Question 1

When developing a teaching plan to help increase activity tolerance at home for a 70-year-old with severe chronic obstructive pulmonary disease ( COPD ) , the nurse should teach the patient that an appropriate exercise goal is to

Accepted Answer

A)   walk until pulse rate exceeds 130.
B)   walk for a total of 20 minutes daily.
C)   exercise until shortness of breath occurs.
D)   limit exercise to activities of daily living ( ADLs ) .E) None of the above
F) C) and D)

Question 2

Which information given by an asthmatic patient while the nurse is doing the admission assessment is most indicative of a need for a change in therapy?

Accepted Answer

A)   The patient uses cromolyn (Intal)  before any aerobic exercise.
B)   The patient says that the asthma symptoms are worse every spring.
C)   The patient's heart rate increases after using the albuterol (Proventil)  inhaler.
D)   The patient's only medications are albuterol (Proventil)  and salmeterol (Serevent) .E) A) and B)
F) All of the above D

Question 3

Which action should the nurse anticipate taking first when a patient who is experiencing an asthma attack develops bradycardia and a decrease in wheezing?

Accepted Answer

A)   Assist with endotracheal intubation.
B)   Document changes in respiratory status.
C)   Encourage the patient to cough and deep breathe.
D)   Administer IV methylprednisolone (SoluMedrol) .E) C) and D)
F) A) and B)

Question 4

After the nurse has completed diet teaching for a patient with chronic obstructive pulmonary disease ( COPD )  who has a body mass index ( BMI )  of 20, which patient statement indicates that the teaching has been effective?

Accepted Answer

A)   "I will drink lots of fluids with my meals."
B)   "I will have ice cream as a snack every day."
C)   "I will exercise for 15 minutes before meals."
D)   "I will decrease my intake of meat or poultry."E) B) and C)
F) A) and C)

Question 5

A patient with chronic obstructive pulmonary disease ( COPD )  is admitted to the hospital. How can the nurse best position the patient to improve gas exchange?

Accepted Answer

A)   Resting in bed with the head elevated to 45 to 60 degrees
B)   Sitting up at the bedside in a chair and leaning slightly forward
C)   Resting in bed in a high-Fowler's position with the knees flexed
D)   In the Trendelenburg position with several pillows behind the headE) B) and C)
F) A) and B)

Question 6

When preparing a patient with possible asthma for pulmonary function testing, the nurse will teach the patient to

Accepted Answer

A)   avoid eating or drinking for several hours before the testing.
B)   use rescue medications immediately before the tests are done.
C)   take oral corticosteroids at least 2 hours before the examination.
D)   withhold bronchodilators for 6 to 12 hours before the examination.E) B) and C)
F) A) and B) D

Question 7

A patient with chronic bronchitis has a nursing diagnosis of impaired breathing pattern related to anxiety. Which nursing action is most appropriate to include in the plan of care?

Accepted Answer

A)   Titrate oxygen to keep saturation at least 90%.
B)   Discuss a high-protein, high-calorie diet with the patient.
C)   Suggest the use of over-the-counter sedative medications.
D)   Teach the patient how to effectively use pursed lip breathing.E) All of the above
F) B) and D)

Question 8

A patient with chronic obstructive pulmonary disease ( COPD )  has rhonchi throughout the lung fields and a chronic, nonproductive cough. Which nursing action will be most effective?

Accepted Answer

A)   Change the oxygen flow rate to the highest prescribed rate.
B)   Reinforce the ongoing use of pursed lip breathing techniques.
C)   Educate the patient to use the Flutter airway clearance device.
D)   Teach the patient about consistent use of inhaled corticosteroids.E) None of the above
F) B) and C)

Question 9

Which action will be included in the plan of care for a 23-year-old with cystic fibrosis (CF)  who is admitted to the hospital with increased dyspnea?

Accepted Answer

A)   Schedule a sweat chloride test.
B)   Arrange for a hospice nurse visit.
C)   Place the patient on a low-sodium diet.
D)   Perform chest physiotherapy every 4 hours.E) A) and D)
F) A) and C)

Question 10

A patient who is hospitalized with cystic fibrosis (CF)  coughs up large quantities of thick green mucus. The nurse will plan to teach the patient about

Accepted Answer

A)   antibiotic resistance.
B)   inhaled bronchodilators.
C)   oral corticosteroid therapy.
D)   aerosolized tobramycin (TOBI) .E) A) and B)
F) A) and C) D

Question 11

A patient with cystic fibrosis (CF)  has blood glucose levels that are consistently 200 to 250 mg/dL. Which nursing action will the nurse plan to implement?

Accepted Answer

A)   Discuss the role of diet in blood glucose control.
B)   Educate the patient about administration of insulin.
C)   Give oral hypoglycemic medications before meals.
D)   Evaluate the patient's home use of pancreatic enzymes.E) B) and C)
F) A) and D)

Question 12

When teaching the patient with chronic obstructive pulmonary disease ( COPD )  about exercise, which information should the nurse include?

Accepted Answer

A)   "Stop exercising if you start to feel short of breath."
B)   "Use the bronchodilator before you start to exercise."
C)   "Breathe in and out through the mouth while you exercise."
D)   "Upper body exercise should be avoided to prevent dyspnea."E) None of the above
F) All of the above

Question 13

A 20-year-old patient with cystic fibrosis (CF)  tells the nurse that she is considering having a child. Which initial response by the nurse is best?

Accepted Answer

A)   "Are you aware of the normal lifespan for patients with CF?"
B)   "Do you need any information to help you with the decision?"
C)   "You will need to have genetic counseling before making a decision."
D)   "Many women with CF do not have difficulty in conceiving children."E) C) and D)
F) B) and D)

Question 14

A patient with severe chronic obstructive pulmonary disease ( COPD )  tells the nurse, "I wish I were dead! I cannot do anything for myself anymore." Based on this information, which nursing diagnosis is most appropriate?

Accepted Answer

A)   Complicated grieving related to expectation of death
B)   Ineffective coping related to unknown outcome of illness
C)   Deficient knowledge related to lack of education about COPD
D)   Chronic low self-esteem related to increased physical dependenceE) A) and B)
F) B) and D)

Question 15

To evaluate the effectiveness of therapy for a patient with cor pulmonale, the nurse will monitor the patient for

Accepted Answer

A)   elevated temperature.
B)   clubbing of the fingers.
C)   jugular vein distention.
D)   complaints of chest pain.E) None of the above
F) A) and D)

Question 16

Which finding by the nurse for a patient with a nursing diagnosis of impaired gas exchange will be most useful in evaluating the effectiveness of treatment?

Accepted Answer

A)   Pulse oximetry reading of 91%
B)   Absence of wheezes or crackles
C)   Decreased use of accessory muscles
D)   Respiratory rate of 22 breaths/minuteE) All of the above
F) C) and D)

Question 17

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

Accepted Answer

A)   keep the air entrainment ports clean and unobstructed.
B)   give a high enough flow rate to keep the bag from collapsing.
C)   use an appropriate adaptor to ensure adequate oxygen delivery.
D)   drain moisture condensation from the oxygen tubing every hour.E) B) and C)
F) A) and B)

Question 18

The nurse has received a change-of-shift report about the following patients with chronic obstructive pulmonary disease ( COPD ) . Which patient should the nurse assess first?

Accepted Answer

A)   A patient with a respiratory rate of 38
B)   A patient with loud expiratory wheezes
C)   A patient with jugular vein distention and peripheral edema
D)   A patient who has a cough productive of thick, green mucusE) A) and C)
F) All of the above

Question 19

Which action by a patient who has asthma indicates a good understanding of the nurse's teaching about peak flow meter use?

Accepted Answer

A)   The patient records an average of three peak flow readings every day.
B)   The patient inhales rapidly through the peak flow meter mouthpiece.
C)   The patient uses the albuterol (Proventil)  metered-dose inhaler (MDI)  for peak flows in the yellow zone.
D)   The patient calls the health care provider when the peak flow is in the green zone.E) None of the above
F) A) and B)

Question 20

Which information will the nurse include when teaching the patient with asthma about the prescribed medications?

Accepted Answer

A)   Utilize the inhaled corticosteroid when shortness of breath occurs.
B)   Inhale slowly and deeply when using the dry-powder inhaler (DPI) .
C)   Hold your breath for 5 seconds after using the bronchodilator inhaler.
D)   Tremors are an expected side effect of rapidly acting bronchodilators.E) All of the above
F) A) and D)

Exam 29: Nursing Management: Obstructive Pulmonary Diseases

When developing a teaching plan to help increase activity tolerance at home for a 70-year-old with severe chronic obstructive pulmonary disease ( COPD ) , the nurse should teach the patient that an appropriate exercise goal is to

Correct AnswerverifiedShow Answer

Which information given by an asthmatic patient while the nurse is doing the admission assessment is most indicative of a need for a change in therapy?

Correct AnswerverifiedD

Which action should the nurse anticipate taking first when a patient who is experiencing an asthma attack develops bradycardia and a decrease in wheezing?

Correct AnswerverifiedShow Answer

After the nurse has completed diet teaching for a patient with chronic obstructive pulmonary disease ( COPD ) who has a body mass index ( BMI ) of 20, which patient statement indicates that the teaching has been effective?

Correct AnswerverifiedShow Answer

A patient with chronic obstructive pulmonary disease ( COPD ) is admitted to the hospital. How can the nurse best position the patient to improve gas exchange?

Correct AnswerverifiedShow Answer

When preparing a patient with possible asthma for pulmonary function testing, the nurse will teach the patient to

Correct AnswerverifiedD

A patient with chronic bronchitis has a nursing diagnosis of impaired breathing pattern related to anxiety. Which nursing action is most appropriate to include in the plan of care?

Correct AnswerverifiedShow Answer

A patient with chronic obstructive pulmonary disease ( COPD ) has rhonchi throughout the lung fields and a chronic, nonproductive cough. Which nursing action will be most effective?

Correct AnswerverifiedShow Answer

Which action will be included in the plan of care for a 23-year-old with cystic fibrosis (CF) who is admitted to the hospital with increased dyspnea?

Correct AnswerverifiedShow Answer

A patient who is hospitalized with cystic fibrosis (CF) coughs up large quantities of thick green mucus. The nurse will plan to teach the patient about

Correct AnswerverifiedD

A patient with cystic fibrosis (CF) has blood glucose levels that are consistently 200 to 250 mg/dL. Which nursing action will the nurse plan to implement?

Correct AnswerverifiedShow Answer

When teaching the patient with chronic obstructive pulmonary disease ( COPD ) about exercise, which information should the nurse include?

Correct AnswerverifiedShow Answer

A 20-year-old patient with cystic fibrosis (CF) tells the nurse that she is considering having a child. Which initial response by the nurse is best?

Correct AnswerverifiedShow Answer

A patient with severe chronic obstructive pulmonary disease ( COPD ) tells the nurse, "I wish I were dead! I cannot do anything for myself anymore." Based on this information, which nursing diagnosis is most appropriate?

Correct AnswerverifiedShow Answer

To evaluate the effectiveness of therapy for a patient with cor pulmonale, the nurse will monitor the patient for

Correct AnswerverifiedShow Answer

Which finding by the nurse for a patient with a nursing diagnosis of impaired gas exchange will be most useful in evaluating the effectiveness of treatment?

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

The nurse has received a change-of-shift report about the following patients with chronic obstructive pulmonary disease ( COPD ) . Which patient should the nurse assess first?

Correct AnswerverifiedShow Answer

Which action by a patient who has asthma indicates a good understanding of the nurse's teaching about peak flow meter use?

Correct AnswerverifiedShow Answer

Which information will the nurse include when teaching the patient with asthma about the prescribed medications?

Correct AnswerverifiedShow Answer

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