Med Surg Exam The Patient With Asthma

The Patient With Asthma 1. Besides dyspnea, what is the most common characteristic associated with pulmonary disease? a. Chest pain b. Hemoptysis c. Cough d. Digit clubbing 2. Kussmaul respirations as a respiratory pattern may be associated with which characteristic(s)? a. b. c. d. Increased work of breathing Inadequate alveolar ventilation in relation to metabolic demands Slightly increased ventilatory rate, large tidal volumes, and no expiratory pause Alternating periods of deep and shallow breathing 3. A patient reports needing to sit up at night in order to breathe. What term does the healthcare professional document about this condition? a. Hyperpnea b. Atelectasis c. Orthopnea d. Apnea 4. Which statement is true regarding the pathophysiologic process of asthma? a. The inflammatory process is due to the loss of bronchial smooth muscle spasm. b. Inflammation results in airway hyperresponsiveness. c. Immunoglobulin A (IgA) is the major factor. d. Vascular permeability increases. 5. Upon auscultation of your patient’s lung sounds, you notice a high-pitched wheezing sound. This is due to: a. Less mucus production b. Bronchodilation c. Fluid accumulation in the lungs d. Asthma 6. You have admitted a 20-year-old male to the emergency room with a history of asthma. He is having an acute asthma attack and is wheezing, fighting for air, hypoxic, and afraid. What is causing these acute symptoms? a. Relaxation of bronchial smooth muscle with dry mucous membranes b. Constriction of the bronchial smooth muscle and air trapping c. Acute destruction of lung tissue d. Contraction of the elastic fibers of the lung 7. A client with COPD calls the pulmonary clinic reporting the last 24 hours the peak flow meter readings have been in the yellow range. Which of these interventions by the nurse is appropriate at this time? a. Use your prescription for rescue medication and retest yourself. b. This is a satisfactory reading, continue your present regimen c. d. Go to the nearest emergency department. Increase your controller medication dose. 8. After receiving education on the correct use of emergency drug therapy for asthma, which statement by the client indicates a correct understanding of the nurse’s instructions? a. “All asthma drugs help everybody breathe better.” b. “I must carry my Fluticason (Flovent) inhaler when activity is anticipated.” c. “I must have my emergency inhaler with me at all times.” d. “Preventive drugs can stop an attack.” 9. The nurse is evaluating understanding of the treatment regimen for a client newly diagnosed with asthma. Which of these statements by the client indicates understanding of the regimen? a. “I will take albuterol when I go to sleep.” b. “I will keep the rescue medication readily accessible on the first floor of my home.” c. “I will take the long acting beta agonist even when my breathing seems OK.” d. “I will immediately take the anti-inflammatory medication for an acute asthma attack.” 10. A client with acute exacerbation of asthma has been admitted to the medical surgical unit for treatment. The client is reporting increased shortness of breath with inspiratory and expiratory wheezes. When planning care for this client, which medication will the nurse administer first? a. Albuterol-2 inhalations b. Fluticasone-2 inhalations c. Ipratropium-2 inhalations d. Salmeterol-2 inhalations 11. The nurse is caring for a patient who is prescribed a long-acting beta2 agonist. The patient states, “The medication is too expensive to use every day. I only use my inhaler when I have an attack.” How would the nurse respond? a. “You are using the inhaler incorrectly. This medication should be taken daily.” b. “If you decrease environmental stimuli, it will be okay for you to use the inhaler only for asthma attacks.” c. “Tell me more about your fears related to feelings of breathlessness.” d. “It is important to use this type of inhaler every day. Let’s identify potential community services to help you.” 12. A nurse assesses several patients who have a history of asthma. Which patient would the nurse assess first? a. A 66-year-old patient with a barrel chest and clubbed fingernails b. A 48-year-old patient with an oxygen saturation level of 92% at rest c. A 35-year-old patient who has a longer expiratory phase than inspiratory phase d. A 27-year-old patient with a heart rate of 120 beats/min 13. A nurse administers medications to a patient who has asthma. Which medication classification is paired correctly with its physiologic response to the medication? a. Bronchodilator—stabilizes the membranes of mast cells and prevents the release of inflammatory mediators b. Cholinergic antagonist—causes bronchodilation by inhibiting the parasympathetic nervous system c. Corticosteroid—relaxes bronchial smooth muscles by binding to and activating pulmonary beta2 receptors d. Cromolyn—disrupts the production of pathways of inflammatory mediators 14. After teaching a patient who is prescribed a long-acting beta2 agonist medication, a nurse assesses the patient’s understanding. Which statement indicates that the patient comprehends the teaching? a. “I will carry this medication with me at all times in case I need it.” b. “I will take this medication when I start to experience an asthma attack.” c. “I will take this medication every morning to help prevent an acute attack.” d. “I will be weaned off this medication when I no longer need it.” 15. After teaching a patient who is prescribed salmeterol (Serevent), the nurse assesses the patient’s understanding. Which statement by the patient indicates a need for additional teaching? a. b. c. d. “I will be certain to shake the inhaler well before I use it.” “It may take a while before I notice a change in my asthma.” “I will use the drug when I have an asthma attack.” “I will be careful not to let the drug escape out of my nose and mouth.” 16. A nurse assesses a patient who is prescribed fluticasone (Flovent) and notes oral lesions. What action would the nurse take? a. Encourage oral rinsing after fluticasone administration. b. Obtain an oral specimen for culture and sensitivity. c. Start the patient on a broad-spectrum antibiotic. d. Document the finding as a known side effect. 17. The nurse instructs a patient on the steps needed to obtain a peak expiratory flow rate. In which order would these steps occur? 1. “Take as deep a breath as possible.” 2. “Stand up (unless you have a physical disability).” 3. “Place the meter in your mouth, and close your lips around the mouthpiece.” 4. “Make sure the device reads zero or is at base level.” 5. “Blow out as hard and as fast as possible for 1 to 2 seconds.” 6. “Write down the value obtained.” 7. “Repeat the process two additional times, and record the highest number in your chart.” a. 4, 2, 1, 3, 5, 6, 7 b. 3, 4, 1, 2, 5, 7, 6 c. 2, 1, 3, 4, 5, 6, 7 d. 1, 3, 2, 5, 6, 7, 4 18. A healthcare professional is educating a patient on asthma. The professional tells the patient that the most successful treatment for chronic asthma begins with which action? a. Administration of broad-spectrum antibiotics b. Administration of drugs that decrease airway inflammation c. Administration of drugs that reduce bronchospasm d. Avoidance of the causative agent