Chapter 28: Obstructive Pulmonary Diseases

Chapter 28: Obstructive Pulmonary Diseases

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse teaches a patient with chronic bronchitis about a new prescription for Advair Diskus (combined fluticasone and salmeterol). Which action by the patient would indicate to the nurse that teaching about medication administration has been successful?

a.	The patient shakes the device before use.
b.	The patient rapidly inhales the medication.
c.	The patient attaches a spacer to the Diskus.
d.	The patient performs huff coughing after inhalation.

 

 

ANS:  B

The patient should inhale the medication rapidly. Otherwise the dry particles will stick to the tongue and oral mucosa and not get inhaled into the lungs. Advair Diskus is a dry powder inhaler; shaking is not recommended. Spacers are not used with dry powder inhalers. Huff coughing is a technique to move mucus into larger airways to expectorate. The patient should not huff cough or exhale forcefully after taking Advair in order to keep the medication in the lungs.

 

DIF:    Cognitive Level: Apply (application)           REF:               552

TOP:   Nursing Process: Evaluation            MSC:  NCLEX: Physiological Integrity

 

2. The nurse teaches a patient how to administer formoterol (Perforomist) through a nebulizer. Which action by the patient indicates good understanding of the teaching?

a.	The patient attaches a spacer before using the inhaler.
b.	The patient coughs vigorously after using the inhaler.
c.	The patient removes the facial mask when misting stops.
d.	The patient activates the inhaler at the onset of expiration.

 

 

ANS:  C

A nebulizer is used to administer aerosolized medication. A mist is seen when the medication is aerosolized, and when all of the medication has been used, the misting stops. The other options refer to inhaler use. Coughing vigorously after inhaling and activating the inhaler at the onset of expiration are both incorrect techniques when using an inhaler.

 

DIF:    Cognitive Level: Apply (application)           REF:               551

TOP:   Nursing Process: Evaluation            MSC:  NCLEX: Physiological Integrity

 

3. A patient is scheduled for spirometry. Which action should the nurse take to prepare the patient for this procedure?

a.	Give the rescue medication immediately before testing.
b.	Administer oral corticosteroids 2 hours before the procedure.
c.	Withhold bronchodilators for 6 to 12 hours before the examination.
d.	Ensure that the patient has been NPO for several hours before the test.

 

 

ANS:  C

Bronchodilators are held before spirometry so that a baseline assessment of airway function can be determined. Testing is repeated after bronchodilator use to determine whether the decrease in lung function is reversible. There is no need for the patient to be NPO. Oral corticosteroids should be held before spirometry. Rescue medications (which are bronchodilators) would not be given until after the baseline pulmonary function was assessed.

 

DIF:    Cognitive Level: Apply (application)           REF:               543

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Physiological Integrity

 

4. Which information will the nurse include in the asthma teaching plan for a patient being discharged?

a.	Use the inhaled corticosteroid when shortness of breath occurs.
b.	Inhale slowly and deeply when using the dry powder inhaler (DPI).
c.	Hold your breath for 5 seconds after using the bronchodilator inhaler.
d.	Tremors are an expected side effect of rapidly acting bronchodilators.

 

 

ANS:  D

Tremors are a common side effect of short-acting b₂-adrenergic (SABA) medications and not a reason to avoid using the SABA inhaler. Inhaled corticosteroids do not act rapidly to reduce dyspnea. Rapid inhalation is needed when using a DPI. The patient should hold the breath for 10 seconds after using inhalers.

 

DIF:    Cognitive Level: Apply (application)           REF:               550

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Physiological Integrity

 

5. The emergency department nurse is evaluating the effectiveness of therapy for a patient who has received treatment during an asthma attack. Which assessment finding is the best indicator that the therapy has been effective?

a.	No wheezes are audible.
b.	O2 saturation is >90%.
c.	Accessory muscle use has decreased.
d.	Respiratory rate is 16 breaths/minute.

 

 

ANS:  B

The goal for treatment of an asthma attack is to keep the O₂ saturation above 90%. The other patient data may occur when the patient is too fatigued to continue with the increased work of breathing required in an asthma attack.

 

DIF:    Cognitive Level: Analyze (apply)     REF:   545                TOP:   Nursing Process: Evaluation

MSC:  NCLEX: Physiological Integrity