H&C Prep U Ch 24: Management of Patients with Chronic Pulmonary Disease

In which grade of COPD is the forced expiratory volume in 1 second (FEV1) greater than 80% predicted

1

A client is prescribed metaproterenol 20 mg four times each day. How many mg of metaproterenol does the client take each day? Enter the correct number ONLY

80mg

A physician orders triamcinolone and salmeterol for a client with a history of asthma. What action should the nurse take when administering these drugs

Administer the salmeterol and then administer the triamcinolone.

What are the primary causes for an acute exacerbation of COPD? Select all that apply

Air pollution • Tracheobronchial infection

A client with asthma is prescribed a short acting beta-adrenergic (SABA) for quick relief. Which of the following is the most likely drug to be prescribed

Albuterol

A physician orders a beta2 adrenergic-agonist agent (bronchodilator) that is short-acting and administered only by inhaler. What drug would the nurse know to administer to the client

Albuterol

In which statements regarding medications taken by a client diagnosed with COPD do the the drug name and the drug category correctly match? Select all that apply

Albuterol is a bronchodilator. Ciprofloxacin is an antibiotic. Prednisone is a corticosteroid.

A nurse is caring for a client with status asthmaticus. Which medication should the nurse prepare to administer

An inhaled beta2-adrenergic agonist

A client is diagnosed with a chronic respiratory disorder. After assessing the client's knowledge of the disorder, the nurse prepares a teaching plan. This teaching plan is most likely to include which nursing diagnosis

Anxiety

A client experiencing an asthmatic attack is prescribed methylprednisolone intravenously. What action should the nurse take

Assesses fasting blood glucose levels

The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstruction and that leads to the collapse of alveoli. What complication should the nurse monitor for

Atelectasis

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

Atelectasis

Which statement is true about both lung transplant and bullectomy

Both aim to improve the overall quality of life of a client with COPD.

Which is the most important risk factor for development of COPD

Cigarette smoking

A young adult with cystic fibrosis is admitted to the hospital for an acute airway exacerbation. Aggressive treatment is indicated. What is the first action by the nurse

Collects sputum for culture and sensitivity

A client is being admitted to the medical-surgical unit for the treatment of an exacerbation of acute asthma. Which medication is contraindicated in the treatment of asthma exacerbations

Cromolyn sodium

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 disorder within its classification. Which of the following is that disorder

Emphysema

The nurse has instructed the client to use a peak flow meter. The nurse evaluates client learning as satisfactory when the client

Exhales hard and fast with a single blow

Which exposure accounts for most cases of COPD

Exposure to tobacco smoke

Which exposure acts as a risk factor for and accounts for the majority of cases of chronic obstructive pulmonary disease (COPD)

Exposure to tobacco smoke

A nurse has established a nursing diagnosis of ineffective airway clearance. The datum that best supports this diagnosis is that the client

Has wheezes in the right lung lobes

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

High-protein

Asthma is cause by which type of response

IgE-mediated

Which measure may increase complications for a client with COPD

Increased oxygen supply

Which of the following factors contribute to the underlying pathophysiology of chronic obstructive pulmonary disease (COPD)? Select all that apply

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

A nursing student is taking a pathophysiology examination. Which of the following factors would the student correctly identify as contributing to the underlying pathophysiology of chronic obstructive pulmonary disease (COPD)? Choose all that apply

Inflamed airways that obstruct airflow Mucus secretions that block airways Overinflated alveoli that impair gas exchange

Which of the following is the key underlying feature of asthma

Inflammation

A nurse is teaching a client with emphysema how to perform pursed-lip breathing. The client asks the nurse to explain the purpose of this breathing technique. Which explanation should the nurse provide

It helps prevent early airway collapse.

A client has a history of chronic obstructive pulmonary disease (COPD). Following a coughing episode, the client reports sudden and unrelieved shortness of breath. Which of the following is the most important for the nurse to assess

Lung sounds

What is histamine, a mediator that supports the inflammatory process in asthma, secreted by

Mast cells

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

Oxygen through nasal cannula at 2 L/minute

Which terms means an increase in the red blood cell concentration in the blood

Polycythemia

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

Providing sufficient oxygen to improve oxygenation

A patient is being treated for status asthmaticus. What danger sign does the nurse observe that can indicate impending respiratory failure

Respiratory acidosis

As status asthmaticus worsens, the nurse would expect which acid-base imbalance

Respiratory acidosis

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

Respiratory acidosis

A nurse administers albuterol (Proventil), as ordered, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect

Respiratory rate of 22 breaths/minute

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

Sputum and a productive cough

A nurse is discussing asthma complications with a client and family. What complications should the nurse include in the teaching? Select all that apply

Status asthmaticus Respiratory failure Atelectasis

To help prevent infections in clients with COPD, the nurse should recommend vaccinations against two bacterial organisms. Which of the following are the two vaccinations

Streptococcus pneumonia and Haemophilus influenzae

Cystic fibrosis (CF) is diagnosed by clinical signs and symptoms in addition to which test

Sweat chloride concentration

A nurse is developing a teaching plan for a client with asthma. Which teaching point has the highest priority

Take ordered medications as scheduled.

Which of the following is not a primary symptom of COPD

Weight gain

At 11 p.m., a client is admitted to the emergency department. He has a respiratory rate of 44 breaths/minute. He's anxious, and wheezes are audible. The client is immediately given oxygen by face mask and methylprednisolone (Depo-medrol) I.V. At 11:30 p.m., the client's arterial blood oxygen saturation is 86%, and he's still wheezing. The nurse should plan to administer

albuterol (Proventil).

A client with chronic obstructive pulmonary disease (COPD) is recovering from a myocardial infarction. Because the client is extremely weak and can't produce an effective cough, the nurse should monitor closely for

atelectasis.

A client with bronchiectasis is admitted to the nursing unit. The primary focus of nursing care for this client includes

implementing measures to clear pulmonary secretions.

The classification of Stage II of COPD is defined as

moderate COPD.

A client is being admitted to an acute health care facility with an exacerbation of chronic obstructive pulmonary disease (COPD). The nurse is placing this information on the Medication Reconciliation Record. What medication information needs to be clarified with the health care provider

salmeterol/fluticasone MDI daily at 0800

The classification of Stage III of COPD is defined as

severe COPD.

A nurse is caring for a client admitted with an exacerbation of asthma. The nurse knows the client's condition is worsening when he

uses the sternocleidomastoid muscles.

The classification of Stage IV of COPD is defined as

very severe COPD.

Upon assessment, the nurse suspects that a client with COPD may have bronchospasm. What manifestations validate the nurse's concern? Select all that apply

• Compromised gas exchange • Wheezes • Decreased airflow

A client with chronic obstructive pulmonary disease (COPD) reports increased shortness of breath and fatigue for 1 hour after awakening in the morning. Which of the following statements by the nurse would best help with the client's shortness of breath and fatigue

"Delay self-care activities for 1 hour."

A client with chronic obstructive pulmonary disease (COPD) expresses a desire to quit smoking. The first appropriate response from the nurse is

"Have you tried to quit smoking before?"

The nurse is reviewing pressurized metered-dose inhaler (pMDI) instructions with a client. Which statement by the client indicates the need for further instruction

"I can't use a spacer or holding chamber with the MDI."

A nurse has just completed teaching with a client who has been prescribed a meter-dosed inhaler for the first time. Which statement if made by the client would indicate to the nurse that further teaching and follow-up care is necessary

"I do not need to rinse my mouth with this type of inhaler."

A client with chronic obstructive pulmonary disease (COPD) and cor pulmonale is being prepared for discharge. The nurse should provide which instruction

"Weigh yourself daily and report a gain of 2 lb in 1 day."