EX1 CH28 Cardiac Disorder

The health care provider has prescribed salmeterol for a patient with asthma. In reviewing the use of dry powder inhalers (DPIs) with the patient, what instructions should the nurse provide?

"Close lips tightly around the mouthpiece and breathe in deeply and quickly."

Which instruction does the nurse document in the diet plan for the patient with chronic obstructive pulmonary disease (COPD)?

"Eat egg custard every day."

The health care provider has prescribed an inhaled corticosteroid for the patient with asthma. The nurse should provide which instructions to the patient regarding the use of a dry powder inhaler (DPI)?

"Hold your breath for at least 10 seconds to increase medication absorption by your lungs."

The registered nurse is teaching a student nurse about care management in a patient with oxygen saturation less than 90 percent, dyspnea, breathlessness, and forced expiratory volume in one second (FEV1) less than 60 percent. Which statement made by the student nurse indicates effective learning?

"I should advise the patient to avoid smoking and occupational exposure to irritants."

The nurse provides education to a caregiver of a patient with bloody sputum, dyspnea, fever, chills, and chest pain. Which statement made by the caregiver indicates effective learning?

"I should ask the patient to drink three liters of water daily."

A patient has frequent attacks of difficulty breathing and wheezing. The nurse is teaching the caregiver about the proper way of positioning the patient to decrease the sense of panic during an attack. Which statement of the caregiver indicates the need for further teaching?

"I should make the patient lay in a side-lying position."

A patient with chronic obstructive pulmonary disease (COPD) has severe dyspnea. The nurse is educating the patient about necessary interventions to conserve energy and avoid further complications. Which statement made by the patient indicates the need for further teaching?

"I should perform deep breathing and effective coughing before meals."

The nurse is evaluating an asthmatic patient's knowledge of self-care. Which statement by the patient indicates an adequate understanding of the instructions given?

"I will keep my rescue inhaler with me at all times."

The nurse provides home care instructions to a patient who has emphysema. Which statement by the patient indicates correct understanding of the teaching?

"I'll report any change in the color of my sputum."

Which statement made by the patient with chronic obstructive pulmonary disease (COPD) indicates a need for further teaching regarding the use of an ipratropium inhaler?

"If my breathing gets worse, I should keep taking extra puffs of the inhaler until I can breathe more easily."

The nurse is teaching a patient pursed-lip breathing (PLB). What instructions by the nurse are correct?

"Make breathing out (exhalation) three times longer than breathing in (inhalation)."

The nurse determines that the patient understood medication instructions about the use of a spacer device when taking inhaled medications after hearing the patient state what as the primary benefit?

"More of the medication will get down into my lungs to help my breathing."

The nurse reviews pursed-lip breathing with a 61-year-old patient with emphysema. Which statement made by the patient indicates correct understanding of this technique?

"My exhalation should be longer than my inhalation."

The nurse provides information to a group of nursing students about women with cystic fibrosis (CF) regarding conception and pregnancy. Which statement made by a student nurse related to female patients with CF indicates understanding of the education?

"She may have menstrual irregularities and secondary amenorrhea."

The nurse provides information to a student nurse about antibiotic therapy for a patient with cystic fibrosis (CF) who experiences a productive cough, PaO2 of 50 mmHg, arteriolar vasoconstriction, and cor pulmonale. Which statement made by the student nurse indicates effective learning?

"The patient will require prolonged high-dose antibiotic therapy."

The nurse teaches a group of nursing students about lung volume parameter in patients with asthma. Which statement made by a student nurse indicates the need for further teaching?

"With asthma, there is increased forced expiratory volume in one second."

The patient with asthma asks the nurse, "How will I know when my inhaler is empty?" What is the best response by the nurse?

"You need to keep track of how many puffs you have used and how many puffs are available."

A nurse who is teaching a program about cultural and ethnic health disparities that contribute to obstructive pulmonary diseases would include which statements in the presentation? Select all that apply.

-"Cystic fibrosis is not very common in African Americans or Hispanics." -"Asthma prevalence and age-adjusted death rates are the highest among Puerto Ricans." -"Hispanics have lower death rates from chronic obstructive diseases than other ethnic groups." -"Despite higher rates of smoking in other groups, whites have the highest incidence of chronic obstructive pulmonary diseases."

The nurse teaches a patient regarding the administration of fluticasone through an inhaler. Which statements made by the patient indicate effective learning? Select all that apply.

-"I should keep my medicine away from humid places." -"I should engage the lever while loading the medicine."

The nurse is explaining the pathophysiology of asthma to a patient. Which is the most appropriate explanation?

-"Inflammation causes bronchoconstriction, hyperreactivity, and edema of the airways."

A patient with asthma is prescribed formoterol. What should the nurse include in the medication education provided to the patient? Select all that apply.

-"Side effects include cold or flu-like symptoms." -"Formoterol is not the only medication that you will need to treat your asthma." -"If wheezing gets worse, there are other types of medications that are more beneficial than formoterol."

A patient presents with acute exacerbation of asthma. The nurse expects which strategies will be included in the treatment plan? Select all that apply.

-Administration of 100% oxygen -Intravenous administration of corticosteroids -Nebulization with short-acting β2-adrenergic agonists (SABAs)

A patient with cystic fibrosis is being treated by the nurse with chest physiotherapy for the left upper lobe (LUL) of the lung. Put the steps in the order that they should be performed.

-Albuterol (Proventil) nebulizer therapy -Position patient on right side with head up -Application of percussion and vibration -Effective coughing with expectoration

A patient with chronic obstructive pulmonary disease (COPD) needs to be taught about effective huff coughing in a stepwise manner. In which order should the nurse put the steps for teaching the patient?

-Assume a sitting position -Inhale slowly through your mouth -Hold your breath for 2 to 3 seconds -Forcefully exhale quickly

A patient presents to the emergency department with acute exacerbation of asthma. What actions should the nurse perform to monitor the patient's respiratory and cardiovascular systems? Select all that apply.

-Auscultate the lung sounds -Measure blood pressure and respiratory rate -Monitor arterial blood gases (ABGs) and pulse oximetry

When teaching a patient with asthma about ways to reduce the severity of asthma and asthma attacks, which measures should be included? Select all that apply.

-Avoid food irritants -Avoid animals with fur -Identify personal triggers

The nurse is assessing the respiratory system of an 87-year-old patient admitted with emphysema. Which assessment findings does the nurse expect? Select all that apply.

-Barrel chest -End-expiratory wheezes

A patient with an acute attack of asthma is in a state of panic. Which nursing measures help to relieve the panic? Select all that apply.

-Be calm, quiet, and reassuring. -Encourage pursed-lip breathing -Utilize the "talking down" technique

A patient is prescribed albuterol with a metered dose inhaler (MDI). After taking the cap off and shaking the inhaler, the nurse should instruct the patient to perform the steps of taking the medication in what order?

-Breathe out completely -Hold the inhaler straight -Breathe slowly through mouth -Press down the inhaler -Hold the breath for 10 seconds -Wait for one minute after every puff

A patient who has bronchiectasis asks the nurse, "What conditions would warrant a call to the clinic?" Which of these would the nurse include in the answer? Select all that apply.

-Chest pain -Fever and chills -Blood clots in the sputum -Increased sputum production

A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy through a mask. Which nursing actions should the nurse perform to ensure proper care of the patient? Select all that apply.

-Choose the optimal oxygen device -Assess the need to adjust the oxygen flow rate -Monitor for signs of adverse effects of oxygen therapy

The nurse is teaching a class about smoking cessation. Select the respiratory-related symptoms associated with cigarette smoking. Select all that apply.

-Chronic cough -Decreased sense of taste -Paralysis of the cilia inside the lungs

Which should the nurse include when providing information related to health promotion and disease prevention to a patient with cystic fibrosis (CF)? Select all that apply.

-Consume more fluids and caloric supplements -Learn about central venous access devices (CVAD) that may be used for long-term medication administration

What are late complications of cystic fibrosis (CF) caused by pulmonary hypertension? Select all that apply.

-Cor pulmonale -Respiratory failure

A 61-year-old patient with asthma is admitted to the hospital. The nurse understands that symptoms of asthma include what? Select all that apply.

-Cough -Wheezing -Chest tightness

What adventitious sounds may be auscultated when assessing a patient with pleuritic chest pain and dyspnea? Select all that apply.

-Crackles -Rhonchi -Wheezes

A patient with a blood sugar level of 210 mg/dL has bone density of -1.5 standard deviation. The nurse expects what diagnostic findings? Select all that apply.

-Destruction of islet cells in the pancreas -Insufficient levels of testosterone hormone -Chronically elevated inflammatory cytokines

A patient with advanced stage chronic obstructive pulmonary disease (COPD) experiences significant weight loss. The nurse expects that what will be included on the patient's plan of care? Select all that apply.

-Encourage rest before meals -Encourage high-protein supplements between meals

A patient is using a peak flow meter to check asthma. What is the order of interventions that the patient should follow while using the device?

-Ensure that the indicator is at the bottom of the numbered scale -Stand up -Take a deep breath to fill the lungs -Place the mouthpiece in the mouth and close the lips -Blow hard and fast in a single blow

The nurse is planning care for a patient with cystic fibrosis (CF). Which actions by the nurse are most appropriate? Select all that apply.

-Evaluates blood glucose levels -Provides fat-soluble vitamin supplementation -Prepares to provide pancreatic enzyme replacement medications

The nurse is providing education about the risk factors of asthma. Which factors does the nurse explain are associated with asthma? Select all that apply

-Immune response -Genetic predisposition -Exposure to air pollutants

The nurse is providing education about the risk factors of asthma. Which factors does the nurse explain are associated with asthma? Select all that apply.

-Immune response -Genetic predisposition -Exposure to air pollutants

The nurse recalls that the steps that lead to airway remodeling occur in what order?

-Inhalation of animal dander -Degranulation of mast cells -Release of inflammatory mediators -Cellular infiltration -Neuropeptides release

The nurse provides education to a patient who is prescribed a metered-dose inhaler. Which actions taken by the patient indicate the need for further teaching? Select all that apply.

-Inhales more than one puff with each inspiration -Does not shake the metered-dose inhaler before use

What are the advantages of a diskus over a metered-dose inhaler? Select all that apply.

-It requires less manual dexterity. -It contains an easily visible color that indicates the number of doses left

A patient has hyperventilation, dyspnea, nasal flaring, anxiety, and pursed-lip breathing. The nurse concludes that the patient has an ineffective breathing pattern due to alveolar hypoventilation. Which interventions should the nurse implement for this patient to promote safe and effective care? Select all that apply.

-Monitor for respiratory muscle fatigue -Encourage slow, deep breathing and coughing -Elevate the head of the bed and provide an overbed table for the patient

The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD). What does the nurse recognize are the predominant inflammatory cells in this disorder? Select all that apply.

-Neutrophils -Lymphocytes -Macrophages

Which complications in a patient with chronic obstructive pulmonary disorder (COPD) require acute intervention? Select all that apply.

-Pneumonia -Cor pulmonale -Exacerbations

Which diagnostic findings indicate that a patient has asthma? Select all that apply.

-Positive skin test for allergens -Serum and sputum eosinophilia -Chest x-ray indicating hyperinflation

The nurse expects what assessment findings in a patient with cystic fibrosis and bronchiectasis? Select all that apply.

-Protuberant abdomen -Emaciated appearance of the extremities

When performing pilocarpine iontophoresis in a patient with steatorrhea, the nurse should perform the steps of the procedure in what order?

-Provide education to the patient -Place pilocarpine on the skin -Wait for five minutes -Collect sweat onto a gauge -Analyze the level of chloride concentration

The nurse is teaching a patient how to use an inhaler. What steps should the nurse teach the patient? Please place in sequential order.

-Shake the inhaler -Breathe out all the way -Place the inhaler near or in your mouth as instructed by your health care provider (HCP). -As you start breathing in slowly through the mouth, press down on the inhaler one time -Keep breathing in slowly and as deeply as possible -Hold your breath as you count to 10 slowly

What are complications associated with pancreatic insufficiency? Select all that apply

-Steatorrhea -Low body mass index

What are complications associated with pancreatic insufficiency? Select all that apply.

-Steatorrhea -Low body mass index

A nurse observes a patient with asthma using a metered-dose inhaler. The nurse should correct which patient actions? Select all that apply.

-The patient holds the breath for five seconds -The patient presses the meter dose inhaler gently

The nurse is caring for a patient with chronic obstructive pulmonary disease. About what medications will the nurse educate the patient that have the side effects of a feeling of early satiety and a bloating sensation? Select all that apply.

-Theophylline -Corticosteroids

A smoker with forced expiratory volume in one second (FEV1) of 50 percent and arterial blood oxygen saturation less than 85 percent is referred for pulmonary rehabilitation (PR). Which interventions does the nurse anticipate will be part of the PR? Select all that apply.

-Using the internet to deliver daily motivational messages -Teaching exercises that focus on the muscles used for ambulation along with upper limb exercises

The patient is prescribed a high-flow oxygen delivery system. Which of these are high-flow devices? Select all that apply.

-Venturi mask -Mechanical ventilator

What discharge instructions should the nurse include for the patient with asthma? Select all that apply.

-Wash the nebulizer regularly -Medication noncompliance may lead to exacerbations -It is important to know the purpose and side effects of prescribed medications.

Which complications, along with edema in the ankles, does the nurse expect in a patient with chronic obstructive pulmonary disease (COPD)? Select all that apply.

-Weight gain -Hepatomegaly -Jugular vein distension

The patient has a prescription for albuterol 3 mg by nebulizer. Available is a solution containing 24mg/mL. How many mL should the nurse administer?

0.125 mL

The patient has a prescription to receive 600 mg guaifenesin every four hours as needed (PRN). Available are 400 mg tablets. How many tablets should the nurse prepare to give?

1.5 tablets

The nurse is overseeing an exercise program for patients with mild chronic obstructive pulmonary disease (COPD). Part of the program involves walking. Vital signs are taken after walking. The nurse becomes concerned when a 60-year-old patient's pulse rate is what?

120 beats/minute

The patient has a prescription for albuterol 5 mg via nebulizer. Available is a solution containing 2 mg/mL. Calculate how many mL the nurse should use to prepare the patient's dose. Fill in the blank using one decimal place. __ mL

2.5

The patient has a prescription to receive methylprednisolone sodium succinate 150 mg intravenous (IV) push stat. Available is a solution containing 60 mg/mL. How many mL of methylprednisolone should the nurse administer?

2.5 mL

A patient with a tracheostomy has difficulty breathing. Which device will be the most feasible for the patient to breathe through the tracheostomy tube?

4

After assessing the peak flow meter readings of a patient with asthma, the nurse concludes that the patient should inhale quick relief medicine right away. What could be the peak flow number of the patient?

40 percent of personal best number

An asthmatic patient has been prescribed 4 puffs of salmeterol daily. The canister of the meter dose inhaler has 200 puffs. The nurse instructs the patient that the canister will be empty and will need to be replaced in how many days? Record your answer using a whole number. __ days

50

A patient is prescribed an inhaler for treatment of asthma. The medication canister contains 200 puffs, scheduled to last for 25 days. The nurse should instruct the patient to inhale how many puffs per day to receive the prescribed amount? Record your answer using a whole number. ________

8

Which parameter should the nurse consider while assessing a patient with cystic fibrosis (CF)?

Abundant bronchial mucus

The licensed practical nurse is caring for a chronic obstructive pulmonary disease (COPD) patient who has severe hypoxemia. The primary health care provider prescribed oxygen administration for this patient. Which intervention can the nurse perform for the patient?

Adjust the oxygen flow rate depending on the desired oxygen level

The nurse is assessing a patient who is having an acute asthma attack. Which nursing intervention is the priority for this patient?

Administering an albuterol bronchodilator

The nurse is caring for a patient who is being mechanically ventilated that has a PaCO2 of 60 mm Hg, a respiratory pH of 6.8, and a PaO2 of 60 mm Hg. Which intervention will benefit the patient?

Administering sodium bicarbonate

A patient develops vascular congestion, edema, and breathlessness within 30 minutes of the consumption of food containing tartrazine. The nurse identifies that which treatment may exacerbate the patient's condition?

Administration of intravenous corticosteroid

An adolescent who has a history of asthma experiences wheezing after vigorous exercise. What nursing instruction is helpful for this patient?

Advise the patient to avoid dry air

What would be the appropriate nursing intervention for the patient whose laboratory report shows oxygen saturation of 45 mm Hg and carbon dioxide saturation of 60 mm Hg?

Advise the patient to plan sexual activity during the early afternoon

Which nursing intervention will the nurse include in the teaching plan for a patient with difficulty in breathing due to low oxygen level in the blood?

Advise the patient to refrain from sexual activity after eating

The nurse is caring for the patient with chronic obstructive pulmonary disease (COPD). The nurse will include in the patient plan of care:

Advise the patient to rest at least 30 minutes before eating

What instruction should the nurse give to a patient with asthma who has received a prescription for albuterol and ipratropium nebulization?

After the treatment, cough effectively

The patient has a prescription for each of the inhalers. Which one should the nurse offer to the patient at the onset of an asthma attack?

Albuterol

Which inhaler should the nurse be prepared to administer to the patient at the onset of an asthma attack?

Albuterol

A patient with asthma has a body temperature of 102° F and produces purulent sputum. The nurse anticipates that which drug will be prescribed?

An antibiotic

A patient presents to the emergency department with sudden-onset wheezing and coughing with progressive respiratory distress. What condition or diagnosis does the nurse recognize?

An asthma attack

A 45-year-old man with asthma is brought to the emergency department by automobile. He is short of breath and appears frightened. During the initial nursing assessment, which clinical manifestation might be present as an early manifestation during an exacerbation of asthma?

Anxiety

A patient with asthma is admitted in the emergency department with severe dyspnea and is unable to speak. The nurse finds that the patient looks drowsy and confused. Which other finding does the nurse expect?

Arterial blood gas deterioration

A male patient with chronic obstructive pulmonary disease (COPD) becomes dyspneic at rest. His baseline blood gas results are PaO2 70 mm Hg, PaCO2 52mm Hg, and pH 7.34. What updated patient assessment requires the nurse's priority intervention?

Arterial pH 7.26

Which finding indicates to the nurse that a patient's respiratory status is improving following an acute asthma exacerbation?

Audible wheezing

What is the most common sign during an initial assessment that alerts the nurse that the patient has chronic obstructive pulmonary disease?

Barrel chest

What is the most appropriate time to obtain peak flow readings with the best peak flow number?

Between noon and 2 PM

The nurse caring for a patient with diabetes mellitus and chronic obstructive pulmonary disease (COPD) on oral prednisone will monitor which parameter regularly?

Blood sugar

The nurse anticipates that which treatment therapy will be prescribed for a patient with massive hemoptysis?

Bronchial artery embolization

The nurse identifies that which treatment strategy will be beneficial for a patient that has a hemoglobin level of 7.8 mg/dL, inflammation, hemoptysis, and elastic and muscular structural changes to the bronchial wall?

Bronchial artery embolization

The nurse recognizes that which treatment may provide relief to a patient with asthma that has a PaO2 of 60 mm Hg and dyspnea?

Bronchial thermoplasty

The nurse expects that what diagnosis will be made for a patient that has permanent, abnormal dilation of medium-sized bronchi, inflammation, and elastic and muscular structural destruction of the bronchial wall?

Bronchiectasis

During an assessment of a 45-year-old patient with asthma, the nurse notes wheezing and dyspnea. The nurse determines that these symptoms are related to which pathophysiologic feature of the disease?

Bronchoconstriction

The nurse identifies the nursing diagnosis of "ineffective airway clearance" for a 58-year-old patient with asthma. The nurse should assess for which common etiologic factor for this nursing diagnosis?

Bronchospasm

The nurse is preparing a patient for a procedure with the thoracoscope to reduce the exacerbations of chronic obstructive pulmonary disease (COPD). What procedure should the nurse be sure the patient understands?

Bullectomy

A patient with chronic obstructive pulmonary disease (COPD) is experiencing anxiety. What medication as ordered should the nurse administer to this patient?

Buspirone

The nurse finds that a patient is experiencing breathlessness, chest tightness, and a cough after climbing stairs. What is the most likely reason for these symptoms?

Capillary leakage in the airway

A patient experiences chronic sinusitis. The nurse recognizes that which treatment strategy may help relieve the patient's symptoms caused by impaired ciliary movement in the airway?

Chest wall oscillation

A patient in the outpatient clinic has symptoms including chronic cough, sputum production, and dyspnea. On taking a detailed history of the patient, the nurse finds that this patient has a prolonged exposure to smoke. Which condition would the nurse most likely suspect the patient to have?

Chronic obstructive pulmonary disease (COPD)

Which corticosteroid can be administered directly through inhalation?

Ciclesonide

The nurse provides education to a patient with asthma about how to take medication through a metered dose inhaler. Which action performed by the patient indicates effective learning?

Cleans the device with water

The nurse determines that the patient has experienced the full benefits of medication therapy with ipratropium when which assessment finding is noted?

Clear lung sounds

The nurse concludes that interventions carried out to promote airway clearance in a patient admitted with asthma are successful on the basis of which finding?

Clearance of mucous from the bronchi

On examining a patient with asthma the nurse finds that the patient experiences asthmatic symptoms throughout the day, besides experiencing night-time awakenings more than four times a week. The patient's forced expiratory volume in the first second of expiration (FEV1) is less than 60%, and normal activity is very limited. Which treatment option should the nurse consider appropriate?

Consider oral corticosteroids

What is an autosomal recessive, multisystem disease characterized by altered function of the exocrine glands?

Cystic fibrosis (CF)

The nurse is caring for a patient with asthma. The patient's forced expiratory volume in one second is 70 percent. What does the nurse infer regarding how often the patient's symptoms occur?

Daily, particularly in the morning

When teaching the patient with chronic obstructive pulmonary disease (COPD) about smoking cessation, what information should be included related to the effects of smoking on the lungs and the increased incidence of pulmonary infections?

Decreased alveolar macrophage function

The nurse is educating a patient regarding breathing techniques. What technique should the nurse avoid in a patient with chronic obstructive pulmonary disease (COPD) who has marked hyperinflation?

Diaphragmatic breathing

A patient is hospitalized with a cough, weight loss, increased sputum, and decreased pulmonary function. The patient reports pain in the lower right quadrant, nausea, and emesis. The nurse suspects that the patient is experiencing what condition?

Distal intestinal obstructive syndrome

The nurse is providing postural drainage therapy on a patient who has cystic fibrosis. Postural drainage is used to do what?

Drain secretions from specific segments of the lungs and bronchi into the trachea

A patient with asthma is prescribed ipratropium bromide. The nurse recognizes that the patient may develop what side effect of the medication?

Dry mouth

A male patient experiences a cough, perfuse sweating, local hypoxia, and arteriolar vasoconstriction. The patient states, "I hope that this condition allows me to have biologic children." What is the best nursing response?

Educate the patient about assisted reproductive technology

The nurse concludes that nursing interventions to promote airway clearance in a patient admitted with chronic obstructive pulmonary disease (COPD) are successful based on which finding?

Effective and productive coughing

A patient with wheezing, coughing, and frequent pneumonia experiences large, oily, and frequent bowel movements. The patient's medical history reveals poor absorption of fats and proteins. The nurse anticipates what assessment finding?

Emaciated appearance of the extremities

The nurse is educating the patient on oxygen use for the home. The patient asks the nurse "Does this mean that I will not be able to go anywhere?" The most appropriate response by the nurse is:

Encourage the patient to continue normal activity and travel plans

The nurse is caring for a patient with an oxygen saturation of 45 percent of personal best who stops breathing while sleeping and has a tendency to sleep during the day. Which intervention by the nurse will help the patient most while recovering?

Encourage the patient to use typed messages to communicate.

A patient with asthma experiences anaphylaxis. Which medication should the nurse prepare to administer?

Epinephrine

The nurse is assigned to care for a patient who has anxiety and an exacerbation of asthma. What is the primary reason for the nurse to carefully inspect the chest wall of this patient?

Evaluate the use of intercostal muscles

When teaching a patient about chronic obstructive pulmonary disease (COPD) rehabilitation, what strategy should the nurse teach the patient as essential to perform for energy conservation?

Exercise training

The nurse determines that a patient is not experiencing the beneficial effects of ipratropium after noting which finding in the patient?

Expiratory wheezing

A patient with allergic asthma has been prescribed omalizumab. The patient requests that the medication be administered at home for convenience. Which nursing action is appropriate in this case?

Explain to the patient that the medication should be administered strictly at the clinic

The nurse is reviewing the diagnostic reports of a patient admitted for assessment of respiratory issues. Which diagnostic finding would confirm a diagnosis of chronic obstructive pulmonary disease (COPD)?

FEV1/FVC ratio of 65%

Nursing assessment findings of jugular venous distention and pedal edema would be indicative of what complication of chronic obstructive pulmonary disease (COPD)?

Fluid volume excess resulting from cor pulmonale

The nurse observes that a patient with cystic fibrosis (CF) has a body temperature of 102° F, shortness of breath, sore throat, and purulent mucous. The nurse expects what other assessment finding?

Formation of bullae and blebs in lungs

A patient with intermittent obstruction of the terminal ileum experiences thickened, dehydrated stools and increased mucus production. Subsequently, the patient develops chronic malabsorption due to partial bowel obstruction. The nurse anticipates that which intervention will be included on the patient's plan of care?

Gastric decompression and ingesting polyethylene glycol

Before administering ipratropium bromide, the nurse must confirm that the patient does not have which comorbidity?

Glaucoma

A patient with emphysema is receiving oxygen at 1 L/min by way of nasal cannula. Why does the nurse understand that this prescription is appropriate?

High concentrations of oxygen eliminate the respiratory drive

Which laboratory abnormality observed by the nurse confirms the diagnosis of a patient with low body mass index, wheezing, coughing, frequent pneumonia, bleeding, and sweating?

High sweat chloride level

A 45-year-old patient is experiencing an asthma exacerbation. To facilitate airflow, the nurse should place the patient in which position?

High-Fowler's

In which position is it most appropriate for the nurse to place a patient experiencing an asthma exacerbation?

High-Fowler's

A patient experiences pleuritic chest pain, dyspnea, wheezing, clubbing of digits, weight loss, and blood streaked sputum. The nurse anticipates that which test will be prescribed?

High-resolution computer tomography

When planning teaching for the patient with chronic obstructive pulmonary disease (COPD), the nurse understands that what causes the manifestations of the disease?

Hyperinflation of alveoli and destruction of alveolar walls

A patient who is a chronic smoker is diagnosed with chronic obstructive pulmonary disease (COPD). What causes the loss of elastic recoil in the patient's lungs and the destruction of alveoli?

Imbalance of protease and antiprotease ratio

The nurse is assessing a patient with asthma who has been diagnosed with a severe and life-threatening exacerbation. What findings would the nurse find?

Increased CO2 level

Which change occurs during cystic fibrosis?

Increased inflation of lungs

When teaching the patient with bronchiectasis about manifestations to report to the health care provider, which manifestation should be included?

Increasing dyspnea

The nurse is caring for the patient with chronic obstructive pulmonary disease (COPD). The patient complains of difficult breathing. What action by the nurse is most appropriate?

Initiate oxygen administration at low flow rates

What is a priority nursing assessment for a 38-year-old patient experiencing an acute asthma exacerbation?

Inspection of the chest wall

A child with a nonproductive cough states, "I am having trouble breathing." What action should the nurse take to reduce the severity of breathlessness in the child?

Instruct the child to bend forward slightly

Which intervention by the nurse would be most appropriate for safe and effective care for a patient with expiratory airflow obstruction, ineffective cough, decreased airway humidity, and abnormal breath sounds?

Instruct the patient to inhale deeply, bend forward slightly, and perform three or four huffs.

After the inhalation of puffs of mometasone, a patient develops oropharyngeal candidiasis, hoarseness and dry cough. What action should the nurse take to reduce the symptoms?

Instruct the patient to rinse the mouth with water after inhalation

The nurse recognizes that which patient condition is associated with a sweat chloride level of 75 mmol/L and chromosome 7 mutation's effect on the development of bone?

Insufficient testosterone levels

A patient with cystic fibrosis (CF) is hospitalized with exacerbation of symptoms, wheezing, purulent sputum, and a fasting blood glucose level of 194 mmol/L. The nurse anticipates that what medication will be prescribed?

Insulin

A patient experiencing an acute asthma exacerbation has received a bronchodilator and supplemental oxygen. Which treatment should the nurse anticipate if the patient's condition remains unchanged?

Intravenous corticosteroids

A patient with chronic obstructive pulmonary disease (COPD) is suspected to have developed cor pulmonale. The nurse recognizes that which test result helps confirm the diagnosis?

Large pulmonary vessels on chest x-ray

Which intervention is beneficial to a patient with chronic obstructive pulmonary disease (COPD)?

Limiting fluids during mealtimes

What complication does the nurse expect in a child with chronic pulmonary disease who is diagnosed with α1-antitrypsin (AAT) deficiency?

Liver disease

A patient who has been taking low-dose inhaled corticosteroids along with long-acting ß2-agonists for three months is assessed for control of asthma. The patient's laboratory reports reveal inadequate control of asthma. Which treatment does the nurse expect to be prescribed?

Medium dose inhaled corticosteroids and long-acting ß2-agonist

A patient is concerned that he or she may have asthma. The nurse assesses the severity of the symptoms. Based on this information, how would the nurse classify the patient's asthma? Refer to chart.

Mild persistent

During an assessment of a 45-year-old patient with asthma, the nurse notes wheezing and dyspnea. The nurse interprets that these symptoms are related to what pathophysiologic change?

Narrowing of the airway

A patient requires oxygen administration in low concentrations of 24% at 1 L/min for a long duration. Which device is the most appropriate for this patient?

Nasal cannula

Which complication does the nurse monitor in the patient who is using an oxygen-conserving cannula?

Necrosis over tops of ears

Which cells cause inflammation in a patient with an inflamed airway and productive cough who has Pseudomonas aeruginosa infection?

Neutrophils

The nurse is caring for a patient with cystic fibrosis (CF). What is the most important factor for the nurse to consider when using clearance techniques and devices?

No single technique has shown superiority over the others

When should a nurse schedule postural drainage for a patient who has chronic obstructive pulmonary disease (COPD)?

One hour before a meal

The nurse determines that a patient is experiencing common adverse effects from the inhaled corticosteroid beclomethasone after what occurs?

Oropharyngeal candidiasis and hoarseness

Prolonged exposure to a high level of oxygen leads to pulmonary damage caused by what?

Oxygen toxicity

Which assessment finding does the nurse expect when caring for a patient with asthma?

PaCO2 of 30 mm Hg

When teaching the patient with cystic fibrosis about the diet and medications, what is the priority information to be included in the discussion?

Pancreatic enzymes and adequate fat, calories, protein, and vitamins are needed

The nurse is caring for a five-year-old child with low body weight and poor growth. The parent reports that the child is unable to digest fat- and protein-rich foods. The nurse suspects that the child has what condition?

Pancreatic insufficiency

A patient with cystic fibrosis (CF) experiences oily, irregular bowel movements and has a fat-soluble vitamin deficiency. The nurse anticipates what prescription?

Pancrelipase before each meal

A patient with cystic fibrosis (CF) has a body mass index (BMI) of 15.6 kg/m 2 and experiences frequent, bulky, and foul-smelling stools? What does the nurse expect to find on the patient's plan of care?

Pancrelipase before each meal

Which laboratory finding helped the nurse reach the conclusion that a patient with a chronic cough and dyspnea has hypercapnia?

Partial pressure of carbon dioxide (PaCO2) is 55 mm Hg

Which finding helped the nurse reach the conclusion that a patient with chronic obstructive pulmonary disease (COPD) requires oxygen therapy?

Partial pressure of oxygen (PaO2) 52 mm Hg

The nurse gathers data related to individual patients' forced expiratory volume in one-second values. The nurse suspects that which patient has intermittent asthma?

Patient A

The nurse assesses four patients and recognizes that which patient is likely to experience small bowel obstruction?

Patient B

The registered nurse (RN) working on a pulmonary floor is delegating tasks to a licensed practical nurse (LPN). Which patient intervention can appropriately be delegated to the LPN?

Patient B

The nurse is caring for the patient with cystic fibrosis (CF). Which is the most important factor for the nurse to consider?

Patients with CF often survive into their 40s.

When teaching a patient with chronic obstructive pulmonary disease (COPD) about using pursed-lip breathing (PLB), what is the most important instruction?

Perform PLB before, during, and after activities that cause shortness of breath

Which strategy should the nurse teach a patient with emphysema to manage anxiety related to impaired gas exchange?

Perform pursed-lip breathing

A patient with cystic fibrosis (CF) experiences wheezing, coughing, and frequent pneumonia. The patient's computer tomography shows bullae and blebs of 1 to 2 cm in the lungs. The nurse anticipates that what will be included on the patient's plan of care?

Pleural abrasion

Which condition may develop if a patient with localized hypoxia and arteriolar vasoconstriction who has blebs and large cysts in the lungs is left untreated?

Pneumothorax

A patient reports severe abdominal pain, and the laboratory report indicates accumulation of mucus and high levels of liver enzymes. Which condition may develop if the patient is left untreated?

Portal hypertension

When caring for a patient with chronic obstructive pulmonary disease (COPD), the nurse identifies a nursing diagnosis of imbalanced nutrition: less than body requirements after noting a weight loss of 30 lb. Which intervention should the nurse add to the plan of care for this patient?

Prescribe a high-calorie, high-protein diet with six small meals a day

The nurse is caring for a patient diagnosed with cor pulmonale. What symptoms assessed by the nurse correlate with the assigned diagnosis?

Presence of edema in the ankles

The nurse understands that which description best characterizes chronic obstructive pulmonary disease (COPD)?

Progressive persistent expiratory airflow limitation

The nurse teaches pursed-lip breathing to a patient with emphysema. The nurse explains that the primary reason for this technique is what?

Promoting carbon dioxide elimination

The nurse determines that the patient is not experiencing adverse effects of albuterol after noting which patient vital sign?

Pulse rate of 72 beats/minute

The purpose of this exercise is to prolong exhalation and thereby prevent bronchiolar collapse and air trapping.

Pursed-lip breathing (PLB)

Which measure should a patient with chronic obstructive pulmonary disorder (COPD) take when performing physical activity?

Remember to think about steps and breathing while walking

Before discharge, the nurse discusses nutrition with the patient with emphysema and pneumonia. The nurse instructs the patient to do what?

Rest for 30 minutes before eating

The patient has been receiving oxygen by nasal cannula. The nurse suspects the patient is experiencing oxygen toxicity after noting which finding?

Restlessness

The nurse administering beclomethasone to a patient can help reduce side effects by instructing the patient to perform which action?

Rinse mouth thoroughly after each use

What is the best method to prevent oral infection while the patient is taking fluticasone?

Rinse the mouth with water after the second puff of medication

The nurse is assisting a patient to learn self-administration of beclomethasone, two puffs inhaled every six hours. What should the nurse explain as the best way to prevent oral infection while taking this medication?

Rinse the mouth with water following the second puff of medication

The nurse is caring for a patient with severe chronic obstructive pulmonary disease (COPD) who has frequent exacerbations. What treatment strategy does the nurse recognize would be most beneficial for this patient?

Roflumilast

While reviewing the laboratory reports of a patient with a chronic cough, dyspnea, and lung inflammation, the nurse finds that the patient has a forced expiratory volume of 55%. Which treatment strategy would be most effective for this patient?

Salmeterol and formotero

The nurse is transporting an oxygen dependent patient to the radiology department. Which mask would be most effective during transportation?

Simple face mask

The nurse provides teaching to a patient with asthma who has been advised to use nebulization. What should the nurse include in the instructions about nebulization?

Sit in an upright position during the treatment

The nurse is teaching a patient how to use a hand-held nebulizer. Which guideline is correct?

Sit in an upright position during the treatment.

The nurse determines that a 61-year-old patient with chronic bronchitis has a nursing diagnosis of "impaired gas exchange" after noting an oxygen saturation of 88%. What is an appropriate intervention to add to the care plan?

Sit the patient upright in a chair leaning slightly forward

The nurse determines that a 61-year-old patient with chronic bronchitis has a nursing diagnosis of "impaired gas exchange," after noting an oxygen saturation of 88%. What is an appropriate intervention to add to the care plan?

Sit the patient upright in a chair leaning slightly forward

A patient who has a family history of α1-protease inhibitor deficiency reports fever of unknown cause, malaise, and cough associated with purulent sputum. Which test should the patient undergo regularly to assess the severity of the condition?

Spirometry

The nurse is caring for a patient with suspected chronic obstructive pulmonary disease (COPD). What diagnostic test should the nurse monitor for confirmation of the presence of COPD?

Spirometry

A patient presents with a productive cough and a body temperature of 102° F. The patient's white blood cell (WBC) count is 15,000/mm3. The nurse expects that what diagnostic test will be prescribed?

Sputum culture test

A four-year-old child with cystic fibrosis (CF) experiences a cough associated with viscous, purulent, and greenish sputum. The nurse expects that which organism will be found in the patient's sputum?

Staphylococcus aureus

The nurse identifies that which treatment strategy will likely be prescribed for a patient with cor pulmonale, arteriolar vasoconstriction, and a PaO2 of 50 mm Hg?

Supplemental oxygenation

A patient in the emergency ward is dyspneic and speaks unclear words. Assessment findings include a respiratory rate of 45 breaths/minute, a pulse of 130 beats/minute, oxygen saturation of 90%, and neck vein distention. Which treatment does the nurse expect will help alleviate the patient's symptoms?

Supplementary oxygen through nasal cannula

An infant is undergoing evaluation for possible cystic fibrosis. The nurse anticipates that which procedure will be prescribed as the main diagnostic test for cystic fibrosis?

Sweat chloride test

Which diagnostic test will help determine the condition of a patient that has a productive cough, perfuse sweating, local hypoxia, and arteriolar vasoconstriction?

Sweat test

The nurse is assigned to care for a patient in the emergency department admitted with an exacerbation of asthma. The patient has received a β2-adrenergic agonists bronchodilator and supplemental oxygen. If the patient's condition does not improve, the nurse should anticipate what as the most likely next step in treatment?

Systemic corticosteroids

The nurse determines that a patient is experiencing the most common adverse effect of albuterol after noting which sign?

Tachycardia

While caring for a patient with a chronic cough and dyspnea associated with the inflammation of lung parenchyma, a nurse instructs the patient, "You should reduce the salt in your diet." What is the reason behind this instruction?

The patient has cor pulmonale

A patient experiencing severe wheezing arrives in the emergency department and is diagnosed with severe exacerbation of asthma. During the admission assessment, the nurse on the inpatient unit notes that the patient continues to struggle with breathing; however, there is an absence of wheezing. How should the nurse interpret the assessment findings?

The patient has respiratory failure and needs mechanical ventilation

What does the nurse interpret from finding that a patient, after being treated for chronic cough and dyspnea associated with inflammation in lung parenchyma, loses muscle mass?

The patient is on corticosteroid therapy

A nurse is caring for a patient diagnosed with chronic obstructive pulmonary disease (COPD). The lab reports of the patient reveal a hemoglobin level of 20 g/dL. What could be the reason for the increased hemoglobin?

The production of red blood cells increases in response to hypoxia

The nurse is caring for a child who is suspected of having cystic fibrosis (CF). The nurse knows that the gold standard of diagnosing this condition is:

The sweat chloride test

A patient with a forced expiratory volume of 80 percent and a three-day history of breathlessness develops nausea, vomiting, headache, tachycardia, and dysrhythmias. The nurse suspects that which medication that the patient takes is the cause of the patient's symptoms?

Theophylline

An asthmatic patient is in acute respiratory distress. The nurse auscultates the lungs and notes cessation of inspiratory wheezing. How does the nurse interpret this finding?

There is worsening airway inflammation and bronchoconstriction

The nurse recognizes the patient with which reported awakening as mildly asthmatic?

Three to four days per month

The nurse recognizes that which intervention will be beneficial to the patient with pleuritic chest pain, dyspnea, wheezing, and mouth bleeding?

To prevent infection, encourage the patient to receive the pneumococcal and influenza vaccinations

A patient has had chronic obstructive pulmonary disease (COPD) for three months. Further assessment reveals that forced expiratory volume in one second (FEV1) is 65 percent. Which treatment option would be most appropriate for this patient?

Treatment with albuterol and ipratropium combination

The nurse is caring for an adult patient with bronchiectasis. The nurse knows that the primary cause of this disease in adults is related to what?

Untreated or delayed treatment of bacterial lung infections

The nurse is teaching energy conservation techniques to a patient with severe dyspnea and oxygen saturation of 50 mm Hg. Which action of the patient indicates effective learning?

Using a tripod posture and placing the mirror on the table while using an electric razor

Which intervention by the student nurse indicates the need for further teaching while performing percussion of a patient with chronic obstructive pulmonary disorder (COPD)?

Using both hands at once during percussion

A patient is experiencing an exacerbation of chronic obstructive pulmonary disease (COPD) and requires supplemental oxygen. To deliver the precise amount of oxygen, the nurse should use which type of equipment?

Venturi mask

A patient needs to receive oxygen at a 28% concentration. The nurse will set up which oxygen delivery device?

Venturi mask

A patient with an acute exacerbation of chronic obstructive pulmonary disease (COPD) needs to receive precise amounts of oxygen. Which equipment should the nurse prepare to use?

Venturi mask

The nurse determines that the patient has understood medication instructions about the use of a metered dose inhaler (MDI) when the patient performs which action?

Waits one minute between each puff from the MDI

The nurse identifies the nursing diagnosis of activity intolerance for a patient with asthma. In patients with asthma, the nurse assesses for which etiologic factor for this nursing diagnosis?

Work of breathing

The nurse is assigned to care for an 83-year-old patient with an acute asthma exacerbation. Which arterial blood gas (ABG) result would prompt the nurse to notify the provider immediately?

pH 7.30, PaO2 74 mm Hg, PaCO2 65 mm Hg

Which treatment may increase restlessness and insomnia in a patient with chronic obstructive pulmonary disease (COPD)?

β 2 agonists