Question 1

The nurse is caring for a Spanish-speaking client admitted for exacerbation of chronic obstructive pulmonary disease (COPD). The client speaks very little English and is a smoker. Which action would be the most beneficial for this client?

Accepted Answer

A)A Spanish-speaking client who smokes and is diagnosed with COPD requires information regarding smoking cessation. For clients who do not speak English, it is appropriate for the nurse to obtain written education material for the client in the client's native language, Spanish. Relatives should not be used as medical interpreters because of the need for knowledge of medical terminology. Encouraging aerobic activity is not an appropriate intervention for a client diagnosed with COPD. Writing down questions might be appropriate for an English-speaking client but will not be appropriate for a Spanish-speaking client being treated in an English-speaking healthcare environment.
B)A Spanish-speaking client who smokes and is diagnosed with COPD requires information regarding smoking cessation. For clients who do not speak English, it is appropriate for the nurse to obtain written education material for the client in the client's native language, Spanish. Relatives should not be used as medical interpreters because of the need for knowledge of medical terminology. Encouraging aerobic activity is not an appropriate intervention for a client diagnosed with COPD. Writing down questions might be appropriate for an English-speaking client but will not be appropriate for a Spanish-speaking client being treated in an English-speaking healthcare environment.
C)A Spanish-speaking client who smokes and is diagnosed with COPD requires information regarding smoking cessation. For clients who do not speak English, it is appropriate for the nurse to obtain written education material for the client in the client's native language, Spanish. Relatives should not be used as medical interpreters because of the need for knowledge of medical terminology. Encouraging aerobic activity is not an appropriate intervention for a client diagnosed with COPD. Writing down questions might be appropriate for an English-speaking client but will not be appropriate for a Spanish-speaking client being treated in an English-speaking healthcare environment.
D)A Spanish-speaking client who smokes and is diagnosed with COPD requires information regarding smoking cessation. For clients who do not speak English, it is appropriate for the nurse to obtain written education material for the client in the client's native language, Spanish. Relatives should not be used as medical interpreters because of the need for knowledge of medical terminology. Encouraging aerobic activity is not an appropriate intervention for a client diagnosed with COPD. Writing down questions might be appropriate for an English-speaking client but will not be appropriate for a Spanish-speaking client being treated in an English-speaking healthcare environment.

Question 2

The nurse is providing care to a client with asthma. When developing the client's plan of care, which intervention would be most appropriate to promote effective gas exchange?

Accepted Answer

A)Placing the client in Fowler position facilitates breathing and lung expansion, promoting effective gas exchange. Providing adequate rest periods prevents fatigue and reduces oxygen demands. Reducing excessive stimuli promotes rest. Assisting with activities of daily living conserves energy and reduces oxygen demands.
B)Placing in Fowler position facilitates breathing and lung expansion, promoting airway clearance. Providing adequate rest periods prevents fatigue and reduces oxygen demands. Reducing excessive stimuli promotes rest. Assisting with activities of daily living conserves energy and reduces oxygen demands.
C)Placing in Fowler position facilitates breathing and lung expansion, promoting airway clearance. Providing adequate rest periods prevents fatigue and reduces oxygen demands. Reducing excessive stimuli promotes rest. Assisting with activities of daily living conserves energy and reduces oxygen demands.
D)Placing in Fowler position facilitates breathing and lung expansion, promoting airway clearance. Providing adequate rest periods prevents fatigue and reduces oxygen demands. Reducing excessive stimuli promotes rest. Assisting with activities of daily living conserves energy and reduces oxygen demands.

Question 3

The nurse is collecting a health history for a 12-month-old child. The child lives in a home where both parents smoke, and the child has had respiratory syncytial virus twice since birth. The child's older sister was recently diagnosed with asthma. The nurse understands that this child's risk of developing asthma later in life is

Accepted Answer

A)Risk factors for asthma include exposure to air pollution, including secondary smoke from cigarettes, and early exposure to respiratory syncytial virus. Genetic factors may also play a role in asthma development. Because of the presence of these risk factors, this child has an above average risk of developing asthma later in life.
B)Risk factors for asthma include exposure to air pollution, including secondary smoke from cigarettes, and early exposure to respiratory syncytial virus. Genetic factors may also play a role in asthma development. Because of the presence of these risk factors, this child has an above average risk of developing asthma later in life.
C)Risk factors for asthma include exposure to air pollution, including secondary smoke from cigarettes, and early exposure to respiratory syncytial virus. Genetic factors may also play a role in asthma development. Because of the presence of these risk factors, this child has an above average risk of developing asthma later in life.
D)Risk factors for asthma include exposure to air pollution, including secondary smoke from cigarettes, and early exposure to respiratory syncytial virus. Genetic factors may also play a role in asthma development. Because of the presence of these risk factors, this child has an above average risk of developing asthma later in life.

Question 4

The nurse is providing care to a client diagnosed with chronic obstructive pulmonary disease (COPD)after years of experiencing emphysema. Which clinical manifestation does the nurse anticipate when assessing this client?

Accepted Answer

A)Barrel chest occurs because the lungs are chronically overinflated with air, so the rib cage stays partially expanded. While coughing, wheezing, and tachycardia may also be experienced by a client diagnosed with COPD, these are not specific to COPD caused by emphysema.
B)Barrel chest occurs because the lungs are chronically overinflated with air, so the rib cage stays partially expanded. While coughing, wheezing, and tachycardia may also be experienced by a client diagnosed with COPD, these are not specific to COPD caused by emphysema.
C)Barrel chest occurs because the lungs are chronically overinflated with air, so the rib cage stays partially expanded. While coughing, wheezing, and tachycardia may also be experienced by a client diagnosed with COPD, these are not specific to COPD caused by emphysema.
D)Barrel chest occurs because the lungs are chronically overinflated with air, so the rib cage stays partially expanded. While coughing, wheezing, and tachycardia may also be experienced by a client diagnosed with COPD, these are not specific to COPD caused by emphysema.

Question 5

The nurse caring for a client diagnosed with chronic obstructive pulmonary disease (COPD)is educating the client on effective coughing techniques. Which statement made by the client indicates a need for further teaching?

Accepted Answer

A)Adequate fluid intake is at least 2-2.5 quarts of fluid daily, so the statement about drinking 1-1.5 quarts daily indicates the need for further teaching. The other statements are accurate so do not indicate a need for further teaching.
B)Adequate fluid intake is at least 2-2.5 quarts of fluid daily, so the statement about drinking 1-1.5 quarts daily indicates the need for further teaching. The other statements are accurate so do not indicate a need for further teaching.
C)Adequate fluid intake is at least 2-2.5 quarts of fluid daily, so the statement about drinking 1-1.5 quarts daily indicates the need for further teaching. The other statements are accurate so do not indicate a need for further teaching.
D)Adequate fluid intake is at least 2-2.5 quarts of fluid daily, so the statement about drinking 1-1.5 quarts daily indicates the need for further teaching. The other statements are accurate so do not indicate a need for further teaching.

Question 6

The nurse is providing care to a client recently diagnosed with chronic obstructive pulmonary disease (COPD). Which conditions will you include when you teach the client's family about the types of COPD?

Accepted Answer

A)Although one or the other may dominate, COPD typically includes components of both chronic bronchitis and emphysema, two distinctly different processes. Asthma and atelectasis are not types of COPD, although asthma is a risk factor for COPD.
B)Although one or the other may dominate, COPD typically includes components of both chronic bronchitis and emphysema, two distinctly different processes. Asthma and atelectasis are not types of COPD, although asthma is a risk factor for COPD.
C)Although one or the other may dominate, COPD typically includes components of both chronic bronchitis and emphysema, two distinctly different processes. Asthma and atelectasis are not types of COPD, although asthma is a risk factor for COPD.
D)Although one or the other may dominate, COPD typically includes components of both chronic bronchitis and emphysema, two distinctly different processes. Asthma and atelectasis are not types of COPD, although asthma is a risk factor for COPD.

Question 7

The nurse is planning care for the client diagnosed with chronic obstructive pulmonary disease (COPD)who has a breathing rate of 32 per minute, elevated blood pressure, and fatigue. Which nursing diagnosis is the priority for this client?

Accepted Answer

A)The client's respiratory rate of 32 per minute is an indication of an ineffective breathing pattern. The elevated blood pressure and fatigue are indications of a compromised respiratory status. The diagnosis of Ineffective Breathing Pattern would be the priority for the client at this time. There is no information to support Ineffective Airway Clearance, as there is no mention that the client is coughing. There is no information to support Anxiety or Ineffective Coping.
B)The client's respiratory rate of 32 per minute is an indication of an ineffective breathing pattern. The elevated blood pressure and fatigue are indications of a compromised respiratory status. The diagnosis of Ineffective Breathing Pattern would be the priority for the client at this time. There is no information to support Ineffective Airway Clearance, as there is no mention that the client is coughing. There is no information to support Anxiety or Ineffective Coping.
C)The client's respiratory rate of 32 per minute is an indication of an ineffective breathing pattern. The elevated blood pressure and fatigue are indications of a compromised respiratory status. The diagnosis of Ineffective Breathing Pattern would be the priority for the client at this time. There is no information to support Ineffective Airway Clearance, as there is no mention that the client is coughing. There is no information to support Anxiety or Ineffective Coping.
D)The client's respiratory rate of 32 per minute is an indication of an ineffective breathing pattern. The elevated blood pressure and fatigue are indications of a compromised respiratory status. The diagnosis of Ineffective Breathing Pattern would be the priority for the client at this time. There is no information to support Ineffective Airway Clearance, as there is no mention that the client is coughing. There is no information to support Anxiety or Ineffective Coping.

Question 8

The nurse is planning care for a client diagnosed with chronic obstructive pulmonary disease (COPD). Which interventions should the nurse select to address the client's ineffective breathing pattern? Select all that apply.

Accepted Answer

A)Techniques used to instruct a client to control the breathing pattern include pursed-lip breathing, abdominal breathing, and relaxation such as visualization and meditation. Providing oxygen 2 liters per nasal cannula will not improve the client's breathing pattern. Deep breathing and coughing should be done every 2 hours to help keep the airway clear and prevent the pooling of secretions, not to control the breathing pattern.
B)Techniques used to instruct a client to control the breathing pattern include pursed-lip breathing, abdominal breathing, and relaxation such as visualization and meditation. Providing oxygen 2 liters per nasal cannula will not improve the client's breathing pattern. Deep breathing and coughing should be done every 2 hours to help keep the airway clear and prevent the pooling of secretions, not to control the breathing pattern.
C)Techniques used to instruct a client to control the breathing pattern include pursed-lip breathing, abdominal breathing, and relaxation such as visualization and meditation. Providing oxygen 2 liters per nasal cannula will not improve the client's breathing pattern. Deep breathing and coughing should be done every 2 hours to help keep the airway clear and prevent the pooling of secretions, not to control the breathing pattern.
D)Techniques used to instruct a client to control the breathing pattern include pursed-lip breathing, abdominal breathing, and relaxation such as visualization and meditation. Providing oxygen 2 liters per nasal cannula will not improve the client's breathing pattern. Deep breathing and coughing should be done every 2 hours to help keep the airway clear and prevent the pooling of secretions, not to control the breathing pattern.
E)Techniques used to instruct a client to control the breathing pattern include pursed-lip breathing, abdominal breathing, and relaxation such as visualization and meditation. Providing oxygen 2 liters per nasal cannula will not improve the client's breathing pattern. Deep breathing and coughing should be done every 2 hours to help keep the airway clear and prevent the pooling of secretions, not to control the breathing pattern.

Question 9

The nurse is assigned to care for a client admitted to the hospital with chronic obstructive pulmonary disease (COPD). Which medication does the nurse anticipate to decrease this client's risk for developing a respiratory infection?

Accepted Answer

A)An influenza vaccine may be ordered to reduce the risk of respiratory infections. A broad-spectrum antibiotic may be prescribed if infection is suspected but would not be ordered to reduce the risk of developing an infection. Bronchodilators and corticosteroid therapy are not used to prevent infections.
B)An influenza vaccine may be ordered to reduce the risk of respiratory infections. A broad-spectrum antibiotic may be prescribed if infection is suspected but would not be ordered to reduce the risk of developing an infection. Bronchodilators and corticosteroid therapy are not used to prevent infections.
C)An influenza vaccine may be ordered to reduce the risk of respiratory infections. A broad-spectrum antibiotic may be prescribed if infection is suspected but would not be ordered to reduce the risk of developing an infection. Bronchodilators and corticosteroid therapy are not used to prevent infections.
D)An influenza vaccine may be ordered to reduce the risk of respiratory infections. A broad-spectrum antibiotic may be prescribed if infection is suspected but would not be ordered to reduce the risk of developing an infection. Bronchodilators and corticosteroid therapy are not used to prevent infections.

Question 10

The nurse is reviewing discharge instructions with a client who is newly diagnosed with asthma. Which client statement indicates a need for further teaching?

Accepted Answer

A)When using two different medications taken by inhalation, the bronchodilator should always be used first. This helps open the airways to enhance the effectiveness of the second medication. The other statements are accurate and require no further education.
B)When using two different medications taken by inhalation, the bronchodilator should always be used first. This helps open the airways to enhance the effectiveness of the second medication. The other statements are accurate and require no further education.
C)When using two different medications taken by inhalation, the bronchodilator should always be used first. This helps open the airways to enhance the effectiveness of the second medication. The other statements are accurate and require no further education.
D)When using two different medications taken by inhalation, the bronchodilator should always be used first. This helps open the airways to enhance the effectiveness of the second medication. The other statements are accurate and require no further education.

Question 11

The nurse is planning care for a client diagnosed with chronic obstructive pulmonary disease (COPD). Which interventions should the nurse select to meet nutritional needs? Select all that apply.

Accepted Answer

A)A diet high in protein and fats without excess carbohydrates is recommended to minimize carbon dioxide production during metabolism. Frequent small meals with between-meal supplements, not three meals with minimal snacking, help maintain intake and reduce fatigue associated with eating.
B)A diet high in protein and fats without excess carbohydrates is recommended to minimize carbon dioxide production during metabolism. Frequent small meals with between-meal supplements, not three meals with minimal snacking, help maintain intake and reduce fatigue associated with eating.
C)A diet high in protein and fats without excess carbohydrates is recommended to minimize carbon dioxide production during metabolism. Frequent small meals with between-meal supplements, not three meals with minimal snacking, help maintain intake and reduce fatigue associated with eating.
D)A diet high in protein and fats without excess carbohydrates is recommended to minimize carbon dioxide production during metabolism. Frequent small meals with between-meal supplements, not three meals with minimal snacking, help maintain intake and reduce fatigue associated with eating.
E)A diet high in protein and fats without excess carbohydrates is recommended to minimize carbon dioxide production during metabolism. Frequent small meals with between-meal supplements, not three meals with minimal snacking, help maintain intake and reduce fatigue associated with eating.

Question 12

The nurse is providing care to a client diagnosed with chronic obstructive pulmonary disease (COPD). Which factors in the client's history support the current diagnosis? Select all that apply.

Accepted Answer

A)Risk factors associated with the development of COPD include working in an industrial environment, a history of asthma, and cigarette smoking. Working in an office setting with air conditioning and playing golf several times a week are not risk factors for the development of COPD.
B)Risk factors associated with the development of COPD include working in an industrial environment, a history of asthma, and cigarette smoking. Working in an office setting with air conditioning and playing golf several times a week are not risk factors for the development of COPD.
C)Risk factors associated with the development of COPD include working in an industrial environment, a history of asthma, and cigarette smoking. Working in an office setting with air conditioning and playing golf several times a week are not risk factors for the development of COPD.
D)Risk factors associated with the development of COPD include working in an industrial environment, a history of asthma, and cigarette smoking. Working in an office setting with air conditioning and playing golf several times a week are not risk factors for the development of COPD.
E)Risk factors associated with the development of COPD include working in an industrial environment, a history of asthma, and cigarette smoking. Working in an office setting with air conditioning and playing golf several times a week are not risk factors for the development of COPD.

Question 13

Which of the following triggers can stimulate an acute asthma attack? Select all that apply.

Accepted Answer

A)Stress, exercise, and animal dander are all known triggers of asthma. Loud noises may trigger hearing loss or headaches, but they will not trigger asthma. Bright lights are also not known to trigger asthma.
B)Stress, exercise, and animal dander are all known triggers of asthma. Loud noises may trigger hearing loss or headaches, but they will not trigger asthma. Bright lights are also not known to trigger asthma.
C)Stress, exercise, and animal dander are all known triggers of asthma. Loud noises may trigger hearing loss or headaches, but they will not trigger asthma. Bright lights are also not known to trigger asthma.
D)Stress, exercise, and animal dander are all known triggers of asthma. Loud noises may trigger hearing loss or headaches, but they will not trigger asthma. Bright lights are also not known to trigger asthma.
E)Stress, exercise, and animal dander are all known triggers of asthma. Loud noises may trigger hearing loss or headaches, but they will not trigger asthma. Bright lights are also not known to trigger asthma.

Question 14

Which assessment finding by the nurse supports the diagnosis that a client is in the early stages of chronic obstructive pulmonary disease (COPD)?

Accepted Answer

A)The earliest-presenting symptom of COPD is coughing in the morning with clear sputum unless the client develops an infection, in which case the sputum would become yellow or green in color. With the progression of COPD, the body compensates by producing extra red blood cells. These extra blood cells clog the small blood vessels of the fingers, leading to the development of cyanotic nail beds and clubbing of the fingertips. Enlargement and thickening of the right ventricle of the heart often results in dysrhythmias.
B)The earliest-presenting symptom of COPD is coughing in the morning with clear sputum unless the client develops an infection, in which case the sputum would become yellow or green in color. With the progression of COPD, the body compensates by producing extra red blood cells. These extra blood cells clog the small blood vessels of the fingers, leading to the development of cyanotic nail beds and clubbing of the fingertips. Enlargement and thickening of the right ventricle of the heart often results in dysrhythmias.
C)The earliest-presenting symptom of COPD is coughing in the morning with clear sputum unless the client develops an infection, in which case the sputum would become yellow or green in color. With the progression of COPD, the body compensates by producing extra red blood cells. These extra blood cells clog the small blood vessels of the fingers, leading to the development of cyanotic nail beds and clubbing of the fingertips. Enlargement and thickening of the right ventricle of the heart often results in dysrhythmias.
D)The earliest-presenting symptom of COPD is coughing in the morning with clear sputum unless the client develops an infection, in which case the sputum would become yellow or green in color. With the progression of COPD, the body compensates by producing extra red blood cells. These extra blood cells clog the small blood vessels of the fingers, leading to the development of cyanotic nail beds and clubbing of the fingertips. Enlargement and thickening of the right ventricle of the heart often results in dysrhythmias.

Question 15

A client diagnosed with chronic obstructive pulmonary disease (COPD)has a pulse oximetry reading of 93%, increased red blood and white blood cell count, temperature of 101°F, pulse 100 bpm, respirations 35 bpm, and a chest x-ray that showed a flattened diaphragm with infiltrates. Based on this data, which order does the nurse question for this client?

Accepted Answer

A)Based on the hypoxic drive theory and the need for hypoxia to stimulate breathing, oxygen saturation for clients with COPD should be between 88% and 92%. Therefore, this client may not require oxygen administration at this time, and oxygen at 3-4 L/min may lead to respiratory depression or respiratory failure. The prescriptions for antibiotics, NSAIDs, and bronchodilators are expected for this client's condition.
B)Based on the hypoxic drive theory and the need for hypoxia to stimulate breathing, oxygen saturation for clients with COPD should be between 88% and 92%. Therefore, this client may not require oxygen administration at this time, and oxygen at 3-4 L/min may lead to respiratory depression or respiratory failure. The prescriptions for antibiotics, NSAIDs, and bronchodilators are expected for this client's condition.
C)Based on the hypoxic drive theory and the need for hypoxia to stimulate breathing, oxygen saturation for clients with COPD should be between 88% and 92%. Therefore, this client may not require oxygen administration at this time, and oxygen at 3-4 L/min may lead to respiratory depression or respiratory failure. The prescriptions for antibiotics, NSAIDs, and bronchodilators are expected for this client's condition.
D)Based on the hypoxic drive theory and the need for hypoxia to stimulate breathing, oxygen saturation for clients with COPD should be between 88% and 92%. Therefore, this client may not require oxygen administration at this time, and oxygen at 3-4 L/min may lead to respiratory depression or respiratory failure. The prescriptions for antibiotics, NSAIDs, and bronchodilators are expected for this client's condition.

Question 16

The pathophysiologic stimulus that initiates asthma is

Accepted Answer

A)In asthma, the airways are in a persistent state of inflammation. This inflammation can lead to bronchoconstriction, airway edema, and increased mucus secretion. Therefore, inflammation is the primary stimulus that initiates asthma.
B)In asthma, the airways are in a persistent state of inflammation. This inflammation can lead to bronchoconstriction, airway edema, and increased mucus secretion. Therefore, inflammation is the primary stimulus that initiates asthma.
C)In asthma, the airways are in a persistent state of inflammation. This inflammation can lead to bronchoconstriction, airway edema, and increased mucus secretion. Therefore, inflammation is the primary stimulus that initiates asthma.
D)In asthma, the airways are in a persistent state of inflammation. This inflammation can lead to bronchoconstriction, airway edema, and increased mucus secretion. Therefore, inflammation is the primary stimulus that initiates asthma.

Question 17

The nurse is caring for a 72-year-old client who has presented to the emergency department for the third time in 8 months with acute asthma exacerbations. The client states that he has trouble holding his inhaler, and sometimes he forgets to take his medication. He is also worried because he thinks his new drugs are adversely interacting with medications for his other conditions. What nursing diagnosis is appropriate for this client?

Accepted Answer

A)Based on his repeated trips to the emergency department, his reported trouble holding his inhaler, and his inconsistency with taking his medications, an appropriate nursing diagnosis for this client is Ineffective Health Management. The client appears to have adequate knowledge about how to cope with his diseases; he is just unable to follow through with managing his medications at all times. Therefore, Deficient Knowledge and Ineffective Coping are not appropriate diagnoses based on this information. Not enough information is provided to determine if the client is at risk for aspiration.
B)Based on his repeated trips to the emergency department, his reported trouble holding his inhaler, and his inconsistency with taking his medications, an appropriate nursing diagnosis for this client is Ineffective Health Management. The client appears to have adequate knowledge about how to cope with his diseases; he is just unable to follow through with managing his medications at all times. Therefore, Deficient Knowledge and Ineffective Coping are not appropriate diagnoses based on this information. Not enough information is provided to determine if the client is at risk for aspiration.
C)Based on his repeated trips to the emergency department, his reported trouble holding his inhaler, and his inconsistency with taking his medications, an appropriate nursing diagnosis for this client is Ineffective Health Management. The client appears to have adequate knowledge about how to cope with his diseases; he is just unable to follow through with managing his medications at all times. Therefore, Deficient Knowledge and Ineffective Coping are not appropriate diagnoses based on this information. Not enough information is provided to determine if the client is at risk for aspiration.
D)Based on his repeated trips to the emergency department, his reported trouble holding his inhaler, and his inconsistency with taking his medications, an appropriate nursing diagnosis for this client is Ineffective Health Management. The client appears to have adequate knowledge about how to cope with his diseases; he is just unable to follow through with managing his medications at all times. Therefore, Deficient Knowledge and Ineffective Coping are not appropriate diagnoses based on this information. Not enough information is provided to determine if the client is at risk for aspiration.

Question 18

The nurse is evaluating care provided to a client diagnosed with chronic obstructive pulmonary disease (COPD). Which observation would indicate that care provided to this client has been effective?

Accepted Answer

A)Evidence that care provided to a client with COPD was successful would be the client conducting morning care and ambulating in the room while maintaining an oxygen saturation of 92%. This outcome identifies the client's ability to maintain adequate oxygenation and perform activities of daily living. The client's leaving the unit to smoke suggests that care has not been effective. The client who needs assistance with morning care and meals because of shortness of breath needs additional interventions. The client who states that his family would prefer he go to a nursing home may or may not have been positively affected by the interventions; not enough information is provided to know.
B)Evidence that care provided to a client with COPD was successful would be the client conducting morning care and ambulating in the room while maintaining an oxygen saturation of 92%. This outcome identifies the client's ability to maintain adequate oxygenation and perform activities of daily living. The client's leaving the unit to smoke suggests that care has not been effective. The client who needs assistance with morning care and meals because of shortness of breath needs additional interventions. The client who states that his family would prefer he go to a nursing home may or may not have been positively affected by the interventions; not enough information is provided to know.
C)Evidence that care provided to a client with COPD was successful would be the client conducting morning care and ambulating in the room while maintaining an oxygen saturation of 92%. This outcome identifies the client's ability to maintain adequate oxygenation and perform activities of daily living. The client's leaving the unit to smoke suggests that care has not been effective. The client who needs assistance with morning care and meals because of shortness of breath needs additional interventions. The client who states that his family would prefer he go to a nursing home may or may not have been positively affected by the interventions; not enough information is provided to know.
D)Evidence that care provided to a client with COPD was successful would be the client conducting morning care and ambulating in the room while maintaining an oxygen saturation of 92%. This outcome identifies the client's ability to maintain adequate oxygenation and perform activities of daily living. The client's leaving the unit to smoke suggests that care has not been effective. The client who needs assistance with morning care and meals because of shortness of breath needs additional interventions. The client who states that his family would prefer he go to a nursing home may or may not have been positively affected by the interventions; not enough information is provided to know.

Question 19

The nurse is planning care for a client diagnosed with chronic obstructive pulmonary disease (COPD). When planning care for this client, which interventions are appropriate to enhance the client's breathing pattern? Select all that apply.

Accepted Answer

A)Providing adequate rest periods and assisting with ADLs prevents fatigue and reduces oxygen demands. Relaxation techniques reduce anxiety and its effect on the respiratory rate. Pursed-lip breathing helps keep airways open by maintaining positive pressure. A cough suppressant is not an appropriate medication for a client with COPD as it is important for the client to expel mucus to maintain adequate oxygenation.
B)Providing adequate rest periods and assisting with ADLs prevents fatigue and reduces oxygen demands. Relaxation techniques reduce anxiety and its effect on the respiratory rate. Pursed-lip breathing helps keep airways open by maintaining positive pressure. A cough suppressant is not an appropriate medication for a client with COPD as it is important for the client to expel mucus to maintain adequate oxygenation.
C)Providing adequate rest periods and assisting with ADLs prevents fatigue and reduces oxygen demands. Relaxation techniques reduce anxiety and its effect on the respiratory rate. Pursed-lip breathing helps keep airways open by maintaining positive pressure. A cough suppressant is not an appropriate medication for a client with COPD as it is important for the client to expel mucus to maintain adequate oxygenation.
D)Providing adequate rest periods and assisting with ADLs prevents fatigue and reduces oxygen demands. Relaxation techniques reduce anxiety and its effect on the respiratory rate. Pursed-lip breathing helps keep airways open by maintaining positive pressure. A cough suppressant is not an appropriate medication for a client with COPD as it is important for the client to expel mucus to maintain adequate oxygenation.
E)Providing adequate rest periods and assisting with ADLs prevents fatigue and reduces oxygen demands. Relaxation techniques reduce anxiety and its effect on the respiratory rate. Pursed-lip breathing helps keep airways open by maintaining positive pressure. A cough suppressant is not an appropriate medication for a client with COPD as it is important for the client to expel mucus to maintain adequate oxygenation.

Question 20

What is one genetic cause of COPD?

Accepted Answer

A)In 1% of cases, COPD is caused by a genetic deficiency in alpha-1 antitrypsin, which is necessary for normal lung development and function. A defect in the CFTR gene causes cystic fibrosis. A mutation in the superoxide dismutase 1 gene causes amyotrophic lateral sclerosis (ALS), a neuromuscular disease that can reduce an individual's ability to control breathing muscles. Certain mutations in the human leukocyte antigen (HLA)allele are associated with increased risk of sarcoidosis, which causes inflammatory cells to collect in the lungs.
B)In 1% of cases, COPD is caused by a genetic deficiency in alpha-1 antitrypsin, which is necessary for normal lung development and function. A defect in the CFTR gene causes cystic fibrosis. A mutation in the superoxide dismutase 1 gene causes amyotrophic lateral sclerosis (ALS), a neuromuscular disease that can reduce an individual's ability to control breathing muscles. Certain mutations in the human leukocyte antigen (HLA)allele are associated with increased risk of sarcoidosis, which causes inflammatory cells to collect in the lungs.
C)In 1% of cases, COPD is caused by a genetic deficiency in alpha-1 antitrypsin, which is necessary for normal lung development and function. A defect in the CFTR gene causes cystic fibrosis. A mutation in the superoxide dismutase 1 gene causes amyotrophic lateral sclerosis (ALS), a neuromuscular disease that can reduce an individual's ability to control breathing muscles. Certain mutations in the human leukocyte antigen (HLA)allele are associated with increased risk of sarcoidosis, which causes inflammatory cells to collect in the lungs.
D)In 1% of cases, COPD is caused by a genetic deficiency in alpha-1 antitrypsin, which is necessary for normal lung development and function. A defect in the CFTR gene causes cystic fibrosis. A mutation in the superoxide dismutase 1 gene causes amyotrophic lateral sclerosis (ALS), a neuromuscular disease that can reduce an individual's ability to control breathing muscles. Certain mutations in the human leukocyte antigen (HLA)allele are associated with increased risk of sarcoidosis, which causes inflammatory cells to collect in the lungs.

Quiz 15: Oxygenation

The nurse is caring for a Spanish-speaking client admitted for exacerbation of chronic obstructive pulmonary disease (COPD) . The client speaks very little English and is a smoker. Which action would be the most beneficial for this client?

The nurse is providing care to a client with asthma. When developing the client's plan of care, which intervention would be most appropriate to promote effective gas exchange?

The nurse is providing care to a client diagnosed with chronic obstructive pulmonary disease (COPD) after years of experiencing emphysema. Which clinical manifestation does the nurse anticipate when assessing this client?

The nurse caring for a client diagnosed with chronic obstructive pulmonary disease (COPD) is educating the client on effective coughing techniques. Which statement made by the client indicates a need for further teaching?

The nurse is providing care to a client recently diagnosed with chronic obstructive pulmonary disease (COPD) . Which conditions will you include when you teach the client's family about the types of COPD?

The nurse is planning care for the client diagnosed with chronic obstructive pulmonary disease (COPD) who has a breathing rate of 32 per minute, elevated blood pressure, and fatigue. Which nursing diagnosis is the priority for this client?

The nurse is planning care for a client diagnosed with chronic obstructive pulmonary disease (COPD) . Which interventions should the nurse select to address the client's ineffective breathing pattern? Select all that apply.

The nurse is assigned to care for a client admitted to the hospital with chronic obstructive pulmonary disease (COPD) . Which medication does the nurse anticipate to decrease this client's risk for developing a respiratory infection?

The nurse is reviewing discharge instructions with a client who is newly diagnosed with asthma. Which client statement indicates a need for further teaching?

The nurse is planning care for a client diagnosed with chronic obstructive pulmonary disease (COPD) . Which interventions should the nurse select to meet nutritional needs? Select all that apply.

The nurse is providing care to a client diagnosed with chronic obstructive pulmonary disease (COPD) . Which factors in the client's history support the current diagnosis? Select all that apply.

Which of the following triggers can stimulate an acute asthma attack? Select all that apply.

Which assessment finding by the nurse supports the diagnosis that a client is in the early stages of chronic obstructive pulmonary disease (COPD) ?

The pathophysiologic stimulus that initiates asthma is

The nurse is evaluating care provided to a client diagnosed with chronic obstructive pulmonary disease (COPD) . Which observation would indicate that care provided to this client has been effective?

The nurse is planning care for a client diagnosed with chronic obstructive pulmonary disease (COPD) . When planning care for this client, which interventions are appropriate to enhance the client's breathing pattern? Select all that apply.

What is one genetic cause of COPD?