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BSNC 6000 Mod. 1 Exam Questions With Correct Answers. A 58-year-old client with a 40-year history of smoking one to two packs of cigarettes a day has a chronic cough producing thick sputum, peripheral edema, and cyanotic nail beds. Based on this information, he most likely has which of the foll...

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  • August 16, 2024
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  • 2024/2025
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BRIGHTSTARS EXAM STUDY SOLUTIONS 8/15/2024 2:05 PM



BSNC 6000 Mod. 1 Exam Questions With
Correct Answers.


A 58-year-old client with a 40-year history of smoking one to two packs of cigarettes a day has a
chronic cough producing thick sputum, peripheral edema, and cyanotic nail beds. Based on this
information, he most likely has which of the following conditions?
A. Adult respiratory distress syndrome (ARDS)
B. Asthma
C. Chronic obstructive bronchitis

D. Emphysema - answer✔✔C. Chronic obstructive bronchitis


Because of his extensive smoking history and symptoms, the client most likely has chronic
obstructive bronchitis. Chronic bronchitis is a type of chronic obstructive pulmonary disease
(COPD) that is defined as a productive cough of more than 3 months occurring within a span of
2 years. Patients typically present with chronic productive cough, malaise, and symptoms of
excessive coughing such as chest or abdominal pain.
A nurse plans care for a client with chronic obstructive pulmonary disease, knowing that the
client is most likely to experience what type of acid-base imbalance?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis

D. Metabolic alkalosis - answer✔✔A. Respiratory acidosis
Respiratory acidosis is most often due to hypoventilation. Chronic respiratory acidosis is most
commonly caused by COPD. In end-stage disease, pathological changes lead to airway collapse,
air trapping, and disturbance of ventilation-perfusion relationships. Respiratory acidosis is a state
in which there is usually a failure of ventilation and an accumulation of carbon dioxide. The
primary disturbance of elevated arterial PCO2 is the decreased ratio of arterial bicarbonate to
arterial PCO2, which leads to a lowering of the pH.

,BRIGHTSTARS EXAM STUDY SOLUTIONS 8/15/2024 2:05 PM
A 66-year-old client has marked dyspnea at rest, is thin, and uses accessory muscles to breathe.
He's tachypneic, with a prolonged expiratory phase. He has no cough. He leans forward with his
arms braced on his knees to support his chest and shoulders for breathing. This client has
symptoms of which of the following respiratory disorders?
A. ARDS
B. Asthma
C. Chronic obstructive bronchitis

D. Emphysema - answer✔✔D. Emphysema


These are classic signs and symptoms of a client with emphysema. In the early stages of the
disease, the physical examination may be normal. Patients with emphysema are typically referred
to as "pink puffers," meaning cachectic and non-cyanotic. Expiration through pursed lips
increases airway pressure and prevents airway collapse during respiration, and the use of
accessory muscles of respiration indicates advanced disease.
It's highly recommended that clients with asthma, chronic bronchitis, and emphysema have
Pneumovax and flu vaccinations for which of the following reasons?
A. All clients are recommended to have these vaccines.
B. These vaccines produce bronchodilation and improve oxygenation.
C. These vaccines help reduce the tachypnea these clients experience.
D. Respiratory infections can cause severe hypoxia and possibly death in these clients. -
answer✔✔D. Respiratory infections can cause severe hypoxia and possibly death in these
clients.
Teaching for a client with chronic obstructive pulmonary disease (COPD) should include which
of the following topics?
A. How to have his wife learn to listen to his lungs with a stethoscope from Wal-Mart.
B. How to increase his oxygen therapy.
C. How to treat respiratory infections without going to the physician.

D. How to recognize the signs of an impending respiratory infection. - answer✔✔D. How to
recognize the signs of an impending respiratory infection.


Respiratory infection in clients with a respiratory disorder can be fatal. It's important that the
client understands how to recognize the signs and symptoms of an impending respiratory
infection. Acute exacerbation of COPD is an acute worsening of respiratory symptoms.

, BRIGHTSTARS EXAM STUDY SOLUTIONS 8/15/2024 2:05 PM
Assessing severity is often based on the model developed by Anthonisen and colleagues which
classifies severity by the presence of worsening dyspnea, sputum volume, and purulence. Mild
exacerbations are defined by the presence of 1 of these symptoms in addition to one of the
following: increased wheezing, increased cough, fever without another cause, upper respiratory
infection within 5 days, or an increase in heart rate or respiratory rate from the patient's baseline.
Which of the following respiratory disorders is most common in the first 24 to 48 hours after
surgery?
A. Atelectasis
B. Bronchitis
C. Pneumonia

D. Pneumothorax - answer✔✔A. Atelectasis


Atelectasis develops when there's interference with the normal negative pressure that promotes
lung expansion. Clients in the postoperative phase often splint their breathing because of pain
and positioning, which causes hypoxia. Postoperative atelectasis typically occurs within 72 hours
of general anesthesia and is a well-known postoperative complication. The decrease in pressure
allows for passive movement of air into the lungs. This process is inhibited by general anesthesia
due to diaphragm relaxation. Patients lying supine have cephalad displacement of the diaphragm
further decreasing the transmural pressure gradient and increasing the likelihood of atelectasis.
It's uncommon for any of the other respiratory disorders to develop.
Which of the following additional assessment data should immediately be gathered to determine
the status of a client with a respiratory rate of 4 breaths/minute?
A. Arterial blood gas (ABG) and breath sounds.
B. Level of consciousness and a pulse oximetry value.
C. Breath sounds and reflexes.

D. Pulse oximetry value and heart sounds. - answer✔✔B. Level of consciousness and a pulse
oximetry value.
First, the nurse should attempt to rouse the client because this should increase the client's
respiratory rate. If available, a spot pulse oximetry check should be done and breath sounds
should be checked. The physician should be notified immediately of the findings. The care of the
patient at the scene depends on the vital signs. If the patient is comatose and in respiratory
distress, airway control must be obtained before doing anything else.
A client has started a new drug for hypertension. Thirty minutes after he takes the drug, he
develops chest tightness and becomes short of breath and tachypnea. He has a decreased level of
consciousness. These signs indicate which of the following conditions?

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