A plan of care for the patient with COPD

 A plan of care for the patient with COPD

 

1)     A plan of care for the patient with COPD could include (select all that apply)

a.      Exercise such as walking

b.     High flow rate of O2 administration

c.      Low-dose chronic oral corticosteroid therapy

d.     Use of a peak flow meter to monitor the progression of COPD

e.      Breathing exercises such as pursed lip breathing that focus on exhalation

2)     In evaluating an asthmatic patient’s knowledge of self-care, the nurse realizes that additional instruction is needed when the patient says

a.      “I use my corticosteroid inhaler when I feel short of breath.”

b.     “I get a flu shot every year and see my health care provider if I have an upper respiratory tract infection.”

c.      “I use my inhaler before I visit my aunt who has a cat, but I only visit for a few minutes because of my allergies.”

d.     “I walk 30 minutes every day but sometimes I have to use my bronchodilator inhaler before walking to prevent me from getting short of breath.”

3)     The nurse needs to apply oxygen to a patient who has a precise oxygen level prescribed. Which of the following oxygen delivery systems should the nurse select to administer the oxygen?

a.      Nasal cannula

b.     Venturi mask

c.      Simple face mask without inflated reservoir bag

d.     Plastic face mask with inflated reservoir bag

4)     The major advantage of a Venturi mask is that it can

a.      Deliver up to 80% O2

b.     Provide continuous humidity

c.      Deliver a precise concentration of O2

d.     Be used while a patient eats and sleeps

5)     The nurse is caring for a patient who has decreased mobility. Which intervention is a simple and cost-effective method for reducing the risks of stasis of pulmonary secretions and decreased chest wall expansion?

a.      Antibiotics

b.     Frequent change of position

c.      Oxygen humidification

d.     Chest physiotherapy

6)     A patient has been newly diagnosed with emphysema. In discussing his condition with the nurse, which of his statements would indicate a need for further education?

a.      “I’ll make sure that I rest between activities so I don’t get so short of breath.”

b.     “I’ll rest for 30 minutes before I eat my meal.”

c.      “If I have trouble breathing at night, I’ll use two to three pillows to prop up.”

d.     “If I get short of breath, I’ll turn up my oxygen level to 6 L/min.”

7)     The nurse is caring for a patient who exhibits labored breathing and uses accessory muscles. The patient has crackles in both lung bases and diminished lung sounds. Which would be priority assessments for the nurse to perform? (select all that apply)

a.      SpO2 levels

b.     Amount of sputum production

c.      Change in respiratory rate and pattern

d.     Pain in lower calf area

10) The effects of cigarette smoking on the respiratory system include

a. Hypertrophy of capillaries causing hemoptysis.

b. Hyperplasia of goblet cells and increased production of mucus.

c. Increased proliferation of cilia and decreased clearance of mucus.

d. Proliferation of alveolar macrophages to decrease the risk for infection.

12) A patient who has bronchiectasis asks the nurse, “What conditions would warrant a call to the clinic?”

a. Blood clots in the sputum

b. Sticky sputum on a hot day

c. Increased shortness of breath after eating a large meal

d. Production of large amounts of sputum on a daily basis

13) In evaluating an asthmatic patient’s knowledge of self-care, the nurse realizes that additional instruction is needed when the patient says:

a. I use my corticosteroid inhaler when I feel short of breath.

b. I get the flu shot every year and see my healthcare provider if I have an upper respiratory                      tract infection.

c. I use my inhaler before I visit my aunt who has a cat, but I only visit for a few minutes because of my allergies.

d. I walk 30 minutes every day but sometimes I have to use my bronchodilator inhaler before walking to prevent me from getting short of breath.

14) A patient has been newly diagnosed with emphysema. In discussing his condition with the nurse, which of the following statements would indicate a need for further education?

a. I will make sure that I rest between activities so I don’t get so short of breath.

b. I’ll rest for 30 minutes before I eat my meal.

c. If I have trouble breathing at night, I’ll use two or three pillows to prop myself up.

d. If I get short of breath, I’ll turn up my oxygen level to 6L/min.

15) The nurse is caring for a patient who exhibits labored breathing and is using accessory muscles in the process. The patient has crackles in both lung bases and diminished lung sounds. Which would be priority assessments for the nurse to perform? (Select all that apply):

a. SpO2 levels

b. Amount of sputum production

c. Change in respiratory rate and pattern

d. Pain in lower calf area

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