Chap 24 Prep-U

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? a. Chest pain during respiration b. Sputum and a productive cough c. Fever, chills, and diaphoresis d. Tachypnea and tachycardia

sputum and a productive cough

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. Decreased airflow c. Wheezes d. Jugular vein distention e. Ascites

a. Compromised gas exchange b. Decreased airflow c. Wheezes

The diagnosis of pulmonary hypertension associated with chronic obstructive pulmonary disease (COPD) is suspected when which of the following is noted? Select all that apply. a. Dyspnea and fatigue disproportionate to pulmonary function abnormalities b. Right ventricular enlargement c. Elevated plasma brain natriuretic peptide (BNP) d. Enlargement of central pulmonary arteries e. Left ventricular hypertrophy

a. Dyspnea and fatigue disproportionate to pulmonary function abnormalities b. Right ventricular enlargement c. Elevated plasma brain natriuretic peptide (BNP) d. Enlargement of central pulmonary arteries

Asthma is cause by which type of response? a. IgE-mediated b. IgA-mediated c. IgD-mediated d. IgM-mediated

a. IgE-mediated

The nurse, caring for a patient with emphysema, understands that airflow limitations are not reversible. The end result of deterioration is: a. Diminished alveolar surface area. b. Hypercapnia resulting from decreased carbon dioxide elimination. c. Hypoxemia secondary to impaired oxygen diffusion. d. Respiratory acidosis.

d. respiratory acidosis

Which of the following is not a primary symptom of COPD? a. Cough b. Sputum production c. Dyspnea upon exertion d. Weight gain

d. weight gain

Which exposure accounts for most cases of COPD? a. Exposure to tobacco smoke b. Occupational exposure c. Passive smoking d. Ambient air pollution

exposure to tobacco smoke

A nurse is caring for a client admitted with an exacerbation of asthma. The nurse knows the client's condition is worsening when he: a. sits in tripod position. b. has a pulse oximetry reading of 93%. c. uses the sternocleidomastoid muscles. d. wants the head of the bed raised to a 90-degree level.

c. uses the sternocleidomastoid muscles

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

c. weigh yourself daily and report a gain of 2 lb in 1 day

A client with asthma has developed obstruction of the airway. Which of the following does the nurse understand as having potentially contributed to this problem? Choose all that apply. Thick mucus Swelling of bronchial membranes Destruction of the alveolar wall Airway remodeling

Thick mucus Swelling of bronchial membranes Airway remodeling

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. Restricting oral intake to 1,000 mL/day b. Providing the client a low-sodium diet c. Performing chest physiotherapy as ordered d. Discussing palliative care and end-of-life issues with the client

c. performing chest physiotherapy as ordered

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. Status asthmaticus b. Respiratory failure c. Pertussis d. Atelectasis e. Thoracentesis

Status asthmaticus Atelectasis Respiratory failure

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

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

A nurse evaluates the results of a spirometry test to help confirm a diagnosis of obstructive lung disease. Which one of the following results indicates an initial early stage of COPD? (FEV1 refers to forced expired volume in 1 second.) a. FEV1 > 80% b. FEV1 = 30% c. FEV1 = 70% d. FEV1 = 50%

a. FEV1> 80%

Which of the following factors contribute to the underlying pathophysiology of chronic obstructive pulmonary disease (COPD)? Select all that apply. a. Inflamed airways obstruct airflow. b. Mucus secretions block airways. c. Overinflated alveoli impair gas exchange. d. Dry airways obstruct airflow.

a. Inflamed airways obstruct airflow. b. Mucus secretions block airways. c. Overinflated alveoli impair gas exchange.

A nurse administers albuterol (Proventil), as ordered, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect? a. Respiratory rate of 22 breaths/minute b. Dilated and reactive pupils c. Heart rate of 100 beats/minute d. Urine output of 40 ml/hour

a. Respiratory rate of 22 breaths/minute

A nurse is teaching the client about use of the pictured item with 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. Use normal inhalations with the device. c. Activate the MDI once. 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. c. Activate the MDI once. d. The device may increase delivery of the MDI medication.

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? a. Decreased oxygen requirements b. Increased sputum production c. Decreased activity tolerance d. Hyperthermia

a. decreased oxygen requirements

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. paradoxical chest wall movement with respirations. c. tracheal deviation to the unaffected side. d. muffled or distant heart sounds.

a. diminished or absent breath sounds on the affected side

The nurse is assigned to care for a patient with COPD with hypoxemia and hypercapnia. When planning care for this patient, what does the nurse understand is the main goal of treatment? a. Providing sufficient oxygen to improve oxygenation b. Avoiding the use of oxygen to decrease the hypoxic drive c. Monitoring the pulse oximetry to assess need for early intervention when PCO2 levels rise d. Increasing pH

a. providing sufficient oxygen to improve oxygenation

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 acidosis b. Respiratory alkalosis c. Metabolic alkalosis d. Metabolic acidosis

a. respiratory acidosis

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

b. Oxygen through nasal cannula at 2 L/minute

Which is the strongest predisposing factor for asthma? a. Congenital malformations b. Allergy c. Male gender d. Air pollution

b. allergy

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 a. Pneumonia b. Atelectasis c. Emphysema d. Pleurisy

b. atelectasis

The classification of Stage II of COPD is defined as a. at risk for COPD. b. moderate COPD. c. severe COPD. d. very severe COPD. e. mild COPD.

b. moderate COPD

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 type of disorder within its classification. Which of the following is part of that disorder? a. Cystic fibrosis b. Bronchiectasis c. Emphysema d. Asthma

c. emphysema

A client with bronchiectasis is admitted to the nursing unit. The primary focus of nursing care for this client includes a. teaching the family how to perform postural drainage. b. instructing the client on the signs of respiratory infection. c. implementing measures to clear pulmonary secretions. d. providing the client a low-calorie, high-fiber diet.

c. implementing measures to clear pulmonary secretions

What is histamine, a mediator that supports the inflammatory process in asthma, secreted by? a. Eosinophils b. Lymphocytes c. Mast cells d. Neutrophils

c. mast cells

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. Low-fat b. 1,800-calorie ADA c. Full-liquid d. High-protein

d. high protein