Exam Prep Questions
When performing an assessment on the client with emphysema, the nurse finds that the client has a barrel chest. The alteration in the client’s chest is due to:
- A. Collapse of distal alveoli
- B. Hyperinflation of the lungs
- C. Long-term chronic hypoxia
- D. Use of accessory muscles
The nurse notes that a client with COPD demonstrates increased dyspnea in certain positions. Which position is most likely to lessen the client’s dyspnea?
- A. Lying supine with a single pillow
- B. Standing or sitting upright
- C. Side lying with the head elevated
- D. Lying with head slightly lowered
When reviewing the chart of a client with long standing lung disease, the nurse should pay close attention to the results of which pulmonary function test?
- A. Residual volume
- B. Total lung capacity
- C. FEV1/FVC ratio
- D. Functional residual capacity
The physician has ordered O2 at 3 liters/minute via nasal cannula. O2 amounts greater than this are contraindicated in the client with COPD because:
- A. Higher concentrations result in severe headache.
- B. Hypercapnic drive is necessary for breathing.
- C. Higher levels will be required later for pO2.
- D. Hypoxic drive is needed for breathing.
The client taking a bronchodilator tells the nurse that he is going to begin a smoking cessation program when he is discharged. The nurse should tell the client to notify the doctor if his smoking pattern changes because he will:
- A. Need his medication dosage adjusted
- B. Require an increase in antitussive medication
- C. No longer need annual influenza immunization
- D. Not derive as much benefit from inhaler use
Lab results indicate that the client’s serum aminophylline level is 17 mcg/mL. The nurse recognizes that the aminophylline level is:
- A. Within therapeutic range
- B. Too high and should be reported
- C. Questionable and should be repeated
- D. Too low to be therapeutic
The morning weight for a client with emphysema indicates that the client has gained 5 pounds in less than a week, even though his oral intake has been modest. The client’s weight gain may reflect which associated complication of COPD?
- A. Polycythemia
- B. Cor pulmonale
- C. Left ventricular failure
- D. Compensated acidosis
The nurse is teaching the client the appropriate way to use a metered dose inhaler. Which observation indicates the client needs additional teaching?
- A. The client takes a deep breath while depressing the canister
- B. The client holds the canister two finger widths from the mouth
- C. The client waits 30 seconds before repeating the inhalation
- D. The client exhales slowly and deeply
The client with COPD may lose weight despite having adequate caloric intake. When counseling the client in ways to maintain an optimal weight, the nurse should tell the client to:
- A. Continue the same caloric intake and decrease his activity level
- B. Increase his activity level to stimulate his appetite
- C. Increase the amount of complex carbohydrates and decrease the amount of fat, intake
- D. Decrease the amount of complex carbohydrates while increasing calories, protein, fat, vitamins, and minerals
The client has been receiving garamycin 65 mg IVPB every 8 hours for the past 6 days. Which lab result indicates an adverse reaction to the medication?
- A. WBC 7500
- B. Serum glucose 92
- C. Protein 3.5
- D. Serum Creatinine 2.0