Question 1

The nurse is assessing a client diagnosed with asthma. The client's breath sounds initially had wheezing but are diminishing until no audible sounds are heard. This has occurred because:

Accepted Answer

When wheezing diminishes until no audible sounds are heard in an asthma patient, it often indicates that swelling has increased to the point where airways are significantly blocked. This reduction in airway diameter can lead to a decrease or absence of airflow, making breath sounds difficult or impossible to hear, signaling a potentially severe obstruction and a need for immediate medical intervention.

Question 2

A client has been diagnosed with chronic obstructive pulmonary disease. Which of the following nursing diagnoses would be the most important at this time?

Accepted Answer

Impaired gas exchange would be the most important nursing diagnosis to address in a client with COPD as this is a primary complication of the disease and can lead to serious respiratory distress and hypoxemia. While the other options may also be relevant, addressing impaired gas exchange takes priority in this situation.

Question 3

A client is experiencing a sudden onset of headache, nausea, cough, fever, myalgia, and fatigue. The nurse suspects this client is experiencing:

Accepted Answer

The sudden onset of symptoms such as headache, nausea, cough, fever, myalgia, and fatigue are all typical symptoms of seasonal influenza. None of the other options would present with all of these symptoms together.

Question 4

The nurse suspects a client is experiencing chronic obstructive pulmonary disease when which of the following is assessed? (Select all that apply.)

Accepted Answer

Chronic obstructive pulmonary disease (COPD) is characterized by breathing difficulties due to narrowed airways and excessive mucus production. Dyspnea on exertion, sputum production, and cough are common symptoms of COPD. Peripheral edema, jugular vein distention, and high blood pressure are associated with other medical conditions and are not typically associated with COPD.

Question 5

The nurse is caring for a client who has completed pulmonary function testing. Which of the following indicates the amount of air inhaled or exhaled with each breath during normal breathing?

Accepted Answer

Tidal volume is the amount of air inhaled or exhaled with each breath during normal breathing.

Question 6

A client diagnosed with chronic obstructive pulmonary disease has the complication of cor pulmonale. Which of the following instructions will be included in the client's discharge teaching?

Accepted Answer

Cor pulmonale is a complication of chronic obstructive pulmonary disease that causes right-sided heart failure. One of the symptoms can be fluid retention, leading to weight gain. Therefore, it is important for the client to weigh themselves daily and report a weight gain of 2 pounds or more to their physician. A higher oxygen level may be necessary during exertion, but it should not be adjusted without consulting a healthcare provider. Increasing sodium in the diet and maintaining bed rest are not recommended for clients with cor pulmonale.

Question 7

The parents of a child diagnosed with cystic fibrosis ask the nurse how their child developed the disease. Which of the following should the nurse explain to these parents?

Accepted Answer

Cystic fibrosis is an autosomal recessive disorder, which means a child must inherit two copies of the defective gene (one from each parent) to develop the disease.

Question 8

A client is being treated for exacerbation of chronic obstructive pulmonary disease. Which of the following nursing interventions will the nurse expect to be completed?

Accepted Answer

Oxygen therapy is necessary to improve oxygenation in clients with COPD exacerbation. Limiting fluids is not a necessary intervention and may even be harmful. Respiratory isolation is typically not necessary unless the client has a contagious respiratory infection. Scheduling activities at one time may be helpful for energy conservation, but it is not a specific intervention for COPD exacerbation.

Question 9

A client states, "I don't know why I should quit smoking. It can't improve anything." The nurse responds by informing the client about the decrease in lung cancer rates over time after a person quits smoking. Which of the following is correct?

Accepted Answer

The lung cancer rate for a person who quits smoking approaches that of a nonsmoker approximately 10 years after quitting. This significant reduction over time highlights the long-term health benefits of quitting smoking.

Question 10

A client is diagnosed with stage I mild, chronic obstructive pulmonary disease. Which of the following assessment findings will support this diagnosis? (Select all that apply.)

Accepted Answer

Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitations, which can be mild or severe. Forced expiratory volume in 1 second (FEV1) greater than 80% and mild airflow limitations are indicative of stage I (mild) COPD. Chronic cough and sputum production are common in COPD but do not necessarily determine the stage of the disease. Extreme dyspnea on exertion and right-sided heart failure are more characteristic of advanced COPD stages.

Question 11

A client diagnosed with asthma is having an acute episode at home. Which of the following medications should the client be instructed not to use during this episode?

Accepted Answer

Serevent should not be used during an acute asthma episode as it is a long-acting bronchodilator and may not provide immediate relief of symptoms. Instead, short-acting bronchodilators like Albuterol, Proventil, and Ventolin are recommended for acute asthma episodes.

Question 12

A client is being admitted with the diagnosis of asthma. To facilitate breathing, in what position would the nurse place the client?

Accepted Answer

The most appropriate position for a client with asthma is high-Fowler's position, which is sitting up with the head of the bed elevated at a 90-degree angle. This position helps to expand the chest and improve breathing. Lateral, prone, and supine positions would not be ideal for a client with asthma.

Question 13

The nurse is to collect a stool specimen from a client diagnosed with cystic fibrosis. The nurse would expect to see:

Accepted Answer

Clients with cystic fibrosis may have bulky, foul-smelling stool due to malabsorption and poor digestion. This can be caused by the pancreas not producing enough digestive enzymes. Other symptoms may include difficulty gaining weight and frequent respiratory infections. Black, tarry stool is associated with upper gastrointestinal bleeding, clay-colored stool may indicate a problem with the liver or bile ducts, and green stool may be caused by a high intake of leafy greens or certain medications.

Question 14

The nurse is caring for a client diagnosed with cystic fibrosis. Which of the following medications does the nurse realize are commonly used to help treat this disorder? (Select all that apply.)

Accepted Answer

N-acetylcysteine is a mucolytic agent that helps to break up thick respiratory secretions in cystic fibrosis. Dornase alfa is a medication that aids in breaking down the DNA content of mucus, also aiding in secretion clearance. Ibuprofen is suggested to help slow the progression of lung disease in patients with cystic fibrosis by reducing inflammation. Acetaminophen, furosemide, and digitalis are not commonly used to treat cystic fibrosis.

Question 15

A client diagnosed with asthma is receiving instructions about the use of albuterol. The client should be aware that albuterol may cause:

Accepted Answer

Albuterol is a bronchodilator medication that can stimulate the nervous system and lead to nervousness or restlessness as potential side effects. It does not typically cause bradycardia, drowsiness, or nasal congestion.

Question 16

The nurse is caring for a client diagnosed with chronic obstructive pulmonary disease. Which of the following interventions require extra care by the nurse?

Accepted Answer

Administering pain medications to a client with chronic obstructive pulmonary disease (COPD) requires extra care because certain pain medications, especially opioids, can depress the respiratory drive. This can exacerbate respiratory difficulties in clients with COPD by reducing their respiratory rate and depth, leading to increased carbon dioxide retention and potential respiratory failure.

Question 17

A client diagnosed with chronic obstructive pulmonary disease is scheduled for diagnostic tests. Which of the following are used to aid in the diagnosis of this disorder? (Select all that apply.)

Accepted Answer

The answer of A client diagnosed with chronic obstructive pulmonary...

Question 18

A client has been smoking for the last 40 years and has a history of emphysema. Which of the following findings would the nurse not expect to find?

Accepted Answer

Emphysema is a progressive lung disease that causes destruction of the alveolar walls, resulting in decreased gas exchange and increased air trapping. This leads to decreased FVC and increased anterior-posterior chest diameter due to hyperinflation of the lungs. Pursed lip breathing is a compensatory mechanism to decrease airway resistance and maintain oxygenation. However, increased FEV1 may not be expected as it reflects the amount of air that can be forcibly exhaled in one second, and in emphysema, this is often decreased due to airway obstruction.

Quiz 33: Obstructive Pulmonary Disease: Nursing Management