patent airway? A. Teaching the client how to perform controlled coughing B. Administering ordered sedatives regularly C. Assisting with feeding D. Limiting oral fluid intake

A. Teaching the client how to perform controlled coughing

A nurse assesses a client's respiratory status. Which observation indicates that the client is having difficulty breathing? A. Use of accessory muscles B. Diaphragmatic breathing C. Pursed-lip breathing D. Controlled breathing

A. Use of accessory muscles

The nurse is caring for a client with asthma. The nurse should conduct a focused assessment to detect: A. inspiratory and expiratory wheezing. B. increased forced expiratory volume. C. normal breath sounds. D. morning headaches.

A. inspiratory and expiratory wheezing.

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 airways are so swollen that no air can get through. B. the attack is over. C. the swelling has decreased. D. crackles have replaced wheezes.

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

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? A. "There are no other symptoms; however, your cough may get worse as the disease progresses." B. "Other symptoms you may develop are shortness of breath on exertion, and sputum production." C. "As your COPD worsens, you will develop frequent respiratory infections." D. "You can also expect to experience a progressive weight gain."

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

When instructing clients on how to decrease the risk of chronic obstructive pulmonary disease (COPD), the nurse should emphasize which instruction? A. Avoid exposure to people with known respiratory infections. B. Abstain from cigarette smoking. C. Maintain a high-protein diet. D. Participate regularly in aerobic exercises.

B. Abstain from cigarette smoking.

Which of the following would not be considered a primary symptom of COPD? A. Dyspnea on exertion B. Weight gain C. Sputum production D. Cough

B. Weight gain

The nurse understands that a client with acute respiratory distress related to asthma may experience: A. nasophaygeal drainage with oxygen saturation of 95%. B. dyspnea, wheezing, and polycythemia. C. acute laryngotracheitis and itchy eyes. D. an exacerbation of goiter and low-pitched stridor.

B. dyspnea, wheezing, and polycythemia.

The nurse is caring for a patient with COPD. The patient is receiving oxygen therapy via nasal cannula. The nurse understands that the goal of oxygen therapy is to maintain the patient's SaO2 level at or above what percent? A. 50% B. 70% C. 90% D. 30%

C. 90%

Which of the following exposures accounts for the majority of cases with regard to risk factors for chronic obstructive pulmonary disease (COPD)? A. Occupational exposure B. Ambient air pollution C. Exposure to tobacco smoke D. Passive smoking

C. Exposure to tobacco smoke

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

C. Lung sounds

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? A. Bronchitis B. Asthma C. Polycythemia D. Emphysema

C. Polycythemia

Which of the following should a nurse encourage in patients who are at the risk of pneumococcal and influenza infections? A. Mobilizing early B. Using prescribed opioids C. Receiving vaccination D. Using incentive spirometry

C. Receiving vaccination

The nurse is caring for an elderly, debilitated client who has been bedridden for an extended period. Which sign or symptom indicates that the client has hypoxia? A. chills B. productive cough C. confusion D. pleuritic chest pain

C. confusion

When assessing a client with asthma, which findings would most likely indicate the presence of a respiratory infection? A. bilateral expiratory wheezing B. chest tightness C. cough productive of yellow sputum D. respiratory rate of 30 breaths/min

C. cough productive of yellow sputum

A client with bacterial pneumonia is to be started on IV antibiotics. Which diagnostic tests must be completed before antibiotic therapy begins? A. urinalysis B. chest radiograph C. sputum culture D. red blood cell count

C. sputum culture

Which of the following is the most important risk factor for development of COPD? A. Genetic abnormalities B. Occupational exposure C. Air pollution D. Cigarette smoking

D. Cigarette smoking

Which would be most important to teach a client older than 65 years to prevent a recurrence of bacterial pneumonia? A. Receive prophylactic antibiotic therapy. B. Seek prompt antibiotic therapy for viral infections. C. Decrease the amount of protein in the diet. D. Obtain influenza and pneumococcal vaccines.

D. Obtain influenza and pneumococcal vaccines.

A client being seen in the emergency department has labored respirations. Auscultation reveals inspiratory and expiratory wheezes. Oxygen saturation is 86%. The client was nonresponsive to an albuterol (Ventolin) inhaler and intravenous methylprednisolone (Solu-Medrol). The nurse administers the following prescribed treatment first: A. Normal saline 0.9% at 100 mL/hr intravenously B. Intravenous magnesium sulfate C. Oral fluid of at least 2500 mL/day D. Oxygen therapy through a non-rebreather mask

D. Oxygen therapy through a non-rebreather mask

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. Intravenous methylprednisolone (Solu-Medrol) 120 mg C. Vancomycin 1 gram intravenously over 1 hour D. Oxygen through nasal cannula at 2 L/minute

D. Oxygen through nasal cannula at 2 L/minute

When suctioning a client's tracheostomy tube, what should the nurse do? A. Use a bolus of sterile water to stimulate cough. B. Insert the suction catheter about 2 inches (5 cm) into the cannula. C. Use clean gloves during the procedure. D. Oxygenate the client before suctioning.

D. Oxygenate the client before suctioning.

The nurse is caring for a client diagnosed with chronic obstructive pulmonary disease (COPD) and experiencing respiratory acidosis. The decrease in pH exists because the client's lungs: A. are unable to inspire sufficient oxygen. B. have ineffective cilia from years of smoking. C. are unable to exchange oxygen and carbon dioxide. D. are not able to blow off carbon dioxide.

D. are not able to blow off carbon dioxide.

Which mental status change may occur when a client with pneumonia is first experiencing hypoxia? A. depression B. coma C. apathy D. irritability

D. irritability