Exam Mode – Questions and choices are randomly arranged, time limit of 1min per question, answers and grade will be revealed after finishing the exam. Choose the letter of the correct answer. You have 100 mins to finish this exam. Good luck! Congratulations - you have completed MSN Exam for Asthma and COPD (EM)*. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been
rated as %%RATING%% Your answers are highlighted below. Shaded items are complete.
Text Mode – Text version of the exam 1. An elderly client with pneumonia may appear with which of the following symptoms first?
2. Which of the following pathophysiological mechanisms that occurs in the lung parenchyma allows pneumonia to develop?
3. A 7-year-old client is brought to the E.R. He’s tachypneic and afebrile and has a respiratory rate of 36 breaths/minute and a nonproductive cough. He recently had a cold. From his history, the client may have which of the following?
4. Which of the following assessment findings would help confirm a diagnosis of asthma in a client suspected of having the disorder?
5. Which of the following types of asthma involves an acute asthma attack brought on by an upper respiratory infection?
6. A client with acute asthma showing inspiratory and expiratory wheezes and a decreased expiratory volume should be treated with which of the following classes of medication right away?
7. A 19-year-old comes into the emergency department with acute asthma. His respiratory rate is 44 breaths/minute, and he appears to be in acute respiratory distress. Which of the following actions should be taken first?
8. A 58-year-old client with a 40-year history of smoking one to two packs of cigarettes a day has a chronic cough producing thick sputum, peripheral edema, and cyanotic nail beds. Based on this information, he most likely has which of the following conditions?
9. The term “blue bloater” refers to which of the following conditions?
10. The term “pink puffer” refers to the client with which of the following conditions?
11. A 66-year-old client has marked dyspnea at rest, is thin, and uses accessory muscles to breathe. He’s tachypneic, with a prolonged expiratory phase. He has no cough. He leans forward with his arms braced on his knees to support his chest and shoulders for breathing. This client has symptoms of which of the following respiratory disorders?
12. It’s highly recommended that clients with asthma, chronic bronchitis, and emphysema have Pneumovax and flu vaccinations for which of the following reasons?
13. Exercise has which of the following effects on clients with asthma, chronic bronchitis, and emphysema?
14. Clients with chronic obstructive bronchitis are given diuretic therapy. Which of the following reasons best explains why?
15. A 69-year-old client appears thin and cachectic. He’s short of breath at rest and his dyspnea increases with the slightest exertion. His breath sounds are diminished even with deep inspiration. These signs and symptoms fit which of the following conditions?
16. A client with emphysema should receive only 1 to 3 L/minute of oxygen, if needed, or he may lose his hypoxic drive. Which of the following statements is correct about hypoxic drive?
17. Teaching for a client with chronic obstructive pulmonary disease (COPD) should include which of the following topics?
18. Which of the following respiratory disorders is most common in the first 24 to 48 hours after surgery?
19. Which of the following measures can reduce or prevent the incidence of atelectasis in a post-operative client?
20. Emergency treatment of a client in status asthmaticus includes which of the following medications?
21. Which of the following treatment goals is best for the client with status asthmaticus?
22. Dani was given dilaudid for pain. She’s sleeping and her respiratory rate is 4 breaths/minute. If action isn’t taken quickly, she might have which of the following reactions?
23. Which of the following additional assessment data should immediately be gathered to determine the status of a client with a respiratory rate of 4 breaths/minute?
24. A client is in danger of respiratory arrest following the administration of a narcotic analgesic. An arterial blood gas value is obtained. The nurse would expect to PaCO2 to be which of the following values?
25. A client has started a new drug for hypertension. Thirty minutes after he takes the drug, he develops chest tightness and becomes short of breath and tachypneic. He has a decreased level of consciousness. These signs indicate which of the following conditions?
26. Emergency treatment for a client with impending anaphylaxis secondary to hypersensitivity to a drug should include which of the following actions first?
27. Following the initial care of a client with asthma and impending anaphylaxis from hypersensitivity to a drug, the nurse should take which of the following steps next?
28. A client’s ABG results are as follows: pH: 7.16; PaCO2 80 mm Hg; PaO2 46 mm Hg; HCO3– 24 mEq/L; SaO2 81%. This ABG result represents which of the following conditions?
29. A nurse plans care for a client with chronic obstructive pulmonary disease, knowing that the client is most likely to experience what type of acid-base imbalance?
30. A nurse is caring for a client who is on a mechanical ventilator. Blood gas results indicate a pH of 7.50 and a PCO2 of 30 mm Hg. The nurse has determined that the client is experiencing respiratory alkalosis. Which laboratory value would most likely be noted in this condition?
31. A nurse reviews the arterial blood gas results of a patient and notes the following: pH 7.45; PCO2 30 mm Hg; and bicarbonate concentration of 22 mEq/L. The nurse analyzes these results as indicating:
32. A client is scheduled for blood to be drawn from the radial artery for an ABG determination. Before the blood is drawn, an Allen’s test is performed to determine the adequacy of the:
33. A nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client, knowing that the client is at risk for which acid-base disorder?
34. A nurse is caring for a client with an ileostomy understands that the client is most at risk for developing which acid-base disorder?
35. A nurse is caring for a client with diabetic ketoacidosis and documents that the client is experiencing Kussmaul’s respirations. Based on this documentation, which of the following did the nurse observe?
36. A nurse understands that the excessive use of oral antacids containing bicarbonate can result in which acid-base disturbance?
37. A nurse is caring for a client with renal failure. Blood gas results indicate a pH of 7.30; a PCO2 of 32 mm Hg, and a bicarbonate concentration of 20 mEq/L. The nurse has determined that the client is experiencing metabolic acidosis. Which of the following laboratory values would the nurse expect to note?
38. A nurse is preparing to obtain an arterial blood gas specimen from a client and plans to perform the Allen’s test on the client. Number in order of priority the steps for performing the Allen’s test (#1 is first step).
39. A nurse is preparing to obtain a sputum specimen from a client. Which of the following nursing actions will facilitate obtaining the specimen?
40. A nurse is caring for a client after a bronchoscopy and biopsy. Which of the following signs if noted in the client should be reported immediately to the physician?
41. A nurse is suctioning fluids from a client via a tracheostomy tube. When suctioning, the nurse must limit the suctioning to a maximum of:
42. A nurse is suctioning fluids from a client through an endotracheal tube. During the suctioning procedure, the nurse notes on the monitor that the heart rate decreases. Which of the following is the most appropriate nursing intervention?
43. An unconscious client is admitted to an emergency room. Arterial blood gas measurements reveal a pH of 7.30, a low bicarbonate level, a normal carbon dioxide level, and a normal oxygen level. An elevated potassium level is also present. These results indicate the presence of:
44. A nurse is caring for a client hospitalized with acute exacerbation of COPD. Which of the following would the nurse expect to note on assessment of this client?
45. An oxygenated delivery system is prescribed for a client with COPD to deliver a precise oxygen concentration. Which of the following types of oxygen delivery systems would the nurse anticipate to be prescribed?
46. Theophylline (Theo-Dur) tablets are prescribed for a client with chronic airflow limitation, and the nurse instructs the client about the medication. Which statement by the client indicates a need for further teaching?
47. A nurse is caring for a client with emphysema. The client is receiving oxygen. The nurse assesses the oxygen flow rate to ensure that it does not exceed
48. The nurse reviews the ABG values of a client. The results indicate respiratory acidosis. Which of the following values would indicate that this acid-base imbalance exists?
49. A nurse instructs a client to use the pursed lip method of breathing. The client asks the nurse about the purpose of this type of breathing. The nurse responds, knowing that the primary purpose of pursed lip breathing is:
50. A nurse reviews the ABG values and notes a pH of 7.50, a PCO2 of 30 mm Hg, and an HCO3 of 25 mEq/L. The nurse interprets these values as indicating:
51. Aminophylline (theophylline) is prescribed for a client with acute bronchitis. A nurse administers the medication, knowing that the primary action of this medication is to:
52. A client is receiving isoetharine hydrochloride (Bronkosol) via a nebulizer. The nurse monitors the client for which side effect of this medication?
53. A nurse teaches a client about the use of a respiratory inhaler. Which action by the client indicated a need for further teaching?
54. A female client is scheduled to have a chest radiograph. Which of the following questions is of most importance to the nurse assessing this client?
55. A client has just returned to a nursing unit following bronchoscopy. A nurse would implement which of the following nursing interventions for this client?
56. A client has an order to have radial ABG drawn. Before drawing the sample, a nurse occludes the:
57. A nurse is assessing a client with chronic airflow limitation and notes that the client has a “barrel chest.” The nurse interprets that this client has which of the following forms of chronic airflow limitation?
58. A client has been taking benzonatate (Tessalin Perles) as prescribed. A nurse concludes that the medication is having the intended effect if the client experiences:
59. Which of the following would be an expected outcome for a client recovering from an upper respiratory tract infection? The client will:
60. Which of the following individuals would the nurse consider to have the highest priority for receiving an influenza vaccination?
61. A client with allergic rhinitis asks the nurse what he should do to decrease his symptoms. Which of the following instructions would be appropriate for the nurse to give the client?
62. An elderly client has been ill with the flu, experiencing headache, fever, and chills. After 3 days, she develops a cough productive of yellow sputum. The nurse auscultates her lungs and hears diffuse crackles. How would the nurse best interpret these assessment findings?
63. Guaifenesin 300 mg four times daily has been ordered as an expectorant. The dosage strength of the liquid is 200mg/5ml. How many mL should the nurse administer each dose?
64. Pseudoephedrine (Sudafed) has been ordered as a nasal decongestant. Which of the following is a possible side effect of this drug?
65. A client with COPD reports steady weight loss and being “too tired from just breathing to eat.” Which of the following nursing diagnoses would be most appropriate when planning nutritional interventions for this client?
66. When developing a discharge plan to manage the care of a client with COPD, the nurse should anticipate that the client will do which of the following?
67. Which of the following outcomes would be appropriate for a client with COPD who has been discharged to home? The client:
68. Which of the following physical assessment findings would the nurse expect to find in a client with advanced COPD?
69. Which of the following is the primary reason to teach pursed-lip breathing to clients with emphysema?
70. Which of the following is a priority goal for the client with COPD?
71. A client’s arterial blood gas levels are as follows: pH 7.31; PaO2 80 mm Hg, PaCO2 65 mm Hg; HCO3– 36 mEq/L. Which of the following signs or symptoms would the nurse expect?
72. When teaching a client with COPD to conserve energy, the nurse should teach the client to lift objects:
73. The nurse teaches a client with COPD to assess for s/s of right-sided heart failure. Which of the following s/s would be included in the teaching plan?
74. The nurse assesses the respiratory status of a client who is experiencing an exacerbation of COPD secondary to an upper respiratory tract infection. Which of the following findings would be expected?
75. Which of the following ABG abnormalities should the nurse anticipate in a client with advanced COPD?
76. Which of the following diets would be most appropriate for a client with COPD?
77. The nurse is planning to teach a client with COPD how to cough effectively. Which of the following instructions should be included?
78. A 34-year-old woman with a history of asthma is admitted to the emergency department. The nurse notes that the client is dyspneic, with a respiratory rate of 35 breaths/minute, nasal flaring, and use of accessory muscles. Auscultation of the lung fields reveals greatly diminished breath sounds. Based on these findings, what action should the nurse take to initiate care of the client?
79. The nurse would anticipate which of the following ABG results in a client experiencing a prolonged, severe asthma attack?
80. A client with acute asthma is prescribed short-term corticosteroid therapy. What is the rationale for the use of steroids in clients with asthma?
81. The nurse is teaching the client how to use a metered dose inhaler (MDI) to administer a Corticosteroid drug. Which of the following client actions indicates that he us using the MDI correctly? Select all that apply.
82. A client is prescribed metaproterenol (Alupent) via a metered dose inhaler (MDI), two puffs every 4 hours. The nurse instructs the client to report side effects. Which of the following are potential side effects of metaproterenol?
83. A client has been taking flunisolide (Aerobid), two inhalations a day, for treatment of asthma. He tells the nurse that he has painful, white patches in his mouth. Which response by the nurse would be the most appropriate?
84. Which of the following health promotion activities should the nurse include in the discharge teaching plan for a client with asthma?
85. The client with asthma should be taught that which of the following is one of the most common precipitating factors of an acute asthma attack?
86. A female client comes into the emergency room complaining of SOB and pain in the lung area. She states that she started taking birth control pills 3 weeks ago and that she smokes. Her VS are: 140/80, P 110, R 40. The physician orders ABG’s, results are as follows: pH: 7.50; PaCO2 29 mm Hg; PaO2 60 mm Hg; HCO3– 24 mEq/L; SaO2 86%. Considering these results, the first intervention is to:
87. Basilar crackles are present in a client’s lungs on auscultation. The nurse knows that these are discrete, noncontinuous sounds that are:
88. A cyanotic client with an unknown diagnosis is admitted to the E.R. In relation to oxygen, the first nursing action would be to:
89. Immediately following a thoeacentesis, which clinical manifestations indicate that a complication has occurred and the physician should be notified?
90. If a client continues to hypoventilate, the nurse will continually assess for a complication of:
91. A client is admitted to the hospital with acute bronchitis. While taking the client’s VS, the nurse notices he has an irregular pulse. The nurse understands that cardiac arrhythmias in chronic respiratory distress are usually the result of:
92. Auscultation of a client’s lungs reveals crackles in the left posterior base. The nursing intervention is to:
93. The most reliable index to determine the respiratory status of a client is to:
94. A client with COPD has developed secondary polycythemia. Which nursing diagnosis would be included in the plan of care because of the polycythemia?
95. The physician has scheduled a client for a left pneumonectomy. The position that will most likely be ordered postoperatively for his is the:
96. Assessing a client who has developed atelectasis postoperatively, the nurse will most likely find:
97. A fifty-year-old client has a tracheostomy and requires tracheal suctioning. The first intervention in completing this procedure would be to:
98. A client states that the physician said the tidal volume is slightly diminished and asks the nurse what this means. The nurse explains that the tidal volume is the amount of air:
99. An acceleration in oxygen dissociation from hemoglobin, and thus oxygen delivery to the tissues, is caused by:
100. Lisa is newly diagnosed with asthma and is being discharged from the hospital after an episode of status asthmaticus. Discharge teaching should include which of the following:
|