Exam 4 Prep

Question 1

What is the primary clinical symptom of emphysema?

Answer 1

Wheezing

Question 2

A patient is presenting with chronic obstructive pulmonary disease. The patient has a chronic productive cough with dyspnea on excretion. Arterial blood gases show a low oxygen level and high carbon dioxide level in the blood. On assessment, the patient has cyanosis in the lips and edema in the abdomen and legs. Based on your nursing knowledge and the patient’s symptoms, you suspect the patient suffers from what type of COPD?

Answer 2

Chronic bronchitis

Question 3

The nurse concludes that a client has understood teaching about menopause when the client states:

Answer 3

“I know I have begun menopause and it will take awhile to finish.”

Question 4

Signs and symptoms of andropause include all of the following except:

Answer 4

Decrease in intellectual capacity

Question 5

S/S of Cystic Fibrosis:

Answer 5

1. Cold
2. Thick sticky mucus
3. Steatorrhea {Fatty stools}
   - Diarrhea

Question 6

Pathophysiology of chronic bronchitis:

Answer 6

Air sacs in alveoli in the lungs do not work properly due to chronic irritation, chronic irritation, and reoccurring of larger airway

+ Cough and sputum production for at least 3 months in each of 2 consecutive years
+ Ciliary function is reduced, bronchial walls thicken, bronchial airways narrow, and mucous may plug airways
+ Alveoli become damaged, fibrosed, and alveolar macrophage function diminishes
+ The patient is more susceptible to respiratory infections

Question 7

What is the primary nursing intervention for a pt with emphysema?

Answer 7

You assess O2 Saturation (Pulse Ox) before administering O2 if its too low

Question 8

What are complications experienced in COPD?

Answer 8

Scar tissue that could lead to pulmonary hypertension (and airway narrowing)
Clubbing of fingers due to chronic hypoxemia
Barrel chest
Right sided heart failure {Cor Pulmonale)

Question 9

What is the proper way of using a metered dose inhaler (MDI)?

Answer 9

Expel med in barrel and inhale
2 puffs of same med = wait 1 min between puffs
Bronchodilators will be administered before corticosteroids

Question 10

What are discharge instructions for a pt with COPD?

Answer 10

+ Avoid smoking and irritants that would irritate or exacerbate their breathing activities
+ Pace to conserve energy
+ Seek help if they have a fever
+ Pursed lip breathing
+ Get vaccinations (influenza and pneumonia)
+ Compliance with medications

Question 11

S/S of chronic bronchitis:

Answer 11

+ Color dusky due to cyanosis
+ Cyanosis is also seen in their nail beds
+ Peripheral edema (Edema of the limbs)
+ Hypercapnia
+ Increased Sputum production [Chronic productive cough]

Question 12

What pt teaching will you offer for a pt to manage emphysema:

Answer 12

Stop smoking

Question 13

S/S of Pulmonary Hypertension:

Answer 13

1. JVD
2. Fatigue
3. Chest pain
4. Palpations
5. Lower extremity swelling
6. Sleep apnea
7. Daytime Hypersomnolence
8. Light headedness/ dizziness
9. Syncope
10. Loud tricuspid regurgitation murmurs
11. Dyspnea
12. Abdominal swelling
13. Peripheral edema
14. Tachycardia

Question 14

Normal AP lateral ratio:

Answer 14

1 - 2

Question 15

Risk factors for child being born with cystic fibrosis:

Answer 15

+ Both parents carry the gene so the child has a 50% {1:4 chance} chance of being a carrier of cystic fibrosis
+ The mutated gene is = Chromosome 7

Question 16

What is the priority assessment of a child with cystic fibrosis:

Answer 16

(Their pancreas is not functioning properly)

Malnutrition because the child will not be able to absorb Vitamins D, E, K, A {Fat soluble vitamins}

Question 17

S/S of emphysema: (Will you see residual lung volumes decreased or increased)

Answer 17

1. Increased residual lung volume

2. These pts., inhalation is not the problem, but exhalation is a problem (Trapped air)

Question 18

Emphysema: What do you expect to see of their diaphragm on imaging?

Answer 18

Its flat because of the increased residual lung volume

Question 19

Interventions to make for pts with asthma for prevention:

Answer 19

Teach them to avoid their triggers

Question 20

By avoiding asthma triggers, if they are maintaining or managing their asthma properly, then what else will happen:

Answer 20

+ better airway
+ high PERF because they are able to exhale more efficiently
+ less visits to the ER / hospital visits / Drs office / sick visits
+ less use of rescue drugs

Question 21

What is a consideration you would make in pt teaching with asthma:

Answer 21

+ Watching for status asthmaticus
+ medication compliance even without symptoms
+ Asthma is reversible

Question 22

For patients with uncomplicated hypertension and no specific indications for another medication, what is the initial medication?

Answer 22

Thiazide diuretic

Question 23

The nurse is preparing an education plan for a patient newly diagnosed with hypertension. What should be included in the education plan?

Answer 23

Engage in regular aerobic physical activity such as brisk walking (at least 30 min/day most days of the week).

Question 24

What is an acceptable score for chest pain using a numeric scale?

Answer 24

0

Question 25

The client is admitted with a diagnosis of angina caused by coronary vasospasm. The nurse recognizes this type of angina is classified as:

Answer 25

Variant (Printzmetal’s) angina

Question 26

A child with CHD experiences hypercyanotic tet spells. The nurse would place the child in which position for relief?

Answer 26

Knee-to-chest

Question 27

What is an expected assessment finding in a child with coarctation of the aorta?

Answer 27

Disparity in blood pressure between the upper and lower extremities

Question 28

The nurse is caring for patients in an outpatient clinic. Which information should the teach regarding recommendations for early detection of colon cancer?

Answer 28

At age 50, a colonoscopy, then once at least every 10 years

Question 29

The client is diagnosed with cancer of the head of the pancreas. When assessing the patient, which signs and symptoms would the nurse expect to find?

Answer 29

Clay-colored stools and dark urine

Question 30

Mr. Gonzalez has been diagnosed with bone cancer. You know this type of cancer is classified as:

Answer 30

Sarcoma

Question 31

Which of the following are the two main symptoms of osteosarcomas?

Answer 31

Pain and swelling

Question 32

What is usually the first clinical manifestation of breast cancer?

Answer 32

Painless lump

Question 33

What are the current guidelines for breast cancer screening?

Answer 33

Yearly mammograms starting at age 40