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A patient is having pulmonary-function studies performed. The patient performs a spirometry test, revealing an FEV1/FVC ratio of 60%. How should the nurse interpret this assessment finding?
- A. Strong exercise tolerance
- B. Exhalation volume is normal
- C. Respiratory infection
- D. Obstructive lung disease
Correct Answer: D
Rationale: Spirometry is used to evaluate airflow obstruction, which is determined by the ratio of forced expiration volume in 1 second to forced vital capacity. Obstructive lung disease is apparent when an FEV1/FVC ratio is less than 70%.
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An admitting nurse is assessing a patient with COPD. The nurse auscultates diminished breath sounds, which signify changes in the airway. These changes indicate to the nurse to monitor the patient for what?
- A. Kyphosis and clubbing of the fingers
- B. Dyspnea and hypoxemia
- C. Sepsis and pneumothorax
- D. Bradypnea and pursed lip breathing
Correct Answer: B
Rationale: These changes in the airway require that the nurse monitor the patient for dyspnea and hypoxemia. Kyphosis is a musculoskeletal problem. Sepsis and pneumothorax are atypical complications. Tachypnea is much more likely than bradypnea. Pursed lip breathing can relieve dyspnea.
A clinic nurse is caring for a patient who has just been diagnosed with chronic obstructive pulmonary disease (COPD). The patient asks the nurse what he could have done to minimize the risk of contracting this disease. What would be the nurses best answer?
- A. The most important risk factor for COPD is exposure to occupational toxins.
- B. The most important risk factor for COPD is inadequate exercise.
- C. The most important risk factor for COPD is exposure to dust and pollen.
- D. The most important risk factor for COPD is cigarette smoking.
Correct Answer: D
Rationale: The most important risk factor for COPD is cigarette smoking. Lack of exercise and exposure to dust and pollen are not risk factors for COPD. Occupational risks are significant but are far exceeded by smoking.
A student nurse is developing a teaching plan for an adult patient with asthma. Which teaching point should have the highest priority in the plan of care that the student is developing?
- A. Gradually increase levels of physical exertion.
- B. Change filters on heaters and air conditioners frequently.
- C. Take prescribed medications as scheduled.
- D. Avoid goose-down pillows.
Correct Answer: C
Rationale: Although all of the measures are appropriate for a client with asthma, taking prescribed medications on time is the most important measure in preventing asthma attacks.
A nurses assessment reveals that a client with COPD may be experiencing bronchospasm. What assessment finding would suggest that the patient is experiencing bronchospasm?
- A. Fine or coarse crackles on auscultation
- B. Wheezes or diminished breath sounds on auscultation
- C. Reduced respiratory rate or lethargy
- D. Slow, deliberate respirations
Correct Answer: B
Rationale: Wheezing and diminished breath sounds are consistent with bronchospasm. Crackles are usually attributable to other respiratory or cardiac pathologies. Bronchospasm usually results in rapid, inefficient breathing and agitation.
A school nurse is caring for a 10-year-old girl who is having an asthma attack. What is the preferred intervention to alleviate this clients airflow obstruction?
- A. Administer corticosteroids by metered dose inhaler
- B. Administer inhaled anticholinergics
- C. Administer an inhaled beta-adrenergic agonist
- D. Utilize a peak flow monitoring device
Correct Answer: C
Rationale: Asthma exacerbations are best managed by early treatment and education of the patient. Quick-acting beta-adrenergic medications are the first used for prompt relief of airflow obstruction. Systemic corticosteroids may be necessary to decrease airway inflammation in patients who fail to respond to inhaled beta-adrenergic medication. A peak flow device will not resolve short-term shortness of breath.