Chapter 30: Care of Patients with Noninfectious Lower Respiratory Problems

Chapter 30: Care of Patients with Noninfectious Lower Respiratory Problems

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A nurse assesses several clients who have a history of asthma. Which client should the nurse assess first?
   1. A 66-year-old client with a barrel chest and clubbed fingernails
   2. A 48-year-old client with an oxygen saturation level of 92% at rest
   3. A 35-year-old client who has a longer expiratory phase than inspiratory phase
   4. A 27-year-old client with a heart rate of 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:     Applying/Application                         REF: 552                     KEY: Respiratory distress/failure| assessment/diagnostic examination  MSC:    Integrated Process: Nursing Process: Assessment      NOT:   Client Needs Category: Safe and Effective Care Environment: Management of Care

2. A nurse cares for a client with arthritis who reports frequent asthma attacks. Which action should the nurse take first?
   1. Review the client’s pulmonary function test results.
   2. Ask about medications the client is currently taking.
   3. Assess how frequently the client uses a bronchodilator.
   4. Consult the provider and request arterial blood gases.

ANS:   B

Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can trigger asthma in some people. This results from increased production of leukotriene when aspirin or NSAIDs suppress other inflammatory pathways and is a high priority given the client’s history. Reviewing pulmonary function test results will not address the immediate problem of frequent asthma attacks. This is a good intervention for reviewing response to bronchodilators. Questioning the client about the use of bronchodilators will address interventions for the attacks but not their cause. Reviewing arterial blood gas results would not be of use in a client between attacks because many clients are asymptomatic when not having attacks.

DIF:     Applying/Application                         REF: 553                     KEY: Respiratory distress/failure| medication                                                                   MSC:             Integrated Process: Nursing Process: Assessment                                       NOT: Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

3. After teaching a client who is prescribed a long-acting beta₂ agonist medication, a nurse assesses the client’s understanding. Which statement indicates the client comprehends the teaching?
   1. “I will carry this medication with me at all times in case I need it.”
   2. “I will take this medication when I start to experience an asthma attack.”
   3. “I will take this medication every morning to help prevent an acute attack.”
   4. “I will be weaned off this medication when I no longer need it.”

ANS:           C

Long-acting beta₂ agonist medications will help prevent an acute asthma attack because they are long acting. The client will take this medication every day for best effect. The client does not have to always keep this medication with him or her because it is not used as a rescue medication. This is not the medication the client will use during an acute asthma attack because it does not have an immediate onset of action. The client will not be weaned off this medication because this is likely to be one of his or her daily medications.

DIF:            Applying/Application                         REF:    554                   KEY: Medication| patient education    MSC:                                                  Integrated Process: Teaching/Learning NOT:                     Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

4. After teaching a client how to perform diaphragmatic breathing, the nurse assesses the client’s understanding. Which action demonstrates that the client correctly understands the teaching?
   1. The client lays on his or her side with his or her knees bent.
   2. The client places his or her hands on his or her abdomen.
   3. The client lays in a prone position with his or her legs straight.
   4. The client places his or her hands above his or her head.

ANS:           B

To perform diaphragmatic breathing correctly, the client should place his or her hands on his or her abdomen to create resistance. This type of breathing cannot be performed effectively while lying on the side or with hands over the head. This type of breathing would not be as effective lying prone.

DIF:            Applying/Application                         REF:    562                   KEY: Respiratory distress/failure| patient education                                                    MSC: Integrated Process: Teaching/Learning                               NOT:                                                 Client Needs Category: Physiological Integrity: Physiological Adaptation