Deck 26: Coordinating Care for Patients With Lower Airway Disorders

Question 1

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 reveals a spot on the lungs that the physician believes is an inoperable lung cancer.Due to the patient's poor nutritional status,chemotherapy is not an option.The health-care provider also believes that the location of the cancer would make radiation therapy unsuccessful.In advocating for this patient,what should the nurse encourage the health-care team to do?

A) Provide palliative care to keep the patient comfortable without diagnostic testing
B) Perform any procedure necessary to diagnose the patient properly
C) Promote the use of blood tests to diagnose the suspected cancer
D) Determine the patient's and family's wishes regarding diagnostic testing

Answer 1

Determine the patient's and family's wishes regarding diagnostic testing

Question 2

The nurse is planning care for the patient diagnosed with chronic obstructive pulmonary disease (COPD)who has a breathing rate of 32 per minute,elevated blood pressure,and fatigue.Which nursing diagnosis is the priority for this patient?

A) Ineffective Coping
B) Ineffective Airway Clearance
C) Anxiety
D) Ineffective Breathing Pattern

Answer 2

Ineffective Breathing Pattern

Question 3

The nurse is providing care to a patient admitted after experiencing an acute asthma attack.Which assessment findings indicate the need for immediate intervention by the nurse?

A) Retractions and fatigue
B) Tachycardia and tachypnea
C) Inaudible breath sounds
D) Diffuse wheezing and the use of accessory muscles when inhaling

Answer 3

Inaudible breath sounds

Question 4

Friends of a patient hospitalized with asthma would like to bring the patient a gift.Which gift would the nurse recommend for this patient?

A) A basket of flowers
B) A stuffed animal
C) Fruit and candy
D) A book

Question 5

The nurse is providing care to a patient newly diagnosed with asthma.When developing the patient's plan of care,which intervention would be most appropriate to promote airway clearance?

A) Provide adequate rest periods
B) Reduce excessive stimuli
C) Assist with activities of daily living
D) Place in Fowler position

Question 6

A male Hispanic patient has had a lung biopsy.The results indicate a poor prognosis for the patient.The family is at the patient's bedside and begins to moan and cry loudly.The health-care provider has told the nurse that he needs to have the consent form signed for surgery.The patient has asked the nurse to allow the family private time.What should the nurse do at this time?

A) Ask the family to come back later
B) Have the doctor get the consent with the family present
C) Provide the patient and family privacy
D) Take the patient to another room

Question 7

The student nurse is questioning the instructor about the different types of chemotherapeutic agents used to treat cancer.Which statement by the instructor best explains why lung cancers are less sensitive to antineoplastic agents than other types of cancers?

A) "Lung cancer cells have a low growth fraction,so they are less sensitive to antineoplastic agents."
B) "Lung cancer cells grow in a high-oxygen environment,so they are not very sensitive to antineoplastic agents."
C) "Lung cancer cells have been growing for a long time before detection,so they are less sensitive to antineoplastic agents."
D) "Lung cancer cells have a very erratic cell cycle,so they are not very sensitive to antineoplastic agents."

Question 8

The nurse is reviewing discharge instructions with a patient who is newly diagnosed with asthma.Which patient statement indicates a need for further teaching?

A) "I need to rinse my mouth after every use of my inhaler."
B) "I need to take my Singulair at least one hour before I eat."
C) "I can resume my ephedra when I return home."
D) "Because I am on theophylline,I will need to have therapeutic blood levels drawn."

Question 9

A nurse is caring for a patient recovering from a wedge resection of the left lung for a tumor.Which is an appropriate goal for the nursing diagnosis of ineffective airway clearance?

A) Participation in care by the patient
B) Maintain a patent airway
C) Maintain current weight
D) Express feelings and concerns

Question 10

An older adult patient diagnosed with asthma has a respiratory rate of 28 at rest with audible wheezes upon inspiration.Based on this data,which nursing diagnosis is the most appropriate?

A) Ineffective Airway Clearance
B) Impaired Tissue Perfusion
C) Ineffective Breathing Pattern
D) Activity Intolerance

Question 11

The nurse is caring for a patient who is undergoing diagnostic tests to rule out lung cancer.The patient asks the nurse why a computed tomography (CT)scan was ordered.What is the best response by the nurse?

A) "The doctor prefers this test."
B) "To rule out the possibility that your problems are caused by pneumonia."
C) "It is more specific in diagnosing your condition."
D) "Why are you concerned about this test?"

Question 12

Which assessment finding supports the nurse's suspicion that a patient is experiencing chronic obstructive pulmonary disease (COPD)?

A) Dysrhythmias
B) Cyanotic nail beds
C) Clubbing of the fingers
D) Cough in the morning producing clear sputum

Question 13

The nurse instructs a patient with asthma on bronchodilator therapy.Which statement indicates patient understanding?

A) "The medication widens the airways because it acts on the parasympathetic nervous system."
B) "The medication widens the airways because it stimulates the fight-or-flight response of the nervous system."
C) "The medication widens the airways because it decreases the production of histamine that narrows the airways."
D) "The medication widens the airways because it decreases the production of mucous that narrows the airways."

Question 14

The nurse is providing care to a patient diagnosed with chronic obstruction pulmonary disease (COPD)after years of experiencing emphysema.Which clinical manifestation does the nurse anticipate when assessing this patient?

A) Tachycardia
B) Cough
C) Barrel chest
D) Wheezing

Question 15

The nurse is providing care to an infant in the emergency department (ED).Initial assessment indicates that the infant is experiencing an asthma attack.The infant is unresponsive to medication and a chest x-ray reveals a foreign body partially obstructing the airway.While placing an oxygen mask on the infant,the nurse notes a total obstruction of the airway.Which nursing action is appropriate?

A) Attempt to clear the obstruction by delivering back blows and chest thrusts.
B) Attempt to clear the obstruction by delivering back blows.
C) Attempt to clear the obstruction by delivering back blows and abdominal thrusts.
D) Attempt to clear the obstruction by delivering abdominal thrusts.

Question 16

The nurse working on a pediatric unit is caring for a patient newly diagnosed with asthma.Which assessment data indicates exhaustion and the need for immediate intervention?

A) Slightly diminished breath sounds
B) Decreased wheezing
C) Increased crackles
D) Increased respiratory rate

Question 17

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?

A) "No one knows for sure what the risk is for someone who quits smoking."
B) "Your risk of lung cancer will be equal to that of a nonsmoker."
C) "Your risk of lung cancer will decline if you quit,but it will remain higher than a nonsmoker's."
D) "Your risk of lung cancer will never drop because the damage has already been done."

Question 18

A patient asks why asthma medication is needed even though the patient's last attack was several months ago.Which response by the nurse is appropriate?

A) "The medication needs to be taken or your lungs will be severely damaged and we will not be able to prevent an acute attack."
B) "The medication needs to be taken indefinitely according to your doctor,so you should discuss this with him."
C) "The medication is still needed to decrease inflammation in your airways and help prevent an attack."
D) "The medication needs to be taken for at least a year;then,if you have not had an acute attack,you can stop it."

Question 19

A nurse is teaching environmental control to the parents of a child with asthma.Which statement by the parents indicates effective teaching?

A) "We'll be sure to use the fireplace often to keep the house warm in the winter."
B) "We will replace the carpet in our child's bedroom with tile."
C) "We'll keep the plants in our child's room dusted."
D) "We're glad the dog can continue to sleep in our child's room."

Question 20

The nurse is instructing a patient who is prescribed ipratropium bromide (Atrovent)for asthma.Which should be included in this patient's teaching?

A) Take no more than the prescribed number of doses each day.
B) Rinse the mouth after taking this medication.
C) Take on an empty stomach.
D) Take with meals or a full glass of water.

Question 21

The nurse is providing care for a patient diagnosed with chronic obstructive pulmonary disease (COPD).Which intervention is inappropriate to control the patient's breathing pattern?

A) Instruct in pursed-lip breathing
B) Teach visualization and meditation
C) Deep breathing and coughing every hour
D) Instruct in abdominal breathing

Question 22

The nurse is providing care to a patient diagnosed with chronic obstructive pulmonary disease (COPD).A nursing diagnosis for this patient is Imbalanced Nutrition: Less than Body Requirements.Which intervention is appropriate for this nursing diagnosis?

A) Encourage a diet high in protein and fats
B) Keep snacks to a minimum
C) Encourage carbohydrate-rich foods to provide needed calories for energy
D) Suggest the patient eat three meals per day to maintain energy needs

Question 23

The nurse is teaching a patient diagnosed with chronic obstructive pulmonary disease (COPD).Which patient statement indicates a need for further teaching?

A) "I should inhale by sniffing."
B) "I should avoid aerosol sprays."
C) "I should limit my fluid intake to 1-1.5 quarts daily."
D) "I should get a flu vaccine every year."

Question 24

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 that showed a flattened diaphragm with infiltrates.Based on this data,which prescription does the nurse question for this patient?

A) Antibiotic therapy
B) Nonsteroidal anti-inflammatory agents
C) Oxygen by nasal cannula at 3-4 liters/minute
D) Bronchodilators such as an adrenergic stimulating drugs or anticholinergic agents

Question 25

The nurse is providing care to a patient diagnosed with chronic obstructive pulmonary disease (COPD).Which observation would indicate that care provided to this patient has been effective?

A) Patient conducts morning care and ambulates in room while maintaining an oxygen saturation of 92% on room air per oximetry reading.
B) Patient needs assistance with morning care and meals due to shortness of breath.
C) Patient states family members are discussing admission to a nursing home for continuing care.
D) Patient leaves hospital unit to smoke outside four times a day.