Deck 28: Chronic Lower Respiratory Tract Disorders

Question 1

A young patient with acquired immunodeficiency syndrome (AIDS)reports debilitating night sweats.Why should the home health nurse suggest that the patient visit the clinic?

A) To get a prescription for antibiotics
B) Tuberculosis (TB)screening
C) Complete blood count (CBC)
D) Treatment with an aerosol inhalant

Answer 1

Tuberculosis (TB)screening

Question 2

A patient with COPD asks a nurse if nicotine patches are very effective for smoking cessation.What is the best response by the nurse?

A) "No.Only about 25% are successful."
B) "Yes.The success rate is between 50% and 60%."
C) "No.Prescriptions such as Wellbutrin are 90% effective."
D) "Yes.Individual success has been obtained with combination of patches and gum."

Answer 2

"No.Only about 25% are successful."

Question 3

A patient with TB asks the nurse how long he will have to take his TB medications.What is the nurse's best response?

A) "Generally about 2 weeks."
B) "Depending on the drug, it may be as long as 2 years."
C) "TB drugs are usually taken throughout the life span."
D) "People frequently ask that question.It depends on many things."

Answer 3

"Depending on the drug, it may be as long as 2 years."

Question 4

A 25-year-old patient with cystic fibrosis (CF)tells the home health nurse that he wants to take a nice vacation.What is the best suggestion for the nurse to make?

A) Greece in July
B) Colorado in May
C) New York in November
D) The Mexican coast in August

Question 5

A patient with cystic fibrosis (CF)furiously refuses any more manual chest physiotherapeutic treatment.Which alternative is appropriate for the nurse to suggest?

A) Flutter mucus device
B) Increase ambulation to 1 to 2 hours a day
C) Steam inhalator several times a day
D) Drink 3 quarts of fluid per day

Question 6

Which assessment made by a nurse indicates that respiratory arrest is imminent in a patient with asthma?

A) Agitation
B) Tachycardia
C) Absence of wheezing
D) Flaring nares

Question 7

A patient with asthma asks the purpose of learning how to use a peak expiratory flow rate (PEFR)device.What is the nurse's best response regarding PEFR?

A) Dilates the bronchi to relieve dyspnea
B) Measures expired air to evaluate ventilation
C) Soothes inflamed bronchi, reducing spasm
D) Liquefies sputum for easier expectoration

Question 8

What is a characteristic of chronic obstructive pulmonary disease that places a patient at risk for poor nutrition?

A) Increased metabolism
B) Anxiety
C) Chronic constipation
D) Excessive respiratory effort

Question 9

A patient with TB asks how to protect family members from the disease.Which discharge instruction given by the nurse is most informative?

A) "Your family will need to take treatments to prevent infection."
B) "You will need to wear a mask at home to protect your family members."
C) "You should always cover your mouth and nose if coughing or sneezing."
D) "You should avoid intimate contact with everyone."

Question 10

What is the result of status asthmaticus that is not corrected?

A) Pneumothorax, severe hypoxemia, and respiratory arrest
B) Hypertension, cerebrovascular accident (CVA), and cardiac arrest
C) Respiratory alkalosis, pneumonia, and death
D) Lung abscess, cor pulmonale, and respiratory failure

Question 11

A nurse recognizes that a patient diagnosed with COPD has a rising level of partial pressure of carbon dioxide (CO₂)in arterial blood (PaCO₂).How should the nurse interpret this assessment?

A) More arterial O₂ is available than is needed.
B) The ventilation-perfusion ratio is becoming balanced.
C) Respiratory acidosis has begun.
D) The anticholinergic medications are effective.

Question 12

A nurse is caring for an 80-year-old patient with COPD and suspects right-sided heart failure after assessing and recording the data.What should decrease with right-sided heart failure?

A) Blood pressure
B) Urine output
C) Respirations
D) Heart rate

Question 13

Which nursing intervention enhances the nutritional status of a patient with COPD?

A) Offer small, frequent meals.
B) Encourage extra liquids with meals.
C) Assist the patient to exercise before meals.
D) Supply information about nutrition.

Question 14

A nurse is assigned to care for a patient with the diagnosis of centriacinar (centrilobar)emphysema.What is a characteristic of this type of emphysema?

A) No significant smoking history in the patient
B) Enlarged and broken down bronchioles with intact alveoli
C) Hypoelastic bronchi and bronchioles
D) Deficiency of the enzyme inhibitor alpha₁-antitrypsin.

Question 15

A nurse is providing education to a patient taking rifampin as a result of an exposure to TB.What side effect of this drug should the nurse include?

A) Extreme drowsiness
B) Illness if aged cheese or smoked meats are consumed
C) Body fluids to become red-orange
D) Oral contraceptive pills to become ineffective

Question 16

Which walking program would be the most effective for the nurse to recommend as part of a progressive walking program for an obese patient with COPD?

A) 10 to 15 minutes a day
B) 20 to 30 minutes a day
C) 45 to 60 minutes a day
D) Up to 2 hours a day

Question 17

What should a nurse focus on when assessing for major sources of infection in a patient with COPD?

A) Stasis of respiratory secretions
B) Low body weight
C) Episodes of postural hypotension
D) Delayed antigen-antibody response

Question 18

What should a nurse expect when assessing the CBC results of a patient with chronic bronchitis?

A) Decreased platelets
B) Decreased white blood cells (WBCs)
C) Increased eosinophils
D) Increased red blood cells (RBCs)

Question 19

A nurse is caring for a patient with asthma and assesses signs and symptoms of inadequate oxygenation.Which intervention is the most appropriate?

A) Provide postural drainage.
B) Administer oxygen (O₂)at 8 L/min.
C) Position the patient flat in bed with small pillow.
D) Increase fluid intake.

Question 20

A patient with COPD is observed to have extreme shortness of breath when ambulating.Which nursing intervention is most inappropriate?

A) Bunch all nursing activities and treatments close together.
B) Schedule rest periods during the day.
C) Assist the patient only when needed to encourage independence.
D) Provide daily ambulation to build tolerance.

Question 21

A nurse cautions a group of individuals with COPD that using O₂ at levels greater than 1 to 3 L/min can cause the loss of their _____.

Question 22

What should a patient who had the BCG (Bacillus Calmette-Guérin)vaccine 2 years ago anticipate?

A) False-positive result from TB skin tests
B) Being at risk for contracting TB
C) 3-week prophylactic protocol of rifampin or isoniazid (isonicotinic acid hydrazide [INH])
D) Needing a booster every 2 years

Question 23

A patient with COPD delightedly tells the nurse that he has quit smoking and is using chewing tobacco.What is the most appropriate nursing intervention?

A) Congratulate him on his quitting smoking.
B) Warn him of the dangers of oral cancer.
C) Suggest that he add nicotine patches in addition to the chewing tobacco.
D) Point out that he is still addicted and is using tobacco.

Question 24

A nurse uses a picture to demonstrate the bullae and blebs associated with emphysema.How do blebs differ from bullae? (Select all that apply.)

A) They are between the alveolar spaces in the lungs.
B) They are in the lung parenchyma.
C) They can rupture, causing the lungs to collapse.
D) They are responsible for diaphragm flattening.
E) They are precancerous.

Question 25

What nursing action should be implemented to help combat anorexia in a patient with COPD?

A) Recommend a large meal in the middle of the day.
B) Suggest taking only cold liquid nutritional drinks.
C) Perform oral hygiene before meals.
D) Gently exercise for 10 minutes before a meal.

Question 26

A nurse explains to a family how the asthma attack progresses by using a progressive list of pathologic events._____ (Place the options in the correct sequence.Do not separate answers with a space or punctuation.Example: ABCD.)

A)Bronchoconstriction
B)Ventilation-perfusion mismatch
C)Production of mucous plugs
D)Hypoxemia with compensatory hyperventilation
E)Triggering of inflammatory process

Question 27

A nurse documents and reports the presence of foul, bulky stool in a patient with cystic fibrosis (CF).What does this finding indicate about the patient?

A) Is being adequately maintained on the present dose of pancreatic enzyme
B) Is not adequately digesting food
C) Has diarrhea related to excess mucus in the bowel
D) Has inadequate hydration

Question 28

A newly diagnosed patient with non-small cell lung carcinoma (NSCLC)is anxious about upcoming surgery.Which intervention by the nurse would be most helpful?

A) Support the patient in preparation for surgery.
B) Educate the patient regarding the high survival rate with this type of carcinoma.
C) Assure the patient that chemotherapy and radiation can be used in this sort of cancer.
D) Refer the patient to the American Cancer Society for postdischarge follow-up.