1.
Nurse Murphy administers albuterol (Proventil), as prescribed, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect?
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.
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?
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.)
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?
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.
4.
Which of the following types of lung cancer is the most prevalent carcinoma of the lung for both men and women?
Correct Answer
A. Adenocarcinoma
Explanation
Adenocarcinoma presents more peripherally as peripheral masses or nodules and often metastasizes.
5.
Emphysema is described as:
Correct Answer
A. A disease of the airways characterized by destruction of the walls of overdistended alveoli.
Explanation
Emphysema is a category of COPD.
6.
Which of the following is the most important risk factor for development of Chronic Obstructive Pulmonary Disease?
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.
7.
Of the following oxygen administration devices, which has the advantage of providing high oxygen concentration?
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.
8.
Emphysema is not linked to which of the following terms?
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:
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.
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?
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.
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?
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.
12.
A male client with emphysema becomes restless and confused. What step should nurse Jasmine take next?
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.
13.
Emphysema can be cured.
Correct Answer
B. False
Explanation
There is no cure but the symptoms can be treated and progression of the disease can be slowed.
14.
Once diagnosed with emphysema, the disease state is constant.
Correct Answer
B. False
Explanation
The disease state is progressive. Even though it cannot be stopped it can be slowed with treatment.
15.
Air flows through the trachea into the left and right bronchi upon inspiration.
Correct Answer
A. True
16.
A person with emphysema will not exhibit noticeable symptoms.
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
17.
The inhalation of environmental air pollutants in the #1 cause of emphysema cases.
Correct Answer
B. False
Explanation
Smoking is the #1 cause of emphysema
18.
A lung transplant is the only way to slow the progression of emphysema.
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
19.
Carbon monoxide is the waste product expelled from the body when you breathe out.
Correct Answer
B. False
Explanation
Carbon dioxide is the waste product, not carbon monoxide