NUR 325 Exam 3 Final Q&A
chronic obstructive pulmonary disease (COPD) - ANSWER-A preventable, treatable,
but often progressive disease characterized by persistent airflow limitation. COPD is
associated with an enhanced chronic inflammatory response in the airways and
lungs, primarily caused by cigarette smoking and other noxious particles or gases.
Exacerbations and other coexisting illnesses contribute to the severity of the
disease.
Clinical manifestations of COPD - ANSWER--Barrel Chest
-Cough with Mucus (bronchitis)
-Dyspnea (emphysema)
-Fatigue
-Wheezing
-Frequent respiratory infections
-Commonly diagnosed via spirometry (FEV1 <70%)
-Weight loss
-Clubbing
-Polycythemia
What is the most significant modifiable risk factor for the development of impaired
gas exchange?
A. tobacco use
B. drug overdose
C. age
D prolonged immobility - ANSWER-A.
Tobacco use is the most preventable cause of death and disease and is the most
important risk factor in the development of impaired gas exchange. Age is not a
modifiable risk factor. Drug overdose and immobility both contribute to impaired gas
exchange but are not as significant as tobacco use.
When evaluating the concept of gas exchange, how should the nurse best describe
the movement of oxygen and carbon dioxide?
A. Oxygen and carbon dioxide are exchanged across the capillary membrane to
provide oxygen to hemoglobin.
B. The level of inspired oxygen must be sufficient to displace the carbon dioxide
molecules in the alveoli.
C. Gas moves from an area of high pressure to an area of low pressure across the
alveolar membrane.
D. Gases are exchange between the atmosphere and the blood based on the
oxygen-carrying capacity of the hemoglobin. - ANSWER-C.
Oxygen and carbon dioxide move across the alveolar membrane based on the
partial pressure of each gas. Molecules of oxygen are not exchanged for molecules
of carbon dioxide. The pressure gradient of each gas in the alveoli is responsible for
the movement of each gas, respectfully.
, A patient is having the arterial blood gas (ABG) measured. What should the nurse
identify as the parameters to be evaluated by this test?
A. presence of a pulmonary embolus.
B. ratio of hemoglobin and hematocrit.
C. status of acid-base balance in arterial blood.
D. adequacy of oxygen transport. - ANSWER-C.
The ABG results will indicate the acid-base balance of the arterial blood and the
partial pressure of oxygen and carbon dioxide. The ABG does not reveal the ratio of
hemoglobin and hematocrit, the adequacy of oxygen transport to the cells, or the
presence of a pulmonary embolus.
The nurse is administering oral glucocorticoids to a patient with asthma. What finding
indicates a therapeutic response to the medication?
A. no observable respiratory difficulty or shortness of breath over the last 24 hours.
B. a decrease in the amount of nasal drainage and sneezing.
C. no sputum production, and a decrease in coughing episodes.
D. relief of an acute asthmatic attack. - ANSWER-A.
Glucocorticoids decrease inflammation and prevent bronchospasm in the patient
with asthma. The glucocorticoids are used to prevent problems. Anticholinergics
decrease the allergic response and decrease sneezing and rhinorrhea. Antitussives
are used to decrease cough, and mucolytics assist in the removal of mucus.
Sympathomimetic agents (B2 agonist) are used to relieve bronchospasm in an acute
episode.
The nurse is caring for a patient with COPD. The patient tells the nurse he is having
a "hard time breathing". His respiratory rate is 32 breaths per minute, pulse is 120
beats per minute, and O2 sat is 90%. What would be the best nursing intervention
for this patient?
A. administer a PRN dose of an intranasal glucocorticoid.
B. initiate oxygen via a nasal cannula, ad begin at a flow rate of 2 L/min.
C. begin oxygen via a face mask at 60% FiO2.
D. encourage coughing and deep breathing to clear the airway. - ANSWER-B.
The normal respiratory drive is a person's level of carbon dioxide in the arterial
blood. The COPD patient had compensated for his chronic high levels of CO2, and
his respiratory drive is dependent on his oxygen levels, not his CO2 levels. If the
COPD patient's oxygen level is rapidly increased to what would be considered
normal, it would diminish his respiratory drive. The patient with COPD who has
difficulty breathing should be given low levels of oxygen and closely observed for the
quality and rate of ventilation. A dose of glucocorticoids will not address his
immediate needs, but it may provide decreased inflammation and better ventilation
over an extended period of time. Encouraging coughing and deep breathing in a
patient with COPD does not meet his needs as effectively as administration of low-
level oxygen does.
The nurse should anticipate that which patient will need to be treated with insertion
of a chest tube?
A. a patient with a pleural effusion requiring fluid removal.
B. a patient undergoing a bronchoscopy for a biopsy.
C. a patient experiencing a problem with a pneumothorax.
D. a patient with asthma and severe shortness of breath. - ANSWER-C.
chronic obstructive pulmonary disease (COPD) - ANSWER-A preventable, treatable,
but often progressive disease characterized by persistent airflow limitation. COPD is
associated with an enhanced chronic inflammatory response in the airways and
lungs, primarily caused by cigarette smoking and other noxious particles or gases.
Exacerbations and other coexisting illnesses contribute to the severity of the
disease.
Clinical manifestations of COPD - ANSWER--Barrel Chest
-Cough with Mucus (bronchitis)
-Dyspnea (emphysema)
-Fatigue
-Wheezing
-Frequent respiratory infections
-Commonly diagnosed via spirometry (FEV1 <70%)
-Weight loss
-Clubbing
-Polycythemia
What is the most significant modifiable risk factor for the development of impaired
gas exchange?
A. tobacco use
B. drug overdose
C. age
D prolonged immobility - ANSWER-A.
Tobacco use is the most preventable cause of death and disease and is the most
important risk factor in the development of impaired gas exchange. Age is not a
modifiable risk factor. Drug overdose and immobility both contribute to impaired gas
exchange but are not as significant as tobacco use.
When evaluating the concept of gas exchange, how should the nurse best describe
the movement of oxygen and carbon dioxide?
A. Oxygen and carbon dioxide are exchanged across the capillary membrane to
provide oxygen to hemoglobin.
B. The level of inspired oxygen must be sufficient to displace the carbon dioxide
molecules in the alveoli.
C. Gas moves from an area of high pressure to an area of low pressure across the
alveolar membrane.
D. Gases are exchange between the atmosphere and the blood based on the
oxygen-carrying capacity of the hemoglobin. - ANSWER-C.
Oxygen and carbon dioxide move across the alveolar membrane based on the
partial pressure of each gas. Molecules of oxygen are not exchanged for molecules
of carbon dioxide. The pressure gradient of each gas in the alveoli is responsible for
the movement of each gas, respectfully.
, A patient is having the arterial blood gas (ABG) measured. What should the nurse
identify as the parameters to be evaluated by this test?
A. presence of a pulmonary embolus.
B. ratio of hemoglobin and hematocrit.
C. status of acid-base balance in arterial blood.
D. adequacy of oxygen transport. - ANSWER-C.
The ABG results will indicate the acid-base balance of the arterial blood and the
partial pressure of oxygen and carbon dioxide. The ABG does not reveal the ratio of
hemoglobin and hematocrit, the adequacy of oxygen transport to the cells, or the
presence of a pulmonary embolus.
The nurse is administering oral glucocorticoids to a patient with asthma. What finding
indicates a therapeutic response to the medication?
A. no observable respiratory difficulty or shortness of breath over the last 24 hours.
B. a decrease in the amount of nasal drainage and sneezing.
C. no sputum production, and a decrease in coughing episodes.
D. relief of an acute asthmatic attack. - ANSWER-A.
Glucocorticoids decrease inflammation and prevent bronchospasm in the patient
with asthma. The glucocorticoids are used to prevent problems. Anticholinergics
decrease the allergic response and decrease sneezing and rhinorrhea. Antitussives
are used to decrease cough, and mucolytics assist in the removal of mucus.
Sympathomimetic agents (B2 agonist) are used to relieve bronchospasm in an acute
episode.
The nurse is caring for a patient with COPD. The patient tells the nurse he is having
a "hard time breathing". His respiratory rate is 32 breaths per minute, pulse is 120
beats per minute, and O2 sat is 90%. What would be the best nursing intervention
for this patient?
A. administer a PRN dose of an intranasal glucocorticoid.
B. initiate oxygen via a nasal cannula, ad begin at a flow rate of 2 L/min.
C. begin oxygen via a face mask at 60% FiO2.
D. encourage coughing and deep breathing to clear the airway. - ANSWER-B.
The normal respiratory drive is a person's level of carbon dioxide in the arterial
blood. The COPD patient had compensated for his chronic high levels of CO2, and
his respiratory drive is dependent on his oxygen levels, not his CO2 levels. If the
COPD patient's oxygen level is rapidly increased to what would be considered
normal, it would diminish his respiratory drive. The patient with COPD who has
difficulty breathing should be given low levels of oxygen and closely observed for the
quality and rate of ventilation. A dose of glucocorticoids will not address his
immediate needs, but it may provide decreased inflammation and better ventilation
over an extended period of time. Encouraging coughing and deep breathing in a
patient with COPD does not meet his needs as effectively as administration of low-
level oxygen does.
The nurse should anticipate that which patient will need to be treated with insertion
of a chest tube?
A. a patient with a pleural effusion requiring fluid removal.
B. a patient undergoing a bronchoscopy for a biopsy.
C. a patient experiencing a problem with a pneumothorax.
D. a patient with asthma and severe shortness of breath. - ANSWER-C.
