MEDSURG MOD 3

The underlying pathology in asthma is which of the following?

reversible diffuse airway inflammation

Hospital acquired pneumonia (HAP) develops _____ hours or more after admission and does not appear to be incubating at the time of admission.

48

Granulomas, new tissue masses of live and dead bacilli, are surrounded by macrophages, which form a protective wall. They are then transformed to a fibrous tissue mass, the central portion of which is called which of the following?

Ghon tubercle

pO2 values below _____ indicate that tissues are not receiving enough oxygen.

90%

Which of the following environmental factors are primarily associated with asthma? Select all that apply.

A positive family history and environmental factors, including seasonal changes, high pollen counts, mold, pet dander, climate changes (particularly cold air), and air pollution, are primarily associated with asthma.

Which of the following is not an acceptable location to attach a pulse oximetry probe?

A probe or sensor is attached to the fingertip, forehead, earlobe, or bridge of the nose.

Which of the following is key in treating the disease and controlling the spread of infection?

Adherence

In patients with COPD who have primary emphysema the chronic hyperinflation of the chest leads to which of the following?

Barrel chest configuration

After each position change, the nurse encourages the patient to do which of the following?

Breathe deeply and cough

Surgical options might be necessary for patients who do not demonstrate symptom improvement with nonsurgical therapies. Which of the following are surgical options? Select all that apply.

Bullectomy Lung transplant Lung Volume Reduction Surgery

The nurse is obtaining a sputum sample from a patient. Place the following answers in the correct order for collecting a sputum sample.

The sputum sample is obtained by having patients do the following: (1) rinse the mouth with water to minimize contamination by normal oral flora, (2) breathe deeply several times, (3) cough deeply, and (4) expectorate the raised sputum into a sterile container.

Which of the following are common triggers of asthma? Select all that apply.

Common triggers for asthma symptoms and exacerbations include airway irritants (e.g., air pollutants, cold, heat, weather changes, strong odors or perfumes, smoke, occupational exposure), foods (e.g., shellfish, nuts), exercise, stress, hormonal factors, medications, viral respiratory tract infections, and gastroesophageal reflux.

Short-term

Corticosteroids

Which of the following are teaching guidelines for isoniazid? Select all that apply.

If you begin to experience numbness, burning, or tingling of your arms or legs, notify the TB health care provider. Take all other anti-TB drugs prescribed along with INH. Avoid alcoholic beverages while taking INH.

Long-term

Leukotriene Modifiers Inhaled Corticosteroids Systemic Corticosteroids Anticholinergics

Which of the following are the first-line medications to treat TB? Select all that apply.

PZA Rifampin INH Myambutol

Which of the following are nursing education component for patient being discharged with a diagnosis of COPD? Select all that apply.

Patient with COPD should be education on Breathing exercises, Activity pacing, Palliative care, Oxygen therapy, Self-care activities, Nutritional therapy and physical conditioning.

Monitoring and managing potential complications of pneumonia the nurse must be aware of which of the following? Select all that apply.

Pleural Effusion Continuing symptoms after initial treatment Shock and Respiratory Failure Delirium

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable slowly progressive respiratory disease of airflow ________ involving the airways, pulmonary parenchyma, or both.

obstruction

Which of the following is used to evaluate airflow obstruction in patients with COPD?

Spirometry

The nurse should obtain current educational materials for the patient based on which of the following? Select all that apply.

The nurse should obtain current educational materials for the patient based on the patient's diagnosis, causative factors, educational level, and cultural background.

With peak flow meters, the patient takes a deep breath and places their lips around the mouthpiece. The patient then?

The patient takes a deep breath and places lips around the mouthpiece, and then exhales hard and fast.

Which of the following terms is used to describe pneumonia that is distributed in a patchy fashion?

The term bronchopneumonia is used to describe pneumonia that is distributed in a patchy fashion, having originated in one or more localized areas within the bronchi and extending to the adjacent surrounding lung parenchyma.

There are systemic or extrapulmonary manifestations of COPD. These include which of the following? Select all that apply.

There are systemic or extrapulmonary manifestations of COPD. These include musculoskeletal wasting, metabolic syndrome, and depression (a frequent comorbidity that accompanies chronic debilitating illnesses).

Which of the following are stages of parapneumonic pleural effusions? Select all that apply.

There are three stages of parapneumonic pleural effusions based on pathogenesis: uncomplicated, complicated, and thoracic empyema.

To prevent transmission of TB to others, the nurse carefully instructs the patient about which of the following? Select all that apply.

To prevent transmission of TB to others, the nurse carefully instructs the patient about important hygiene measures, including mouth care, covering the mouth and nose when coughing and sneezing, proper disposal of tissues, and hand hygiene.

Tuberculosis (TB) is an infectious disease that primarily affects the lung parenchyma. It also may be transmitted to other parts of the body, including which of the following? Select all that apply.

Tuberculosis (TB) is an infectious disease that primarily affects the lung parenchyma. It also may be transmitted to other parts of the body, including the meninges, kidneys, bones, and lymph nodes.

Pneumonia can be classified as which of the following? Select all that apply.

Ventilator-associated pneumonia (VAP) Health care-associated pneumonia (HCAP) Community-acquired pneumonia (CAP)

Carbapenems Cephalosporins Aminoglycosides sulfonamides

broad-spectrum, bactericidal beta-lactam antimicrobials. The group consists of four drugs. classified into five subgroups, or "generations," based on their pharmacology and spectrum of activity. bactericidal agents with similar pharmacologic, antimicrobial, and toxicologic characteristics. The drug class is not effective against gram-negative anaerobes. bacteriostatic drugs that were once effective against a wide range of gram-positive and gram-negative bacteria. However, increasing resistance is making them less useful.

Which of the following are key for symptom management in stable COPD?

bronchodilators

A 2nd dose of pneumococcal vaccine may be given at 65 years if the first dose was given 15 years previously.

false

Acute bronchitis, a disease of the airways, is defined as the presence of cough and sputum production for at least three months in each of two consecutive years.

false

Bronchodilators are key for symptom management in unstable COPD.

false

COPD and lower respiratory diseases are the third leading cause of death in the United States.

false

Corticosteroids are key for symptom management in stable COPD.

false

In patients with COPD who have a primary emphysematous component, chronic hyperinflation leads to the concave chest configuration.

false

In suspected HAP, treatment is usually initiated with a gram negative IV antibiotic and may be monotherapy or combination therapy.

false

In suspected HAP, treatment is usually initiated with a gram positive IV antibiotic and may be monotherapy or combination therapy.

false

Most patients with status asthmaticus will need mechanical ventilation.

false

Oxygen supplementation is not necessary in treating asthma exacerbations.

false

Pneumonia affects only diffusion, not ventilation.

false

Pulmonary function tests are used to evaluate airflow obstruction, which is determined by the ratio of FEV1 to forced vital capacity (FVC).

false

TB spreads from person to person by contact.

false

The patient with streptococcal (pneumococcal) pneumonia usually has a slow onset of chills, slow rising fever (38.5° to 40.5°C [101° to 105°F]), and pleuritic chest pain that is aggravated by deep breathing and coughing.

false

The respiratory system depends on the neuro system for perfusion, or blood flow through the pulmonary system.

false

The term difficulty breathing is sometimes used to describe rapid onset, severe, and persistent asthma that does not respond to conventional therapy.

false

The term pneumocystis is used to describe pneumonia that is distributed in a patchy fashion, having originated in one or more localized areas within the bronchi and extending to the adjacent surrounding lung parenchyma.

false

The three most common symptoms of asthma are cough, vomiting, and blurred vision.

false

The two main types of emphysema are hypoxic and hypercapniac.

false

The underlying pathology in asthma is irreversible diffuse airway inflammation that leads to long-term airway narrowing.

false

There are three stages of parapneumonic pleural effusions based on pathogenesis: simple, very complicated, and thoracic.

false

Which of the following are clinical manifestations of tuberculosis? Select all that apply.

fatigue cough night sweats fever

COPD and lower respiratory diseases are the ______ leading cause of death in the United States?

fourth

Adherence to the prescribed treatment regimen is key in treating the disease and controlling the spread of ______

infection

Tuberculosis (TB) is an infectious disease that primarily affects the ____________ parenchyma, It also may be transmitted to other parts of the body, including the meninges, kidneys, bones, and lymph nodes.

lung

Grade III or IV Grade II Grade I

medication therapy includes regular treatment with one or more bronchodilators and/or inhaled corticosteroids for repeated exacerbations. a short-acting bronchodilator and regular treatment with one or more long-acting bronchodilators may be used. typically prescribed a short-acting bronchodilator.

To prevent of TB to others, the nurse carefully instructs the patient about important hygiene measures, including mouth care, covering the mouth and nose when coughing and sneezing, proper disposal of tissues, and hand hygiene.

transmission

A 2nd dose of pneumococcal vaccine may be given at 65 years if the first dose was given five years previously.

true

Adherence to the prescribed treatment regimen is key in treating the disease and controlling the spread of infection.

true

Although inhaled and systemic corticosteroids may improve the symptoms of COPD, they do not slow the decline in lung function.

true

An exacerbation of COPD is defined as an event in the natural course of the disease characterized by acute changes (worsening) in the patient's respiratory symptoms beyond the normal day-to-day variations.

true

Antibiotics are ineffective in viral upper respiratory tract infections and pneumonia, and their use may be associated with adverse effects.

true

Bronchospasm, which occurs in many pulmonary diseases, reduces the caliber of the small bronchi and may cause dyspnea, static secretions, and infection.

true

Chronic bronchitis, a disease of the airways, is defined as the presence of cough and sputum production for at least three months in each of two consecutive years.

true

Community-acquired pneumonia (CAP): Pneumonia occurring in the community or ≤48 hours after hospital admission or institutionalization of patients who do not meet the criteria for health care-associated pneumonia (HCAP) Health care-associated pneumonia (HCAP): Pneumonia occurring in a nonhospitalized patient with extensive health care contact with one or more of the following: Hospitalization for ≥2 days in an acute care facility within 90 days of infection Residence in a nursing home or long-term care facility Antibiotic therapy, chemotherapy, or wound care within 30 days of current infection Hospital-acquired pneumonia (HAP): Pneumonia occurring ≥48 hours after hospital admission that did not appear to be incubating at the time of admission Ventilator-associated pneumonia (VAP): A type of HAP that develops ≥48 hours after endotracheal tube intubation

true

Granulomas, new tissue masses of live and dead bacilli, are surrounded by macrophages, which form a protective wall. They are then transformed to a fibrous tissue mass, the central portion of which is called a Ghon tubercle.

true

In diagnosing COPD, several diagnoses must be ruled out. The primary differential diagnosis is asthma. It may be difficult to differentiate between a patient with COPD and one with chronic asthma

true

In suspected HAP, treatment is usually initiated with a broad-spectrum IV antibiotic and may be monotherapy or combination therapy.

true

Ineffective breathing patterns and shortness of breath are due to the modified respiratory mechanics of the chest wall and lung resulting from air trapping.

true

Long-Acting Beta2-Agonists can be given inhaled or oral.

true

Most patients with status asthmaticus do not need mechanical ventilation.

true

PCV13 is recommended for all adults 65 years of age or older as well as adults 19 years or older with conditions that weaken the immune system, such as HIV infection, organ transplantation, leukemia, lymphoma, and severe kidney disease.

true

Prednisone is a systemic corticosteroid.

true

The immediate nursing care of patients with asthma depends upon the severity of symptoms.

true

The respiratory system is composed of the upper and lower respiratory tracts

true

The term status asthmaticus is sometimes used to describe rapid onset, severe, and persistent asthma that does not respond to conventional therapy.

true

To prevent transmission of TB to others, the nurse carefully instructs the patient about important hygiene measures, including mouth care, covering the mouth and nose when coughing and sneezing, proper disposal of tissues, and hand hygiene.

true

Tuberculosis (TB) is an infectious disease that primarily affects the lung parenchyma.

true

Ventilation- movement of air in and out of the airways Upper respiratory tract- warms and filters inspired air Lower respiratory tract- responsible for gas exchange or diffusion

true

With asthma exacerbations, quick-acting beta2-adrenergic agonist medications are first used for prompt relief of airflow obstruction.

true