Question 1

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).It is most appropriate for the nurse to teach the patient about

Accepted Answer

A)   á2-antitrypsin testing.
B)   use of the nicotine patch.
C)   continuous pulse oximetry.
D)   effects of leukotriene modifiers. A

Question 2

A patient who is 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) . A

Question 3

The nurse develops a teaching plan to help increase activity tolerance at home for an older adult with severe chronic obstructive pulmonary disease (COPD).Which instructions would be most appropriate for the nurse to include in the plan of care?

Accepted Answer

A)   Stop exercising when short of breath.
B)   Walk until pulse rate exceeds 130 beats/minute.
C)   Limit exercise to activities of daily living (ADLs) .
D)   Walk 15 to 20 minutes daily at least 3 times/week. D

Question 4

A young adult female patient with cystic fibrosis (CF)tells the nurse that she is not sure about getting married and having children some day.Which initial response by the nurse is best?

Accepted Answer

A)   "Are you aware of the normal lifespan for patients with CF?"
B)   "Do you need any information to help you with that decision?"
C)   "Many women with CF do not have difficulty conceiving children."
D)   "You will need to have genetic counseling before making a decision."

Question 5

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

Accepted Answer

A)   The patient uses albuterol (Proventil)  before any 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 (Proventil)  inhaler.
D)   The patient's only medications are albuterol (Proventil)  and salmeterol (Serevent) .

Question 6

Which nursing action for a patient with chronic obstructive pulmonary disease (COPD)could the nurse delegate to experienced unlicensed assistive personnel (UAP)?

Accepted Answer

A)   Obtain oxygen saturation using pulse oximetry.
B)   Monitor for increased oxygen need with exercise.
C)   Teach the patient about safe use of oxygen at home.
D)   Adjust oxygen to keep saturation in prescribed parameters.

Question 7

The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD).Which information obtained from the patient would prompt the nurse to consult with the health care provider before administering the prescribed theophylline?

Accepted Answer

A)   The patient reports a recent 15-pound weight gain.
B)   The patient denies any shortness of breath at present.
C)   The patient takes cimetidine (Tagamet)  150 mg daily.
D)   The patient complains about coughing up green mucus.

Question 8

A young adult patient with cystic fibrosis (CF)is admitted to the hospital with increased dyspnea.Which intervention should the nurse include in the plan of care?

Accepted Answer

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

Question 9

The nurse takes an admission history on a patient with possible asthma who has new-onset wheezing and shortness of breath.Which information may indicate a need for a change in therapy?

Accepted Answer

A)   The patient has chronic inflammatory bowel disease.
B)   The patient has a history of pneumonia 6 months ago.
C)   The patient takes propranolol (Inderal)  for hypertension.
D)   The patient uses acetaminophen (Tylenol)  for headaches.

Question 10

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/minute and the current peak flow is 420 L/minute.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 (Proventil) .
C)   Ask about recent exposure to any new allergens or asthma triggers.
D)   Question the patient about use of the prescribed inhaled corticosteroids.

Question 11

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 12

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)   Perform percussion before assisting the patient to the drainage position.
D)   Give the ordered albuterol (Proventil)  before the patient receives the therapy.

Question 13

The nurse is admitting a patient diagnosed with an acute exacerbation of chronic obstructive pulmonary disease (COPD).What is the best way for the nurse 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 patient's level of dyspnea.
D)   Avoid administration of oxygen at a rate of more than 2 L/minute.

Question 14

A patient with chronic obstructive pulmonary disease (COPD)has poor gas exchange.Which action by the nurse would be most appropriate?

Accepted Answer

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

Question 15

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)   Oxygen saturation is >90%.
C)   Accessory muscle use has decreased.
D)   Respiratory rate is 16 breaths/minute.

Question 16

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/minute
C)   Use of accessory muscles in breathing
D)   Peak expiratory flow rate of 240 L/minute

Question 17

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

Accepted Answer

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

Question 18

Which assessment finding in a patient who has received omalizumab (Xolair)is most important to report immediately to the health care provider?

Accepted Answer

A)   Pain at injection site
B)   Flushing and dizziness
C)   Peak flow reading 75% of normal
D)   Respiratory rate 22 breaths/minute

Question 19

A patient in the clinic with cystic fibrosis (CF)reports increased sweating and weakness during the summer months.Which action by the nurse would be most appropriate?

Accepted Answer

A)   Have the patient add dietary salt to meals.
B)   Teach the patient about the signs of hypoglycemia.
C)   Suggest decreasing intake of dietary fat and calories.
D)   Instruct the patient about pancreatic enzyme replacements.

Question 20

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/minute
C)   A patient who has a cough productive of thick, green mucus
D)   A patient with jugular venous distention and peripheral edema

Exam 25: Nursing Management: Obstructive Pulmonary Diseases

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) .It is most appropriate for the nurse to teach the patient about

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

The nurse develops a teaching plan to help increase activity tolerance at home for an older adult with severe chronic obstructive pulmonary disease (COPD) .Which instructions would be most appropriate for the nurse to include in the plan of care?

A young adult female patient with cystic fibrosis (CF) tells the nurse that she is not sure about getting married and having children some day.Which initial response by the nurse is best?

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

Which nursing action for a patient with chronic obstructive pulmonary disease (COPD) could the nurse delegate to experienced unlicensed assistive personnel (UAP) ?

The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) .Which information obtained from the patient would prompt the nurse to consult with the health care provider before administering the prescribed theophylline?

A young adult patient with cystic fibrosis (CF) is admitted to the hospital with increased dyspnea.Which intervention should the nurse include in the plan of care?

The nurse takes an admission history on a patient with possible asthma who has new-onset wheezing and shortness of breath.Which information may indicate a need for a change in therapy?

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/minute and the current peak flow is 420 L/minute.Which action should the nurse take first?

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

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?

The nurse is admitting a patient diagnosed with an acute exacerbation of chronic obstructive pulmonary disease (COPD) .What is the best way for the nurse to determine the appropriate oxygen flow rate?

A patient with chronic obstructive pulmonary disease (COPD) has poor gas exchange.Which action by the nurse would be most appropriate?

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?

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

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

Which assessment finding in a patient who has received omalizumab (Xolair) is most important to report immediately to the health care provider?

A patient in the clinic with cystic fibrosis (CF) reports increased sweating and weakness during the summer months.Which action by the nurse would be most appropriate?

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?