d. withhold bronchodilators for 6 to 12 hours before the examination.Which information will the nurse include when teaching the patient with asthma about the prescribed medications?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.d. Tremors are an expected side effect of rapidly acting bronchodilators.When the nurse is evaluating the effectiveness of therapy for a patient who has received treatment during an asthma attack, which finding is the best indicator that the therapy has been effective?a. No wheezes are audible.b. Oxygen saturation is >90%.c. Accessory muscle use has decreased.d. Respiratory rate is 16 breaths/minute.b. Oxygen saturation is >90%.
A patient seen in the asthma clinic has recorded daily peak flows that are 85% of the baseline. Which action will the nurse plan to take?a. Teach the patient about the use of oral corticosteroids.b. Administer a bronchodilator and recheck the peak flow.c. Instruct the patient to continue to use current medications.d. Evaluate whether the peak flow meter is being used correctly.c. Instruct the patient to continue to use current medications.Which action by a patient who has asthma indicates a good understanding of the nurse’s teaching about peak flow meter use?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.c. The patient uses the albuterol (Proventil) metered-dose inhaler (MDI) for peak flows in the yellow zone.A 32-year-old patient who denies any history of smoking is seen in the clinic with a new diagnosis of emphysema. The nurse will anticipate teaching the patient abouta. 1-antitrypsin testing.b. use of the nicotine patch.c. continuous pulse oximetry.d. effects of leukotriene modifiers.a. 1-antitrypsin testing.Which information about a newly admitted patient with chronic obstructive pulmonary disease (COPD) indicates that the nurse should consult with the health care provider before administering the prescribed theophylline?a. The patient has had a recent 10-pound weight gain.b. The patient has a cough productive of green mucus.c. The patient denies any shortness of breath at present.d. The patient takes cimetidine (Tagamet) 150 mg daily.d. The patient takes cimetidine (Tagamet) 150 mg daily.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?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.d. Teach the patient how to effectively use pursed lip breathing.A patient with chronic obstructive pulmonary disease (COPD) has a nursing diagnosis of imbalanced nutrition: less than body requirements. An appropriate intervention for this problem is toa. increase the patient’s intake of fruits and fruit juices.b. have the patient exercise for 10 minutes before meals.c. assist the patient in choosing foods with a lot of texture.d. offer high calorie snacks between meals and at bedtime.d. offer high calorie snacks between meals and at bedtime.When the nurse is interviewing a patient with a new diagnosis of chronic obstructive pulmonary disease (COPD), which information will help most in confirming a diagnosis of chronic bronchitis?a. The patient tells the nurse about a family history of bronchitis.b. The patient’s history indicates a 40 pack-year cigarette history.c. The patient denies having any respiratory problems until the last 6 months.d. The patient complains about a productive cough every winter for 3 months.d. The patient complains about a productive cough every winter for 3 months.After the nurse has finished teaching a patient about pursed lip breathing, which patient action indicates that more teaching is needed?a. The patient inhales slowly through the nose.b. The patient puffs up the cheeks while exhaling.c. The patient practices by blowing through a straw.d. The patient’s ratio of inhalation to exhalation is 1:3.b. The patient puffs up the cheeks while exhaling.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?a. Pulse oximetry reading of 91%b. Absence of wheezes or cracklesc. Decreased use of accessory musclesd. Respiratory rate of 22 breaths/minutea. Pulse oximetry reading of 91%To evaluate the effectiveness of therapy for a patient with cor pulmonale, the nurse will monitor the patient fora. elevated temperature.b. clubbing of the fingers.c. jugular vein distention.d. complaints of chest pain.c. jugular vein distention.When a hospitalized patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen, the best action by the nurse is toa. minimize oxygen use to avoid oxygen dependency.b. maintain the pulse oximetry level at 90% or greater.c. administer oxygen according to the patient’s level of dyspnea.d. avoid administration of oxygen at a rate of more than 2 L/min.b. maintain the pulse oximetry level at 90% or greater.Which information will the nurse include in teaching a patient with chronic obstructive pulmonary disease (COPD) who has a new prescription for home oxygen therapy?a. Storage of oxygen tanks will require adequate space in the home.b. Travel opportunities will be limited because of the use of oxygen.c. Oxygen flow should be increased if the patient has more dyspnea.d. Oxygen use can improve the patient’s prognosis and quality of life.d. Oxygen use can improve the patient’s prognosis and quality of life.A patient is receiving 35% oxygen via a Venturi mask. To ensure the correct amount of oxygen delivery, it is most important that the nursea. 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.a. keep the air entrainment ports clean and unobstructed.Postural drainage with percussion and vibration is ordered twice daily for a patient with chronic bronchitis. The nurse will plan toa. carry out the procedure 3 hours after the patient eats.b. maintain the patient in the lateral position for 20 minutes.c. perform percussion before assisting the patient to the drainage position.d. give the ordered albuterol (Proventil) after the patient has received the therapy.a. carry out the procedure 3 hours after the patient eats.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 toa. 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).b. walk for a total of 20 minutes daily.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?a. Complicated grieving related to expectation of deathb. Ineffective coping related to unknown outcome of illnessc. Deficient knowledge related to lack of education about COPDd. Chronic low self-esteem related to increased physical dependenced. Chronic low self-esteem related to increased physical dependenceA patient with chronic obstructive pulmonary disease (COPD) is admitted to the hospital. How can the nurse best position the patient to improve gas exchange?a. Resting in bed with the head elevated to 45 to 60 degreesb. Sitting up at the bedside in a chair and leaning slightly forwardc. Resting in bed in a high-Fowler’s position with the knees flexedd. In the Trendelenburg position with several pillows behind the headb. Sitting up at the bedside in a chair and leaning slightly forwardWhich diagnostic test will the nurse plan to discuss with a 54-year-old patient with progressively increasing dyspnea who is being evaluated for a possible diagnosis of chronic obstructive pulmonary disease (COPD)?a. Eosinophil countb. Pulmonary function testingc. Immunoglobin E (IgE) levelsd. Radioallergosorbent test (RAST)b. Pulmonary function testingWhich 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?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.d. Perform chest physiotherapy every 4 hours.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 abouta. antibiotic resistance.b. inhaled bronchodilators.c. oral corticosteroid therapy.d. aerosolized tobramycin (TOBI).d. aerosolized tobramycin (TOBI).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?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.”b. “Do you need any information to help you with the decision?”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?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.c. Educate the patient to use the Flutter airway clearance device.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?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.”b. “I will have ice cream as a snack every day.”When teaching the patient with chronic obstructive pulmonary disease (COPD) about exercise, which information should the nurse include?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.”b. “Use the bronchodilator before you start to exercise.”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?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).d. The patient’s only medications are albuterol (Proventil) and salmeterolWhen the nurse takes an admission history for a patient with possible asthma who has new-onset wheezing and shortness of breath, which information may indicate a need for a change in therapy?a. The patient has a history of pneumonia 2 years ago.b. The patient has chronic inflammatory bowel disease.c. The patient takes propranolol (Inderal) for hypertension.d. The patient uses acetaminophen (Tylenol) for headaches.c. The patient takes propranolol (Inderal) for hypertension.Which topic will the nurse include in medication teaching for a patient with newly-diagnosed persistent asthma?a. Use of long-acting -adrenergic medicationsb. Side effects of sustained-release theophyllinec. Self-administration of inhaled corticosteroidsd. Complications associated with oxygen therapyc. Self-administration of inhaled corticosteroidsA 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?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.b. Educate the patient about administration of insulin.
When caring for a patient with a history of asthma, which assessment finding should the nurse communicate immediately to the health care provider?a. Pulse oximetry reading of 91%b. Respiratory rate of 26 breaths/minutec. Use of accessory muscles in breathingd. Peak expiratory flow rate of 240 mL/minc. Use of accessory muscles in breathingWhich action should the nurse anticipate taking first when a patient who is experiencing an asthma attack develops bradycardia and a decrease in wheezing?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).a. Assist with endotracheal intubation.A patient who is experiencing an acute asthma attack is admitted to the emergency department. The nurse’s first action should be toa. listen to the patient’s breath sounds.b. ask about inhaled corticosteroid use.c. determine when the dyspnea started.d. obtain the forced expiratory volume (FEV) flow rate.a. listen to the patient’s breath sounds.Which finding in a patient who has received omalizumab (Xolair) is most important to report immediately to the health care provider?a. Pain at injection siteb. Flushing and dizzinessc. Respiratory rate 22 breaths/minuted. Peak flow reading 75% of normalb. Flushing and dizzinessThe nurse in the emergency department receives arterial blood gas results for four recently admitted patients with obstructive pulmonary disease. Which patient will require the most rapid action by the nurse?a. 20-year-old with ABG results: pH 7.28, PaCO2 60 mm Hg, and PaO2 58 mm Hgb. 32-year-old with ABG results: pH 7.50, PaCO2 30 mm Hg, and PaO2 65 mm Hgc. 40-year-old with ABG results: pH 7.34, PaCO2 33 mm Hg, and PaO2 80 mm Hgd. 64-year-old with ABG results: pH 7.31, PaCO2 58 mm Hg, and PaO2 64 mm Hga. 20-year-old with ABG results: pH 7.28, PaCO2 60 mm Hg, and PaO2 58 mm HgWhich of these nursing actions included in the care plan for a patient with chronic obstructive pulmonary disease (COPD) should the nurse delegate to experienced nursing assistive personnel (NAP)?a. Obtain oxygen saturation using pulse oximetry.b. Monitor for increased oxygen need with exercise.c. Teach the patient about safe use of oxygen at home.d. Adjust oxygen to keep saturation in prescribed parameters.a. Obtain oxygen saturation using pulse oximetry.A patient with asthma who has a baseline peak flow reading of 600 mL calls the nurse, stating that the current peak flow is 420 mL. Which action should the nurse take first?a. Tell the patient to go to the hospital emergency department.b. Instruct the patient to use the prescribed albuterol (Proventil).c. Ask about recent exposure to any new allergens or asthma triggers.d. Question the patient about use of the prescribed inhaled corticosteroids.b. Instruct the patient to use the prescribed albuterol (Proventil).The following medications are prescribed by the health care provider for a patient having an acute asthma attack. Which one will the nurse administer first?a. salmeterol (Serevent) 50 mcg per dry-powder inhaler (DPI)b. albuterol (Ventolin) 2.5 mg per nebulizerc. triamcinolone (Azmacort) 2 puffs per metered-dose inhaler (MDI)d. methylprednisolone (Solu-Medrol) 60 mg IVb. albuterol (Ventolin) 2.5 mg per nebulizerThe 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?a. A patient with a respiratory rate of 38b. A patient with loud expiratory wheezesc. A patient with jugular vein distention and peripheral edemad. A patient who has a cough productive of thick, green mucusa. A patient with a respiratory rate of 38Which actions will the nurse take to prepare a patient for a pulmonary function test?To prepare for your pulmonary function test, follow these instructions:. No bronchodilator medication for four hours.. No smoking for four hours before the test.. No heavy meals.. Do not wear any tight clothing.. The complete pulmonary function test takes around one and a half hours.. Which assessment finding in a patient with impaired gas exchange is most useful?CONCLUSION: hypoxemia was the defining characteristic that presented the best predictive ability to determine Impaired gas exchange.
Which instruction will the nurse include in the diet plan for a patient with chronic obstructive pulmonary disease COPD )?A person with COPD should try to eat plenty of protein, complex carbohydrates, and fiber-rich foods and add healthy sources of fat to meals and snacks. Dietary patterns for people with COPD depend on many factors, including body weight and overall health.
Which exercise goal is most appropriate for a patient with chronic obstructive pulmonary disease?A person with COPD should aim to do aerobic exercise for about 30 minutes five times a week, which is the advice for all adults. Resistance training: This strengthens muscles, including those that help with breathing.
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A patient who is experiencing an asthma attack develops bradycardia and a decrease in wheezing
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