Management of Patients with Chronic Pulmonary Diseases

Which statement is true about both lung transplants and bullectomy? A. Both procedures cure COPD B. Both procedures improve the overall quality of life of a client with COPD C. Both procedures treat end-stage emphysema D. Both procedures treat patients with bullous emphysema

B. Both procedures improve the overall quality of life of a client with COPD

A nurse administers Albuterol (Proventil) as ordered, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect? A. Dilated and reactive pupils B. Heart rate of 100 beats/min C. Respiratory rate of 22 breaths/min D. Urine output of 40 mL/hour

C. Respiratory rate of 22 breaths/min

As status asthmaticus worsens, the nurse would expect to find which acid-base imbalance? A. Metabolic acidosis B. Respiratory alkalosis C. Respiratory acidosis D. Metabolic alkalosis

C. Respiratory acidosis

The classification of Stage III of COPD is defined as: A. At risk for COPD B. Severe COPD C. Very severe COPD D. Mild COPD E. Moderate COPD

B. Severe COPD

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? A. Emphysema B. Pneumonia C. Atelectasis D. Pleurisy

C. Atelectasis

Asthma is caused by high type of response? A. IgE-mediated B. IgM-mediated C. IgD-mediated D. IgA-mediated

A. IgE-mediated

Which exposure accounts for most cases of COPD? A. Ambient air pollution B. Passive smoking C. Exposure to tobacco smoke D. Occupational exposure

C. Exposure to tobacco smoke

Which exposure acts as a risk factor for and accounts for the majority of cases of chronic obstructive pulmonary disease (COPD)? A. Passive smoking B. Ambient air pollution C. Exposure to tobacco smoke D. Occupational exposure

C. Exposure to tobacco smoke

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? A. 1800 calories ADA B. Low-fat C. High-protein D. Full-liquid

C. High-protein

What is histamine, a mediator that supports the inflammatory process in asthma, secreted by? A. Lymphocytes B. Eosinophils C. Mast cells D. Neutrophils

C. Mast cells

A client is prescribed methylprednisolone (Solu-Medrol) 125 mg intravenously. The medication is available in 125 mg single-dose vial containing 2 mL. The nurse will administer methylprednisolone over 2 minutes. How many mL will the nurse administer each 15 seconds?

0.25 mL

The nurse is reviewing pressurized metered-dose inhaler (pMDI) instructions with a client. Which statement by the client indicates the need for further instruction? A. "I will take a slow, deep breath in after pushing down on the MDI." B. "I can't use a spacer or holding chamber with the MDI." C. "I will shake the MDI container before I use it." D. "Because I am prescribed a corticosteroid-containing MDI, I will rinse my mouth with water after use."

B. "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 ________ mmHg and n arterial oxygen saturation of at least _______ %. A. 60 mmHg; 90% B. 58 mmHg; 88% C. 54 mmHg; 84% D. 56 mmHg; 86%

A. 60 mmHg; 90%

Which of the following is accurate regarding status asthmaticus? A. A severe asthma episode that is refractory to initial therapy B. Usually does not progress to severe obstruction C. Usually occurs with warning D. Patients have a productive cough

A. A severe asthma episode that is refractory to initial therapy

A client 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? A. Albuterol B. Fluticasone propionate C. Ipratropium bromide D. Ipratropium bromide and Albuterol sulfate

A. Albuterol

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: A. Albuterol (Proventil) B. Propranolol (Inderal) C. Alprazolam (Xanax) D. Morphine

A. Albuterol (Proventil)

Upon assessment, the nurse suspects that a client with COPD may have bronchospasm. What manifestations validate the nurse's concern? (Select all that apply.) A. Compromised gas exchange B. Jugular vein distention C. Decreased airflow D. Wheezes E. Ascites

A. Compromised gas exchange C. Decreased airflow D. Wheezes

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: A. Diminished or absent breath sounds on the affected side B. Muffled or distant heart sounds C. Tracheal deviation to the unaffected side D. Paradoxical chest wall movement with respirations

A. Diminished or absent breath sounds on the affected side

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

A. Implementing measures to clear pulmonary secretions

Which measure may increase complications for a client with COPD? A. Increased oxygen supply B. Administration of antitussive agents C. Administration of antibiotics D. Decreased oxygen supply

A. Increased oxygen supply

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

A. Lung sounds

A nursing student is taking a pathophysiology examination. Which of the following factors would the student correctly identify as contributing to the underlying pathophysiology of chronic obstructive pulmonary disease (COPD)? (Select all that apply.) A. Overinflated alveoli that impair gas exchange B. Inflamed airways that obstruct air flow C. Mucus secretions that block airways D. Dry airways that obstruct air flow E. Decreased number of goblet cells

A. Overinflated alveoli that impair gas exchange B. Inflamed airways that obstruct air flow C. Mucus secretions that block airways

A nurse is teaching the client about use of a metered-dose inhaler (MDI). What instructions should the nurse include in the teaching? (Select all that apply.) A. Take a slow, deep inhalation from the device. B. Activate the MDI once C. Use normal inhalation's with the device D. The device may increase delivery of the MDI medication E. It is not necessary to hold your breath after using

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

In which statements regarding medications taken by a client diagnosed with COPD do the drug name and the drug category correctly match? (Select all that apply.) A. Dexamethasone is an antibiotic B. Albuterol is a bronchodilator C. Ciprofloxacin is an antibiotic D. Cotrimoxazole is a bronchodilator E. Prednisone is a corticosteroid

B. Albuterol is a bronchodilator C. Ciprofloxacin is an antibiotic E. Prednisone is a corticosteroid

The classification of Stage II of COPD is defined as: A. Very severe COPD B. At risk for COPD C. Moderate COPD D. Severe COPD E. Mild COPD

C. Moderate COPD

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. Vancomycin 1 gram intravenously over 1 hour B. Oxygen through nasal cannula at 2L/min C. Ipratropium bromide (Alupent) by metered-dose inhaler D. Intravenous methylprednisolone (Solu-Medrol) 120 mg

B. Oxygen through nasal cannula at 2L/min

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? A. Respiratory alkalosis B. Respiratory acidosis C. Metabolic alkalosis D. Metabolic acidosis

B. Respiratory acidosis

A nurse is discussing asthma complications with a client and family. What complications should the nurse include in the teaching? (Select all that apply.) A. Thoracentesis B. Respiratory failure C. Status asthmaticus D. Pertussis E. Atelectasis

B. Respiratory failure C. Status asthmaticus E. Atelectasis

Which statement describes emphysema? A. A disease that results in reversible airflow obstruction, a common clinical outcome B. Presence of cough and sputum for at least a combined total of 2 to 3 months in each of two consecutive years C. A disease of the airways characterized by destruction of the walls of overdistended alveoli D. Chronic dilation of a bronchus or bronchi

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

Which statement describes emphysema? A. Chronic dilation of a bronchus or bronchi B. A disease that results in reversible airflow obstruction, a common clinical outcome C. A disease of the airways characterized by destruction of the walls of overdistended alveoli D. Presence of cough and sputum production for at least a combined total of 2 to 3 months in each of two consecutive years

C. 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 fo the disorder, the nurse prepares a teaching plan. This teaching plan is most likely to include which nursing diagnosis? A. Unilateral neglect B. Imbalanced nutrition: More than body requirement C. Anxiety D. Impaired swallowing

C. Anxiety

A client with chronic obstructive pulmonary disease (COPD) is recovering from a myocardial infarction. Because the client is extremely weak and can't produce an effective cough, the nurse should monitor closely for: A. Pleural effusion B. Oxygen toxicity C. Atelectasis D. Pulmonary edema

C. Atelectasis

A client with chronic obstructive pulmonary disease (COPD) expresses a desire to quit smoking. The first appropriate response from the nurse is: A. "I can refer you to the American Lung Association." B. "Nicotine patches would be appropriate for you." C. "Many options are available for you." D. "Have you tried to quit smoking before?"

D. "Have you tried to quit smoking before?"

A nurse has just completed teaching with a client who has been prescribed a meter-dosed inhaler for the first time. Which statement if made by the client would indicate to the nurse that further teaching and follow-up care is necessary? A. "I will make sure to take slow, deep breaths as I push on my inhaler." B. "After I breathe in, I will hold my breath for 10 seconds." C. "If I use a spacer, I know I am only supposed to push on the inhaler once." D. "I do not need to rinse my mouth with this type of inhaler."

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

A client with chronic obstructive pulmonary disease (COPD) and cor pulmonale is being prepared for discharge. The nurse should provide which instruction? A. "Eat a high-sodium diet." B. "Limit yourself to smoking only 2 cigarettes per day." C. "Maintain bed rest." D. "Weigh yourself daily and report a gain of 2 lbs in 1 day."

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

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

D. Allergy

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. What of the following is that disorder? A. Cystic fibrosis B. Bronchiectasis C. Asthma D. Emphysema

D. Emphysema

The nurse is assigned the care of a 30-year-old client diagnosed with cystic fibrosis (CF). Which nursing intervention will be included in the client's care plan? A. Discussing palliative care and end-of-life issues with the client B. Providing the client a low-sodium diet C. Restricting oral intake to 1000 mL/day D. Performing chest physiotherapy as ordered

D. Performing chest physiotherapy as ordered

A client is being sent home with oxygen therapy. The nurse instructs that: A. The client should raise the flow of oxygen is shortness of breath increases B. Oxygen is addictive and its use must be decreased C. The client will not be able to travel with oxygen D. Smoking or a flame is dangerous near oxygen

D. Smoking or a flame is dangerous near oxygen

A nurse is developing a teaching plan for a client with asthma. Which teaching point has the highest priority? A. Avoid goose down pillows B. Avoid contact with fur-bearing animals C. Change filters on heating and air conditioning units frequently D. Take ordered medications as scheduled

D. Take ordered medications as scheduled