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A nurse is completing a focused respiratory assessment of a child with asthma. What assessment finding is most closely associated with the characteristic signs and symptoms of asthma?
- A. Shallow respirations
- B. Increased anterior-posterior (A-P) diameter
- C. Bilateral wheezes
- D. Bradypnea
Correct Answer: C
Rationale: The three most common symptoms of asthma are cough, dyspnea, and wheezing. There may be generalized wheezing (the sound of airflow through narrowed airways), first on expiration and then, possibly, during inspiration as well. Respirations are not usually slow and the childs A-P diameter does not normally change.
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A pediatric nurse practitioner is caring for a child who has just been diagnosed with asthma. The nurse has provided the parents with information that includes potential causative agents for an asthmatic reaction. What potential causative agent should the nurse describe?
- A. Pets
- B. Lack of sleep
- C. Psychosocial stress
- D. Bacteria
Correct Answer: A
Rationale: Common causative agents that may trigger an asthma attack are as follows: dust, dust mites, pets, soap, certain foods, molds, and pollens. Lack of sleep, stress, and bacteria are not common triggers for asthma attacks.
A nurse is documenting the results of assessment of a patient with bronchiectasis. What would the nurse most likely include in documentation?
- A. Sudden onset of pleuritic chest pain
- B. Wheezes on auscultation
- C. Increased anterior-posterior (A-P) diameter
- D. Clubbing of the fingers
Correct Answer: D
Rationale: Characteristic symptoms of bronchiectasis include chronic cough and production of purulent sputum in copious amounts. Clubbing of the fingers also is common because of respiratory insufficiency. Sudden pleuritic chest pain is a common manifestation of a pulmonary embolism. Wheezes on auscultation are common in patients with asthma. An increased A-P diameter is noted in patients with COPD.
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 nurse is creating a health promotion intervention focused on chronic obstructive pulmonary disease (COPD). What should the nurse identify as a complication of COPD?
- A. Lung cancer
- B. Cystic fibrosis
- C. Respiratory failure
- D. Hemothorax
Correct Answer: C
Rationale: Complications of COPD include respiratory failure, pneumothorax, atelectasis, pneumonia, and pulmonary hypertension (cor pulmonale). Lung cancer, cystic fibrosis, and hemothorax are not common complications.
A nurse is explaining to a patient with asthma what her new prescription for prednisone is used for. What would be the most accurate explanation that the nurse could give?
- A. To ensure long-term prevention of asthma exacerbations
- B. To cure any systemic infection underlying asthma attacks
- C. To prevent recurrent pulmonary infections
- D. To gain prompt control of inadequately controlled, persistent asthma
Correct Answer: D
Rationale: Prednisone is used for a short-term (3-10 days) burst to gain prompt control of inadequately controlled, persistent asthma. It is not used to treat infection or to prevent exacerbations in the long term.