Respiratory Disorders - COPD Flashcards
Respiratory Disorders - COPD/Saunders NCLEX-PN Review (Ch. 48)
- A nurse is caring for a client with emphysema who is receiving oxygen. The nurse checks the oxygen flow rate to ensure that it does not exceed:
A. 1 L/minute
B. 2 L/minute
C. 6 L/minute
D. 10 L/minute
B. 2 L/minute
Rationale:
Between 1 and 3 L/minute of oxygen by nasal cannula may be required to raise the PaO2 level to 60 to 80 mm Hg. However, oxygen is used cautiously in the client with emphysema and should not exceed 2 L/min. Because of the long-standing hypercapnia (High CO2) that occurs in this disorder, the respiratory drive is triggered by low oxygen levels rather than by increase CO2 levels, which is the case in a normal respiratory system.
Test-Taking Strategy:
Recalling the physiology associated with emphysema is required to answer this question. Remember that oxygen is used cautiously in the client with emphysema.
Respiratory Disorders - COPD/Saunders NCLEX-PN Review (Ch. 48)
- A nurse is providing instructions to a hospitalized client with a diagnosis of emphysema about positions that will enhance the effectiveness of breating during dyspneic periods. Which position will the nurse instruct the client to assume?
A. Sitting up in bed.
B. Side-lying in bed.
C. Sitting in a recliner chair.
D. Sitting on the side of the bed, leaning on an overbed table.
D. Sitting on the side of the bed, leaning on an overbed table.
Rationale:
Positions that will assist the client with breathing include sitting up and leaning on an overbed table, sitting up and resting with elbows on the knees, or standing or leaning against the wall. The positions in options A and B, and C will not enhance the effectiveness of breathing.
Test-Taking Strategy:
Eliminate option B because side-lying will not promote appropriate lung expansion. Next, eliminate options A and C because they are comparable or alike.
Respiratory Disorders - COPD/Saunders NCLEX-PN Review (Ch. 48)
- A nurse is instructing a client about pursed lip breathing and the client asks the nurse about its purpose. The nurse tells the client that the primary purpose of pursed lip breathing is to:
A. Promote oxygen intake.
B. Strengthen the diaphragm.
C. Strengthen the intercostal muscles.
D. Promote carbon dioxide elimination.
D. Promote carbon dioxide elimination.
Rationale:
Pursed lip breathing facilitates maximal expirations for clients with obstructive lung disease and promotes CO2 elimination. This type of breathing allows better expiration by increasing airway pressure, which keeps air passages open during exhalation. Options A, B and C are not purposes of this type of breathing.
Respiratory Disorders - COPD/Saunders NCLEX-PN Review (Ch. 48)
- A nurse is caring for a client hospitalized with acute exacerbation of COPD. Which of the following would the nurse expect to note in evaluating this client?
A. Hypocapnia
B. A hyperinflated chest on x-ray.
C. Increased oxygen saturation with exercise
D. A widened diaphragm noted on chest x-ray.
B. A hyperinflated chest on x-ray.
Rationale:
Clinical manifestations of COPD include hypoxemia, hypercapnia,dyspnea and exertion and at rest, oxygen desaturation with exercise, and the use of accessory muscles of respiration. Chest x-ray will reveal a hyperinflated chest and a flattened diaphragm if the disease is advance.
Test-taking Strategy:
Eliminate option C because oxygenation desaturation rather than saturation would occur. Next, eliminate option A because the client with COPD, hypercapnia would be noted. From the remaining options, reading carefully will assist in directing you to option B.
Respiratory Disorders - COPD/Burke Book Chapter 23
Which of the following statement best represents a nurse’s understanding of use of supplemental oxygen in clients with COPD?
A. Because oxygen is flammable, the client should not smoke.
B. Oxygen is used only at night for clients with COPD
C. Oxygen is never used for clients with COPD because they may become dependent on it.
D. The client needs to be closely monitored for signs of respiratory depression.
D. The client needs to be closely monitored for signs of respiratory depression.
Rationale:
COPD clients have increased CO2 levels in their blood, suppressing it as an effective stimulus for respirations; instead, a drop in blood oxygen levels stimulates the drive to breathe. Low doses of O2 are useful for the COPD client, particularly at night. High doses of O2 suppresses the drive to breathe and may result in respiratory failure.
Respiratory Disorders - COPD/Burke Workbook Chapter 23
The most common cause of COPD is:
A. environmental pollution
B. alpha-1 antitrypsin deficiency
C. heredity
D. smoking
D. smoking
Respiratory Disorders - COPD/Berman Book Chapter 35
A client with COPD requires some supplemental oxygen. The nurse ensures consistent and safe delivery with which of the following?
A. 2 L/min per nasal cannula
B. 6 L/min per face mask
C. 8 L/min per partial rebreather mask
D. 10 L/min per nonrebreather mask
A. 2 L/min per nasal cannula
Respiratory Disorders - COPD/Berman Workbook Chapter 35
What doe clients with emphysema frequently develop?
A. Bronchitis
B. COPD
C. Barrel chest
D. Flail chest
C. Barrel chest
Respiratory Disorders - COPD/Saunders NCLEX-PN Review (Ch. 49)
- A client has begun therapy with theophylline (Theo-24). the nurse tells the client to limit the intake of which of the following while taking this medication?
A. Oranges and pineapple
B. Coffee, cola, and chocolate
C. Oysters, lobster, and shrimp
D. Cottage cheese, cream cheese, and dairy creamers
B. Coffee, cola, and chocolate
“Think” methyxanthine is associated with caffeine!
Respiratory Disorders - COPD/Saunders NCLEX-PN Review (Ch. 49)
- A client with an order to take theophylline (Theolair-SR) daily has been given medication instructions by the nurse. The nures determines that the client needs further information about the medication if the clietn states that he or she will:
A. Drink at least 2 L fluids/day
B. Take the daily dose at bedtime
C. Avoid changing brands of the medications without physician approval.
D. Avoid OTC cough and cold medications unless approved by the physician.
B. Take the daily dose at bedtime
Remember: Methylxanthines are associated with caffeine! This patient will be up all night.
Respiratory Disorders - COPD (ATI Med Surge Book - Ch. 20)
A nurse is reinforcing discharge teaching to a client who has COPD. The client will be using oxygen at home. Prior to discharge, the nurse monitors the client for signs for cor pulmonale. Which of the following are findings of cor pulmonale? Select all that apply.
A. Cyanotic lips B. Enlarged liver C. Tachypnea D. Distended neck veins E. Normal sinus rhythm F. Insatiable appetite
A. Cyanotic lips
B. Enlarged liver
C. Tachypnea
D. Distended neck veins
Rationale:
Clients with cor pulmonale are more likely to have cardiac dysrhythmias and anorexia.
Respiratory Disorders - COPD (ATI Med Surge Book - Ch. 20)
A nurse is reinforcing discharge teaching to a client who has COPD. The client will be using oxygen at home. During discharge teaching, which of the following is most important for the nurse to reinforce?
A. Smoking cessation
B. Equipment maintenance
C. Incorporating rest into ADLs
D. Anxiety management
A. Smoking cessation
Rationale:
Keeping the client free from injury and harm is the first priority. All other options are not the priority.
Respiratory Disorders - COPD (ATI Med Surge Book - Ch. 20)
The client is concerned about leaving the house while on continuous oxygen. Which of the following statements should the nurse make?
A. “There are portable oxygen delivery systems that you can take with you.”
B. “When you go out you can remove the oxygen, just make sure you place it back on when you get home.”
C. “You probably will not be able to out as much as you used to.”
D. “Home health services will come to you so you will not need to go out.”
A. “There are portable oxygen delivery systems that you can take with you.”
Respiratory Disorders - COPD (ATI Med Surge Book - Ch. 20)
A nurse is collecting data from a client newly admitted with COPD. Which of the following findings should the nurse expect to find? Select all that apply.
A. Crackles and wheezes heard upon auscultation.
B. Shortness of breath upon exertion.
C. A nonproductive cough, especially upon rising in the morning.
D. Clubbing of fingers and toes
E. Rapid and shallow breathing.
F. Oxygen saturation of 95%.
A. Crackles and wheezes heard upon auscultation.
B. Shortness of breath upon exertion.
D. Clubbing of fingers and toes
E. Rapid and shallow breathing.
Rationale:
A client with COPD may have a productive cough upon rising in the morning.
