Vision: A PREMIER UNIVERSITY delivering

“Excellent nursing education that

world-class education that promotes
sustainable development amidst climate
change.
Benguet State University provides graduates with self-
direction, competence and

Mission: To provide quality education to

COLLEGE OF NURSING compassion.”

enhance food security, sustainable La Trinidad, Benguet “The College of Nursing is committed
communities, industry innovation, climate www.bsu.edu.ph/ 422- 2127 to provide a strong academic and
resilience, gender equality, institutional professional foundation for the
development and partnerships. practice of nursing.”

NCM 112
Care of clients with problems in Oxygenation, Fluid and Electrolytes, Infectious, Inflammatory
and immunologic response, Cellular Aberrations, Acute and Chronic.

WORKSHEET 3
NAME: [ ] SCORE:________
SECTION: [ ] DATE: _________

Care of Patients with Non-infectious Lower Respiratory Problems

Part 1

1. While assisting a patient with intermittent asthma to identify specific triggers of asthma, what should the nurse
explain?
a. Food and drug allergies do not manifest in respiratory symptoms.
b. Exercise-induced asthma is seen only in individuals with sensitivity to cold air.
c. Asthma attacks are psychogenic in origin and can be controlled with relaxation techniques.
d. Viral upper respiratory infections are a common precipitating factor in acute asthma attacks.

2. Priority Decision: A patient is admitted to the emergency department with an acute asthma attack. Which patient
assessment is of greatest concern to the nurse?
a. The presence of a pulsus paradoxus
b. Markedly diminished breath sounds with no wheezing
c. Use of accessory muscles of respiration and a feeling of suffocation
d. A respiratory rate of 34 and increased pulse and blood pressure

3. A patient with asthma has the following arterial blood gas (ABG) results early in an acute asthma attack: pH 7.48,
PaCO2 30 mm Hg, PaO2 78 mm Hg. What is the most appropriate action by the nurse?
a. Prepare the patient for mechanical ventilation.
b. Have the patient breathe in a paper bag to raise the PaCO2.
c. Document the findings and monitor the ABGs for a trend toward alkalosis.
d. Reduce the patient’s oxygen flow rate to keep the PaO2 at the current level.

4. Priority Decision: Which medication should the nurse anticipate being used first in the emergency department for
relief of severe respiratory distress related to asthma?
a. Prednisone orally
b. Ipratopium inhaler
c. Fluticasone inhaler
d. Albuterol nebulizer

5. When teaching the patient about going from a metered-dose inhaler (MDI) to a dry powder inhaler (DPI), which
statement by the patient shows the nurse that the patient needs more teaching?
a. “I do not need to use the spacer like I used to.”
b. “I will hold my breath for 10 seconds or longer if I can.”
c. “I will not shake this inhaler like I did with my old inhaler.”
d. “I will store it in the bathroom so I will be able to clean it when I need to.”

6. What causes the pulmonary vasoconstriction leading to the development of cor pulmonale in the patient with
COPD?
a. Increased viscosity of the blood
b. Alveolar hypoxia and hypercapnia
c. Long-term low-flow oxygen therapy
d. Administration of high concentrations of oxygen

7. Which method of oxygen administration is the safest system to use for a patient with COPD?
a. Venturi mask
b. Nasal cannula
 Vision: A PREMIER UNIVERSITY delivering
“Excellent nursing education that
world-class education that promotes
sustainable development amidst climate
change.
Benguet State University provides graduates with self-
direction, competence and

Mission: To provide quality education to

COLLEGE OF NURSING compassion.”

enhance food security, sustainable La Trinidad, Benguet “The College of Nursing is committed
communities, industry innovation, climate www.bsu.edu.ph/ 422- 2127 to provide a strong academic and
resilience, gender equality, institutional professional foundation for the
development and partnerships. practice of nursing.”

c. Simple face mask

d. Non-rebreathing mask

8. Which breathing technique should the nurse teach the patient with moderate COPD to promote exhalation?
a. Intermittent coughing
b. Thoracic breathing
c. Pursed lip breathing
d. Diaphragmatic breathing

9. Priority Decision: During an acute exacerbation of mild COPD, the patient is severely short of breath and the nurse
identifies a nursing diagnosis of ineffective breathing pattern related to obstruction of airflow and anxiety. What is
the best action by the nurse?
a. Prepare and administer routine bronchodilator medications.
b. Perform chest physiotherapy to promote removal of secretions.
c. Administer oxygen at 5 L/min until the shortness of breath is relieved.
d. Position the patient upright with the elbows resting on the over-the-bed table.

10. Which dietary modification helps to meet the nutritional needs of patients with COPD?
a. Eating a high-carbohydrate, low-fat diet
b. Avoiding foods that require a lot of chewing
c. Preparing most foods of the diet to be eaten hot
d. Drinking fluids with meals to promote digestion

Part 2

Indicate whether the following clinical manifestations are most characteristic of asthma (A), chronic obstructive pulmonary
disease (COPD) (C), or both (B).

Clinical Manifestations Answer

a. Wheezing

b. Weight loss

c. Barrel chest

d. Polycythemia

e. Cor pulmonale

f. Persistent cough

g. Flattened diaphragm

h. Decreased breath sounds

i. Increased total lung capacity

j. Frequent sputum production

k. Increased fractional exhaled nitric oxide (FENO)