Med-Surg: Pulmonary Questions

Which PEV1 % is classified as mild? Moderate? Severe?

Mild: fev1 > 80% Moderate: fev1 50-80% Severe: 30% VERY severe: <30%

Which drug is a rescue agent for an asthma attack? **Hint SABA

Albuterol

A nurse is providing discharge teaching to a client who has COPD and a new prescription for albuterol. Which of the following statements by the client indicates an understanding of the teaching? A. "this medication can increase my blood sugar levels." B. "this medication can decrease my immune response." C. "I can have an increase in my heart rate while taking this medication." D. "I can have mouth sores while taking this medication."

Answer: C Why: Bronchodilators can cause tachycardia

A nurse is instructing a client on the use of an incentive spirometer. Which of the following statements by the client indicates an understanding of the teaching? A. "I will place the adapter on my finger to read my blood oxygen saturation level." B. "I will lie on my back with my knees bent." C. "I will rest my hand over my abdomen to create resistance." D. "I will take in a deep breath and hold it before exhaling."

Answer: D

A nurse is caring for a child who is experiencing status asthmaticus. Which of the following interventions is the priority for the nurse to take? 1) Administer a short-acting B2 agonist (SABA) 2) Obtain peak flow rating 3) Administer inhaled gluccocorticoid 4) Determine cause of exacerbation

Answer: 1) administer SABA why: sba relieves bronchoconstriction and provides ventilation

A home health nurse visits a client who has COPD and receives oxygen at 2 L/min via nasal cannula. The client reports difficulty breathing. Which of the following actions is the nurse's priority? ANSWERS - Multiple Choice 1) Increase O2 flow to 3L/min 2) Assess clients respiratory status 3) Call emergncy services for the client 4) Have client cough and expectorate secretions

Answer: 2

A nurse is caring for a client who has returned to the unit following a surgical procedure. The client's oxygen saturation is 85%. Which of the following actions should the nurse take first? ANSWERS - Multiple Choice 1) give O2 t 2l/min 2)Administer analgesic medication 3) encourage coughing and deep breathing 4) raise HOB

Answer: 4 Why: improve perfusion

A nurse in an urgent care center is caring for a client who is having an acute asthma exacerbation. Which of the following actions is the nurse's highest priority?ANSWERS - Multiple Choice 1) give o2 therapy 2) Providing immediate rest for the client 3) Position pt in high fowlers 4) Nebulized Beta adrenergic

Answer: 4 Why: greatest risk is airway obstruction

A nurse is discharging a client who has COPD. the client is concerned about not being able to leave the house due to the need for staying on continuous oxygen. Which of the following responses should the nurse make? A. "there are portable oxygen delivery systems that you can take with you." B. "When you go out, you can remove the oxygen and then reapply it when you get home." C. "You probably will not be able to go out as much as you used to." E. "home health services will come to you so you will not need to get out."

Answer: A

A nurse is providing dietary teaching for a client who has chronic obstructive pulmonary disease. Which of the following instructions should the nurse include? 1) Eat 3 large meals a day 2) limit water intake with meals 3) reduce protein intake 4) use bronchodilator 1 hr before eating

Answer: 2 limit intake with meals Why: prevent early satiety

A nurse is teaching a client who has emphysema about self-management strategies. Which of the following statements by the client indicates an understanding of the teaching? ANSWERS - Multiple Choice 1) "I will inhale slowly through pursed lips to help me breathe better" 2) "I will avoid getting a flu shot" 3) "I will follow a diet high in calories and protein" 4) "I will lie on my stomach to practice abdominal breathing every day"

Answer: 3 Emphysema pt are usually skinny and malnourished

A nurse is caring for a client who has chronic obstructive pulmonary disease (COPD). The client tells the nurse, "I can feel the congestion in my lungs, and I certainly cough a lot, but I can't seem to bring anything up." Which of the following actions should the nurse take to help this client with tenacious bronchial secretions? 1) Maintain semi-fowlers position 2)Give O2 via nasal cannula 3) help client select low salt diet 4) encourage the client to drink 2-3L per day

Answer: 4

A nurse is developing a plan of care for a client who has COPD. The nurse should include which of the following interventions in the plan? ANSWERS - Multiple Choice 1) Restrict fluid intake to less than 2L per day 2) provide client with a low protein diet 3) Have client use early mornin g hours for exercise and activity 4) Instruct client to use pursed lip breathing

Answer: 4

A nurse is preparing to administer an initial dose of prednisone to a client who has COPD. the nurse should monitor for which of the following adverse effects of this medication? (select all that apply.) A. hypokalemia B. tachycardia C. Fluid retention D. Nausea E. Black, tarry stools

Answer: A C E

A nurse is teaching a client who has a new diagnosis of asthma. Which of the following medications should the nurse instruct the client to use to abort an acute asthma attack? 1) Beclomethasone 2) Salmeterol 3) Formoterol 4) Albuterol

Answer: Albuterol

A nurse is assessing a client who has a history of asthma. Which of the following factors should the nurse identify as a risk for asthma? A. sex B. Environmental allergies C. Alcohol use D. history of diabetes

Answer: B Why: DUHHH

A nurse is reinforcing teaching with a client on the purpose of taking a bronchodilator. Which of the following client statements indicates understanding? A. "this medication can decrease my immune response." B. "I take this medication to prevent asthma attacks." C. "I need to take this medication with food." D. "this medication has a slow onset to treat my symptoms."

Answer: B prevents asthma attacks

A nurse is planning to instruct a client on how to perform pursed‐lip breathing. Which of the following statements should the nurse include? A. "take quick breaths upon inhalation." B. "Place your hand over your stomach." C. "take a deep breath in through your nose." D. "Puff your cheeks upon exhalation."

Answer: C

A nurse is providing discharge teaching to a client who has a new prescription for prednisone for asthma. Which of the following client statements indicates understanding? A. "I will decrease my fluid intake while taking this medication." B. "I will expect to have black, tarry stools." C. "I will take my medication with meals." D. "I will monitor for weight loss while on this medication."

Answer: C WHy: taking prednisone on empty stomach causes GI distress

A nurse is caring for a client 2 hr after admission. the client has an saO2 of 91%, exhibits audible wheezes, and is using accessory muscles when breathing. Which of the following classes of medications should the nurse expect to administer? A. Antibiotic B. Beta‐blocker C. Antiviral D. Beta2 agonist

Answer: D causes dilation of the bronchioles

A nurse is caring for a client who has emphysema. Which of the following findings should the nurse expect to assess in this client? (Select all that apply.) 1) Dyspnea 2)Bradycardia 3)Barrel Chest 4)clubbing fingers 5) Deep Respirations

Answers: 1 3 4 Why: client will become TACHYcardic because heart wants to pump more blood to compensate for loss of O2 in blood, Respirations are shallow (barrel chest)

A nurse in the emergency department is caring fora client who is experiencing an acute asthma attack. Which of the following assessments indicates that the respiratory status is declining? (select all that apply.) A. saO2 95% B. Wheezing C. Retraction of sternal muscles D. Pink mucous membranes E. tachycardia

Answers: B C E