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?

Accepted Answer

Night sweats can be a symptom of tuberculosis, which is more common in individuals with compromised immune systems like those with HIV/AIDS. Therefore, TB screening would be appropriate in this case. The other options - prescribing antibiotics, getting a CBC, or using an aerosol inhalant - do not directly address the cause of the night sweats.

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?

Accepted Answer

While nicotine patches can be helpful in smoking cessation, the success rate is only around 25%. It's important for the nurse to provide accurate information to the patient about the effectiveness of different smoking cessation methods.

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?

Accepted Answer

The length of treatment for TB varies depending on the specific drugs being used, as well as the patient's individual response to treatment. However, TB treatment typically lasts for a minimum of 6 months, and can last up to 2 years in some cases.

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?

Accepted Answer

The answer of A 25-year-old patient with cystic fibrosis (CF)tells...

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?

Accepted Answer

The Flutter mucus device is a handheld device that uses positive expiratory pressure to help loosen and clear mucus from the lungs. It is often recommended as an alternative to manual chest physiotherapy for patients with CF who are unable or unwilling to undergo manual chest physiotherapy. The other options may be helpful in managing CF symptoms, but they do not directly address the need for chest physiotherapy.

Question 6

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

Accepted Answer

The absence of wheezing indicates that air is not moving through the airways, suggesting severe airway obstruction and impending respiratory failure. Agitation, tachycardia, and flaring nares can be signs of respiratory distress but are not necessarily indicative of imminent respiratory arrest.

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?

Accepted Answer

A peak expiratory flow rate (PEFR) device is used to measure the amount of air a patient can forcefully exhale in one breath. PEFR is an important tool for monitoring asthma symptoms and evaluating the effectiveness of treatment. By tracking changes in PEFR over time, patients and healthcare providers can work together to adjust medication dosages and develop an asthma action plan.

Question 8

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

Accepted Answer

Excessive respiratory effort, often seen in patients with chronic obstructive pulmonary disease (COPD), can cause shortness of breath, fatigue, and difficulty eating. These patients may avoid eating to conserve energy and reduce respiratory effort, leading to poor nutrition and unintended weight loss.

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?

Accepted Answer

Option C is the most informative because it provides a specific action that the patient can take to directly reduce the risk of transmitting TB to family members. Covering the mouth and nose when coughing or sneezing can help to minimize the spread of infectious droplets in the air. While options A and D contain some truth, they are not specific enough to be practical instructions. Option B may also be useful in certain situations, but it may not be necessary in all cases and is not as effective as basic respiratory hygiene.

Question 10

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

Accepted Answer

Status asthmaticus is a severe and life-threatening asthma attack that does not respond to standard treatment. If left untreated, it can lead to complications such as pneumothorax (collapsed lung), severe hypoxemia (low oxygen levels in the blood), and respiratory arrest (cessation of breathing). It is important to seek medical attention immediately if experiencing a status asthmaticus episode.

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?

Accepted Answer

A rising level of PaCO2 indicates that the patient is retaining CO2, leading to respiratory acidosis. This can be due to decreased respiratory effort or an ineffective clearance of CO2 from the lungs. It is important for the nurse to notify the healthcare provider and assess for interventions to improve ventilation and decrease PaCO2 levels. Options A, B, and D are not correct interpretations of this assessment.

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?

Accepted Answer

With right-sided heart failure, there is a decrease in cardiac output, which can lead to decreased blood flow to the kidneys and decrease in urine output. Blood pressure may actually increase due to fluid retention, respirations may be increased due to shortness of breath, and heart rate may be variable depending on the response of the body to the decreased cardiac output.

Question 13

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

Accepted Answer

Offering small, frequent meals can help patients with COPD maintain their energy levels and avoid feeling too full to breathe. Large meals can trigger breathlessness and fatigue, so breaking up meals can help reduce these effects.

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?

Accepted Answer

Centriacinar (centrilobar) emphysema is a type of emphysema in which the damage to the lung tissue starts at the bronchioles and spreads outwards to the alveoli. As a result, the bronchioles become enlarged and broken down, but the alveoli remain intact. This type of emphysema is commonly associated with a significant smoking history. Hypoelastic bronchi and bronchioles are observed in chronic bronchitis, another type of COPD. Deficiency of the enzyme inhibitor alpha-1-antitrypsin is associated with panacinar emphysema.

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?

Accepted Answer

Rifampin can cause body fluids, such as urine, sweat, and tears, to become red-orange. This is a harmless side effect and the patient should be advised about this to prevent unnecessary concern. It is important to educate the patient that this discoloration of bodily fluids is not harmful and will go away once they discontinue the medication.

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?

Accepted Answer

Walking for 10 to 15 minutes a day is the most effective for an obese patient with COPD because it is a gradual and safe way to increase activity levels.

Question 17

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

Accepted Answer

Stasis of respiratory secretions is a major source of infection in patients with COPD. As COPD patients have difficulty clearing respiratory secretions, this can lead to a buildup of mucus in the airways, providing an ideal environment for bacterial growth and infection. Low body weight, episodes of postural hypotension, and delayed antigen-antibody response may be issues for patients with COPD, but they are not directly related to major sources of infection.

Question 18

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

Accepted Answer

Chronic bronchitis often leads to hypoxia, which stimulates the production of erythropoietin, thereby increasing the red blood cell (RBC) count as the body attempts to carry more oxygen. This condition is known as secondary polycythemia.

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?

Accepted Answer

The answer of A nurse is caring for a patient...

Question 20

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

Accepted Answer

Bunching all nursing activities and treatments together can cause the patient to become more short of breath and may increase the need for additional interventions. Providing rest periods and encouraging independence with assistance when needed are appropriate interventions. Gradual increases in activity through daily ambulation can also help the patient build tolerance.

Quiz 28: Chronic Lower Respiratory Tract Disorders

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

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

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

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?

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

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

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

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 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?

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

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 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?

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?

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

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

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

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

Quiz 28: Chronic Lower Respiratory Tract Disorders

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

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

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

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?

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

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

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

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 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?

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

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 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?

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?

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

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

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

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

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?