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A nurse is assessing a patient who is suspected of having bronchiectasis. The nurse should consider which of the following potential causes?
- A. Pulmonary hypertension
- B. Airway obstruction
- C. Pulmonary infections
- D. Genetic disorders
- E. Atelectasis
Correct Answer: B,C,D
Rationale: Bronchiectasis is a chronic, irreversible dilation of the bronchi and bronchioles. Under the new definition of COPD, it is considered a disease process separate from COPD. Bronchiectasis may be caused by a variety of conditions, including airway obstruction, diffuse airway injury, pulmonary infections and obstruction of the bronchus or complications of long-term pulmonary infections, or genetic disorders such as cystic fibrosis. Bronchiectasis is not caused by pulmonary hypertension or atelectasis.
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A nurse is developing a teaching plan for a patient with COPD. What should the nurse include as the most important area of teaching?
- A. Avoiding extremes of heat and cold
- B. Setting and accepting realistic short- and long-range goals
- C. Adopting a lifestyle of moderate activity
- D. Avoiding emotional disturbances and stressful situations
Correct Answer: B
Rationale: A major area of teaching involves setting and accepting realistic short-term and long-range goals. The other options should also be included in the teaching plan, but they are not areas that are as high a priority as setting and accepting realistic goals.
An asthma educator is teaching a patient newly diagnosed with asthma and her family about the use of a peak flow meter. The educator should teach the patient that a peak flow meter measures what value?
- A. Highest airflow during a forced inspiration
- B. Highest airflow during a forced expiration
- C. Airflow during a normal inspiration
- D. Airflow during a normal expiration
Correct Answer: B
Rationale: Peak flow meters measure the highest airflow during a forced expiration.
A nurse has been asked to give a workshop on COPD for a local community group. The nurse emphasizes the importance of smoking cessation because smoking has what pathophysiologic effect?
- A. Increases the amount of mucus production
- B. Destabilizes hemoglobin
- C. Shrinks the alveoli in the lungs
- D. Collapses the alveoli in the lungs
Correct Answer: A
Rationale: Smoking irritates the goblet cells and mucous glands, causing an increased accumulation of mucus, which, in turn, produces more irritation, infection, and damage to the lung.
A patient arrives in the emergency department with an attack of acute bronchiectasis. Chest auscultation reveals the presence of copious secretions. What intervention should the nurse prioritize in this patients care?
- A. Oral administration of diuretics
- B. Intravenous fluids to reduce the viscosity of secretions
- C. Postural chest drainage
- D. Pulmonary function testing
Correct Answer: C
Rationale: Postural drainage is part of all treatment plans for bronchiectasis, because draining of the bronchiectatic areas by gravity reduces the amount of secretions and the degree of infection. Diuretics and IV fluids will not aid in the mobilization of secretions. Lung function testing may be indicated, but this assessment will not relieve the patients symptoms.
A nurse is working with a child who is undergoing a diagnostic workup for suspected asthma. What are the signs and symptoms that are consistent with a diagnosis of asthma?
- A. Chest tightness
- B. Crackles
- C. Bradypnea
- D. Wheezing
- E. Cough
Correct Answer: A,D,E
Rationale: Asthma is a chronic inflammatory disease of the airways that causes airway hyperresponsiveness, mucosal edema, and mucus production. This inflammation ultimately leads to recurrent episodes of asthma symptoms: cough, chest tightness, wheezing, and dyspnea. Crackles and bradypnea are not typical symptoms of asthma.