Deck 26: Coordinating Care for Patients With Lower Airway Disorders

Question 1

The nurse is providing care to a patient diagnosed with emphysema. Which clinical manifestation does the nurse correlate with this diagnosis?
1)Tachycardia
2)Cough
3)Barrel chest
4)Wheezing

Answer 1

3

Question 2

In providing care to a patient admitted with an acute asthma exacerbation, the nurse prepares which "rescue" medication for administration first?
1)Inhaled anti-inflammatories
2)Mucolytics
3)Long-acting beta₂-adrenergic agonists
4)Short-acting beta₂-adrenergic agonists

Answer 2

4

Question 3

The nurse monitors for which therapeutic effect when administering leukotriene receptor antagonists to patients diagnosed with asthma?
1)Cause bronchodilation of the airways
2)Decrease viscosity of secretions
3)Decrease work of breathing by relaxing muscles around bronchi
4)Inhibit the inflammatory process

Answer 3

4

Question 4

Patients with asthma initially develop respiratory alkalosis. Which arterial blood gas value is consistent with this acid-base disorder?
1)pH 7.32
2)PaCO₂ 30 mm Hg
3)PaO₂ 78 mm Hg
4)SpO₂ 90%

Question 5

The nurse finds a patient admitted with asthma and pneumonia restless, anxious, complaining of increasing difficulty breathing, and stridor. Because of suspected status asthmaticus, an arterial blood gas is ordered. Which result requires an immediate intervention?
1)pH 7.30
2)PaCO₂ 48 mm Hg
3)PaO₂ 50 mm Hg
4)SpO₂ 88%

Question 6

The nurse is caring for a patient newly diagnosed with asthma. Which assessment data indicate the need for an immediate intervention?
1)Diminished breath sounds
2)Decreased respiratory rate
3)Increased crackles
4)Increased respiratory rate

Question 7

The nurse correlates which diagnostic result as consistent with the diagnosis of cystic fibrosis?
1)Elevated serum chloride
2)Elevated sodium levels in sweat
3)Decreased urine chloride
4)Decreased urine specific gravity

Question 8

The nurse monitors for which gastrointestinal clinical manifestations in the patient diagnosed with cystic fibrosis?
1)Diarrhea
2)Hematemesis
3)Melena
4)Steatorrhea

Question 9

The nurse teaches a patient how to implement pursed-lip breathing. Which patient statement indicates a need for additional instruction?
1)"I will sit up with my shoulders relaxed."
2)"I will be sure to exhale twice as long as I inhale."
3)"I will inhale through my mouth while slowly counting."
4)"I will exhale through my mouth as if I was blowing out candles."

Question 10

The nurse is providing care to a patient admitted after experiencing an acute asthma attack. Which assessment findings indicate the need for an immediate intervention?
1)Retractions and fatigue
2)Tachycardia and tachypnea
3)Inaudible breath sounds
4)Diffuse wheezing and the use of accessory muscles when inhaling

Question 11

A patient diagnosed with chronic obstructive pulmonary disease (COPD) has a pulse oximetry reading of 93%, increased red blood and white blood cell count, temperature of 101°F, pulse 100 bpm, respirations 35 bpm, and a chest x-ray examination that showed a flattened diaphragm with infiltrates. Based on this data, which prescription does the nurse question for this patient?
1)Antibiotic therapy
2)Nonsteroidal anti-inflammatory agents
3)Oxygen by nasal cannula at 3 to 4 L/minute
4)Bronchodilators such as an adrenergic stimulating drugs or anticholinergic agents

Question 12

Which clinical manifestation in the patient with chronic obstructive pulmonary disease (COPD) is more indicative of emphysema?
1)Cyanosis
2)Obese
3)Reddish complexion
4)Non-productive cough

Question 13

The nurse develops the nursing diagnosis "Ineffective Airway Clearance related to increased mucus production secondary to chronic inflammation of small airways." For which disorder is this nursing diagnosis most relevant?
1)Asthma
2)Chronic bronchitis
3)Cystic fibrosis
4)Emphysema

Question 14

The nurse correlates which data from a patient's history to a diagnosis of bronchitis?
1)A history of rhinitis
2)A history of eczema
3)A family history of allergies
4)A history of progressive dyspnea

Question 15

The nurse develops the nursing diagnosis "Impaired Gas Exchange related to decreased lung elasticity and hyperinflation of the alveoli secondary to exposure to inhaled pollutants." For which disorder is the nursing diagnosis most relevant?
1)Asthma
2)Chronic bronchitis
3)Cystic fibrosis
4)Emphysema

Question 16

The nurse develops the nursing diagnosis "Ineffective Airway Clearance related to intermittent, reversible airway obstruction secondary to bronchoconstriction and airway inflammation." For which disorder is this nursing diagnosis most relevant?
1)Asthma
2)Bronchiectasis
3)Chronic bronchitis
4)Emphysema

Question 17

In administering bronchodilator therapy to a patient with asthma, the nurse correlates the effectiveness of this classification of medication to which mechanism of action?
1)Bronchodilators widen the airways because they act on the parasympathetic nervous system.
2)Bronchodilators widen the airways because they stimulate the sympathetic nervous system.
3)Bronchodilators decrease inflammation of the airways.
4)Bronchodilators decrease the production of mucus that narrows the airways.

Question 18

The nurse provides education to a patient who is prescribed an aerochamber for the treatment of asthma. Which patient statement indicates the need for additional teaching?
1)"I will place the mouthpiece over my nose and mouth."
2)"I should hear a whistling sound as I inhale the medication."
3)"I should wait a few seconds before I administer the second dose."
4)"I will hold my breath for 10 seconds after inhaling the medication."

Question 19

Which statements by a patient with asthma indicates effective teaching?
1)"We'll use the fireplace to keep the house warm in the winter."
2)"We will replace the carpet in our bedroom with tile."
3)"We'll make sure that we dust our plants frequently."
4)"We're glad we can keep our dog."

Question 20

Friends of a patient hospitalized with asthma would like to bring the patient a gift. Which gift would the nurse recommend for this patient?
1)A basket of flowers
2)A stuffed animal
3)Fruit and candy
4)A book

Question 21

The nurse is teaching the patient recently diagnosed with asthma the correct use of the peak flow meter. In which order does the nurse instruct the patient? (Enter the letter of each step in the proper sequence; use capital letters, and do not use punctuation or spaces. Example: ABCDEF)

A) Place the mouthpiece in my mouth.
B) Ensure the slide marker is at zero (or lowest marking on the scale).
C) Stand up straight.
D) Take a deep breath.
E) Note/record the marking on the scale.
F) Blow a "fast hard blast."

Question 22

Which systems should the nurse anticipate will be affected when planning care for a patient diagnosed with cystic fibrosis? Select all that apply.
1)Respiratory
2)Neurological
3)Reproductive
4)Cardiovascular
5)Gastrointestinal

Question 23

Although all of these patients do not currently smoke cigarettes, the nurse recognizes that which patient is at greatest risk factor for the development of lung cancer?
1)60-year-old black male with a history of smoking in his teens
2)64-year-old white female who went to an elementary school that had asbestos
3)68-year-old black male with a 40 pack-year history of smoking
4)72-year-old white male with a 10 pack-year history of smoking

Question 24

The nurse is caring for a patient in a community clinic who wishes to quit smoking. The patient asks the nurse, "If I quit smoking, will my risk of lung cancer be the same as a nonsmoker? " Which is the best response by the nurse?
1)"No one knows for sure what the risk is for someone who quits smoking."
2)"Your risk of lung cancer will be equal to that of a nonsmoker."
3)"Your risk of lung cancer will decline if you quit, but it will remain higher than a nonsmoker's."
4)"Your risk of lung cancer will never drop because the damage has already been done."

Question 25

In reviewing teaching about use of the peak flow meter in a patient with asthma, which statements by the patient indicate understanding of correct use? Select all that apply.
1)"I will lie flat in the bed."
2)"I take a deep breath before placing the mouthpiece in my mouth."
3)"I breathe out slowly and continuously."
4)"I should repeat three times and the numbers should be close."
5)"I blow out in one fast, hard blast."

Question 26

The community health nurse is preparing an educational program for local residents. Which information does the nurse include about chronic obstructive pulmonary disease (COPD)? Select all that apply.
1)Cigarette smoking is the leading cause of COPD.
2)Approximately 80% to 90% of deaths from COPD are related to smoking.
3)There is an increased incidence of COPD in individuals who abuse alcohol.
4)Less than 5% of all COPD cases are caused by deficiency in alpha-1 antitrypsin.
5)COPD is completely reversible if the individual stops smoking.

Question 27

The nurse is providing care to a patient diagnosed with chronic obstructive pulmonary disease (COPD). Which factors in the patient's history support the current diagnosis? Select all that apply.
1)Working in an industrial environment
2)Working in an office setting with air conditioning
3)History of asthma
4)Current cigarette smoking
5)Playing golf several times a week

Question 28

Which statement by the patient regarding the treatment for cystic fibrosis indicates the need for further teaching?
1)"Taking CFTR modulators will cure my cystic fibrosis."
2)"There are medications that will decrease the viscosity of the secretions."
3)"I may need to take vitamins to support my nutritional needs."
4)"I may also have to take pancreatic enzymes for nutritional purposes."

Question 29

The nurse is caring for an older adult patient who is very thin and emaciated. The patient reports new onset of shortness of breath. A chest x-ray examination reveals a spot on the lungs that the physician believes is an inoperable lung cancer. Because of the patient's poor nutritional status, chemotherapy is not an option. The healthcare provider also believes that the location of the cancer would make radiation therapy unsuccessful. In advocating for this patient, what approach does the nurse collaborate with the healthcare team to offer the patient?
1)Provide palliative care to keep the patient comfortable without diagnostic testing
2)Perform any procedure necessary to diagnose the patient properly
3)Promote the use of blood tests to diagnose the suspected cancer
4)Determine the patient's and family's wishes regarding diagnostic testing

Question 30

Which statements about lung cancer indicate that teaching was effective? Select all that apply.
1)"A reclining position allows full lung expansion."
2)"Controlled breathing reduces shortness of breath."
3)"I will pace myself when doing things with my family."
4)"I will eat three large meals a day to ensure I get enough calories."
5)"Pain medication administered around the clock will improve my comfort."