Question 1

The emergency department nurse is evaluating the effectiveness of therapy for a patient who has received treatment during an asthma attack. Which assessment finding is the best indicator that the therapy has been effective?

Accepted Answer

A) No wheezes are audible. 
B) O2 saturation is >90%. 
C) Accessory muscle use has decreased. 
D) Respiratory rate is 16 breaths/minute.

Question 2

A young adult patient who denies any history of smoking is seen in the clinic with a new diagnosis of chronic obstructive pulmonary disease (COPD). The nurse should plan to teach the patient about

Accepted Answer

A) a1-antitrypsin testing. 
B) leukotriene modifiers. 
C) use of the nicotine patch. 
D) continuous pulse oximetry.

Question 3

The nurse teaches a patient with chronic bronchitis about a new prescription for Advair Diskus (combined fluticasone and salmeterol). Which action by the patient would indicate to the nurse that teaching about medication administration has been successful?

Accepted Answer

A) The patient shakes the device before use. 
B) The patient rapidly inhales the medication. 
C) The patient attaches a spacer to the Diskus. 
D) The patient performs huff coughing after inhalation.

Question 4

Which finding by the nurse for a patient with a nursing diagnosis of impaired gas exchange will be most useful in evaluating the effectiveness of treatment?

Accepted Answer

A) Even, unlabored respirations 
B) Pulse oximetry reading of 92% 
C) Absence of wheezes or crackles 
D) Respiratory rate of 18 breaths/min

Question 5

A patient who is experiencing an acute asthma attack is admitted to the emergency department. Which assessment should the nurse complete first?

Accepted Answer

A) Listen to the patient's breath sounds. 
B) Ask about inhaled corticosteroid use. 
C) Determine when the dyspnea started. 
D) Obtain the forced expiratory volume (FEV) flow rate.

Question 6

The clinic nurse makes a follow-up telephone call to a patient with asthma. The patient reports having a baseline peak flow reading of 600 L/min,and the current peak flow is 420 L/min. Which action should the nurse take first?

Accepted Answer

A) Tell the patient to go to the hospital emergency department. 
B) Instruct the patient to use the prescribed albuterol (Ventolin HF
A) . 
C) Ask about recent exposure to any new allergens or asthma triggers. 
D) Question the patient about use of the prescribed inhaled corticosteroids.

Question 7

The nurse reviews the medication administration record (MAR)for a patient having an acute asthma attack. Which medication should the nurse administer first?

Accepted Answer

A) Methylprednisolone (Solu-Medrol) 60 mg IV 
B) Albuterol (Ventolin HF
A)  2.5 mg per nebulizer 
C) Salmeterol (Serevent) 50 mcg per dry-powder inhaler (DPI) 
D) Ipratropium (Atrovent) 2 puffs per metered-dose inhaler (MDI)

Question 8

The nurse completes an admission assessment on a patient with asthma. Which information given by patient is indicates a need for a change in therapy?

Accepted Answer

A) The patient uses albuterol (Ventolin HF
A)  before aerobic exercise. 
B) The patient says that the asthma symptoms are worse every spring. 
C) The patient's heart rate increases after using the albuterol (Ventolin HF
A)  inhaler. 
D) The patient's only medications are albuterol (Ventolin HFAl) and salmeterol (Serevent).

Question 9

The nurse receives a change-of-shift report on the following patients with chronic obstructive pulmonary disease (COPD). Which patient should the nurse assess first?

Accepted Answer

A) A patient with loud expiratory wheezes 
B) A patient with a respiratory rate of 38 breaths/min 
C) A patient who has a cough productive of thick, green mucus 
D) A patient with jugular venous distention and peripheral edema

Question 10

A patient hospitalized with chronic obstructive pulmonary disease (COPD)is being discharged home on O2 therapy. Which instruction should the nurse include in the discharge teaching?

Accepted Answer

A) Travel is not possible with the use of O2 devices. 
B) O2 flow should be increased if the patient has more dyspnea. 
C) O2 use can improve the patient's prognosis and quality of life. 
D) Storage of O2 requires large metals tanks that each last 4 to 6 hours.

Question 11

A patient who has been experiencing an asthma attack develops bradycardia and a decrease in wheezing. Which action should the nurse take first?

Accepted Answer

A) Notify the health care provider. 
B) Document changes in respiratory status. 
C) Encourage the patient to cough and deep breathe. 
D) Administer IV methylprednisolone (Solu-Medrol).

Question 12

Which instruction should the nurse include in an exercise teaching plan for a patient with chronic obstructive pulmonary disease (COPD)?

Accepted Answer

A) "Avoid upper body exercise to prevent dyspnea." 
B) "Stop exercising if you start to feel short of breath." 
C) "Use the bronchodilator before you start to exercise." 
D) "Breathe in and out through the mouth while you exercise."

Question 13

The nurse teaches a patient about pursed-lip breathing. Which action by the patient would indicate to the nurse that further teaching is needed?

Accepted Answer

A) The patient inhales slowly through the nose. 
B) The patient puffs up the cheeks while exhaling. 
C) The patient practices by blowing through a straw. 
D) The patient's ratio of inhalation to exhalation is 1:3.

Question 14

The nurse assesses a patient with a history of asthma. Which assessment finding indicates that the nurse should take immediate action?

Accepted Answer

A) Pulse oximetry reading of 91% 
B) Respiratory rate of 26 breaths/min 
C) Use of accessory muscles in breathing 
D) Peak expiratory flow rate of 240 L/min

Question 15

The home health nurse is visiting a patient with chronic obstructive pulmonary disease (COPD). Which nursing action is appropriate to implement for a nursing diagnosis of impaired breathing pattern related to anxiety?

Accepted Answer

A) Titrate O2 to keep saturation at least 90%. 
B) Teach the patient how to use pursed-lip breathing. 
C) Discuss a high-protein, high-calorie diet with the patient. 
D) Suggest the use of over-the-counter sedative medications.

Question 16

The nurse interviews a patient with a new diagnosis of chronic obstructive pulmonary disease (COPD). Which information is most specific in confirming a diagnosis of chronic bronchitis?

Accepted Answer

A) The patient tells the nurse about a family history of bronchitis. 
B) The patient indicates a 30 pack-year cigarette smoking history. 
C) The patient reports a productive cough for 3 months every winter. 
D) The patient denies having respiratory problems until the past 12 months.

Question 17

A patient is scheduled for spirometry. Which action should the nurse take to prepare the patient for this procedure?

Accepted Answer

A) Give the rescue medication immediately before testing. 
B) Administer oral corticosteroids 2 hours before the procedure. 
C) Withhold bronchodilators for 6 to 12 hours before the examination. 
D) Ensure that the patient has been NPO for several hours before the test.

Question 18

Postural drainage with percussion and vibration is ordered twice daily for a patient with chronic bronchitis. Which intervention should the nurse include in the plan of care?

Accepted Answer

A) Schedule the procedure 1 hour after the patient eats. 
B) Maintain the patient in the lateral position for 20 minutes. 
C) Give the prescribed albuterol (Ventolin HF
A)  before the therapy. 
D) Perform percussion before assisting the patient to the drainage position.

Question 19

A patient with chronic obstructive pulmonary disease (COPD)has poor gas exchange. Which action by the nurse would support the patient's ventilation?

Accepted Answer

A) Have the patient rest in bed with the head elevated to 15 to 20 degrees. 
B) Encourage the patient to sit up at the bedside in a chair and lean forward. 
C) Ask the patient to rest in bed in a high-Fowler's position with the knees flexed. 
D) Place the patient in the Trendelenburg position with pillows behind the head.

Question 20

The nurse teaches a patient who has asthma about peak flow meter use. Which action by the patient indicates that teaching was successful?

Accepted Answer

A) The patient inhales rapidly through the peak flow meter mouthpiece. 
B) The patient takes montelukast (Singulair) for peak flows in the red zone. 
C) The patient calls the health care provider when the peak flow is in the green zone. 
D) The patient uses an albuterol (Ventolin HF
A)  inhaler for peak flows in the yellow zone.

Exam 28: Obstructive Pulmonary Diseases

The emergency department nurse is evaluating the effectiveness of therapy for a patient who has received treatment during an asthma attack. Which assessment finding is the best indicator that the therapy has been effective?

A young adult patient who denies any history of smoking is seen in the clinic with a new diagnosis of chronic obstructive pulmonary disease (COPD) . The nurse should plan to teach the patient about

The nurse teaches a patient with chronic bronchitis about a new prescription for Advair Diskus (combined fluticasone and salmeterol) . Which action by the patient would indicate to the nurse that teaching about medication administration has been successful?

Which finding by the nurse for a patient with a nursing diagnosis of impaired gas exchange will be most useful in evaluating the effectiveness of treatment?

A patient who is experiencing an acute asthma attack is admitted to the emergency department. Which assessment should the nurse complete first?

The clinic nurse makes a follow-up telephone call to a patient with asthma. The patient reports having a baseline peak flow reading of 600 L/min,and the current peak flow is 420 L/min. Which action should the nurse take first?

The nurse reviews the medication administration record (MAR) for a patient having an acute asthma attack. Which medication should the nurse administer first?

The nurse completes an admission assessment on a patient with asthma. Which information given by patient is indicates a need for a change in therapy?

The nurse receives a change-of-shift report on the following patients with chronic obstructive pulmonary disease (COPD) . Which patient should the nurse assess first?

A patient hospitalized with chronic obstructive pulmonary disease (COPD) is being discharged home on O₂ therapy. Which instruction should the nurse include in the discharge teaching?

A patient who has been experiencing an asthma attack develops bradycardia and a decrease in wheezing. Which action should the nurse take first?

Which instruction should the nurse include in an exercise teaching plan for a patient with chronic obstructive pulmonary disease (COPD) ?

The nurse teaches a patient about pursed-lip breathing. Which action by the patient would indicate to the nurse that further teaching is needed?

The nurse assesses a patient with a history of asthma. Which assessment finding indicates that the nurse should take immediate action?

The home health nurse is visiting a patient with chronic obstructive pulmonary disease (COPD) . Which nursing action is appropriate to implement for a nursing diagnosis of impaired breathing pattern related to anxiety?

The nurse interviews a patient with a new diagnosis of chronic obstructive pulmonary disease (COPD) . Which information is most specific in confirming a diagnosis of chronic bronchitis?

A patient is scheduled for spirometry. Which action should the nurse take to prepare the patient for this procedure?

Postural drainage with percussion and vibration is ordered twice daily for a patient with chronic bronchitis. Which intervention should the nurse include in the plan of care?

A patient with chronic obstructive pulmonary disease (COPD) has poor gas exchange. Which action by the nurse would support the patient's ventilation?

The nurse teaches a patient who has asthma about peak flow meter use. Which action by the patient indicates that teaching was successful?

Exam 28: Obstructive Pulmonary Diseases

The emergency department nurse is evaluating the effectiveness of therapy for a patient who has received treatment during an asthma attack. Which assessment finding is the best indicator that the therapy has been effective?

A young adult patient who denies any history of smoking is seen in the clinic with a new diagnosis of chronic obstructive pulmonary disease (COPD) . The nurse should plan to teach the patient about

The nurse teaches a patient with chronic bronchitis about a new prescription for Advair Diskus (combined fluticasone and salmeterol) . Which action by the patient would indicate to the nurse that teaching about medication administration has been successful?

Which finding by the nurse for a patient with a nursing diagnosis of impaired gas exchange will be most useful in evaluating the effectiveness of treatment?

A patient who is experiencing an acute asthma attack is admitted to the emergency department. Which assessment should the nurse complete first?

The clinic nurse makes a follow-up telephone call to a patient with asthma. The patient reports having a baseline peak flow reading of 600 L/min,and the current peak flow is 420 L/min. Which action should the nurse take first?

The nurse reviews the medication administration record (MAR) for a patient having an acute asthma attack. Which medication should the nurse administer first?

The nurse completes an admission assessment on a patient with asthma. Which information given by patient is indicates a need for a change in therapy?

The nurse receives a change-of-shift report on the following patients with chronic obstructive pulmonary disease (COPD) . Which patient should the nurse assess first?

A patient hospitalized with chronic obstructive pulmonary disease (COPD) is being discharged home on O2 therapy. Which instruction should the nurse include in the discharge teaching?

A patient who has been experiencing an asthma attack develops bradycardia and a decrease in wheezing. Which action should the nurse take first?

Which instruction should the nurse include in an exercise teaching plan for a patient with chronic obstructive pulmonary disease (COPD) ?

The nurse teaches a patient about pursed-lip breathing. Which action by the patient would indicate to the nurse that further teaching is needed?

The nurse assesses a patient with a history of asthma. Which assessment finding indicates that the nurse should take immediate action?

The home health nurse is visiting a patient with chronic obstructive pulmonary disease (COPD) . Which nursing action is appropriate to implement for a nursing diagnosis of impaired breathing pattern related to anxiety?

The nurse interviews a patient with a new diagnosis of chronic obstructive pulmonary disease (COPD) . Which information is most specific in confirming a diagnosis of chronic bronchitis?

A patient is scheduled for spirometry. Which action should the nurse take to prepare the patient for this procedure?

Postural drainage with percussion and vibration is ordered twice daily for a patient with chronic bronchitis. Which intervention should the nurse include in the plan of care?

A patient with chronic obstructive pulmonary disease (COPD) has poor gas exchange. Which action by the nurse would support the patient's ventilation?

The nurse teaches a patient who has asthma about peak flow meter use. Which action by the patient indicates that teaching was successful?

A patient hospitalized with chronic obstructive pulmonary disease (COPD) is being discharged home on O₂ therapy. Which instruction should the nurse include in the discharge teaching?