Emphysema By Rnpedia.Com

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  • 1. 

    Nurse Murphy administers albuterol (Proventil), as prescribed, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect?

    • A.

      Respiratory rate of 22 breaths/minute

    • B.

      Dilated and reactive pupils

    • C.

      Urine output of 40 ml/hour

    • D.

      Heart rate of 100 beats/minute

    Correct Answer
    A. Respiratory rate of 22 breaths/minute
    Explanation
    In a client with emphysema, albuterol is used as a bronchodilator. A respiratory rate of 22 breaths/minute indicates that the drug has achieved its therapeutic effect because fewer respirations are required to achieve oxygenation. Albuterol has no effect on pupil reaction or urine output. It may cause a change in the heart rate, but this is an adverse, not therapeutic, effect.

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  • 2. 

    The nurse in charge is teaching a client with emphysema how to perform pursed-lip breathing. The client asks the nurse to explain the purpose of this breathing technique. Which explanation should the nurse provide?

    • A.

      It helps prevent early airway collapse.

    • B.

      It increases inspiratory muscle strength.

    • C.

      It decreases use of accessory breathing muscles.

    • D.

      It prolongs the inspiratory phase of respiration.

    Correct Answer
    A. It helps prevent early airway collapse.
    Explanation
    Pursed-lip breathing helps prevent early airway collapse. Learning this technique helps the client control respiration during periods of excitement, anxiety, exercise, and respiratory distress. To increase inspiratory muscle strength and endurance, the client may need to learn inspiratory resistive breathing. To decrease accessory muscle use and thus reduce the work of breathing, the client may need to learn diaphragmatic (abdominal) breathing. In pursed-lip breathing, the client mimics a normal inspiratory-expiratory (I:E) ratio of 1:2. (A client with emphysema may have an I:E ratio as high as 1:4.)

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  • 3. 

    Which of the following actions is most appropriate for the nurse to take when the patient demonstrates subcutaneous emphysema along the suture line or chest dressing 2 hours after chest surgery?

    • A.

      Record the observation.

    • B.

      Apply a compression dressing to the area.

    • C.

      Measure the patient’s pulse oximetry.

    • D.

      Report the finding to the physician immediately.

    Correct Answer
    A. Record the observation.
    Explanation
    Subcutaneous emphysema occurs after chest surgery as the air that is located within the pleural cavity is expelled through the tissue opening created by the surgical procedure.

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  • 4. 

    Which of the following types of lung cancer is the most prevalent carcinoma of the lung for both men and women?

    • A.

      Adenocarcinoma

    • B.

      Large cell carcinoma

    • C.

      Squamous cell carcinoma

    • D.

      Small cell carcinoma

    Correct Answer
    A. Adenocarcinoma
    Explanation
    Adenocarcinoma presents more peripherally as peripheral masses or nodules and often metastasizes.

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  • 5. 

    Emphysema is described as:

    • A.

      A disease of the airways characterized by destruction of the walls of overdistended alveoli.

    • B.

      A disease that results in a common clinical outcome of reversible airflow obstruction.

    • C.

      The presence of cough and sputum production for at least a combined total of two or three months in each of two consecutive years.

    • D.

      Chronic dilatation of a bronchus or bronchi

    Correct Answer
    A. A disease of the airways characterized by destruction of the walls of overdistended alveoli.
    Explanation
    Emphysema is a category of COPD.

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  • 6. 

    Which of the following is the most important risk factor for development of Chronic Obstructive Pulmonary Disease?

    • A.

      Cigarette smoking

    • B.

      Occupational exposure

    • C.

      Air pollution

    • D.

      Genetic abnormalities

    Correct Answer
    A. Cigarette smoking
    Explanation
    Pipe, cigar and other types of tobacco smoking are also risk factors. While a risk factor, occupational exposure is not the most important risk factor for development of COPD. Air pollution is a risk factor for development of COPD, but it is not the most important risk factor. A deficiency of alpha-antitrypsin is a risk factor for development of COPD, but it is not the most important risk factor.

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  • 7. 

    Of the following oxygen administration devices, which has the advantage of providing high oxygen concentration?

    • A.

      Non-rebreather mask

    • B.

      Venturi mask

    • C.

      Catheter

    • D.

      Face tent

    Correct Answer
    A. Non-rebreather mask
    Explanation
    The non-rebreather mask provides high oxygen concentration but is usually poor fitting. The Venturi mask provides low levels of supplemental oxygen. The catheter is an inexpensive device that provides a variable fraction of inspired oxygen and may cause gastric distention. A face tent provides a fairly accurate fraction of inspired oxygen, but is bulky and uncomfortable. It would not be the device of choice to provide high oxygen concentration.

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  • 8. 

    Emphysema is not linked to which of the following terms?  

    • A.

      Blue Bloater

    • B.

      Dyspnea

    • C.

      Liver cirrhosis

    • D.

      Tachycardia

    Correct Answer
    A. Blue Bloater
  • 9. 

    A nurse is caring for a male client with emphysema who is receiving oxygen. The nurse assesses the oxygen flow rate to ensure that it does not exceed:

    • A.

      1 L/min

    • B.

      2 L/min

    • C.

      6 L/min

    • D.

      10 L/min

    Correct Answer
    B. 2 L/min
    Explanation
    Oxygen is used cautiously and should not exceed 2 L/min. Because of the long-standing hypercapnia that occurs in emphysema, the respiratory drive is triggered by low oxygen levels rather than increased carbon dioxide levels, as is the case in a normal respiratory system.

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  • 10. 

    A nurse is assessing a male client with chronic airflow limitations and notes that the client has a “barrel chest.” The nurse interprets that this client has which of the following forms of chronic airflow limitations?

    • A.

      Emphysema

    • B.

      Bronchial asthma

    • C.

      Chronic obstructive bronchitis

    • D.

      Bronchial asthma and bronchitis

    Correct Answer
    A. Emphysema
    Explanation
    The client with emphysema has hyperinflation of the alveoli and flattening of the diaphragm. These lead to increased anteroposterior diameter, referred to as “barrel chest.” The client also has dyspnea with prolonged expiration and has hyperresonant lungs to percussion.

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  • 11. 

    Mr. Vasquez 56-year-old client with a 40-year history of smoking one to two packs of cigarettes per 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

    Correct Answer
    C. Chronic obstructive bronchitis
    Explanation
    Because of this extensive smoking history and symptoms the client most likely has chronic obstructive bronchitis. Client with ARDS have acute symptoms of hypoxia and typically need large amounts of oxygen. Clients with asthma and emphysema tend not to have chronic cough or peripheral edema.

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  • 12. 

    A male client with emphysema becomes restless and confused. What step should nurse Jasmine take next?

    • A.

      Encourage the client to perform pursed lip breathing.

    • B.

      Check the client’s temperature.

    • C.

      Assess the client’s potassium level.

    • D.

      Increase the client’s oxygen flow rate.

    Correct Answer
    A. Encourage the client to perform pursed lip breathing.
    Explanation
    Purse lip breathing prevents the collapse of lung unit and helps client control rate and depth of breathing.

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  • 13. 

    Emphysema can be cured.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    There is no cure but the symptoms can be treated and progression of the disease can be slowed.

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  • 14. 

    Once diagnosed with emphysema, the disease state is constant.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    The disease state is progressive. Even though it cannot be stopped it can be slowed with treatment.

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  • 15. 

    Air flows through the trachea into the left and right bronchi upon inspiration.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
  • 16. 

    A person with emphysema will not exhibit noticeable symptoms.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    They will exhibit symptoms including chronic cough, loss of appetite, fatigue, shortness of breath, excessive mucous production, wheezing, and blue tinting of the skin.
    Incorrect

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  • 17. 

    The inhalation of environmental air pollutants in the #1 cause of emphysema cases.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Smoking is the #1 cause of emphysema

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  • 18. 

    A lung transplant is the only way to slow the progression of emphysema.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Smoking cessation, pulmonary rehabilitation, adopting a healthy lifestyle, and prescription drug therapy are all ways to slow the progression of emphysema.
    Incorrect

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  • 19. 

    Carbon monoxide is the waste product expelled from the body when you breathe out.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Carbon dioxide is the waste product, not carbon monoxide

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Quiz Review Timeline +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Feb 27, 2014
    Quiz Edited by
    ProProfs Editorial Team
  • Feb 26, 2013
    Quiz Created by
    Rnpedia.com
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