Chapter 24 Quiz

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Question #1

A nurse notes that the FEV1/FVC ratio is less than 70% and the FEV1 is 25% for a patient with COPD. What stage should the nurse document the patient is in?

A III

B I

C III

D IV

Question #2

A client with asthma is prescribed a short acting beta-adrenergic (SABA) for quick relief. Which of the following is the most likely drug to be prescribed?

A Ipratropium bromide

B Albuterol

C Ipratropium bromide and albuterol sulfate

D Fluticasone propionate

Question #3

The nurse is reviewing pressurized metered-dose inhaler (pMDI) instructions with a client. Which statement by the client indicates the need for further instruction?

A “I will shake the MDI container before I use it.”

B “I can’t use a spacer or holding chamber with the MDI.”

C “Because I am prescribed a corticosteroid-containing MDI, I will rinse my mouth with water after use.”

D “I will take a slow, deep breath in after pushing down on the MDI.”

Question #4

Which of the following is the key underlying feature of asthma?

A Chest tightness

B Shortness of breath

C Inflammation

D Productive cough

Question #5

A nursing student is taking a pathophysiology examination. Which of the following factors would the student correctly identify as contributing to the underlying pathophysiology of chronic obstructive pulmonary disease (COPD)? Choose all that apply.,,

A Decreased numbers of goblet cells

B Inflamed airways that obstruct airflow

C Mucus secretions that block airways

D Dry airways that obstruct airflow

E Overinflated alveoli that impair gas exchange

Question #6

A client has asthma. Which of the following medications is a commonly prescribed mast cell stabilizer used for asthma?

A Budesonide

B Theophylline

C Albuterol

D Cromolyn sodium

Question #7

The nurse has instructed the client to use a peak flow meter. The nurse evaluates client learning as satisfactory when the client

A Sits in a straight–back chair and leans forward

B Inhales deeply and holds the breath

C Exhales hard and fast with a single blow

D Records in a diary the number achieved after one breath

Question #8

A nurse is caring for a client admitted with an exacerbation of asthma. The nurse knows the client’s condition is worsening when he:

A sits in tripod position.

B uses the sternocleidomastoid muscles.

C has a pulse oximetry reading of 93%.

D wants the head of the bed raised to a 90-degree level.

Question #9

A client with chronic obstructive pulmonary disease (COPD) is recovering from a myocardial infarction. Because the client is extremely weak and can’t produce an effective cough, the nurse should monitor closely for:

A atelectasis.

B pulmonary edema.

C pleural effusion.

D oxygen toxicity.

Question #10

A pneumothorax is a possible complication of COPD. Symptoms will depend on the suddenness of the attack and the size of the air leak. The most common, immediate symptom that should be assessed is:

A Sharp, stabbing chest pain

B Tachycardia

C A dry, hacking cough

D Dyspnea

Question #11

A patient is being treated for status asthmaticus. What danger sign does the nurse observe that can indicate impending respiratory failure?

A Respiratory acidosis

B Respiratory alkalosis

C Metabolic acidosis

D Metabolic alkalosis

Question #12

Which statement is true about both lung transplant and bullectomy?

A Both procedures improve the overall quality of life of a client with COPD.

B Both procedures treat end-stage emphysema.

C Both procedures treat patients with bullous emphysema.

D Both procedures cure COPD.

Question #13

A nursing student understands the importance of the psychosocial aspects of disease processes. When working with a patient with COPD, the student would rank which of the following nursing diagnoses as the MOST important when analyzing the psychosocial effects?

A Activity intolerance related to fatigue

B High risk for ineffective therapeutic regimen management related to lack of knowledge

C Ineffective coping related to anxiety

D Disturbed sleep pattern related to cough

Question #14

A nurse has just completed teaching with a client who has been prescribed a meter-dosed inhaler for the first time. Which statement if made by the client would indicate to the nurse that further teaching and follow-up care is necessary?

A “I do not need to rinse my mouth with this type of inhaler.”

B “After I breathe in, I will hold my breath for 10 seconds.”

C “I will make sure to take a slow, deep breath as I push on my inhaler.”

D “If I use the spacer, I know I am only supposed to push on the inhaler once.”

Question #15

A client has a history of chronic obstructive pulmonary disease (COPD). Following a coughing episode, the client reports sudden and unrelieved shortness of breath. Which of the following is the most important for the nurse to assess?

A Skin color

B Respiratory rate

C Heart rate

D Lung sounds

Question #16

As status asthmaticus worsens, the nurse would expect which acid-base imbalance?

A Respiratory alkalosis

B Metabolic acidosis

C Metabolic alkalosis

D Respiratory acidosis

Question #17

At 11 p.m., a client is admitted to the emergency department. He has a respiratory rate of 44 breaths/minute. He’s anxious, and wheezes are audible. The client is immediately given oxygen by face mask and methylprednisolone (Depo-medrol) I.V. At 11:30 p.m., the client’s arterial blood oxygen saturation is 86%, and he’s still wheezing. The nurse should plan to administer:

A morphine.

B alprazolam (Xanax).

C propranolol (Inderal).

D albuterol (Proventil).

Question #18

A nurse is caring for a client with status asthmaticus. Which medication should the nurse prepare to administer?

A An inhaled beta2-adrenergic agonist

B An inhaled corticosteroid

C An oral corticosteroid

D An I.V. beta2-adrenergic agonist

Question #19

For a client with advanced chronic obstructive pulmonary disease (COPD), which nursing action best promotes adequate gas exchange?

A Using a Venturi mask to deliver oxygen as ordered

B Administering a sedative as ordered

C Keeping the client in semi-Fowler’s position

D Encouraging the client to drink three glasses of fluid daily

Question #20

In which grade of COPD is the forced expiratory volume in 1 second (FEV1) greater than 80% predicted?

A IV

B I

C II

D III

Question #21

The classification of Stage III of COPD is defined as

A severe COPD.

B mild COPD.

C moderate COPD.

D very severe COPD.

E at risk for COPD.

Question #22

The nurse is assigned to care for a patient with COPD with hypoxemia and hypercapnia. When planning care for this patient, what does the nurse understand is the main goal of treatment?

A Providing sufficient oxygen to improve oxygenation

B Avoiding the use of oxygen to decrease the hypoxic drive

C Monitoring the pulse oximetry to assess need for early intervention when PCO2 levels

D Increasing pH

Question #23

A Dry airways that obstruct airflow

B Inflamed airways that obstruct airflow

C Overinflated alveoli that impair gas exchange

D Mucus secretions that block airways

E Decreased numbers of goblet cells

Question #24

A young adult with cystic fibrosis is admitted to the hospital for an acute airway exacerbation. Aggressive treatment is indicated. What is the first action by the nurse?

A Collects sputum for culture and sensitivity

B Administers vancomycin intravenously

C Provides nebulized tobramycin (TOBI)

D Gives oral pancreatic enzymes with meals

Question #25

A client experiencing an asthmatic attack is prescribed methylprednisolone intravenously. What action should the nurse take?

A Informs the client to limit fluid intake due to fluid retention

B Aspirates for blood return before injecting the medication

C Encourages the client to decrease caloric intake due to increased appetite

D Assesses fasting blood glucose levels

Question #26

A client with chronic obstructive pulmonary disease (COPD) expresses a desire to quit smoking. The first appropriate response from the nurse is:

A “I can refer you to the American Lung Association.”

B “Nicotine patches would be appropriate for you.”

C “Many options are available for you.”

D “Have you tried to quit smoking before?”

Question #27

A nurse has established a nursing diagnosis of ineffective airway clearance. The datum that best supports this diagnosis is that the client

A Reports shortness of breath

B Has a respiratory rate of 28 breaths/minute

C Has wheezes in the right lung lobes

D Cannot perform activities of daily living

Question #28

A physician orders triamcinolone and salmeterol for a client with a history of asthma. What action should the nurse take when administering these drugs?

A Administer the triamcinolone and then administer the salmeterol.

B Monitor the client’s theophylline level before administering the medications.

C Administer the salmeterol and then administer the triamcinolone.

D Allow the client to choose the order in which the drugs are administered.

Question #29

A home health nurse sees a client with end-stage chronic obstructive pulmonary disease. An outcome identified for this client is preventing infection. Which finding indicates that this outcome has been met?

A Decreased activity tolerance

B Decreased oxygen requirements

C Normothermia

D Increased sputum production

Question #30

The classification of Stage IV of COPD is defined as

A mild COPD.

B at risk for COPD.

C moderate COPD.

D very severe COPD.

E severe COPD.

Question #31

A client with asthma is prescribed a short acting beta-adrenergic (SABA) for quick relief. Which of the following is the most likely drug to be prescribed?

A Ipratropium bromide

B Ipratropium bromide and albuterol sulfate

C Albuterol

D Fluticasone propionate

Question #32

A patient comes to the clinic for the third time in 2 months with chronic bronchitis. What clinical symptoms does the nurse anticipate assessing for this patient?

A Fever, chills, and diaphoresis

B Sputum and a productive cough

C Chest pain during respiration

D Tachypnea and tachycardia

Question #33

Which exposure accounts for most cases of COPD?

A Occupational exposure

B Exposure to tobacco smoke

C Passive smoking

D Ambient air pollution

Question #34

In COPD, the body attempts to improve oxygen-carrying capacity by increasing the amount of red blood cells. Which term refers to this process?

A Bronchitis

B Asthma

C Emphysema

D Polycythemia

Question #35

Which of the following occupy space in the thorax, but do not contribute to ventilation?

A Alveoli

B Lung parenchyma

C Mast cells

D Bullae

Question #36

Asthma is cause by which type of response?

A IgD-mediated

B IgE-mediated

C IgA-mediated

D IgM-mediated

Question #37

A nurse consulting with a nutrition specialist knows it’s important to consider a special diet for a client with chronic obstructive pulmonary disease (COPD). Which diet is appropriate for this client?

A 1,800-calorie ADA

B High-protein

C Low-fat

D Full-liquid

Question #38

A client is diagnosed with a chronic respiratory disorder. After assessing the client’s knowledge of the disorder, the nurse prepares a teaching plan. This teaching plan is most likely to include which nursing diagnosis?

A Impaired swallowing

B Imbalanced nutrition: More than body requirements

C Anxiety

D Unilateral neglect

Question #39

A nurse is assisting with a subclavian vein central line insertion when the client’s oxygen saturation drops rapidly. He complains of shortness of breath and becomes tachypneic. The nurse suspects the client has developed a pneumothorax. Further assessment findings supporting the presence of a pneumothorax include:

A muffled or distant heart sounds.

B diminished or absent breath sounds on the affected side.

C paradoxical chest wall movement with respirations.

D tracheal deviation to the unaffected side.

Question #40

Upon assessment, the nurse suspects that a client with COPD may have bronchospasm. What manifestations validate the nurse’s concern? Select all that apply.,,

A Jugular vein distention

B Compromised gas exchange

C Wheezes

D Ascites

E Decreased airflow

Question #41

The nurse is assigned the care of a 30-year-old client diagnosed with cystic fibrosis (CF). Which nursing intervention will be included in the client’s care plan?

A Restricting oral intake to 1,000 mL/day

B Performing chest physiotherapy as ordered

C Providing the client a low-sodium diet

D Discussing palliative care and end-of-life issues with the client

Question #42

A client with bronchiectasis is admitted to the nursing unit. The primary focus of nursing care for this client includes

A teaching the family how to perform postural drainage.

B implementing measures to clear pulmonary secretions.

C providing the client a low-calorie, high-fiber diet.

D instructing the client on the signs of respiratory infection.

Question #43

Which statement describes emphysema?

A A disease of the airways characterized by destruction of the walls of overdistended alveoli

B A disease that results in reversible airflow obstruction, a common clinical outcome

C Presence of cough and sputum production for at least a combined total of 2 to 3 months in each of two consecutive years

D Chronic dilatation of a bronchus or bronchi

Question #44

Which of the following is the most common chronic disease of childhood?

A Autism

B Asthma

C Obesity

D Cerebral palsy

Question #45

In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to which of the following acid–base imbalances?

A Metabolic acidosis

B Respiratory alkalosis

C Metabolic alkalosis

D Respiratory acidosis

Question #46

A physician orders a beta2 adrenergic-agonist agent (bronchodilator) that is short-acting and administered only by inhaler. What drug would the nurse know to administer to the client?

A Formoterol

B Albuterol

C Ipratropium bromide

D Isoproterenol

Question #47

A client has been classified as status asthmaticus. The nurse understands that this client will likely initially exhibit symptoms of:

A Metabolic acidosis

B Respiratory alkalosis

C Metabolic alkalosis

D Respiratory acidosis

Question #48

A client is being seen in the emergency department for exacerbation of chronic obstructive pulmonary disease (COPD). The first action of the nurse is to administer which of the following prescribed treatments?

A Ipratropium bromide (Alupent) by metered-dose inhaler

B Vancomycin 1 gram intravenously over 1 hour

C Intravenous methylprednisolone (Solu–Medrol) 120 mg

D Oxygen through nasal cannula at 2 L/minute

Question #49

Which is the strongest predisposing factor for asthma?

A Allergy

B Male gender

C Air pollution

D Congenital malformations

Question #50

The classification of Stage II of COPD is defined as

A very severe COPD.

B mild COPD.

C severe COPD.

D at risk for COPD.

E moderate COPD.

Question #51

The goal for oxygen therapy in COPD is to support tissue oxygenation, decrease the work of the cardiopulmonary system, and maintain the resting partial arterial pressure of oxygen (PaO2) of at least ______ mm Hg and an arterial oxygen saturation (SaO2) of at least ___%.

A 60 mm Hg; 90%

B 54 mm Hg; 84%

C 56 mm Hg; 86%

D 58 mm Hg; 88%

Question #52

The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstruction and that leads to the collapse of alveoli. What complication should the nurse monitor for?

A Pleurisy

B Pneumonia

C Atelectasis

D Emphysema

Question #53

When developing a preventative plan of care for a patient at risk for developing chronic obstructive pulmonary disease (COPD), which of the following should be incorporated?

A Weight reduction

B Smoking cessation

C Cholesterol management

D Cancer prevention

Question #54

To help prevent infections in clients with COPD, the nurse should recommend vaccinations against two bacterial organisms. Which of the following are the two vaccinations?

A Streptococcus pneumonia and Haemophilus influenzae

B Haemophilus influenzae and Gardasil

C Streptococcus pneumonia and varicella

D Haemophilus influenzae and varicella

Question #55

The nurse has instructed the client to use a peak flow meter. The nurse evaluates client learning as satisfactory when the client

A Inhales deeply and holds the breath

B Exhales hard and fast with a single blow

C Sits in a straight–back chair and leans forward

D Records in a diary the number achieved after one breath

Question #56

Which exposure acts as a risk factor for and accounts for the majority of cases of chronic obstructive pulmonary disease (COPD)?

A Passive smoking

B Exposure to tobacco smoke

C Ambient air pollution

D Occupational exposure

Question #57

As status asthmaticus worsens, the nurse would expect which acid-base imbalance?

A Respiratory alkalosis

B Respiratory acidosis

C Metabolic alkalosis

D Metabolic acidosis

Question #58

A nurse administers albuterol (Proventil), as ordered, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect?

A Heart rate of 100 beats/minute

B Dilated and reactive pupils

C Urine output of 40 ml/hour

D Respiratory rate of 22 breaths/minute

Question #59

A nurse notes that the FEV1/FVC ratio is less than 70% and the FEV1 is 85% for a patient with COPD. What stage should the nurse document the patient is in?

A II

B III

C I

D IV

Question #60

Which of the following is accurate regarding status asthmaticus?

A Usually occurs with warning

B Usually does not progress to severe obstruction

C Patients have a productive cough.

D A severe asthma episode that is refractory to initial therapy

Question #61

A junior-level nursing class has just finished learning about the management of clients with chronic pulmonary diseases. They learned that a new definition of COPD leaves only one disorder within its classification. Which of the following is that disorder?

A Emphysema

B Cystic fibrosis

C Bronchiectasis

D Asthma

Question #62

What is histamine, a mediator that supports the inflammatory process in asthma, secreted by?

A Neutrophils

B Eosiniphils

C Mast cells

D Lymphocytes

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