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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.
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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.
The nurse is assessing a patient whose respiratory disease is characterized by chronic hyperinflation of the lungs. What would the nurse most likely assess in this patient?
- A. Signs of oxygen toxicity
- B. Chronic chest pain
- C. A barrel chest
- D. Long, thin fingers
Correct Answer: C
Rationale: In COPD patients with a primary emphysematous component, chronic hyperinflation leads to the barrel chest thorax configuration. The nurse most likely would not assess chest pain or long, thin fingers; these are not characteristic of emphysema. The patient would not show signs of oxygen toxicity unless he or she received excess supplementary oxygen.
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 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 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.