Med Surg Exam 3 - Chapter 29 | Attempts: 416

1.

A patient is concerned that he may have Asthma. Of the symptoms that he relates to the nurse, which ones suggest asthma or risk factors for asthma (select all that apply)?

A.

Allergic rhinitis
B.

Prolonged inhalation
C.

History of skin allergies
D.

Cough, especially at night
E.

Gastric reflux or heartburn

Correct Answer(s)
A. Allergic rhinitis
C. History of skin allergies
D. Cough, especially at night
E. Gastric reflux or heartburn

Explanation
The symptoms that suggest asthma or risk factors for asthma are allergic rhinitis, history of skin allergies, cough, especially at night, and gastric reflux or heartburn. Allergic rhinitis and history of skin allergies indicate an allergic predisposition, which is commonly associated with asthma. Cough, especially at night, is a common symptom of asthma, as the airways tend to be more reactive during sleep. Gastric reflux or heartburn can trigger or worsen asthma symptoms, as the acid can irritate the airways. Prolonged inhalation is not specifically mentioned as a symptom or risk factor for asthma, so it is not included in the answer.

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2.

In evaluating an asthmatic patient's knowledge of self-care, the nurse recognizes that additional instruction is needed when the patient says,

A.

"I use my corticosteroid inhaler when I feel short of breath."
B.

"I get a flu shot eery year and see my health care provider if I have an upper respiratory infection."
C.

"I use my inhaler before I visit my aunt who has a cat, but I only visit for a few minutes because of my allergies."
D.

"I walk 30 minutes every day but sometimes I have to use my bronchodilator inhaler before walking to prevent me from getting short of breath."

Correct Answer
A. "I use my corticosteroid inhaler when I feel short of breath."

Explanation
The correct answer is "I use my corticosteroid inhaler when I feel short of breath." This statement suggests that the patient is not using their inhaler as a preventive measure but only when they are already experiencing symptoms. The nurse recognizes that the patient should be using the inhaler regularly as prescribed, regardless of whether they feel short of breath or not. Regular use of corticosteroid inhalers helps to control inflammation and prevent asthma symptoms from occurring.

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3.

A plan of care for the patient with COPD could include (select all that apply)

A.

Exercise such as walking
B.

High flow rate of O2 administration
C.

Low-dose chronic oral corticosteroid therapy
D.

Use of peak flow meter to monitor the progression of COPD
E.

Breathing exercises such as pursed-lip breathing that focus on exhalation

Correct Answer(s)
A. Exercise such as walking
E. Breathing exercises such as pursed-lip breathing that focus on exhalation

Explanation
The plan of care for a patient with COPD may include exercise such as walking to improve cardiovascular fitness and strengthen respiratory muscles. Breathing exercises such as pursed-lip breathing that focus on exhalation can help improve breathing efficiency and reduce shortness of breath. These interventions aim to increase the patient's exercise tolerance and overall lung function. The other options, high flow rate of O2 administration and low-dose chronic oral corticosteroid therapy, may be appropriate for some patients with severe COPD, but they are not universally included in the plan of care. The use of a peak flow meter to monitor the progression of COPD is not typically part of the plan of care for COPD.

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4.

The effects of cigarette soking on the respiratory system include

A.

Hypertrophy of capillaries causing hemoptysis
B.

Hyperplasia of goblet cells and increased production of mucus
C.

Proliferation of alveolar macrophages thus increasing chance of infection
D.

Increased proliferation of cilia and decreased clearance of mucus

Correct Answer
B. Hyperplasia of goblet cells and increased production of mucus

Explanation
Cigarette smoking has been shown to cause hyperplasia of goblet cells in the respiratory system, leading to an increased production of mucus. This excessive mucus production can impair the normal clearance of mucus from the airways, leading to congestion and difficulty breathing. The increased mucus also provides a favorable environment for the growth of bacteria, increasing the risk of respiratory infections. This is why hyperplasia of goblet cells and increased production of mucus is a known effect of cigarette smoking on the respiratory system.

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5.

The major advantage of a Venturi mask is that it can

A.

Deliver up to 80% O2
B.

Provide continuous 100% humidity
C.

Deliver a precise concentration of O2
D.

Be used while a patient eats and sleeps

Correct Answer
C. Deliver a precise concentration of O2

Explanation
A Venturi mask is designed to deliver a precise concentration of oxygen to the patient. It achieves this by using a specific combination of air and oxygen flow rates, which creates a controlled amount of oxygen concentration. This is particularly useful in situations where accurate oxygen delivery is crucial, such as in patients with respiratory conditions who require a specific oxygen concentration to maintain their oxygen levels within a desired range. The Venturi mask allows healthcare professionals to adjust the oxygen concentration precisely, ensuring optimal oxygen therapy for the patient.

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6.

Which of the following guidelines would be a part of teaching patients how to use a metered dose-inhaler (MDI)?

A.

After activating the MDI, breathe in as quickly as you can.
B.

Estimate the amount of remaining medicine in the MDI by floating the canister in water.
C.

Disassemble the plastic canister from the inhaler and rinse both pieces under running water every week.
D.

To determine how long the canister will last, divide the total number of puffs in the canister y the puffs needed per day

Correct Answer
D. To determine how long the canister will last, divide the total number of puffs in the canister y the puffs needed per day

Explanation
The correct answer is to determine how long the canister will last, divide the total number of puffs in the canister by the puffs needed per day. This guideline is important because it helps patients understand how long their medication will last and when they need to refill their prescription. By dividing the total number of puffs in the canister by the puffs needed per day, patients can calculate the number of days the canister will last and ensure they have enough medication on hand. This promotes proper medication management and adherence to the prescribed dosage.

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7.

Which of the following treatments in CF would the nurse expect to implement as collaborative management of patients with CF (select all that apply)?

A.

Sperm banking
B.

IV corticosteroids on a chronic basis
C.

Airway clearance techniques (e.g., Acapella)
D.

GoLYTELY given PRN for severe constipation
E.

Inhaled tobramycin to combat Pseudomonas infection

Correct Answer(s)
A. Sperm banking
C. Airway clearance techniques (e.g., Acapella)
D. GoLYTELY given PRN for severe constipation
E. Inhaled tobramycin to combat Pseudomonas infection

Explanation
The nurse would expect to implement sperm banking as a collaborative management strategy for patients with CF because CF can cause infertility in males. Airway clearance techniques, such as using an Acapella device, would also be implemented to help clear mucus from the airways and improve lung function. GoLYTELY would be given as needed for severe constipation because constipation is a common symptom in CF. Inhaled tobramycin would be used to combat Pseudomonas infection, which is a common type of bacterial infection in CF patients.

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8.

A patient who has bronchiectasis asks the nurse, "What conditions would warrant a call to the clinic?"

A.

Blood clots in the sputum
B.

Sticky sputum on a hot day
C.

Increased shortness of breath after eating a large meal
D.

Production of large amounts of sputum on a daily basis

Correct Answer
A. Blood clots in the sputum

Explanation
Blood clots in the sputum would warrant a call to the clinic because it may indicate a more serious condition such as a pulmonary embolism or lung infection. This symptom should not be ignored and requires immediate medical attention to determine the cause and provide appropriate treatment.

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