COPD (Chronic Obstructive Pulmonary Disease) MCQ Quiz With Answers

Cigarette smoking is the most common cause of chronic obstructive pulmonary disease (COPD). Smoking damages the airways and lung tissue, causing inflammation and narrowing of the air passages. Over time, this leads to the development of COPD, which includes conditions such as chronic bronchitis and emphysema. Smoking also accelerates the natural aging process of the lungs and reduces their ability to function properly. Quitting smoking is essential in preventing and managing COPD.

A decrease in shortness of breath would indicate a therapeutic response to the nebulizer treatment of Albuterol and Atrovent in a client with a history of COPD. This is because these medications are bronchodilators that help to relax and open up the airways, reducing the feeling of breathlessness. If the client's shortness of breath decreases after the treatment, it suggests that the medications are effectively improving their breathing.

The nurse is especially concerned with monitoring the client for decreased gas exchange because of the client's history of chronic obstructive pulmonary disease. This condition causes obstruction in the airways, leading to difficulty in breathing and impaired oxygenation. Monitoring for decreased gas exchange is important to ensure that the client is receiving adequate oxygen and to detect any worsening of respiratory function.

The client with COPD is experiencing symptoms of respiratory acidosis. This occurs when there is an excess of carbon dioxide in the blood, leading to an increase in acidity. The headaches and racing heart are likely due to the body compensating for the increased carbon dioxide levels by increasing the heart rate. The restlessness and confusion may be a result of the acidosis affecting the central nervous system.

Using inhalers every day as directed, even if symptoms are not present, is appropriate patient teaching for a client with COPD before discharge. This is because inhalers help to manage and control the symptoms of COPD by opening up the airways and reducing inflammation. Consistent use of inhalers can prevent exacerbations and improve overall lung function. It is important for the client to understand the importance of using inhalers as prescribed, even when they do not feel any symptoms, to effectively manage their condition and prevent further complications.

The client's skin being pink and having a respiratory rate of 8 per minute indicate that the client may be experiencing carbon dioxide retention, which can be dangerous for someone with COPD. The high oxygen rate of 6 liters per minute may be contributing to this. Lowering the oxygen rate would help prevent further carbon dioxide retention and ensure the client's safety. Therefore, the nurse's first action should be to lower the oxygen rate.

In patients with chronic obstructive pulmonary disease (COPD), the equal pressure point can be found closer to the alveolus at any lung volume. This means that the pressure within the airways is equal to the pressure within the alveoli, indicating that there is a decreased pressure gradient for airflow. This can contribute to the airflow limitation seen in COPD patients.

The correct answer is "I will make sure to puff my cheeks out when I breathe out through my mouth." This statement indicates the need for additional instruction because puffing the cheeks out during pursed-lip breathing is not recommended. Pursed-lip breathing involves inhaling through the nose and exhaling slowly through pursed lips, as if blowing out a candle. Puffing the cheeks out can actually increase air trapping and make breathing more difficult for someone with COPD.

A spacer is a device that is attached to the MDI to improve aerosol delivery. It helps to ensure that the medication is properly delivered to the lungs by slowing down the speed of the medication and reducing the amount of medication that is deposited in the mouth and throat. This is particularly beneficial for clients who have difficulty coordinating their inhalation with the activation of the MDI. By using a spacer, the client is able to receive a more effective dose of the medication, leading to improved outcomes in managing their COPD.

Slowly adapting pulmonary stretch fibers are sensory receptors located in the airways that respond to changes in lung volume. These fibers are particularly important in patients with COPD or airway obstruction because they help regulate the duration of the expiratory phase. By allowing for a longer expiratory phase, these fibers help to prevent air trapping and hyperinflation of the lungs, which are common in these conditions. This allows for more effective emptying of the lungs and helps improve respiratory function.

Monitoring respiratory status is a nursing priority when a client with COPD is receiving oxygen because decreased arterial oxygen is the stimulus for breathing in a client with COPD. This means that if the client's arterial oxygen levels are not monitored and maintained within a safe range, their breathing may become compromised, leading to respiratory distress or even respiratory failure. Therefore, it is important for nurses to closely monitor the client's respiratory status to ensure that they are receiving adequate oxygen and to intervene promptly if any signs of respiratory distress occur.

In a client with COPD and a barrel chest, the nurse would expect to find decreased respiratory excursion when assessing the chest. This is because COPD causes airway obstruction and reduced lung elasticity, leading to difficulty in fully expanding and contracting the lungs during breathing. As a result, the movement of the chest during respiration is restricted, resulting in decreased respiratory excursion.

Resistive breathing training involves exercises that make the respiratory muscles work harder. In a client with COPD, these exercises can help strengthen the weakened respiratory muscles, which may have been affected by the disease. By increasing respiratory muscle strength, the client may experience improved breathing efficiency and a reduced feeling of breathlessness. This can contribute to better overall respiratory function and potentially enhance the client's ability to perform daily activities with less effort.

A client with chronic obstructive pulmonary disease (COPD) and coronary artery disease is at risk for retaining carbon dioxide due to impaired lung function. Giving the client a high oxygen concentration can suppress their respiratory drive and cause apnea, leading to a lack of oxygenation. This is a potential complication that the nurse should closely monitor for in this client.

Discharge instructions for a client prescribed theophylline (Theo-24) for COPD should include the interaction of nicotine transdermal patches. Theophylline is metabolized by the same enzyme system in the liver as nicotine, which can lead to increased theophylline levels in the body when used together. This can result in toxic effects of theophylline, such as nausea, vomiting, tremors, and seizures. Therefore, it is important to educate the client about this interaction and advise them to avoid using nicotine patches while taking theophylline.

Restlessness and palpitations in a client with COPD and a history of coronary artery disease who is receiving aminophylline could indicate a potential adverse reaction to the medication. Aminophylline is a bronchodilator that can cause stimulation of the central nervous system and cardiovascular system. Restlessness and palpitations may be signs of increased sympathetic activity, which can lead to tachycardia and potentially worsen coronary artery disease. Immediate intervention is necessary to assess the client's condition, provide appropriate treatment, and prevent further complications.

If a COPD patient presents with asterixis, which is a flapping tremor of the hands, it suggests severe hypercarbia, or high levels of carbon dioxide in the blood. Conjunctival suffusion, which is redness and swelling of the conjunctiva, the clear membrane that covers the white part of the eye, is a possible symptom of severe hypercarbia. Retinitis pigmentosa, temporal arteritis, retinal detachment, and strabismus are not typically associated with hypercarbia in COPD patients.

Levofloxacin (Levaquin) would not be recommended for treatment in a patient with acute exacerbation of chronic bronchitis associated with COPD if there is evidence of bacterial infection. This is because Levofloxacin is a broad-spectrum antibiotic that primarily targets Gram-negative bacteria, whereas chronic bronchitis exacerbations are commonly caused by Gram-positive bacteria such as Streptococcus pneumoniae or Haemophilus influenzae. Therefore, other antibiotics such as Clindamycin, TMP-SMX, or Doxycycline would be more appropriate for treating bacterial infections associated with chronic bronchitis and COPD.

In restrictive lung diseases such as pulmonary fibrosis, the lungs become stiff and lose their ability to expand fully. This leads to a decrease in total lung capacity (TLC), as the lungs cannot hold as much air. On the other hand, the residual volume (RV), which is the amount of air left in the lungs after a forced exhalation, increases in restrictive diseases because the lungs have difficulty emptying completely. This is why the correct answer is "TLC is decreased; RV is increased."

Long-term COPD is characterized by the progressive damage to the lungs, leading to impaired gas exchange. Erythrocytosis, an increase in red blood cell count, is consistent with COPD as the body compensates for chronic hypoxemia by producing more red blood cells to carry oxygen. Hypoxemia, a low level of oxygen in the blood, is a common finding in COPD due to impaired lung function. Hypercapnia, an elevated level of carbon dioxide in the blood, occurs in COPD as the lungs are unable to effectively remove carbon dioxide. Leukopenia, a decrease in white blood cell count, is not typically associated with long-term COPD.