Chapter 32: Care of Patients with Noninfectious Lower Respiratory Problems

Chapter 32: Care of Patients with Noninfectious Lower Respiratory Problems

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A client with asthma reports “not being able to take deep breaths.” The nurse auscultates decreased breath sounds in the bases, and no wheezes. What is the nurse’s best action?

a.	Encourage the client to stay calm and take deep breaths.
b.	Document the findings and continue to monitor.
c.	Have the client cough forcefully.
d.	Assess the client’s oxygen saturation.

 

 

ANS:  D

Decreased wheezing accompanied by decreased breath sounds can mean airway occlusion from mucus and from inflammation. The nurse should assess the client’s oxygenation and determine whether additional interventions are needed. Coughing forcefully may cause the smaller airways to collapse and may not help the client. Encouraging the client to remain calm and to try to take deep breaths is not helpful. Although providing documentation is important, the nurse needs to do more than that.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Complications from Surgical Procedures and Health Alterations)

MSC:  Integrated Process: Nursing Process (Implementation)

 

2. A client with asthma has been having frequent asthma attacks. What is the nurse’s best action?

a.	Teach the client to stay away from pets.
b.	Assist the client in using an incentive spirometer.
c.	Administer aspirin for its anti-inflammatory properties.
d.	Administer montelukast (Singulair).

 

 

ANS:  D

A client who has been having increased attacks can have some chronic inflammation occurring. This inflammation is probably stimulated by mediators such as histamine and leukotriene and can be blocked by drugs like diphenhydramine (Benadryl) and montelukast (Singulair).

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Pharmacological and Parenteral Therapies—Expected Actions/Outcomes)

MSC:  Integrated Process: Nursing Process (Implementation)

 

3. A client diagnosed with asthma has not responded well to medication. The client is concerned and asks the nurse, “What is wrong with me, and why am I not getting better?” What is the nurse’s best response?

a.	“You just weren’t used to the medication yet.”
b.	“The medication dose has to be increased.”
c.	“It is possible that genetic testing may help.”
d.	“You should try homeopathic medicine.”

 

 

ANS:  C

Some genetic variations may cause the activity of beta-adrenergic receptors to change, meaning that the client would not respond as expected to beta agonists. Genetic testing may help to determine why the drug therapy is not working and may help the clinician to identify new therapy that will work.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Pharmacological and Parenteral Therapies—Expected Actions/Outcomes)

MSC:  Integrated Process: Nursing Process (Implementation)

 

4. The nurse is caring for four clients with asthma. Which client does the nurse assess first?

a.	Client with a barrel chest and clubbed fingernails
b.	Client with an SaO2 level of 92% at rest
c.	Client whose expiratory phase is longer than the inspiratory phase
d.	Client whose heart rate is 120 beats/min

 

 

ANS:  D

Tachycardia can indicate hypoxemia as the body tries to circulate the oxygen that is available. A barrel chest is not an emergency finding. Likewise a pulse oximetry level of 92% is not considered an acute finding. The expiratory phase is expected to be longer than the inspiratory phase in someone with airflow limitation.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Safe and Effective Care Environment (Management of Care—Establishing Priorities)           MSC:              Integrated Process: Nursing Process (Assessment)