Chronic Obstructive Pulmonary Disease Multiple Choice

22 Questions  I  By Sgomes
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  • 1. 
    Why is monitoring respiratory status a nursing priority when a client with COPD is receiving oxygen?
    • A. 

      Hyperventilation leading to respiratory alkalosis and loss of consciousness is a risk.

    • B. 

      Sudden increase in arterial oxygen can precipitate diaphragmatic spasm.

    • C. 

      Decreased arterial oxygen is the stimulus for breathing in a client with COPD.

    • D. 

      Oxygen administration can trigger reflex bronchospasm.


  • 2. 
    Which laboratory results are consistent with longterm COPD? Mark all that apply.
    • A. 

      Erythrocytosis

    • B. 

      Hypoxemia

    • C. 

      Hypercapnia

    • D. 

      Leukopenia


  • 3. 
    A client with COPD complains of headache and a “racing” heart; he is also restless and somewhat confused. Which problem would the nurse suspect?
    • A. 

      Respiratory acidosis

    • B. 

      Respiratory alkalosis

    • C. 

      Metabolic acidosis

    • D. 

      Metabolic alkalosis


  • 4. 
    A client with a history of COPD complains of increased shortness of breath and has wheezing noted upon auscultation. The client is administered a nebulizer treatment of Albuterol and Atrovent. Which evaluation would indicate a therapeutic response to this treatment?
    • A. 

      Increase in wheezing upon auscultation

    • B. 

      Pink frothy sputum

    • C. 

      Decrease in shortness of breath

    • D. 

      Decrease in heart rate.


  • 5. 
    A client is prescribed theophylline (Theo-24) for COPD. Discharge instructions should include the interaction of which of the following:
    • A. 

      Nicotine transdermal patches

    • B. 

      Fosinopril (Monopril)

    • C. 

      Advair Diskus 250/50

    • D. 

      Clopidogrel (Plavix)


  • 6. 
    A client with a diagnosis of chronic obstructive pulmonary disease (COPD) is being discharged from the hospital. Which of the following is appropriate patient teaching before discharge?
    • A. 

      “Make sure to use a humidifier in your room while you sleep.”

    • B. 

      “Apply powder to all crevices to prevent yeast while taking oral steroids.”

    • C. 

      “Turn the oxygen up to no more than 6 L if you are short of breath.”

    • D. 

      “Use your inhalers every day as directed even if symptoms are not present.”


  • 7. 
    An elderly postoperative client has a history of chronic obstructive pulmonary disease. Based on this history, the nurse is especially concerned with monitoring the client for which problem?
    • A. 

      Aspiration

    • B. 

      Delirium

    • C. 

      Decreased gas exchange

    • D. 

      Positioning difficulty


  • 8. 
    A client has COPD and a barrel chest. Which finding would the nurse expect when assessing the chest?
    • A. 

      Paradoxical chest movement

    • B. 

      Presence of a friction rub

    • C. 

      Decreased respiratory excursion

    • D. 

      Absent breath sounds


  • 9. 
    Which statement made by a client with COPD after being taught about the use of pursed lip breathing indicates the need for additional instruction?
    • A. 

      “I will make sure to puff my cheeks out when I breathe out through my mouth.”

    • B. 

      “I will set my lips for breathing out like I am going to whistle.”

    • C. 

      “Breathing out should take me twice as long as breathing in.”

    • D. 

      “I will never hold my breath when trying to lift something heavy.”


  • 10. 
    Which would be an expected effect of resistive breathing training in a client with COPD?
    • A. 

      Energy conservation

    • B. 

      Increased oxygen saturation

    • C. 

      Decreased hypercarbia

    • D. 

      Increased respiratory muscle strength


  • 11. 
    A client with pneumonia is receiving supplemental oxygen, 2 L/min via nasal cannula. The client’s history includes chronic obstructive pulmonary disease (COPD) and coronary artery disease. Because of these findings, the nurse closely monitors the oxygen flow and the client’s respiratory status. Which complication may arise if the client receives a high oxygen concentration?
    • A. 

      Apnea

    • B. 

      Anginal pain

    • C. 

      Respiratory alkalosis

    • D. 

      Metabolic acidosis


  • 12. 
    A patient is getting discharged from a SNF facility. The patient has a history of severe COPD and PVD. The patient is primarily concerned about their ability to breath easily. Which of the following would be the best instruction for this patient? 
    • A. 

      Deep breathing techniques to increase O2 levels.

    • B. 

      Cough regularly and deeply to clear airway passages.

    • C. 

      Cough following bronchodilator utilization

    • D. 

      Decrease CO2 levels by increase oxygen take output during meals.


  • 13. 
    An elderly client is on an anticholinergic metered dose inhaler (MDI) for chronic obstructive pulmonary disease. The nurse would suggest a spacer to
    • A. 

      Enhance the administration of the medication

    • B. 

      Increase client compliance

    • C. 

      Improve aerosol delivery in clients who are not able to coordinate the MDI

    • D. 

      Prevent exacerbation of COPD


  • 14. 
    The nurse enters the room of a client diagnosed with COPD. The client’s skin is pink, and respirations are 8 per minute. The client’s oxygen is running at 6 liters per minute. What should be the nurse’s first action?
    • A. 

      Call the health care provider

    • B. 

      Put the client in Fowler’s position

    • C. 

      Lower the oxygen rate

    • D. 

      Take the vital signs


  • 15. 
    A client with chronic obstructive pulmonary disease (COPD) and a history of coronary artery disease is receiving aminophylline, 25mg/hour. Which one of the following findings by the nurse would require immediate intervention?
    • A. 

      Decreased blood pressure and respirations

    • B. 

      Flushing and headache

    • C. 

      Restlessness and palpitations

    • D. 

      Increased heart rate and blood pressure


  • 16. 
    In restrictive disease (e.g. pulmonary fibrosis), ____. In obstructive disease (e.g.asthma or COPD), ____.
    • A. 

      RV is increased; TLC is decreased

    • B. 

      RV is decreased; TLC is increased

    • C. 

      TLC is increased; RV is decreased

    • D. 

      TLC is decreased; RV is increased


  • 17. 
    In patients with chronic obstructive pulmonary disease (COPD), the equal pressure point can be found closer to the alveolus at any lung volume. A. True B. False, it is further from the alveolus
    • A. 

      True

    • B. 

      False


  • 18. 
    In COPD, there is an increased surface area for gas exchange (DLCO). A. True B. False, DLCO is decreased
    • A. 

      True

    • B. 

      False


  • 19. 
    Slowly adapting pulmonary stretch fibers are useful in patients with COPD or airway obstruction because they:
    • A. 

      Allow for a longer inspiratory phase

    • B. 

      Allow for a longer expiratory phase

    • C. 

      Cause a shorter inspiratory phase

    • D. 

      Cause a shorter expiratory phase

    • E. 

      Increase the anterior-posterior chest wall dimension


  • 20. 
    A patient presents with acute exacerbation of chronic bronchitis associated with COPD. If there is evidence of bacterial infection (e.g. purulent sputum), which of the following antibiotics would NOT be recommended for treatment?
    • A. 

      Clindamycin (Cleocin)

    • B. 

      TMP-SMX (Bactrim)

    • C. 

      Levofloxacin (Levaquin)

    • D. 

      Doxycycline (Vibramycin)


  • 21. 
    What is the most common cause of chronic obstructive pulmonary disease (COPD)?
    • A. 

      Bronchiectasis

    • B. 

      Chronic bronchitis

    • C. 

      Cigarette smoking

    • D. 

      Emphysema

    • E. 

      Asthma


  • 22. 
    A COPD patient presents with asterixis. Severe hypercarbia is suspected. What other symptoms might the patient have?
    • A. 

      Retinitis pigmentosa

    • B. 

      Conjunctival suffusion

    • C. 

      Temporal arteritis

    • D. 

      Retinal detachment

    • E. 

      Strabismus


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