Chapter 29: Nursing Management: Obstructive Pulmonary Diseases

Chapter 29: Nursing Management: Obstructive Pulmonary Diseases

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. A patient with chronic bronchitis who has a new prescription for Advair Diskus
(combined fluticasone and salmeterol) asks the nurse the purpose of using two drugs. The
nurse explains that
a. one drug decreases inflammation, and the other is a bronchodilator.
b. Advair is a combination of long-acting and slow-acting bronchodilators.
c. the combination of two drugs works more quickly in an acute asthma attack.
d. the two drugs work together to block the effects of histamine on the bronchioles.
ANS: A
Salmeterol is a long-acting bronchodilator, and fluticasone is a corticosteroid. They work
together to prevent asthma attacks. Neither medication is an antihistamine. Advair is not
used during an acute attack because the medications do not work rapidly.
DIF: Cognitive Level: Application REF: 598-599
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
2. The nurse has completed patient teaching about the administration of salmeterol
(Serevent) using a metered-dose inhaler (MDI). Which action by the patient indicates
good understanding of the teaching?
a. The patient attaches a spacer before using the MDI.
b. The patient coughs vigorously after using the inhaler.
c. The patient floats the MDI in water to see if it is empty.
d. The patient activates the inhaler at the onset of expiration.
ANS: A
Spacers can improve the delivery of medication to the lower airways. The other patient
actions indicate a need for further teaching.
DIF: Cognitive Level: Application REF: 601-602 TOP: Nursing Process:
Evaluation
MSC: NCLEX: Physiological Integrity
3. When preparing a patient with possible asthma for pulmonary function testing, the nurse
will teach the patient to
a. avoid eating or drinking for several hours before the testing.
b. use rescue medications immediately before the tests are done.
c. take oral corticosteroids at least 2 hours before the examination.
d. withhold bronchodilators for 6 to 12 hours before the examination.
ANS: D
Test Bank 29-2
Bronchodilators are held before pulmonary function testing 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 also should be held before the examination and
corticosteroids given 2 hours before the examination would be at a high level. Rescue
medications (which are bronchodilators) would not be given until after the baseline
pulmonary function was assessed.
DIF: Cognitive Level: Application REF: 593
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
4. Which information will the nurse include when teaching the patient with asthma about
the prescribed medications?
a. Utilize 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 2-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: Application REF: 598-599 | 602
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity