A Client With Chronic Obstructive Pulmonary

COPD questions 1. 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." 2. Which measure may increase complications for a client with COPD?  Increased oxygen supply 3. 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 4. The goal for oxygen therapy in COPD is to support tissue oxygenation, decrease the work of the cardiopulmonary system, and maintain the resting partial arterial pressure of oxygen (PaO2) of at least ______ mm Hg and an arterial oxygen saturation (SaO2) of at least ___%.  60 mm Hg; 90% 5. 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 6. The nurse is assigned the care of a 30-year-old client diagnosed with cystic fibrosis (CF). Which nursing intervention will be included in the client’s care plan?  Performing chest physiotherapy as ordered 7. A patient comes to the clinic for the third time in 2 months with chronic bronchitis. What clinical symptoms does the nurse anticipate assessing for this patient?  Sputum and a productive cough 8. 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 9. 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 10. The classification of Stage III of COPD is defined as  severe COPD 11. 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. Explanation: Nursing management focuses on alleviating symptoms and helping clients clear pulmonary secretions. Although teaching the family how to perform postural drainage and instructing the client on the signs of respiratory infection are important, they are not the nurse’s primary focus. The presence of a large amount of mucus may decrease the client’s appetite and result in inadequate dietary intake; therefore, the client’s nutritional status is assessed and strategies are implemented to ensure an adequate diet. 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. This teaching plan is most likely to include which nursing diagnosis?  Anxiety Explanation: In a client with a respiratory disorder, anxiety worsens such problems as dyspnea and bronchospasm. Therefore, Anxiety is a likely nursing diagnosis. This client may have inadequate nutrition, making Imbalanced nutrition: More than body requirements an unlikely nursing diagnosis. Impaired swallowing may occur in a client with an acute respiratory disorder, such as upper airway obstruction, but not in one with a chronic respiratory disorder. Unilateral neglect may be an appropriate nursing diagnosis when neurologic illness or trauma causes a lack of awareness of a body part; however, this diagnosis doesn't occur in a chronic respiratory disorder. 13. Which statement is true about both lung transplant and bullectomy (lung air pockets)?  Both procedures improve the overall quality of life of a client with COPD. 14. Which statement describes emphysema?  A disease of the airways characterized by destruction of the walls of overdistended alveoli Explanation: Emphysema is a category of COPD. Asthma has a clinical outcome of airflow obstruction. Bronchitis includes the presence of cough and sputum production for at least a combined total of 2 to 3 months in each of two consecutive years. Bronchiectasis is a condition of chronic dilatation of a bronchus or bronchi. 15. A nurse has just completed teaching with a client who has been prescribed a meterdosed inhaler for the first time. Which statement if made by the client would indicate to the nurse that further teaching and follow-up care is necessary?  "I do not need to rinse my mouth with this type of inhaler." 16. A client is being seen in the emergency department for exacerbation of chronic obstructive pulmonary disease (COPD). The first action of the nurse is to administer which of the following prescribed treatments?  Oxygen through nasal cannula at 2 L/minute 17. 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 18. The classification of Stage II of COPD is defined as  moderate COPD. 19. In which statements regarding medications taken by a client diagnosed with COPD do the drug name and the drug category correctly match? Select all that apply.  Ciprofloxacin is an antibiotic.  Albuterol is a bronchodilator.  Prednisone is a corticosteroid. 20. A client is being treated in the ED for respiratory distress coupled with bacterial pneumonia. The client has no medical history. However, the client works in a coal mine and smokes 10 cigarettes a day. The nurse anticipates which order based on the client's immediate needs?  Administration of antibiotics Explanation: Antibiotics are administered to treat respiratory tract infections. Chronic bronchitis is inflammation of the bronchi caused by irritants or infection. Hence, smoking cessation and avoiding pollutants are necessary to slow the accelerated decline of the lung tissue. However, the immediate priority in this case is to cure the infection, pneumonia. Corticosteroids and bronchodilators are administered to asthmatic patients when they show symptoms of wheezing. An ECG is used to evaluate atrial arrhythmias 21. Oxygen has been prescribed for a client with chronic obstructive pulmonary disease (COPD). Which amount of oxygen is considered most appropriate for the COPD client  1 to 2 L/min 22. 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 23. In which grade of COPD is the forced expiratory volume (FEV) less than 30%?  IV 24. The classification of Stage IV of COPD is defined as  very severe COPD. 25. The nurse is reviewing pressurized metered-dose inhaler (pMDI) instructions with a client. Which statement by the client indicates the need for further instruction?  “I can’t use a spacer or holding chamber with the MDI.” 26. In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to which of the following acid–base imbalances?  Respiratory acidosis 27. Which factors increase the risk that a client will develop chronic obstructive pulmonary disease (COPD)? Select all that apply.  History of tobacco use  History of asthma 28. A client with chronic obstructive pulmonary disease (COPD) is recovering from a myocardial infarction. Because the client is extremely weak and can't produce an effective cough, the nurse should monitor closely for:  atelectasis. 29. A nursing student is taking a pathophysiology examination. Which of the following factors would the student correctly identify as contributing to the underlying pathophysiology of chronic obstructive pulmonary disease (COPD)? Choose all that apply.  Mucus secretions that block airways  Inflamed airways that obstruct airflow  Overinflated alveoli that impair gas exchange 30. Which of the following occupy space in the thorax, but do not contribute to ventilation?  Bullae 31. A client with chronic obstructive pulmonary disease (COPD) is admitted to the medicalsurgical unit. To help this client maintain a patent airway and achieve maximal gas exchange, the nurse should:  instruct the client to drink at least 2 L of fluid daily. Explanation: Mobilizing secretions is crucial to maintaining a patent airway and maximizing gas exchange in the client with COPD. Measures that help mobilize secretions include drinking 2 L of fluid daily, practicing controlled pursed-lip breathing, and engaging in moderate activity. Anxiolytics rarely are recommended for the client with COPD because they may cause sedation and subsequent infection from inadequate mobilization of secretions. Because COPD rarely causes pain, pain medication isn't indicated. 32. A client with a history of respiratory problems tells the nurse that he would like to explore strategies to reduce his risks. He also mentions being currently unemployed and not wanting to pursue costly strategies. What would the nurse emphasize as the single most cost-effective intervention to reduce the risk of developing COPD or slow its progression?  Cessation of smoking 33. Which condition places the client at risk for hypercapnia if given high-flow oxygen as treatment for a ventilation perfusion mismatch?  Chronic bronchitis from smoking 34. A client arrives in the emergency room with emphysema and has developed an exacerbation of COPD with respiratory acidosis from airway obstruction. What is the highest priority for the nurse?