Question 1

A patient with lung cancer who is scheduled to begin a course of radiation therapy asks the nurse,"How will they know if I'm cured?" The nurse's best response is based on which understanding of the disease process?

Accepted Answer

Radiation may be used to shrink a tumor to reduce symptoms in patients who are unable to undergo surgery.D.It generally is not curative,and it will not reduce inflammation.A.B.Lung cancer is curable in some cases but not usually with radiation alone.

Question 2

A summer camp worker reports to the camp nurse with complaints of shortness of breath and audible wheezing.Which inhaled medication should the nurse provide?

Accepted Answer

Albuterol is an adrenergic bronchodilator and would be used to help immediately relieve acute bronchospasm.B.D.Cromolyn and nedocromil are mast cell inhibitors.C.Triamcinolone is a corticosteroid.

Question 3

The nurse is providing routine follow-up care for a young adult with asthma who has been on a 3-month course of maintenance therapy.Which activity would best help the nurse to determine if the patient's treatment plan was effective?

Accepted Answer

Many patients with asthma monitor their peak expiratory flow rate at home.This is a measure of the amount of air the patient can blow into a peak flowmeter from fully inflated lungs and is measured in liters per minute.Daily tracking records will indicate respiratory status over time.C.An incentive spirometer encourages deep breathing; correct use will not help evaluate asthmatic control.B.Current pulse oximetry will only provide a measure of current oxygenation and will not indicate long-term efficacy of the treatment plan.A.ABGs may be helpful in severe cases but are invasive and not routine and will only give a current measurement.

Question 4

A patient's arterial blood gas analysis shows a PaCO₂ of 62 mm Hg.What action should the nurse take?

Accepted Answer

Normal PaCO₂ is 35 to 45 mm Hg.62 mm Hg is evidence of hypoventilation and the inability to excrete carbon dioxide.The RN or physician should be notified.C.Increasing nasal oxygen will not help CO₂ excretion.B.Breathing into a paper bag will increase the CO₂ level.D.This is not a normal level and action must be taken immediately.

Question 5

A patient is admitted to a respiratory unit with a diagnosis of left lower lobe pneumonia.The nursing assessment reveals the patient to be febrile and experiencing a weak,congested-sounding cough.The patient has moist crackles throughout the lung fields.Based on the data provided,which nursing diagnosis is most appropriate?

Accepted Answer

Data point to excessive secretions that the patient is not completely coughing up,so Ineffective Airway Clearance is the best choice.A.B.C.Although they may be concerns with pneumonia,there is no evidence of anxiety,impaired gas exchange,or ineffective breathing pattern.

Question 6

A patient is unable to maintain a clear airway effectively with coughing and has a respiratory rate of 22/min with coarse crackles bilaterally.Which intervention should the nurse provide first?

Accepted Answer

Assessment is the first step before providing care,and effective coughing is important to clear the airway.A.Fluids may be helpful once assessment is complete.B.Bedrest will reduce mobilization of secretions.C.Suctioning is only necessary in patients who are unable to cough.

Question 7

While reinforcing discharge teaching for a patient with emphysema,which patient statement indicates that teaching was effective?

Accepted Answer

Emphysema affects the alveolar membranes,causing destruction of the alveolar walls,loss of elastic recoil,and air trapping.B.Smooth muscle spasm is associated with asthma.C.Inflammation and mucus production are associated with chronic bronchitis.A.Walled-off bacteria are characteristic of tuberculosis (TB).

Question 8

A patient diagnosed with a pleural effusion is very dyspneic.With which procedure should the nurse anticipate assisting?

Accepted Answer

Thoracentesis can be done by the physician to remove some of the fluid that has collected and is compressing lung tissue.A.Tracheostomy creates a stoma for the placement of an artificial airway.C.Bronchoscopy visualizes the major airways with an endoscope.D.Pericardiocentesis removes fluid from around the heart.

Question 9

The nurse is caring for a patient with pneumonia.Which laboratory test would best help the nurse to monitor the condition of this patient?

Accepted Answer

WBC is elevated in infection,and ABGs may be abnormal if gas exchange is impaired with pneumonia.CBC may be helpful,but WBC is more specific.A.B.Urinalysis,electrolytes,and creatinine are useful in kidney and bladder problems.C.PTT and potassium may be ordered for cardiovascular problems,among other disorders.

Question 10

The nurse is providing care for a patient prescribed tiotropium (Spiriva).Which statement should be included in the patient education?

Accepted Answer

Tiotropium (Spiriva)is a capsule that is placed in a device and activated before inhalation.The patient should be instructed to not swallow the capsules.B.This medication does not cause blurred vision and anorexia.C.Abdominal pain and bloating is not associated with this medication.D.A headache and sensitivity to light are not adverse effects of this medication.

Question 11

The nurse enters the room of a patient who is acutely short of breath.Which action should the nurse take first?

Accepted Answer

Pursed-lip breathing can help open alveoli and promote excretion of carbon dioxide.A.Fowler's,not Sims',position will help lung expansion.C.Asking the patient the cause is appropriate after the dyspnea is resolved.D.Accessory muscle use is a sign of respiratory distress,not a therapeutic measure.

Question 12

The nurse is providing discharge teaching for a patient with newly diagnosed asthma.What should be included in the discharge teaching?

Accepted Answer

Asthma is characterized by inflammation of the mucosal lining of the bronchial tree and spasm of the bronchial smooth muscles (bronchospasm).A.Alveoli are not generally affected in asthma.C.Some sputum may be present,but purulent sputum suggests infection,not asthma.D.Noncompliance of the chest wall occurs in restrictive,not obstructive,disorders.

Question 13

The nurse is caring for a patient with end-stage chronic obstructive pulmonary disease.Which medication can help reduce acute dyspnea associated with this disease?

Accepted Answer

IV morphine helps acute dyspnea and anxiety in patients with end-stage disease.A.Cortisone may reduce inflammation,but the oral route is too slow for acute dyspnea.D.Meperidine has not been shown to reduce dyspnea.C.Propranolol is a beta blocker and may aggravate bronchoconstriction.

Question 14

A patient with chronic obstructive pulmonary disease works with the nurse to set a goal of ambulating to the bathroom with oxygen.Which statement best documents progress toward this goal?

Accepted Answer

"Ambulated to bathroom with oxygen,dyspnea level 3 on a 0-to-10 scale" directly addresses the goal.A.B.C.Normal arterial blood gases (ABGs),controlled dyspnea,and being assisted to the bathroom are all good outcomes,but they do not directly address the goal.

Question 15

A nurse is providing home care for a patient with chronic obstructive pulmonary disease (COPD).Which order should the nurse question?

Accepted Answer

Oxygen is generally ordered at a flow rate of 1 to 2 L/min for patients with chronic lung disease.Higher flow rates may suppress the hypoxic drive in patients who are chronic CO₂ retainers.B.D.Tiotropium and increasing activity as tolerated are common orders in COPD.A.A low-sodium diet is not contraindicated.

Question 16

A patient with chronic obstructive pulmonary disease is prescribed methylprednisolone (Solu-Medrol).For what reason should the nurse realize that corticosteroids are used in the treatment of this health problem?

Accepted Answer

Corticosteroids are potent anti-inflammatory agents.A.B.They do not dry secretions,and they may cause infection to worsen.C.They do not directly affect oxygenation.

Question 17

A patient with cystic fibrosis has ineffective airway clearance.What intervention would worsen this problem?

Accepted Answer

Movement helps mobilize secretions,so bedrest is not helpful.A.C.D.Percussion,postural drainage,fluids,and mucolytics will all help clear the airway.

Question 18

The nurse is reviewing data collected on a patient with a respiratory disorder.Which factor should the nurse identify that places the patient at risk for lung cancer?

Accepted Answer

Smoking is the biggest risk factor for lung cancer.Radon exposure is also a significant factor.B.C.D.Living in a cold climate,having pets,eating foods high in beta carotene and fiber,living in crowded conditions,and lack of sunlight are not identified risk factors for the development of lung cancer.

Question 19

A patient with lung cancer develops pleural effusion.Which explanation by the nurse would help the patient understand this problem?

Accepted Answer

When excess fluid collects in the pleural space,it is called a pleural effusion.Fluid normally enters the pleural space from surrounding capillaries and is reabsorbed by the lymphatic system.When a pathological condition causes an increase in fluid production or inadequate reabsorption of fluid,excess fluid collects.A.B.D.The fluid is not in the airways or alveoli or around the heart.

Question 20

A patient prescribed theophylline for asthma has a theophylline level of 3 mcg/dL.What should the nurse do?

Accepted Answer

A therapeutic theophylline level is 10 to 20 mcg/mL.The physician should be notified.D.Holding the next dose will further lower the level.B.Doubling the dose is inappropriate without a physician's order.
C.This is not a therapeutic level and action is necessary.

Quiz 31: Nursing Care of Patients With Lower Respiratory Tract Disorders

A patient with lung cancer who is scheduled to begin a course of radiation therapy asks the nurse,"How will they know if I'm cured?" The nurse's best response is based on which understanding of the disease process?

A summer camp worker reports to the camp nurse with complaints of shortness of breath and audible wheezing.Which inhaled medication should the nurse provide?

The nurse is providing routine follow-up care for a young adult with asthma who has been on a 3-month course of maintenance therapy.Which activity would best help the nurse to determine if the patient's treatment plan was effective?

A patient's arterial blood gas analysis shows a PaCO₂ of 62 mm Hg.What action should the nurse take?

A patient is unable to maintain a clear airway effectively with coughing and has a respiratory rate of 22/min with coarse crackles bilaterally.Which intervention should the nurse provide first?

While reinforcing discharge teaching for a patient with emphysema,which patient statement indicates that teaching was effective?

A patient diagnosed with a pleural effusion is very dyspneic.With which procedure should the nurse anticipate assisting?

The nurse is caring for a patient with pneumonia.Which laboratory test would best help the nurse to monitor the condition of this patient?

The nurse is providing care for a patient prescribed tiotropium (Spiriva) .Which statement should be included in the patient education?

The nurse enters the room of a patient who is acutely short of breath.Which action should the nurse take first?

The nurse is providing discharge teaching for a patient with newly diagnosed asthma.What should be included in the discharge teaching?

The nurse is caring for a patient with end-stage chronic obstructive pulmonary disease.Which medication can help reduce acute dyspnea associated with this disease?

A patient with chronic obstructive pulmonary disease works with the nurse to set a goal of ambulating to the bathroom with oxygen.Which statement best documents progress toward this goal?

A nurse is providing home care for a patient with chronic obstructive pulmonary disease (COPD) .Which order should the nurse question?

A patient with chronic obstructive pulmonary disease is prescribed methylprednisolone (Solu-Medrol) .For what reason should the nurse realize that corticosteroids are used in the treatment of this health problem?

A patient with cystic fibrosis has ineffective airway clearance.What intervention would worsen this problem?

The nurse is reviewing data collected on a patient with a respiratory disorder.Which factor should the nurse identify that places the patient at risk for lung cancer?

A patient with lung cancer develops pleural effusion.Which explanation by the nurse would help the patient understand this problem?

A patient prescribed theophylline for asthma has a theophylline level of 3 mcg/dL.What should the nurse do?

Quiz 31: Nursing Care of Patients With Lower Respiratory Tract Disorders

A patient with lung cancer who is scheduled to begin a course of radiation therapy asks the nurse,"How will they know if I'm cured?" The nurse's best response is based on which understanding of the disease process?

A summer camp worker reports to the camp nurse with complaints of shortness of breath and audible wheezing.Which inhaled medication should the nurse provide?

The nurse is providing routine follow-up care for a young adult with asthma who has been on a 3-month course of maintenance therapy.Which activity would best help the nurse to determine if the patient's treatment plan was effective?

A patient's arterial blood gas analysis shows a PaCO2 of 62 mm Hg.What action should the nurse take?

A patient is unable to maintain a clear airway effectively with coughing and has a respiratory rate of 22/min with coarse crackles bilaterally.Which intervention should the nurse provide first?

While reinforcing discharge teaching for a patient with emphysema,which patient statement indicates that teaching was effective?

A patient diagnosed with a pleural effusion is very dyspneic.With which procedure should the nurse anticipate assisting?

The nurse is caring for a patient with pneumonia.Which laboratory test would best help the nurse to monitor the condition of this patient?

The nurse is providing care for a patient prescribed tiotropium (Spiriva) .Which statement should be included in the patient education?

The nurse enters the room of a patient who is acutely short of breath.Which action should the nurse take first?

The nurse is providing discharge teaching for a patient with newly diagnosed asthma.What should be included in the discharge teaching?

The nurse is caring for a patient with end-stage chronic obstructive pulmonary disease.Which medication can help reduce acute dyspnea associated with this disease?

A patient with chronic obstructive pulmonary disease works with the nurse to set a goal of ambulating to the bathroom with oxygen.Which statement best documents progress toward this goal?

A nurse is providing home care for a patient with chronic obstructive pulmonary disease (COPD) .Which order should the nurse question?

A patient with chronic obstructive pulmonary disease is prescribed methylprednisolone (Solu-Medrol) .For what reason should the nurse realize that corticosteroids are used in the treatment of this health problem?

A patient with cystic fibrosis has ineffective airway clearance.What intervention would worsen this problem?

The nurse is reviewing data collected on a patient with a respiratory disorder.Which factor should the nurse identify that places the patient at risk for lung cancer?

A patient with lung cancer develops pleural effusion.Which explanation by the nurse would help the patient understand this problem?

A patient prescribed theophylline for asthma has a theophylline level of 3 mcg/dL.What should the nurse do?

A patient's arterial blood gas analysis shows a PaCO₂ of 62 mm Hg.What action should the nurse take?