Question 1

The nurse is caring for a client with chronic bronchitis who has a nursing diagnosis of impaired breathing pattern related to anxiety. Which of the following nursing actions is best to include in the plan of care?

Accepted Answer

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

Question 2

The nurse is evaluating the effectiveness of therapy for a client who has received treatment during an asthma attack. Which of the following findings is the best indicator that the therapy has been effective?

Accepted Answer

A)  No wheezes are audible.
B)  Oxygen saturation is >92%.
C)  Accessory muscle use has decreased.
D)  Respiratory rate is 16 breaths/minute. B

Question 3

After the nurse has finished teaching a client about pursed lip breathing, which of the following client actions indicate that more teaching is needed?

Accepted Answer

A)  The client inhales slowly through the nose.
B)  The client tenses the neck muscles while exhaling.
C)  The client practises by blowing through a straw.
D)  The client's ratio of inhalation to exhalation is 1:3. B

Question 4

The nurse is teaching a client with chronic obstructive pulmonary disease (COPD) about exercise. Which of the following information should the nurse include?

Accepted Answer

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

Question 5

Which of the following actions should be included in the plan of care for a client with

Accepted Answer

A)  Schedule a sweat chloride test.
B)  Arrange for a hospice nurse visit.
C)  Place the client on a low-sodium diet.
D)  Perform chest physiotherapy every 4 hours.

Question 6

The nurse is interviewing a client with a new diagnosis of chronic obstructive pulmonary disease (COPD). Which of the following information will help most in confirming a diagnosis of chronic bronchitis?

Accepted Answer

A)  The client tells the nurse about a family history of bronchitis.
B)  The client's history indicates a 40 pack-year cigarette history.
C)  The client denies having any respiratory problems until the last 6 months.
D)  The client complains about a productive cough every winter for 3 months.

Question 7

The nurse is caring for a client who is receiving 35% oxygen via a Venturi mask. To ensure the correct amount of oxygen delivery, it is most important that the nurse implement which of the following actions?

Accepted Answer

A)  Keep the air entrainment ports clean and unobstructed.
B)  Give a high enough flow rate to keep the bag from collapsing.
C)  Use an appropriate adaptor to ensure adequate oxygen delivery.
D)  Drain moisture condensation from the oxygen tubing every hour.

Question 8

Which of the following topics should the nurse include in medication teaching for a client with newly diagnosed persistent asthma?

Accepted Answer

A)  Use of long-acting ?-adrenergic medications
B)  Adverse effects of sustained-release theophylline
C)  Self-administration of inhaled corticosteroids
D)  Complications associated with oxygen therapy

Question 9

The nurse has completed client teaching about the administration of salmeterol using a metered-dose inhaler (MDI). Which of the following actions by the client indicates good understanding of the teaching?

Accepted Answer

A)  The client attaches a spacer before using the MDI.
B)  The client coughs vigorously after using the inhaler.
C)  The client floats the MDI in water to see if it is empty.
D)  The client activates the inhaler at the onset of expiration.

Question 10

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

Accepted Answer

A)  Pulse oximetry reading of 91%
B)  Absence of wheezes or crackles
C)  Decreased use of accessory muscles
D)  Respiratory rate of 22 breaths/minute

Question 11

Which of the following information about a newly admitted client with chronic obstructive pulmonary disease (COPD) indicates that the nurse should consult with the health care provider before administering the prescribed theophylline?

Accepted Answer

A)  The client has had a recent 10-pound weight gain.
B)  The client has a cough productive of green mucus.
C)  The client denies any shortness of breath at present.
D)  The client takes cimetidine 150 mg daily.

Question 12

The nurse is caring for a client with a history of asthma. Which of the following assessments finding should the nurse communicate immediately to the health care provider?

Accepted Answer

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

Question 13

The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is receiving oxygen. Which of the following actions is best for the nurse to implement to determine the appropriate oxygen flow rate?

Accepted Answer

A)  Minimize oxygen use to avoid oxygen dependency.
B)  Maintain the pulse oximetry level at 90% or greater.
C)  Administer oxygen according to the client's level of dyspnea.
D)  Avoid administration of oxygen at a rate of more than 2 L/minute.

Question 14

The nurse is developing a teaching plan to help increase activity tolerance at home for a 70-year-old client with severe chronic obstructive pulmonary disease (COPD). Which of the following exercise goals should the nurse teach the client?

Accepted Answer

A)  Walk until pulse rate exceeds 130.
B)  Walk for a total of 20 minutes daily.
C)  Exercise until shortness of breath occurs.
D)  Limit exercise to activities of daily living (ADLs) .

Question 15

The nurse is caring for a client in the emergency department who is experiencing an acute asthma attack. After listening to the client's breath sounds, which of the following actions should the nurse take next?

Accepted Answer

A)  Start an intravenous with Ringer's Lactate.
B)  Ask about inhaled corticosteroid use.
C)  Determine when the dyspnea started.
D)  Obtain the forced expiratory volume (FEV)  flow rate.

Question 16

The nurse is assessing a client in the asthma clinic who has recorded daily peak flows that are 85% of the baseline. Which of the following actions should the nurse plan to take?

Accepted Answer

A)  Teach the client about the use of oral corticosteroids.
B)  Administer a bronchodilator and recheck the peak flow.
C)  Instruct the client to continue to use current medications.
D)  Evaluate whether the peak flow meter is being used correctly.

Question 17

The nurse is conducting an admission history for a client with possible asthma who has new-onset wheezing and shortness of breath. Which of the following information indicates a need for a change in therapy?

Accepted Answer

A)  The client has a history of pneumonia 2 years ago.
B)  The client has chronic inflammatory bowel disease.
C)  The client takes propranolol for hypertension.
D)  The client uses acetaminophen for headaches.

Question 18

Which of the following actions should the nurse anticipate taking first when a client who is experiencing an asthma attack develops bradycardia and a decrease in wheezing?

Accepted Answer

A)  Assist with endotracheal intubation.
B)  Document changes in respiratory status.
C)  Encourage the client to cough and deep breathe.
D)  Administer IV methylprednisolone.

Question 19

The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who has rhonchi throughout the lung fields and a chronic, nonproductive cough. Which of the following nursing actions is best?

Accepted Answer

A)  Change the oxygen flow rate to the highest prescribed rate.
B)  Reinforce the ongoing use of pursed lip breathing techniques.
C)  Educate the client to use the Flutter airway clearance device.
D)  Teach the client about consistent use of inhaled corticosteroids.

Question 20

Which of the following actions by a client who has asthma indicates a good understanding of the nurse's teaching about peak flow meter use?

Accepted Answer

A)  The client records an average of three peak flow readings every day.
B)  The client inhales rapidly through the peak flow meter mouthpiece.
C)  The client uses the albuterol metered-dose inhaler (MDI)  for peak flows in the yellow zone.
D)  The client calls the health care provider when the peak flow is in the green zone.

Exam 31: Nursing Management Obstructive Pulmonary Diseases