Chapter 20: Management of Patients with Chronic Pulmonary
Disease
1 Which of the following is the key underlying feature of asthma?
Inflammation
2 A nurse consulting with a nutrition specialist knows it's
important to consider a special diet for a client with chronic
obstructive pulmonary disease (COPD). Which diet is appropriate for this
client? High-protein
3 What is histamine, a mediator that supports the inflammatory process
in asthma, secreted by? Mast cells
4 A nurse administers albuterol (Proventil), as ordered, to a client with
emphysema. Which finding indicates that the drug is producing a therapeutic
effect?
Respiratory rate of 22 breaths/minute
5 Which of the following is not a primary symptom of COPD?
Weight gain
6 A junior-level nursing class has just finished learning about the
management of clients with chronic pulmonary diseases. They learned that a
new definition of COPD leaves only one type of disorder within its
classification. Which of the following is part of that disorder?
Emphysema
7 A client with bronchiectasis is admitted to the nursing unit. The primary
focus of nursing care for this client includes
implementing measures to clear pulmonary secretions.
8 The nurse has instructed the client to use a peak flow meter. The nurse
evaluates client learning as satisfactory when the client.
Exhales hard and fast with a single blow
9 The nurse should be alert for a complication of bronchiectasis that results
from a combination of retained secretions and obstruction that leads to the
collapse of alveoli. This complication is known as
Atelectasis
10 A patient is being treated for status asthmaticus. What danger sign does
the nurse observe that can indicate impending respiratory failure?
Respiratory acidosis
11 Which exposure acts as a risk factor for and accounts for the majority of
cases of chronic obstructive pulmonary disease (COPD)?
Exposure to tobacco smoke
12 A client is diagnosed with a chronic respiratory disorder. After assessing
the client's knowledge of the disorder, the nurse prepares a teaching plan.
Which nursing diagnosis is this teaching plan most likely to include?
Anxiety
13 Which statement describes emphysema?
A disease of the airways characterized by destruction of the walls of
overdistended alveoli
14 A client with chronic obstructive pulmonary disease (COPD) and cor
pulmonale is being prepared for discharge. The nurse should provide which
instruction?
Weigh yourself daily and report a gain of 2 lb in 1 day."
15 The classification of Stage II of COPD is defined as:
moderate COPD.
16 The nurse is assigned to care for a patient with COPD with hypoxemia and
hypercapnia. When planning care for this patient, what does the nurse
understand is the main goal of treatment?
Providing sufficient oxygen to improve oxygenation
17 Which of the following is accurate regarding status asthmaticus?
A severe asthma episode that is refractory to initial therapy
18 A nurse is developing a teaching plan for a client with asthma. Which
teaching point has the highest priority?
Take ordered medications as scheduled.
19 A nurse administers albuterol (Proventil), as ordered, to a client with
emphysema. Which finding indicates that the drug is producing a therapeutic
effect?
Respiratory rate of 22 breaths/minute
20 Asthma is caused by which type of response?
IgE-mediated
21 A client with asthma is prescribed a short acting beta-adrenergic (SABA)
for quick relief. Which of the following is the most likely drug to be
prescribed?
Albuterol
22 The classification of Stage III of COPD is defined as:
severe COPD.
23 A client with a chronic lung disease is prescribed postural drainage. Place
in order the nurse's actions to perform this procedure. Use all options.
Plan to do the procedure before a meal. Provide medication to loosen
secretions before the procedure. Obtain an emesis basin, sputum cup, and
paper tissues. Instruct client to breathe in through the nose and out through
pursed lips. Place client in position to drain the lower lobes for 10 to 15
minutes and then cough. Place client in position to drain the middle lobe for
10 to 15 minutes and then cough. Place client in position to drain the upper
lobes for 10 to 15 minutes and then cough.
24 A nurse is assisting with a subclavian vein central line insertion when the
client's oxygen saturation drops rapidly. He complains of shortness of breath
and becomes tachypneic. The nurse suspects the client has developed a
pneumothorax. Further assessment findings supporting the presence of a
pneumothorax include:
diminished or absent breath sounds on the affected side.
25 A client has a history of chronic obstructive pulmonary disease (COPD).
Following a coughing episode, the client reports sudden and unrelieved
shortness of breath. Which of the following is the most important for the
nurse to assess?
Lung sounds
26 A nurse is discussing asthma complications with a client and family. What
complications should the nurse include in the teaching? Select all that apply.
Status asthmaticus, Respiratory failure, Pertussis, Atelectasis, Thoracentesis
27 A client with chronic obstructive pulmonary disease (COPD) expresses a
desire to quit smoking. The first appropriate response from the nurse is:
Have you tried to quit smoking before?”
28 Upon assessment, the nurse suspects that a client with COPD may have
bronchospasm. What manifestations validate the nurse’s concern? Select all
that apply. Compromised gas exchange, decreased airflow, Wheezes, Jugular
vein distention, Ascites
29 A client has intermittent asthma attacks. Which of the following therapies
does the nurse teach the client to use at home when experiencing an asthma
attack?
Inhaled albuterol (Ventolin)
30 In COPD, the body attempts to improve oxygen-carrying capacity by
increasing the amount of red blood cells. Which term refers to this process?
Polycythemia