1.
The nurse is teaching a male client with chronic bronchitis about breathing exercises. Which of the following should the nurse include in the teaching?
Correct Answer
C. Use diapHragmatic breathing.
Explanation
In chronic bronchitis the diaphragm is flat and weak. Diaphragmatic breathing helps to strengthen the diaphragm and maximizes ventilation. Exhalation should be longer than inhalation to prevent collapse of the bronchioles. The client with chronic bronchitis should exhale through pursed lips to prolong exhalation, keep the bronchioles from collapsing, and prevent air trapping. Diaphragmatic breathing — not chest breathing — increases lung expansion.
2.
The nurse in charge formulates a nursing diagnosis of Activity intolerance related to inadequate oxygenation and dyspnea for a client with chronic bronchitis. To minimize this problem, the nurse instructs the client to avoid conditions that increase oxygen demands. Such conditions include:
Correct Answer
B. Being overweight.
Explanation
Conditions that increase oxygen demands include obesity, smoking, exposure to temperature extremes, and stress. A client with chronic bronchitis should drink at least 2,000 ml of fluid daily to thin mucus secretions; restricting fluid intake may be harmful. The nurse should encourage the client to eat a high-protein snack at bedtime because protein digestion produces an amino acid with sedating effects that may ease the insomnia associated with chronic bronchitis. Eating more than three large meals a day may cause fullness, making breathing uncomfortable and difficult; however, it doesn’t increase oxygen demands. To help maintain adequate nutritional intake, the client with chronic bronchitis should eat small, frequent meals (up to six a day).
3.
The term “blue bloater” refers to a male client which of the following conditions?
Correct Answer
C. Chronic obstructive bronchitis
Explanation
Clients with chronic obstructive bronchitis appear bloated; they have large barrel chest and peripheral edema, cyanotic nail beds, and at times, circumoral cyanosis. Clients with ARDS are acutely short of breath and frequently need intubation for mechanical ventilation and large amount of oxygen. Clients with asthma don’t exhibit characteristics of chronic disease, and clients with emphysema appear pink and cachectic.
4.
The term “pink puffer” refers to the female client with which of the following conditions?
Correct Answer
D. EmpHysema
Explanation
Because of the large amount of energy it takes to breathe, clients with emphysema are usually cachectic. They’re pink and usually breathe through pursed lips, hence the term “puffer.” Clients with ARDS are usually acutely short of breath. Clients with asthma don’t have any particular characteristics, and clients with chronic obstructive bronchitis are bloated and cyanotic in appearance.
5.
Johnny a firefighter was involved in extinguishing a house fire and is being treated to smoke inhalation. He develops severe hypoxia 48 hours after the incident, requiring intubation and mechanical ventilation. He most likely has developed which of the following conditions?
Correct Answer
A. Adult respiratory distress syndrome (ARDS)
Explanation
Severe hypoxia after smoke inhalation is typically related to ARDS. The other conditions listed aren’t typically associated with smoke inhalation and severe hypoxia.
6.
A 67-year-old client develops acute shortness of breath and progressive hypoxia requiring right femur. The hypoxia was probably caused by which of the following conditions?
Correct Answer
D. Fat embolism
Explanation
Long bone fractures are correlated with fat emboli, whichcause shortness of breath and hypoxia. It’s unlikely the client has developed asthma or bronchitis without a previous history. He could develop atelectasis but it typically doesn’t produce progressive hypoxia.
7.
A client with shortness of breath has decreased to absent breath sounds on the right side, from the apex to the base. Which of the following conditions would best explain this?
Correct Answer
D. Spontaneous pneumothorax
Explanation
A spontaneous pneumothorax occurs when the client’s lung collapses, causing an acute decreased in the amount of functional lung used in oxygenation. The sudden collapse was the cause of his chest pain and shortness of breath. An asthma attack would show wheezing breath sounds, and bronchitis would have rhonchi. Pneumonia would have bronchial breath sounds over the area of consolidation.
8.
A 62-year-old male client was in a motor vehicle accident as an unrestrained driver. He’s now in the emergency department complaining of difficulty of breathing and chest pain. On auscultation of his lung field, no breath sounds are present in the upper lobe. This client may have which of the following conditions?
Correct Answer
C. Pneumothorax
Explanation
From the trauma the client experienced, it’s unlikely he has bronchitis, pneumonia, or TB; rhonchi with bronchitis, bronchial breath sounds with TB would be heard.
9.
Nurse Eve formulates a nursing diagnosis of Activity intolerance related to inadequate oxygenation and dyspnea for a client with chronic bronchitis. To minimize this problem, the nurse instructs the client to avoid conditions that increase oxygen demands. Such conditions include:
Correct Answer
B. Being overweight.
Explanation
Conditions that increase oxygen demands include obesity, smoking, exposure to temperature extremes, and stress. A client with chronic bronchitis should drink at least 2,000 ml of fluid daily to thin mucus secretions; restricting fluid intake may be harmful. The nurse should encourage the client to eat a high-protein snack at bedtime because protein digestion produces an amino acid with sedating effects that may ease the insomnia associated with chronic bronchitis. Eating more than three large meals a day may cause fullness, making breathing uncomfortable and difficult; however, it doesn’t increase oxygen demands. To help maintain adequate nutritional intake, the client with chronic bronchitis should eat small, frequent meals (up to six a day).
10.
A client with acute bronchitis is admitted in the hospital. The nurse assigned to the client is making a plan of care regarding expectoration of thick sputum. Which nursing action is most effective?
Correct Answer
D. Offer fluids at regular intervals
Explanation
Fluids liquefy secretions and therefore make it easier to expectorate
11.
The nurse is caring for an 80-year-old with chronic bronchitis. Upon the morning rounds, the nurse finds an O2 sat of 76%. Which of the following actions should the nurse take first?
Correct Answer
C. Apply oxygen by mask
Explanation
Remember the ABCs (airway, breathing, circulation) when answering this question. Before notifying the physician or assessing the pulse, oxygen should be applied to increase the oxygen saturation, so answers A and D are incorrect. The normal oxygen saturation for a child is 92%–100%, making answer B incorrect.
12.
Which of the following statements are true about acute bronchitis?
Correct Answer
D. All of the above
Explanation
Acute bronchitis is a condition that is commonly caused by a viral respiratory infection, making the first statement true. Smokers and individuals with heart or lung disease are more susceptible to contracting acute bronchitis, supporting the second statement. Acute bronchitis initially affects the nose, sinuses, and throat, and can then spread to the lungs, confirming the third statement. Therefore, all of the above statements are true about acute bronchitis.
13.
Which of the following statements are true about chronic bronchitis?
Correct Answer
D. All of the above
Explanation
Chronic bronchitis is a long-term condition that is caused mainly by cigarette smoke, including long-term exposure to second-hand smoke. It requires regular medical treatment to manage the symptoms and prevent complications.
14.
Which is the most common symptom of bronchitis?
Correct Answer
C. Cough
Explanation
Cough is the most common symptom of bronchitis. It is characterized by the inflammation of the bronchial tubes, which causes the airways to become irritated and produce excessive mucus. This leads to a persistent cough that may be accompanied by phlegm or mucus production. Other symptoms such as shortness of breath, wheezing, fatigue, fever, and chest discomfort may also be present, but cough is the primary and most common symptom of bronchitis.
15.
Which of the following statements describe cough that is the most common symptom of bronchitis?
Correct Answer
D. All of the above
Explanation
The most common symptom of bronchitis is a cough, which can be either dry or produce phlegm. This cough can persist for more than 2 weeks and can be severe enough to cause injury to the chest wall. Therefore, all of the given statements accurately describe the cough that is commonly associated with bronchitis.
16.
What are some of the initial symptoms of bronchitis?
Correct Answer
D. All of the above
Explanation
The initial symptoms of bronchitis include shortness of breath worsened by exertion or mild activity, fatigue, fever with chills and chest discomfort, as well as a cough that produces mucus. These symptoms are commonly experienced by individuals with bronchitis.
17.
Continued forceful coughing may cause chest and abdominal muscles to ache.
Correct Answer
A. True
Explanation
Continued forceful coughing can indeed cause chest and abdominal muscles to ache. When we cough forcefully, it puts a strain on these muscles as they contract and expand rapidly. This repetitive motion can lead to muscle soreness and discomfort in the chest and abdominal area. Therefore, the statement "Continued forceful coughing may cause chest and abdominal muscles to ache" is true.
18.
What are the additional symptoms of chronic bronchitis?
Correct Answer
D. All of the above
Explanation
The additional symptoms of chronic bronchitis include frequent respiratory infections (such as colds or the flu), ankle, feet, and leg swelling, and blue-tinged lips from low levels of oxygen.
19.
It is unusual to have a dry, nagging cough that lingers for several weeks even after acute bronchitis has cleared.
Correct Answer
B. False
Explanation
The statement is false because it is not unusual to have a dry, nagging cough that lingers for several weeks after acute bronchitis has cleared. This lingering cough is known as post-bronchitis cough and can last for several weeks or even months after the initial infection. It is a common symptom and does not indicate any ongoing infection or complication.
20.
Cigarette smoking is the main cause of chronic bronchitis
Correct Answer
A. True
Explanation
Cigarette smoking is the main cause of chronic bronchitis because the harmful chemicals in tobacco smoke irritate and inflame the airways, leading to the production of excess mucus and narrowing of the air passages. This chronic inflammation and mucus buildup can result in a persistent cough, difficulty breathing, and other symptoms characteristic of chronic bronchitis. Quitting smoking is crucial in preventing and managing this condition.