Question 1

All of the following orders are received for a patient having an acute asthma attack.Which one will the nurse administer first?

Accepted Answer

Albuterol (Ventolin) 2.5 mg per nebulizer is the first medication that should be administered during an acute asthma attack as it is a short-acting bronchodilator that can quickly open up the airways and improve breathing. The other medications listed are also important treatments for asthma, but they are not as immediate or fast-acting as albuterol.

Question 2

A 19-year-old male with CF and his wife are considering having a child.In counselling the patient and his wife,the nurse determines their knowledge of the situation by asking them for which following information?

Accepted Answer

Cystic fibrosis (CF) can cause male infertility due to blockage of the vas deferens, making it likely that the patient is sterile. This is a critical consideration for couples wanting to conceive naturally.

Question 3

In planning care for the patient with cystic fibrosis (CF),the nurse understands that which of the following interventions is the most important therapeutic approach to promote pulmonary function in the patient?

Accepted Answer

Chest physiotherapy every 4 hours to mobilize secretions is the most important therapeutic approach to promote pulmonary function in patients with cystic fibrosis. This therapy helps to clear the airways of mucus and secretions, which can reduce the risk of infection, improve breathing, and prevent complications such as pneumonia and bronchitis. While bronchodilators can help to open up the airways, maintenance of prophylactic antibiotics can help prevent infections, and administration of continuous low-flow oxygen can help support breathing, chest physiotherapy is the most effective intervention for promoting pulmonary function in patients with CF.

Question 4

What grade of dyspnea would the nurse document when a patient with COPD walks slower than his peers of the same age and needs to stop for breath when walking at his own pace on a flat surface?

Accepted Answer

The answer of What grade of dyspnea would the nurse...

Question 5

To promote healthy coping in the patient with COPD,what should the nurse do?

Accepted Answer

Teaching the patient relaxation techniques and other alternative therapies can help them manage stress and anxiety, which are important aspects of coping with COPD.

Question 6

Which information given by an asthmatic patient during the admission assessment will be of most concern to the nurse?

Accepted Answer

The patient's reliance solely on albuterol (a short-acting beta-agonist) and salmeterol (a long-acting beta-agonist) without any anti-inflammatory medication (like inhaled corticosteroids) for asthma management is concerning. Proper asthma management typically includes both bronchodilators and anti-inflammatory medications to control symptoms and prevent exacerbations.

Question 7

The nurse has completed teaching a patient about MDI use.Which statement by the patient indicates to the nurse that further patient teaching is needed?

Accepted Answer

Shaking the MDI (Metered Dose Inhaler) to check for fullness is not a recommended method to determine how much medication is left. MDIs have counters for this purpose. Shaking does not accurately indicate the amount of medication remaining.

Question 8

When taking an admission history of a patient with COPD who has new-onset wheezing and shortness of breath,the nurse will be most concerned about which information?

Accepted Answer

Propranolol is a beta-blocker, which can worsen asthma symptoms and cause bronchospasm in patients with COPD. The nurse should be concerned about this medication and notify the provider for a possible alternative. The other information provided is not directly related to the patient's current respiratory symptoms.

Question 9

When evaluating a patient's oral intake,the nurse knows that which fluid intake would be considered adequate for the patient with COPD?

Accepted Answer

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Question 10

When teaching the patient with COPD about exercise,which information should the nurse include?

Accepted Answer

Using a bronchodilator before exercising can help open up the airways and make breathing easier for patients with COPD. Option A is incorrect as patients should push themselves to exercise but at a comfortable pace. Option C is incorrect as patients should breathe in through the nose and out through pursed lips to help control breathing. Option D is incorrect as upper body exercises are actually beneficial for patients with COPD as they help improve muscle strength and endurance for activities of daily living.

Question 11

A patient is receiving 35% oxygen via a Venturi mask.To ensure the correct amount of oxygen delivery,what is it most important for the nurse to do?

Accepted Answer

Keeping the air entrainment ports clean and unobstructed is essential in ensuring the correct amount of oxygen delivery with a Venturi mask. The air entrainment ports regulate the amount of air that mixes with the oxygen, which determines the concentration of oxygen delivered to the patient. If the ports are clogged, the concentration of oxygen delivered may not be accurate. Additionally, proper cleaning and maintenance of the mask and tubing can prevent infection and ensure proper function. The other options (B, C, and D) are not necessary for ensuring the correct amount of oxygen delivery with a Venturi mask.

Question 12

When teaching a patient about the various methods of oxygen administration,the nurse tells the patient that,with high flow rates,pain may develop in the frontal sinuses as a result of which of the following methods?

Accepted Answer

High flow rates through a nasal cannula can cause drying and irritation of the nasal mucosa, leading to discomfort or pain in the frontal sinuses due to the direct airflow.

Question 13

When caring for a patient with CF,the nurse recognizes that the manifestations of the disease are caused by which of the following pathophysiological processes?

Accepted Answer

CF is a genetic disorder characterized by altered function of exocrine glands, leading to an abnormal production of thick, viscous secretions in various organs, including the lungs, pancreas, and liver. This abnormal mucus buildup can clog airways and cause inflammation and infection in the lungs, leading to respiratory distress and recurrent pulmonary infections.

Question 14

A patient with severe COPD tells the nurse he wishes he would die because he is so disabled with his disease that he just cannot do anything for himself.Based on this information,the nurse identifies which of the following nursing diagnoses?

Accepted Answer

The patient's statement suggests that he is experiencing depression related to physical and psychological dependence, as he feels disabled and unable to do anything for himself. The other options do not accurately reflect the patient's current situation.

Question 15

When teaching a patient about continuous home oxygen use,the nurse tells the patient that evaporation of the oxygen accelerates during which season,and they should take extra care to ensure that they do not run out of oxygen?

Accepted Answer

During the summer, higher temperatures can increase the rate of oxygen evaporation in home oxygen systems, making it more likely for patients to run out of oxygen if they are not monitoring their supply closely.

Question 16

What is the best nursing action when a patient with COPD is receiving oxygen?

Accepted Answer

The answer of What is the best nursing action when...

Question 17

A patient with COPD is admitted to the hospital.How can the nurse best position the patient to improve gas exchange?

Accepted Answer

Patients with COPD improve the mechanics of breathing by sitting up in the "tripod" position. Resting in bed with the head elevated would be an alternative position if the patient was confined to bed, but sitting in a chair allows better ventilation. The Trendelenburg's position or sitting upright in bed with the knees flexed would decrease the patient's ability to ventilate well.

Question 18

A patient has been receiving oxygen per nasal cannula during her hospitalization for emphysema.She asks the nurse whether she will have to use oxygen at home.What should the nurse tell the patient about long-term home oxygen therapy?

Accepted Answer

Long-term home oxygen therapy has been shown to improve survival and quality of life for patients with chronic respiratory failure, including those with emphysema/COPD. It is not contraindicated in these patients and should be prescribed by a healthcare provider based on clinical assessment and tests. Nighttime use may be necessary for some patients and can be monitored using pulse oximetry.

Question 19

Which following statement by the patient with COPD indicates that the nurse's teaching about nutrition has been effective?

Accepted Answer

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Question 20

A 70-year-old patient is recovering from an acute episode of COPD.In planning with the patient to increase his activity tolerance at home,which of the following activities does the nurse understand is an appropriate exercise goal for the patient?

Accepted Answer

Walking for 20 minutes a day with a pulse rate less than 150 beats/min is a safe and appropriate exercise goal for a patient recovering from COPD, as it helps improve cardiovascular fitness without overexerting the patient.

Quiz 31: Nursing Management: Obstructive Pulmonary Diseases