Vision: A PREMIER UNIVERSITY delivering

“Excellent nursing education that

world-class education that promotes
provides graduates with self-
sustainable development amidst climate
change.
Benguet State University direction, competence and
compassion.”
Mission: To provide quality education to COLLEGE OF NURSING
enhance food security, sustainable La Trinidad, Benguet “The College of Nursing is committed
communities, industry innovation, climate to provide a strong academic and
resilience, gender equality, institutional
www.bsu.edu.ph/ 422- 2127 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

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
Vision: A PREMIER UNIVERSITY delivering
“Excellent nursing education that
world-class education that promotes
provides graduates with self-
sustainable development amidst climate
change.
Benguet State University direction, competence and
compassion.”
Mission: To provide quality education to COLLEGE OF NURSING
enhance food security, sustainable La Trinidad, Benguet “The College of Nursing is committed
communities, industry innovation, climate to provide a strong academic and
resilience, gender equality, institutional
www.bsu.edu.ph/ 422- 2127 professional foundation for the
development and partnerships. practice of nursing.”

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
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 A
b. Weight loss C
c. Barrel chest C
d. Polycythemia C
e. Cor pulmonale C
f. Persistent cough B
g. Flattened diaphragm C
h. Decreased breath sounds B
i. Increased total lung capacity B
j. Frequent sputum production C
k. Increased fractional exhaled nitric oxide (FENO) A