Nokea
A male 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:
- A. Pleural effusion
- B. Pulmonary edema
- C. Atelectasis
- D. Oxygen toxicity
Correct Answer: C
Rationale: The correct answer is C: Atelectasis. In a client with COPD recovering from a myocardial infarction, the weakened state and ineffective cough can lead to the collapse of alveoli, causing atelectasis. This condition can further impair gas exchange and oxygenation, leading to respiratory distress. Monitoring for atelectasis is crucial to prevent complications. Pleural effusion (A) and pulmonary edema (B) are not directly related to the client's condition and symptoms. Oxygen toxicity (D) is a potential concern with high oxygen therapy but is not the most immediate risk for this client scenario.
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When the nurse reads the diagnosis of centrilobar emphysema, the nurse recognizes that this type of emphysema is characterized by:
- A. No significant smoking history in the patient.
- B. Enlarged and broken down bronchioles, with intact alveoli.
- C. Hypoelastic bronchi and bronchioles.
- D. Deficiency of the enzyme inhibitor alpha "“ antitrypsin.
Correct Answer: B
Rationale: The correct answer is B because centrilobar emphysema is characterized by enlarged and broken down bronchioles with intact alveoli. This type of emphysema primarily affects the respiratory bronchioles and alveolar ducts in the upper lung lobes. The other choices are incorrect because: A) Significant smoking history is usually present in patients with centrilobar emphysema. C) Hypoelastic bronchi and bronchioles are not characteristic of centrilobar emphysema. D) Deficiency of the enzyme inhibitor alpha-1 antitrypsin is associated with a different type of emphysema called panlobar emphysema, not centrilobar emphysema.
Asthma is caused due to
- A. Infection of trachea
- B. Infection of lungs
- C. Bleeding into pleural cavity
- D. Spasm in bronchial muscles
Correct Answer: D
Rationale: The correct answer is D: Spasm in bronchial muscles. Asthma is a chronic respiratory condition characterized by inflammation and narrowing of the airways, leading to difficulty breathing. Bronchial muscles in the airways undergo spasms, causing constriction and making it hard to breathe. Infection of the trachea (A) or lungs (B) may lead to respiratory symptoms but is not the primary cause of asthma. Bleeding into the pleural cavity (C) is unrelated to the pathophysiology of asthma. Therefore, the correct answer is D as it directly correlates with the underlying mechanism of asthma.
Which information from a client helps the nurse confirm the previous diagnosis of chronic stable angina?
- A. The pain wakes me up at night.
- B. The pain is level 3 to 5 (0 to 10 scale).
- C. The pain has gotten worse over the last week.
- D. The pain goes away after I stop jogging.
Correct Answer: D
Rationale: The correct answer is D because chronic stable angina is characterized by chest pain or discomfort that is triggered by physical exertion or emotional stress and relieved by rest or medication. Therefore, the fact that the pain goes away after stopping jogging aligns with the typical pattern of chronic stable angina.
A: The pain waking the client up at night is more indicative of unstable angina or a heart attack.
B: The level of pain on a scale does not provide conclusive evidence of chronic stable angina.
C: Pain worsening over time may suggest unstable angina or a heart attack rather than chronic stable angina.
Which one is a Non-reversible pulmonary disease in which the bronchi are blocked with mucous and infection and rupture of alveoli
- A. Silicosis
- B. Asphyxia
- C. Emphysema
- D. Embolism
Correct Answer: C
Rationale: Emphysema is the correct answer because it is a non-reversible pulmonary disease characterized by the destruction of lung tissue, leading to the blockage of bronchioles and rupture of alveoli. This results in difficulty breathing and reduced oxygen exchange. Silicosis (A) is caused by inhaling silica dust, not related to bronchial blockage. Asphyxia (B) is a condition of suffocation, not related to pulmonary disease. Embolism (D) is the blockage of a blood vessel by a clot, not specific to the bronchi or alveoli.
Which of the following are normal breath sounds?
- A. Sounds heard over the trachea - medium pitch
- B. Sounds heard between the trachea and upper lungs - loud
- C. Sounds heard over the lung fields - quiet and low-pitched
- D. Sounds that are discrete - continuous and musical
Correct Answer: C
Rationale: The correct answer is C. Normal breath sounds over the lung fields are vesicular, characterized as quiet and low-pitched. A is incorrect because bronchial breath sounds over the trachea are high-pitched and loud. B is incorrect as these intermediate sounds occur near large airways, not throughout the lung fields. D describes adventitious sounds like wheezing or crackles, which are abnormal.