Deck 31: Chronic Respiratory Disorders

Question 1

The nurse advises the parents of a child who is in status asthmaticus that if not corrected,the result could be:

A) Pneumothorax, severe hypoxemia, and respiratory arrest
B) Hypertension, cerebrovascular accident (CVA), and cardiac arrest
C) Respiratory alkalosis, pneumonia, and death
D) Lung abscess, cor pulmonale, and respiratory failure

Answer 1

Pneumothorax, severe hypoxemia, and respiratory arrest

Question 2

The nurse is caring for an asthmatic patient with a nursing diagnosis of "Impaired gas exchange,related to air trapping." The intervention that would be appropriate to add to the nursing care plan is to:

A) Provide postural drainage.
B) Administer oxygen (O2) at 8 L/min.
C) Position the patient flat in bed with small pillow.
D) Increase fluid intake.

Answer 2

Increase fluid intake.

Question 3

The nurse is aware that the characteristic of emphysema that gives rise to the pink puffer label is the emphysemic patient's:

A) Dyspnea
B) Barrel chest
C) Thin body
D) Normal arterial blood gases (ABGs)

Answer 3

Normal arterial blood gases (ABGs)

Question 4

The nurse caring for an 80-year-old patient with COPD suspects right-sided heart failure and assesses and records the data.A sign of right-sided heart failure is decreasing:

A) Blood pressure
B) Urine output
C) Respirations
D) Heart rate

Question 5

When the 25-year-old patient with cystic fibrosis (CF)tells the home health nurse that he wants to take a nice vacation,a safe suggestion by the nurse would be a week:

A) In Greece in July.
B) In Colorado in May.
C) In New York in November.
D) On the Mexican coast in August.

Question 6

When a young patient with acquired immunodeficiency syndrome (AIDS)complains of debilitating night sweats,the home health nurse suggests that he visit the clinic for a:

A) Prescription for antibiotics
B) Tuberculosis (TB) screen
C) Complete blood count (CBC)
D) Treatment with an aerosol inhalant

Question 7

As part of a progressive walking program,the obese patient with COPD is horrified when the nurse recommends walking for:

A) 10 to 15 minutes a day.
B) 20 to 30 minutes a day.
C) 45 to 60 minutes a day.
D) Up to 2 hours a day.

Question 8

The nurse recognizes that a rising level of partial pressure of carbon dioxide (CO?)in arterial blood (PaCO?)in a patient with COPD means that:

A) More arterial O2 is available than is needed.
B) The ventilation-perfusion ratio is becoming balanced.
C) Respiratory acidosis has begun.
D) The anticholinergic medications are effective.

Question 9

The patient with COPD asks the nurse if nicotine patches are effective for smoking cessation.The nurse's best response would be:

A) "No. Only about 25% are successful."
B) "Yes. The success rate is between 50% and 60%."
C) "No. Prescriptions such as Wellbutrin are 90% effective."
D) "Yes. Individual success has been obtained with combination of patches and gum."

Question 10

Which of these assessments made by the nurse indicates that respiratory arrest is imminent in a patient with asthma?

A) Agitation
B) Tachycardia
C) Absence of wheezing
D) Flaring nares

Question 11

The nursing intervention that will enhance the nutritional status of a patient with COPD is to:

A) Offer small, frequent meals.
B) Encourage extra liquids with meals.
C) Assist the patient to exercise before meals.
D) Supply information about nutrition.

Question 12

The characteristic of chronic obstructive pulmonary disease (COPD)that places the patient at risk for the nursing diagnosis of "Imbalanced nutrition: Less than body requirements" is:

A) Increased metabolism
B) Anxiety
C) Chronic constipation
D) Excessive respiratory effort

Question 13

The nurse instructs the patient who is taking rifampin as a result of an exposure to TB that side effects of this drug may cause:

A) Extreme drowsiness
B) Illness if aged cheese or smoked meats are consumed
C) Body fluids to become red-orange
D) Oral contraceptive pills to become ineffective

Question 14

In assessing for major sources of infection in a patient with COPD,the nurse focuses on:

A) Stasis of respiratory secretions
B) Low body weight
C) Episodes of postural hypotension
D) Delayed antigen-antibody response

Question 15

An patient with asthma asks the purpose of learning to use a peak expiratory flow rate (PEFR)device.The nurse's best response is that the PEFR:

A) Dilates the bronchi to relieve dyspnea.
B) Measures expired air to evaluate ventilation.
C) Soothes inflamed bronchi, reducing spasm.
D) Liquefies sputum for easier expectoration.

Question 16

When asked by a patient with TB how long he will have to take his TB medications,the nurse's best response would be:

A) "Generally about 2 weeks."
B) "Depending on the drug, it may be as long as 2 years."
C) "TB drugs are usually taken throughout the lifespan."
D) "People frequently ask that question. It depends on many things."

Question 17

The discharge instruction given by the nurse that would be informative to a patient with TB,who asks how to protect his family members from his disease,is:

A) "Your family will need to take treatments to prevent infection."
B) "You will need to wear a mask at home to protect your family members."
C) "You should always cover your mouth and nose if coughing or sneezing."
D) "You should avoid intimate contact with everyone."

Question 18

The patient with COPD has a nursing diagnosis of "Activity intolerance,related to inability to meet O? needs." The intervention that would be inappropriate for this diagnosis would be:

A) Bunch all nursing activities and treatments close together.
B) Schedule rest periods during the day.
C) Assist the patient only when needed to encourage independence.
D) Provide daily ambulation to build tolerance.

Question 19

The nurse assesses wheezes in a patient with asthma and realizes that these breath sounds are a result of:

A) Increased thickness of respiratory secretions
B) Use of accessory muscles of respiration
C) Tachypnea and tachycardia
D) Movement of air through narrowed airways

Question 20

When the nurse reads the diagnosis of centrilobar emphysema,the nurse recognizes that this type of emphysema is characterized by:

A) No significant smoking history in the patient
B) Enlarged and broken down bronchioles with intact alveoli
C) Hypoelastic bronchi and bronchioles
D) Deficiency of the enzyme inhibitor alpha1-antitrypsin.

Question 21

The nurse cautions a group of individuals with COPD that using O₂ at levels greater than 1 to 3 L/min can cause the loss of their _________________________.

Question 22

The nurse documents and reports the presence of foul,bulky stool to alert the physician that the patient with CF:

A) Is being adequately maintained on the present dose of pancreatic enzyme.
B) Is not adequately digesting food.
C) Has diarrhea related to excess mucus in the bowel.
D) Has inadequate hydration.

Question 23

When the patient reports having had the BCG (Bacillus Calmette-Guérin)vaccine 2 years earlier,the nurse reminds the patient that,because of the inoculation,the patient can anticipate:

A) False-positive result from TB skin tests
B) Being at risk for contracting TB
C) 3-week prophylactic protocol of rifampin or izonaizid (isonicotinic acid hydrazide [INH])
D) Needing a booster every 2 years

Question 24

The patient with COPD delightedly tells the nurse that he has quit smoking and is using chewing tobacco.The nurse's best intervention would be to:

A) Congratulate him on his quitting smoking.
B) Warn him of the dangers of oral cancer.
C) Suggest that he add nicotine patches in addition to the chewing tobacco.
D) Point out that he is still addicted and is using tobacco.

Question 25

A newly diagnosed patient with non small cell lung carcinoma (NSCLC)is anxious about having to take chemotherapy.The intervention by the nurse that would be helpful is to:

A) Support the patient in preparation for surgery.
B) Educate the patient regarding the high survival rate with this type of carcinoma.
C) Assure the patient that chemotherapy and radiation can be used in this sort of cancer.
D) Refer the patient to the American Cancer Society for postdischarge follow-up.

Question 26

To help combat anorexia in a patient with COPD,the home health nurse should:

A) Recommend a large meal in the middle of the day.
B) Suggest taking only cold liquid nutritional drinks.
C) Perform oral hygiene before meals.
D) Gently exercise for 10 minutes before a meal.

Question 27

The nurse uses a picture to demonstrate the bullae and blebs associated with emphysema.The nurse points out that the difference between the two is that blebs: (Select all that apply.)

A) Are between the alveolar spaces in the lungs.
B) Are in the lung parenchyma.
C) Can rupture, causing the lungs to collapse.
D) Are responsible for diaphragm flattening.
E) Are precancerous.

Question 28

The nurse assessing the CBC of a patient with chronic bronchitis identifies a typical feature of this disease,which is:

A) Decreased platelets
B) Decreased white blood cells (WBCs)
C) Increased eosinophils
D) Increased red blood cells (RBCs)

Question 29

The nurse reviews the signs and symptoms characteristic of the patient with chronic blue bloater bronchitis,which are: (Select all that apply.)

A) Productive cough
B) Peripheral edema
C) Discolored teeth
D) Exertional dyspnea
E) Elevated red blood cell count

Question 30

The patient with CF furiously refuses any more manual chest physiotherapeutic treatment.The nurse could suggest which alternative?

A) Flutter mucus device
B) Increase ambulation to 1 to 2 hours a day
C) Steam inhalator several times a day
D) Drinking 3 quarts of fluid per day

Question 31

The theophylline blood level is 13 mcg/ml.Which intervention is the most appropriate in light of this finding?

A) Administer the next dose of theophylline as ordered.
B) Skip the next dose, and then resume.
C) Call the charge nurse or physician.
D) Take the patient's blood pressure immediately.

Question 32

The nurse explains to a family how the asthma attack progresses by using a progressive list of pathologic events: (Place the options in the correct sequence.)

A) Bronchoconstriction
B) Ventilation-perfusion mismatch
C) Production of mucous plugs
D) Hypoxemia with compensatory hyperventilation
E) Triggering of inflammatory process