Chapter 26: Coordinating Care for Patients with Lower Airway Disorders Flashcards

1. Friends of a patient hospitalized with asthma would like to bring the patient a gift. Which gift would the nurse recommend for this patient?

1.A basket of flowers
2.A stuffed animal
3.Fruit and candy
4.A book

2. The nurse develops the nursing diagnosis "Ineffective Airway Clearance related to intermittent, reversible airway obstruction secondary to bronchoconstriction and airway inflammation." For which disorder is this nursing diagnosis most relevant?

1.Asthma
2.Bronchiectasis
3.Chronic bronchitis
4.Emphysema

3. Which statements by a patient with asthma indicates effective teaching?

1."We'll use the fireplace to keep the house warm in the winter."
2."We will replace the carpet in our bedroom with tile."
3."We'll make sure that we dust our plants frequently."
4."We're glad we can keep our dog."

4. The nurse monitors for which therapeutic effect when administering leukotriene receptor antagonists to patients diagnosed with asthma?

1.Cause bronchodilation of the airways
2.Decrease viscosity of secretions
3.Decrease work of breathing by relaxing muscles around bronchi
4.Inhibit the inflammatory process

5. In administering bronchodilator therapy to a patient with asthma, the nurse correlates the effectiveness of this classification of medication to which mechanism of action?

1.Bronchodilators widen the airways because they act on the parasympathetic nervous system.
2.Bronchodilators widen the airways because they stimulate the sympathetic nervous system.
3.Bronchodilators decrease inflammation of the airways.
4.Bronchodilators decrease the production of mucus that narrows the airways.

6. In providing care to a patient admitted with an acute asthma exacerbation, the nurse prepares which "rescue" medication for administration first?

1.Inhaled anti-inflammatories
2.Mucolytics
3.Long-acting beta2-adrenergic agonists
4.Short-acting beta2-adrenergic agonists

7. The nurse finds a patient admitted with asthma and pneumonia restless, anxious, complaining of increasing difficulty breathing, and stridor. Because of suspected status asthmaticus, an arterial blood gas is ordered. Which result requires an immediate intervention?

1.pH 7.30
2.PaCO2 48 mm Hg
3.PaO2 50 mm Hg
4.SpO2 88%

8. The nurse is providing care to a patient admitted after experiencing an acute asthma attack. Which assessment findings indicate the need for an immediate intervention?

1.Retractions and fatigue
2.Tachycardia and tachypnea
3.Inaudible breath sounds
4.Diffuse wheezing and the use of accessory muscles when inhaling

9. The nurse is caring for a patient newly diagnosed with asthma. Which assessment data indicate the need for an immediate intervention?

1.Diminished breath sounds
2.Decreased respiratory rate
3.Increased crackles
4.Increased respiratory rate

10. Patients with asthma initially develop respiratory alkalosis. Which arterial blood gas value is consistent with this acid-base disorder?

1.pH 7.32
2.PaCO2 30 mm Hg
3.PaO2 78 mm Hg
4.SpO2 90%

11. The nurse provides education to a patient who is prescribed an aerochamber for the treatment of asthma. Which patient statement indicates the need for additional teaching?

1."I will place the mouthpiece over my nose and mouth."
2."I should hear a whistling sound as I inhale the medication."
3."I should wait a few seconds before I administer the second dose."
4."I will hold my breath for 10 seconds after inhaling the medication."

12. The nurse develops the nursing diagnosis "Ineffective Airway Clearance related to increased mucus production secondary to chronic inflammation of small airways." For which disorder is this nursing diagnosis most relevant?

1.Asthma
2.Chronic bronchitis
3.Cystic fibrosis
4.Emphysema

13. The nurse develops the nursing diagnosis "Impaired Gas Exchange related to decreased lung elasticity and hyperinflation of the alveoli secondary to exposure to inhaled pollutants." For which disorder is the nursing diagnosis most relevant?

1.Asthma
2.Chronic bronchitis
3.Cystic fibrosis
4.Emphysema

14. Which clinical manifestation in the patient with chronic obstructive pulmonary disease (COPD) is more indicative of emphysema?

1.Cyanosis
2.Obese
3.Reddish complexion
4.Non-productive cough

15. The nurse is providing care to a patient diagnosed with emphysema. Which clinical manifestation does the nurse correlate with this diagnosis?

1.Tachycardia
2.Cough
3.Barrel chest
4.Wheezing

16. The nurse correlates which data from a patient's history to a diagnosis of bronchitis?

1.A history of rhinitis
2.A history of eczema
3.A family history of allergies
4.A history of progressive dyspnea

17. The nurse teaches a patient how to implement pursed-lip breathing. Which patient statement indicates a need for additional instruction?

1."I will sit up with my shoulders relaxed."
2."I will be sure to exhale twice as long as I inhale."
3."I will inhale through my mouth while slowly counting."
4."I will exhale through my mouth as if I was blowing out candles."

18. A patient diagnosed with chronic obstructive pulmonary disease (COPD) has a pulse oximetry reading of 93%, increased red blood and white blood cell count, temperature of 101°F, pulse 100 bpm, respirations 35 bpm, and a chest x-ray examination that showed a flattened diaphragm with infiltrates. Based on this data, which prescription does the nurse question for this patient?

1.Antibiotic therapy
2.Nonsteroidal anti-inflammatory agents
3.Oxygen by nasal cannula at 3 to 4 L/minute
4.Bronchodilators such as an adrenergic stimulating drugs or anticholinergic agents

19. The nurse correlates which diagnostic result as consistent with the diagnosis of cystic fibrosis?

1.Elevated serum chloride
2.Elevated sodium levels in sweat
3.Decreased urine chloride
4.Decreased urine specific gravity

20. The nurse monitors for which gastrointestinal clinical manifestations in the patient diagnosed with cystic fibrosis?

1.Diarrhea
2.Hematemesis
3.Melena
4.Steatorrhea

21. Which statement by the patient regarding the treatment for cystic fibrosis indicates the need for further teaching?

1."Taking CFTR modulators will cure my cystic fibrosis."
2."There are medications that will decrease the viscosity of the secretions."
3."I may need to take vitamins to support my nutritional needs."
4."I may also have to take pancreatic enzymes for nutritional purposes."

22. Although all of these patients do not currently smoke cigarettes, the nurse recognizes that which patient is at greatest risk factor for the development of lung cancer?

1.60-year-old black male with a history of smoking in his teens

2.64-year-old white female who went to an elementary school that had asbestos

3.68-year-old black male with a 40 pack-year history of smoking

4.72-year-old white male with a 10 pack-year history of smoking

23. The nurse is caring for a patient in a community clinic who wishes to quit smoking. The patient asks the nurse, "If I quit smoking, will my risk of lung cancer be the same as a nonsmoker?" Which is the best response by the nurse?

1."No one knows for sure what the risk is for someone who quits smoking."
2."Your risk of lung cancer will be equal to that of a nonsmoker."
3."Your risk of lung cancer will decline if you quit, but it will remain higher than a nonsmoker's."
4."Your risk of lung cancer will never drop because the damage has already been done."

24. The nurse is caring for an older adult patient who is very thin and emaciated. The patient reports new onset of shortness of breath. A chest x-ray examination reveals a spot on the lungs that the physician believes is an inoperable lung cancer. Because of the patient's poor nutritional status, chemotherapy is not an option. The healthcare provider also believes that the location of the cancer would make radiation therapy unsuccessful. In advocating for this patient, what approach does the nurse collaborate with the healthcare team to offer the patient?

1.Provide palliative care to keep the patient comfortable without diagnostic testing
2.Perform any procedure necessary to diagnose the patient properly
3.Promote the use of blood tests to diagnose the suspected cancer
4.Determine the patient's and family's wishes regarding diagnostic testing

26. In reviewing teaching about use of the peak flow meter in a patient with asthma, which statements by the patient indicate understanding of correct use? Select all that apply.

1."I will lie flat in the bed."
2."I take a deep breath before placing the mouthpiece in my mouth."
3."I breathe out slowly and continuously."
4."I should repeat three times and the numbers should be close."
5."I blow out in one fast, hard blast."

27. The nurse is providing care to a patient diagnosed with chronic obstructive pulmonary disease (COPD). Which factors in the patient's history support the current diagnosis? Select all that apply.

1.Working in an industrial environment
2.Working in an office setting with air conditioning
3.History of asthma
4.Current cigarette smoking
5.Playing golf several times a week

27. The nurse is providing care to a patient diagnosed with chronic obstructive pulmonary disease (COPD). Which factors in the patient's history support the current diagnosis? Select all that apply.

1.Working in an industrial environment
2.Working in an office setting with air conditioning
3.History of asthma
4.Current cigarette smoking
5.Playing golf several times a week

28. The community health nurse is preparing an educational program for local residents. Which information does the nurse include about chronic obstructive pulmonary disease (COPD)? Select all that apply.

1.Cigarette smoking is the leading cause of COPD.
2.Approximately 80% to 90% of deaths from COPD are related to smoking.
3.There is an increased incidence of COPD in individuals who abuse alcohol.
4.Less than 5% of all COPD cases are caused by deficiency in alpha-1 antitrypsin.
5.COPD is completely reversible if the individual stops smoking.

29. Which systems should the nurse anticipate will be affected when planning care for a patient diagnosed with cystic fibrosis? Select all that apply.

1.Respiratory
2.Neurological
3.Reproductive
4.Cardiovascular
5.Gastrointestinal

30. Which statements about lung cancer indicate that teaching was effective? Select all that apply.

1."A reclining position allows full lung expansion."
2."Controlled breathing reduces shortness of breath."
3."I will pace myself when doing things with my family."
4."I will eat three large meals a day to ensure I get enough calories."
5."Pain medication administered around the clock will improve my comfort."