Chapter 28 2 of 5
The nurse would monitor which comorbidity in the patient treated for an asthma exacerbation with methylprednisolone? 1 Hyperlipidemia 2 Hypothyroidism 3 Diabetes mellitus 4 Raynaud's phenomenon
Answer: 3
A patient presents with acute exacerbation of asthma. The nurse expects which strategies will be included in the treatment plan? Select all that apply. 1 Administration of sedatives 2 Administration of antibiotics 3 Administration of 100% oxygen 4 Intravenous administration of corticosteroids 5 Nebulization with short-acting β2-adrenergic agonists (SABAs)
Answer: 3,4,5
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? 1 Administer the injection to the patient on a home visit. 2 Ask a family member to administer the medication at home. 3 Load the injection and provide it to the patient for self-administration. 4 Explain to the patient that the medication should be administered strictly at the clinic
Answer: 4
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? 1 Absence of wheezing 2 Oxygen saturation 96% 3 Use of accessory muscles 4 Clearance of mucous from the bronchi
Answer: 4
The nurse determines that the patient with chronic obstructive pulmonary disease (COPD) and diabetes mellitus is experiencing adverse effects of albuterol after noting which finding? 1 Blood sugar 139 mg/dL 2 Temperature of 99.1° F 3 Respiratory rate of 21 breaths/minute 4 Pulse rate of 102 beats/minutes
Answer: 4
The nurse is educating a patient who was recently diagnosed with asthma about the use of a peak flow meter. Which statement is the nurse's priority? 1 "The peak flow meter should be used weekly." 2 "The peak flow meter reduces asthma attacks." 3 "The peak flow meter should be used before the use of an inhaler." 4 "You should find your personal best peak flow reading for comparison."
Answer: 4
A nurse has taught the technique of pursed-lip breathing to a patient. During a return demonstration, what patient action requires correction? 1 Puffing of cheeks while exhaling air 2 Slow and deep inhalation through the nose 3 Slow exhalation through pursed lips, as if whistling 4 Exhalation time three times as long as inhalation time
Answer: 1
The nurse determines that a patient is not experiencing the beneficial effects of ipratropium after noting which finding in the patient? 1 Expiratory wheezing 2 Elevated blood pressure 3 Increased low back pain 4 Hypoactive bowel sounds
Answer: 1
The nurse determines that the patient has experienced the full benefits of medication therapy with ipratropium when which assessment finding is noted? 1 Clear lung sounds 2 Heart rate 80 beats/minute 3 Capillary refill less than three seconds 4 Positive bowel sounds in all quadrants
Answer: 1
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? 1 "I will keep my rescue inhaler with me at all times." 2 "I do not need to get a flu shot because I'm under age 50." 3 "I will use my peak flow meter only when I feel like I'm getting sick." 4 "I will use my corticosteroid inhaler only when I feel short of breath."
Answer: 1
The nurse is teaching a patient how to use a hand-held nebulizer. Which guideline is correct? 1 Sit in an upright position during the treatment. 2 Take short, shallow breaths while inhaling the medication. 3 Rinse the nebulizer equipment under running water once a week. 4 During the treatment, breathe in and hold the breath for five seconds
Answer: 1
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? 1 Albuterol 2 Salmeterol 3 Beclomethasone 4 Ipratropium bromide
Answer: 1
The nurse is teaching a patient how to use an inhaler. What steps should the nurse teach the patient? Please place in sequential order. 1. Shake the inhaler. 2. Breathe out all the way. 3. Keep breathing in slowly and as deeply as possible. 4. Hold your breath as you count to 10 slowly. 5. As you start breathing in slowly through the mouth, press down on the inhaler one time. 6. Place the inhaler near or in your mouth as instructed by your health care provider (HCP).
Answer: 1, 2, 6, 5, 3, 4
A patient is having an asthma attack, and is short of breath and appears frightened. The nurse understands that possible triggers for asthma exacerbations include which factors? Select all that apply. 1 Alcohol 2 Perfumes 3 Animal dander 4 Humid weather 5 Gastroesophageal reflux disease (GERD)
Answer: 1,2,3,5
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? 1 "I will pay less for medication because it will last longer." 2 "More of the medication will get down into my lungs to help my breathing." 3 "Now I will not need to breathe in as deeply when taking the inhaler medications." 4 "This device will make it so much easier and faster to take my inhaled medications."
Answer: 2
The nurse teaches a 61-year-old patient with emphysema and pneumonia to obtain which vaccines? Select all that apply. 1 Tetanus 2 Influenza 3 Hepatitis B 4 Pneumococcal 5 Bacille Calmette-Guerin (BCG)
Answer: 2, 4
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. 1 Use sedation. 2 Be calm, quiet, and reassuring. 3 Encourage pursed-lip breathing. 4 Utilize a "walking down" technique. 5 Utilize the "talking down" technique.
Answer: 2,3,5
The nurse determines that a patient is experiencing the most common adverse effect of albuterol after noting which sign? 1 Diarrhea 2 Headache 3 Tachycardia 4 Oral candidiasis
Answer: 3
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? 1 Anxiety 2 Hypoxia 3 Bronchospasm 4 Adventitious breath sounds
Answer: 3
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? 1 "I should make the patient lay in a side-lying position." 2 "I should ask the patient to perform abdominal breathing." 3 "I should ask the patient to purse the lips while breathing." 4 "I should make sure that the patient's environment is calm."
Answer:1
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? 1 40 percent of personal best number 2 60 percent of personal best number 3 75 percent of personal best number 4 85 percent of personal best number
Answer:1
An adolescent who has a history of asthma experiences wheezing after vigorous exercise. What nursing instruction is helpful for this patient? 1 Advise the patient to avoid dry air. 2 Encourage the patient to get exposure to cold air. 3 Recommend the patient to continue vigorous exercise. 4 Advise the patient to avoid swimming in indoor heated pools.
Answer:1
The nurse is caring for a patient with an acute exacerbation of asthma. Following initial treatment, what finding indicates to the nurse that the patient's respiratory status is improving? 1 Wheezing becomes louder. 2 Cough remains nonproductive. 3 Vesicular breath sounds decrease. 4 Aerosol bronchodilators stimulate coughing
Answer:1
When teaching a patient about using a dry powder inhaler, what instructions should be included in this teaching? Select all that apply. 1 Increase the inspiration. 2 Slow down the inspiration. 3 Keep the device moisture-free. 4 Shake the inhaler well before use. 5 Avoid shaking the inhaler before use
Answer:1,3,5
The nurse determines that a patient is experiencing common adverse effects from the inhaled corticosteroid beclomethasone after what occurs? 1 Hypertension and pulmonary edema 2 Oropharyngeal candidiasis and hoarseness 3 Elevation of blood glucose and calcium levels 4 Adrenocortical dysfunction and hyperglycemia
Answer:2
What is the most appropriate time to obtain peak flow readings with the best peak flow number? 1 Five minutes after meals 2 Between noon and 2 PM 3 Early in the morning on an empty stomach 4 Two hours after inhaling a short-acting β2-agonist
Answer:2
A 45-year-old patient is experiencing an asthma exacerbation. To facilitate airflow, the nurse should place the patient in which position? 1 Prone 2 Supine 3 High-Fowler's 4 Trendelenburg
Answer:3
In which position is it most appropriate for the nurse to place a patient experiencing an asthma exacerbation? 1 Supine 2 Lithotomy 3 High-Fowler's 4 Reverse Trendelenburg
Answer:3
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? 1 Chest x-ray 2 Peak flow measurements 3 Intravenous (IV) antibiotics 4 Intravenous corticosteroids
Answer:4
The patient with asthma asks the nurse, "How will I know when my inhaler is empty?" What is the best response by the nurse? 1 "The canister will float in water." 2 "There will be no sound when shaking the canister." 3 "Your wheezing will not improve despite inhaler use." 4 "You need to keep track of how many puffs you have used and how many puffs are available."
Answer:4
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
Answer:50
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.
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
While teaching a 45-year-old patient with asthma about the appropriate use of a peak flow meter, the nurse instructs the patient to notify the health care provider immediately if which situation occurs?
Less than 50% of the patient's personal best is achieved
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 is assigned to care for a patient in the emergency department admitted with an exacerbation of asthma. The patient has received a β-adrenergic 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 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 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? 1 "Close lips tightly around the mouthpiece and breathe in deeply and quickly." 2 "To administer a DPI, you must use a spacer that holds the medicine so that you can inhale it." 3 "You will know you have correctly used the DPI when you taste or sense the medicine going into your lungs." 4 "Hold the inhaler several inches in front of your mouth and breathe in slowly, holding the medicine as long as possible."
answer: 1
A nurse observes a patient using a dry powder inhaler device. The nurse should correct which patient actions? Select all that apply. 1 The patient breathes into the inhaler. 2 The patient performs deep and quick breathing. 3 The patient shakes the medicine before using it. 4 The patient holds the breath for more than 10 seconds. 5 The patient inhales more than 1 puff with each inspiration
answer: 1,3,5
