Alterations Exam 2 Respiratory

Consecutive sputum samples need to be taken __ days in a row.

3

You are teaching an asthma patient able peak flow meter zones. Match the zone with the percentage of the patients personal best. a. Green zone b. Yellow zone c. Red zone 1. 80-100% 2. 50-80% 3. 50% or less

a1, b2, c3

This is a key event in triggering an asthma attack. a. blockage of airway b. bronchospasm c. inflammation of mucous membranes d. none of the above

c

You are teaching an asthma patient able peak flow meter zones. Which zone should the patient be instructed to use their short acting bronchodilator and call 911? a. Yellow zone b. Green zone c. Red zone d. Black zone

c

Smoking is the main cause of _________ ________________.

lung cancer

A severe, life-threatening, acute episode of airway obstruction is called ________________________________

status asthmaticus

The reasoning for having a chest tube ready after a thoracentesis is because of what possible complications? a. tension pneumothorax b. accumulation of fluid c. infection d. subcutaneous emphysema

a,b

These are two conditions that make up chronic obstructive pulmonary disease (COPD). a. emphysema b. chronic bronchitis c. lung cancer d. asthma

a,b

_____________________ and ___________________ are the drugs of choice when treating tuberculosis. a. Isoniazid b. Rifampin c. Albuterol d. Dilantin

a,b

The RN knows that after a thoracentesis patients it is the RN's job to what? Select all that apply a. vitals signs and breath sounds monitored b. encourage the patient to breath deeply c. have a chest tub kit ready d. lay on the affected side to promote lung inflation e. chest x-ray performed afterwards f. examine puncture site

a,b,c, e,f

What ABG findings would you expect to see in a patient with COPD? More than one may be correct a. Low PaO2 b. High PaCO2 c. Low pH d. Normal to High Bicarbonate level

a,b,c,d

Identify all of the possible clinical manifestations of COPD. a. Dyspnea b. Chest breathing c. Use of accessory muscles d. Wheezing e. Rhonchi f. Chest tightness g. Anorexia h. Chronic fatigue

a,b,c,d,f,g,h

A patient was recently diagnosed with COPD. You as the RN are teaching them about possible complications of COPD. Select all that apply a. Acute respiratory failure b. Peptic ulcer disease c. Heart failure d. Cor pulmonale e. Orthopnea

a,b,d

What is included in the RN management for patients diagnosed with COPD? Select all that apply a. Airway maintenance b. Cardiac monitoring c. Excessive coughing d. Breathing techniques e. Positioning f. Oxygen administration g. Exercise regimen h. Hydration status

a,b,d,e,f,g,h

What 3 drug therapies are included in the pharmacologic management of asthma? a. Bronchodilators b. Anti-inflammatory agents c. Anti-hypertensives d. Analgesics e. Leukotriene inhibitors

a,b,e

It is important for the RN to know how to treat an episode of status asthmaticus. Which of these would be the correct treatments? Select all that apply a. IV fluids b. Anti-inflammatory agent c. Potent systemic bronchodilator d. Steroids e. Epinephrine f. Oxygen therapy

a,c,d,e,f

A RN student is trying to explain the pathophysiology of pneumonia to her class. She states that pneumonia is an acute lung infection of lung parenchyma. What she her instructor say? a. Nothing the student is correct b. Pneumonia is a chronic infection c. Pneumonia is an infection of the lung alveoli d. Pneumonia is not an infection

a

After noting 12mm of induration at the sight of a tuberculosis skin test in a client with no tuberculosis risk factors, which information should be given to the client? a. The result is negative, and no follow up is needed. b. The disease is active, and medication is required. c. Additional tests, such as chest x-rays are needed. d. The outcome is inconclusive and further testing is needed.

a

True or false Oxygen therapy should be used with COPD patients to get their O2 saturation above 95% during rest, sleep, or exertion.

False

COPD causes many changes of the lungs. Which of these is not one of them? a. mucus hyposecretion b. hyperinflation of the lungs c. dysfunction of cilia d. gas exchange abnormalities

a

How do daily preventive therapy drugs help prevent asthma attacks? a. changes airway responsiveness b. inhibits airway constriction c. encourages airway responsiveness d. allows air to move easier through the alveoli

a

____________________ involves loss of lung elasticity and hyperinflation of the lung, causing dyspnea, increased respiratory rate, and, eventually, cardiac failure. a. emphysema b. chronic bronchitis c. lung cancer d. asthma

a

The provider has order a TB skin test on your patient. What will you teach your patient about a TB skin test? More than one may be correct a. You will come back to the clinic in 2-3 days to have the test read b. If the induration is larger than 15 mm you are positive if you are immunocompromised c. Presence of induration means you have been exposed to TB d. If the induration is larger than 5 mm you are positive if you are a low risk individual

a

Thoracentesis patients should be __________________________________________ a. sitting position, arms raised and resting overbed table. b. supine and arms crossed c. lay on the affected side d. laying on the nonaffected side

a

A nursing student is explaining asthma to her classmates. She explains asthma as intermittent and nonreversible airflow obstruction affecting airways only and not alveoli. She goes on to explain that asthma causes airway obstruction, inflammation, and airway hyperresponsiveness. Is she correct? a. Yes b. No

No - asthma is reversible airway obstruction not non-reversible

BIGGEST way to reduce risk of COPD? a. influenza vaccine b. Stop drinking c. Stop smoking d. Yearly Dr visits

c

Bronchial breath sounds indicate _____________________. a. COPD b. Asthma c. Pneumonia d. Lung cancer

c

The three types of pneumonia are hospital acquired pneumonia, community acquired pneumonia, and _____________________ pneumonia.

aspiration

The nurse is caring for a client with severe dyspnea who is receiving oxygen via venturi mask. Which action would the nurse take when caring for the client? a. Assess frequently for nasal drying b. Keep the mask tight to the face c. Monitor oxygen saturation levels when the client is eating d. Set the oxygen flow to the highest setting that the client can tolerate

c

A patient with COPD states she can "breath easily" but has a hard time breathing the air out. Why is that? a. The lungs get tired from breathing b. The alveoli spasm during inspiration c. The bronchioles tend to collapse d. She is not using the right breathing technique

c

A patient with confirmed tuberculosis asks you when they can return back to work. What would you tell them? a. When you have a TB test with no induration b. When you have a TB test with an induration under 5 mm c. When you have a negative sputum culture d. Whenever you want

c

The ambulance is bringing in a patient who called because they have COPD and are more short of breath than normal. Once they arrive it is determined they are having a COPD exacerbation with O2 sats at 82%. Which of these would be the appropriate treatment? More than one may be correct a. Long acting bronchodilators b. Supplemental oxygen therapy via high flow c. Oral systemic corticosteroids d. Lay them supine e. Administer short acting bronchodilators f. Give antibiotics

c,e,f

___________________________ is the most accurate test to diagnose asthma. a. Thoracentesis b. Bronchoscopy c. PFT's d. ABG's

c- Pulmonary function test

A pleural fluid analysis is used for which illness? a. pneumonia b. COPD c. Asthma d. Lung cancer

d

An important teaching topic when taking tuberculosis treatment medications is what? a. Keep properly hydrated to avoid crystalluria b. Get potassium labs often as it can cause low potassium c. Do not take with birth control d. Be aware your mucous membranes may turn orange

d

An instructor is explaining to their students about ways infection gets in the lungs. The students begin to shout out answers. Which answer is incorrect? a. aspiration from nasopharynx or oropharynx b. inhalation of microbes present in the air c. Spread from primary infection elsewhere in body d. Fluid sits in the lungs from secondary disease

d

COPD is the loss of elastic recoil and airway obstruction due to ______________________, ______________________, and ______________________. Which one of these options is not correct? a. mucus hypersecretion b. mucosal edema c. bronchospasm d. alveolar edema

d

This is a severe, life-threatening, acute episode of airway obstruction that intensifies once it begins and often does not respond to common therapy. a. COPD b. tuberculosis c. asthma attack d. status asthmaticus

d

Which finding in a client with asthma exacerbation requires the most rapid action by the nurse? a. report of chest tightness b. heart rate of 112 BPM c. expiratory wheezes on both sides d. markedly decreased breath sounds

d

True or false Status asthmaticus does not require prompt medical treatment.

false

True or false IV drug users are less likely to get tuberculosis

false

Pneumonia clinical manifestations - Select the incorrect one a. Cough b. Fever c. Chills d. Dyspnea e. Bradypnea f. Pleuritic chest pain g. Green, yellow, or rust-colored sputum h. Change in mental status

e

It is important for an RN to be able to identify the early clinical manifestations versus the late clinical manifestations of lung cancer. Please select all of the early clinical manifestations of lung cancer. a. persistent cough b. weight loss c. dysphagia d. hemoptysis e. dyspnea f. nausea/vomitting g. wheezing h. chest pain

a,d,e,g,h

A client is admitted to the hospital with chronic asthma. Which complication would the nurse monitor for in this client? a. pneumothorax b. atelectasis c. pulmonary edema d. respiratory acidosis

b

COPD cannot be cured but symptoms can be ____________________. a. suppressed b. managed c. eliminated d. exhausting

b

Increased _______________ and high ________________ meals are important. It is also crucial to monitor for weight loss. a. salt, calories b. hydration, calories c. eating, protein

b

Pneumonia treatment: Select the incorrect one a. Pneumococcal vaccine b. Fluid restriction c. Chest x-ray d. Oxygen e. Analgesics f. Antipyretics g. Antibiotics

b

Select the true statement about tuberculosis. a. Takes 4-5 weeks for symptoms to develop. b. Initially a dry cough but develops to productive c. Tuberculosis patients have incredibly high fevers d. Dyspnea and hemoptysis are early symptoms of TB

b

This is an inflammation of the bronchi and bronchioles caused by chronic exposure to irritants, especially tobacco smoke, triggering inflammation with vasodilation, congestion, mucosal edema, and bronchospasm. a. emphysema b. bronchitis c. lung cancer d. asthma

b

What should be taught to an asthma patient about the yellow zone in the asthma action plan? a. PANIC, and call 911 b. Use inhaler, use caution, and update provider c. No need to do anything this is normal d. Use rescue inhalers, and go to the emergency room

b

COPD exacerbation's are distinguished by changes in _____________, ________________, and ______________________. a. swelling b. shortness of breath c. sputum d. cough

b,c,d

A nurse is teaching a group of patients about the risk factors of COPD. Which of these would be accurate examples of what can cause COPD? Select all that apply a. Alcohol b. Smoking c. Occupational chemicals/dust d. Reoccurring cardiac problems e. α1-antitrypsin deficiency

b,c,e

Which of these findings would you expect to find during a physical examination of patient with COPD? More than one may be correct. a. Prolonged inspiratory wheeze b. ↑ Anterior-posterior diameter c. Bluish-red color of skin d. Hemoglobin 6 g/dL e. Polycythemia f. Pursed lip breathing

b,c,e,f

How should you as an RN retrain breathing techniques to COPD patients? Select all the correct techniques a. tripod positioning b. pursed lip breathing c. using accessory muscles d. diaphragmatic breathing

b,d

Fine and course crackles indicate _______________________. a. COPD b. Asthma c. Pneumonia d. Lung cancer

c

The nurse is performing a screening test for tuberculosis explains that which may be the cause of a positive result? a. Active tuberculosis infection b. A depressed immune system c. A previous exposure to TB d. An imminent tuberculosis infection

c

It is important for COPD patients to be able to identify what can cause COPD exacerbations. Which patient statement indicates the patient understands? a. Spicy foods and alcohol can cause a COPD exacerbation. b. Walking outside for more than 30 minutes can cause a COPD exacerbation c. Bacteria, fungal, and viral infections can cause a COPD exacerbation d. Not taking my medication as stated can cause a COPD exacerbation

c,d

Which would the nurse do to help alleviate the distress of a client with heart failure and pulmonary edema? a. Encourage persistent coughing b. Elevates the client's lower extremities c. Prepare for modified postural drainage d. Place the client in the orthopneic position

d

You are teaching an asthma patient about what causes asthma attacks. You are using the teach back method to ensure patient learning. Which statement would need correction? a. I should pay attention to when allergens are high in the air b. I need to be conscious when I am exercising c. Respiratory infections can cause an asthma attack d. GERD will not affect my asthma

d

True or false Tripod position and orthopneic position are not the same.

false

True or false Patients with emphysema experience damage to their alveoli.

true

True or false Tuberculosis patients can be asymptomatic

true

Mycobacterium tuberculosis causes __________________________

tuberculosis