Nokea
A patients severe asthma has necessitated the use of a long-acting beta agonist (LABA). Which of the patients statements suggests a need for further education?
- A. I know that these drugs can sometimes make my heart beat faster.
- B. Ive heard that this drug is particularly good at preventing asthma attacks during exercise.
- C. Ill make sure to use this each time I feel an asthma attack coming on.
- D. Ive heard that this drug sometimes gets less effective over time.
Correct Answer: C
Rationale: LABAs are not used for management of acute asthma symptoms. Tachycardia is a potential adverse effect and decreased protection against exercise-induced bronchospasm may occur with regular use.
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An asthma nurse educator is working with a group of adolescent asthma patients. What intervention is most likely to prevent asthma exacerbations among these patients?
- A. Encouraging patients to carry a corticosteroid rescue inhaler at all times
- B. Educating patients about recognizing and avoiding asthma triggers
- C. Teaching patients to utilize alternative therapies in asthma management
- D. Ensuring that patients keep their immunizations up to date
Correct Answer: B
Rationale: Asthma exacerbations are best managed by early treatment and education, including the use of written action plans as part of any overall effort to educate patients about self-management techniques, especially those with moderate or severe persistent asthma or with a history of severe exacerbations. Corticosteroids are not used as rescue inhalers. Alternative therapies are not normally a high priority, though their use may be appropriate in some cases. Immunizations should be kept up to date, but this does not necessarily prevent asthma exacerbations.
A nurse is developing the teaching portion of a care plan for a patient with COPD. What would be the most important component for the nurse to emphasize?
- A. Smoking up to one-half of a pack of cigarettes weekly is allowable.
- B. Chronic inhalation of indoor toxins can cause lung damage.
- C. Minor respiratory infections are considered to be self-limited and are not treated.
- D. Activities of daily living (ADLs) should be clustered in the early morning hours.
Correct Answer: B
Rationale: Environmental risk factors for COPD include prolonged and intense exposure to occupational dusts and chemicals, indoor air pollution, and outdoor air pollution. Smoking cessation should be taught to all patients who are currently smoking. Minor respiratory infections that are of no consequence to the person with normal lungs can produce fatal disturbances in the lungs of the person with emphysema. ADLs should be paced throughout the day to permit patients to perform these without excessive distress.
An interdisciplinary team is planning the care of a patient with bronchiectasis. What aspects of care should the nurse anticipate?
- A. Occupational therapy
- B. Antimicrobial therapy
- C. Positive pressure isolation
- D. Chest physiotherapy
- E. Smoking cessation
Correct Answer: B,D,E
Rationale: Chest physiotherapy, antibiotics, and smoking cessation are cornerstones of the care of patients with bronchiectasis. Occupational therapy and isolation are not normally indicated.
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 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.