Question 1 of 9
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Which condition would the nurse associate with chronic obstructive pulmonary disease? Select all that apply. One, some, or all responses may be correct.
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- SarcoidosisSarcoidosis is a chronic respiratory condition, but it does not involve obstruction.
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- EmphysemaEmphysema is a condition considered to be chronic obstructive pulmonary disease.
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- TuberculosisTuberculosis is a chronic respiratory condition, but it does not involve obstruction.
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- Cystic fibrosisCystic fibrosis is a chronic respiratory condition, but it does not involve obstruction.
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- Chronic bronchitisChronic bronchitis is a condition considered to be chronic obstructive pulmonary disease.
Question 2 of 9
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The nurse is caring for a patient with pneumonia. The computed tomography (CT) scan shows the presence of exudative fluid accumulation in the pleural space. Which action would the nurse take next?
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- Perform chest physiotherapy.Chest physiotherapy is not typically indicated for patients with pleural fluid accumulation. This treatment is often used for patients with cystic fibrosis.
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- Apply oxygen via nasal cannula.Before administering oxygen, the nurse would measure the patient’s oxygen saturation and obtain an order for oxygen.
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- Administer corticosteroids as prescribed.Corticosteroids may be indicated to decrease inflammation, but this is not the action the nurse would take first.
- Correct
- Prepare the patient for chest tube insertion.The patient should be prepared for chest tube insertion to drain the exudative fluid.
Question 3 of 9
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The nurse is caring for a patient in the emergency department (ED) who presents with an acute exacerbation of chronic obstructive pulmonary disease (COPD). Upon assessment, the nurse notes an oxygen saturation of 90% and dyspnea with exertion. Which nursing intervention is appropriate?
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- Offer high-protein snacks.The extra work of breathing experienced with COPD exacerbations uses more calories so it is important for the nurse to ensure that the patient eats enough protein to repair tissues.
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- Administer oxygen as ordered.Patients with COPD have adjusted to chronic hypoxia and high levels of carbon dioxide so oxygen should be titrated to an oxygen saturation of 88% to 92%.
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- Prepare the patient for surgery.For severe emphysema, lung volume reduction surgery (LVRS) may be indicated. In this case, the patient presents with an acute exacerbation of COPD, and more assessment should be performed before determining the need for surgery.
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- Administer the influenza vaccine.While the influenza vaccine is used to prevent infections that cause COPD exacerbations, this patient is already experiencing an exacerbation so the need for the vaccine should be discussed later before discharge.
Question 4 of 9
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A patient presents to the emergency department (ED) with a productive cough. Assessment reveals elevated hemoglobin and hematocrit. Which respiratory condition does the nurse suspect the patient has?
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- AsthmaAsthma is characterized by wheezing and shortness of breath.
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- EmphysemaPatients with emphysema typically have symptoms including barrel chest and decreased breath sounds.
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- Cystic fibrosisCystic fibrosis often involves a productive cough but not elevations in hemoglobin and hematocrit.
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- Chronic bronchitisSymptoms of chronic bronchitis are cough with sputum production and polycythemia (elevated hemoglobin and hematocrit).
Question 5 of 9
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The nurse is providing discharge information to a patient newly prescribed a daily fluticasone (Flovent) inhaler for asthma. Which statement by the nurse should be included in the teaching?
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- “Rinse your mouth every time you use your inhaler.”Patients on inhaled corticosteroids (ICS) should be instructed to rinse their mouth after each use to prevent infection.
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- “Avoid drinking alcohol while taking this medication.”Alcohol should be avoided for patients taking leukotriene inhibitors.
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- “You can stop using your inhaler if you start feeling better.”Steroids need to be tapered and not stopped abruptly so this information is incorrect.
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- “You need to limit your coffee intake while on this medication.”Caffeine intake should be limited for patients taking ipratropium (Atrovent).
Question 6 of 9
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The nurse administers an albuterol inhaler to a patient with asthma. Which nursing intervention is appropriate for the nurse to implement?
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- Initiate a fluid restriction.Fluids should be encouraged for asthmatic patients using short-acting beta-adrenergic agonists, not restricted.
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- Monitor serum electrolytes.Because hypokalemia is a common side effect of albuterol, the nurse should monitor serum electrolytes.
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- Instruct the patient to rinse the mouth.Patients need to rinse their mouths after using steroid inhalers, not short-acting beta-adrenergic agonists.
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- Immediately administer the scheduled steroid inhaler.The patient should wait 5 minutes before using a steroid inhaler.
Question 7 of 9
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The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) who has recently developed cor pulmonale. Which patient statement indicates an understanding of this diagnosis?
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- “The left side of my heart is too big because it has to work so hard.”The right side of the heart becomes enlarged with cor pulmonale.
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- “This condition causes me to regurgitate stomach acid which irritates my lungs.”Gastroesophageal reflux disease (GERD) involves acid reflux which can irritate the lungs and contribute to further lung damage.
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- “Unfortunately, there are no medications or treatments available for cor pulmonale.”Treatment for cor pulmonale involves continuous low flow oxygen and medications to treat the heart failure and fluid volume overload.
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- “Over time, my blood has become thicker because of not having enough oxygen available.”Constant hypoxia stimulates erythropoiesis which results in polycythemia and increased blood viscosity.
Question 8 of 9
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The nurse is providing discharge education to a patient with chronic obstructive pulmonary disease (COPD). Which information is important to include?
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- Limit your intake of dietary protein.Protein intake should be increased for patients with COPD to ensure repair of damaged tissues.
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- Normal sputum is thin and green colored.Normal sputum is viscous and white without odor or taste.
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- Use pursed-lip breathing techniques when exercising.Patients with COPD should use pursed-lip breathing techniques to facilitate gas exchange.
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- You can take Benadryl over the counter for allergy relief.Antihistamines should be avoided by patients with COPD as they can cause the mucus to become dry, which makes it more difficult to clear the airway passages.
Question 9 of 9
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Which patient is at an increased risk for lung cancer? Select all that apply. One, some, or all responses may be correct.
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- History of tuberculosis (TB)History of certain lung disorders such as TB or COPD can increase the risk of developing lung cancer.
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- Living in a big city with a lot of smogIncreased exposure to air pollution can cause an increased risk of lung cancer development.
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- Previous treatment for radon exposureRadon exposure increases the risk of lung cancer.
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- Previous diagnosis of prostate cancerPreviously diagnosed prostate cancer is not a risk factor for lung cancer.
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- Sharing a household with a cigarette smokerA person living with a smoker has twice the risk of lung cancer as someone who is not regularly exposed to smoke.
