1.

The clinic nurse is caring for a patient who has just been diagnosed
with chronic obstructive pulmonary disease (COPD). The patient asks the
nurse what he could have done to minimize the risk of contracting this
disease. What would be the nurse's best answer?
A) "The most important risk factor for COPD is inadequate nutrition."
B) "The most important risk factor for COPD is regular exercise."
C) "The most important risk factor for COPD is exposure to dust and
pollen."
D) "The most important risk factor for COPD is cigarette smoking."
2. You are teaching a class to nursing students on chronic obstructive
pulmonary disease (COPD). What would you name for the students as a
complication of COPD?
A) Bronchitis
B) Bronchiectasis
C) Pulmonary hypertension
D) Hemothorax
3. You are caring for a 24-year-old patient with an antitrypsin
deficiency. The patient states he has never smoked in his life. An
antitrypsin deficiency predisposes the patient to what?
A) Pulmonary edema
B) Development of lobular emphysema
C) Cystic fibrosis
D) Empyema
4. The nursing instructor is teaching a class of level I nursing students
how to do a physical assessment on a patient with lung disease and
chronic hyperinflation of the lungs. What would a nurse most likely
assess in this type of patient?
A) Dry, flaky skin
B) Large, drooping eyes
C) A barrel chest
D) Long, thin fingers
5. Your patient is experiencing shortness of breath. To relieve the
symptoms in this patient, you would place your patient in what position?
A) Sitting upright leaning forward slightly
B) Low Fowler's
C) Prone
D) Trendelenburg
6. The nurse is evaluating the diagnostic studies data on a patient with
suspected cystic fibrosis. Which of the following tests is associated
with a diagnosis of cystic fibrosis?
A) An elevated sweat chloride concentration test
B) Presence of ketones in the urine
C) Positive phenylketonuria
D) Lung biopsy
7. The school nurse is caring for a 10-year-old girl who is having an
asthma attack on the school ground at recess. What is the preferred
treatment to alleviate this client's airflow obstruction?
A) Corticosteroids
B) Anticholinergics
C) Beta-adrenergics
D) Peak flow monitoring device
8. The student nurse is developing a teaching plan for a patient with
asthma. Which
teaching point has the highest priority and should be included in the
plan of care the student is developing?
A) Avoid contact with fur-bearing animals
B) Change filters on heating and air conditioning units frequently
C) Take prescribed medications as scheduled
D) Avoid goose-down pillows
9. A student nurse prepares to care for a patient with bronchiectasis.
The student nurse should anticipate that what would be ordered for this
patient?
A) Antihypertensives
B) Potassium supplements
C) Bronchodilators
D) Diuretics
10. The nurse is caring for a 6-year-old patient with cystic fibrosis.
The parents ask how the cystic fibrosis started. The nurse explains that
the key feature in the presentation of cystic fibrosis includes what?
A) Airway obstruction
B) Obstructed bowel
C) Salty sweat
D) Clubbing of the extremities

11. A patient arrives in the emergency room with an attack of acute

bronchiectasis. The
nurse knows that the principle pathologic finding in the diagnosis of
bronchiectasis includes what?
A) Increase in the red blood cell concentration in the blood
B) Leakage of fluid into the alveolar interstitial spaces
C) Chronic, irreversible dilation of the bronchi and bronchioles
D) Obstruction of the pulmonary vasculature by a clot
12. You are taking a course in lung sounds. You are learning about the
lungs of a child with asthma. You learn that the most common symptoms of
asthma are what?
A) Shallow respirations
B) Increased A-P diameter
C) Bilateral wheezes
D) Rhonchi in the lower bases
13. You are developing the teaching portion of a care plan for a patient
with COPD. What would be an important component for you to emphasize?
A) Smoking one-half of a pack weekly is allowable
B) Chronic inhalation of indoor toxins causes lung damage
C) Minor respiratory infections are not treated
D) ADLs should be completed in the waking hours
14. The nursing instructor is teaching her clinical group about
emphysema. The instructor explains that when caring for a patient with
emphysema, you would include what teaching as priority in the plan of
care?
A) Ineffective coping
B) Self-care deficit
C) Activity intolerance
D) Setting and accepting realistic short-term and long-range goals
15. A nurse is documenting her assessment of a patient with
bronchiectasis. What would the nurse note in her documentation?
A) Sudden, pleuritic chest pain
B) Wheezes on auscultation
C) Increased A-P diameter
D) Clubbing of the fingers
16. Your patient is having pulmonary-function studies performed. The
patient has a spirometry test and has an FEVI/FVC ratio of 60%. You know
that this indicates what?
A) Strong exercise tolerance
B) Exhalation volume is normal
C) Healthy lung volumes
D) Obstructive lung disease
17. You have been asked to give a workshop on COPD for a local community
group. When talking about what can be done for patients with COPD, you
stress encouraging a COPD patient not to smoke because smoking does what?
A) Increases the amount of mucus production
B) Oxygenates the hemoglobin
C) Shrinks the alveoli in the lungs
D) Collapses the alveoli in the lungs
18. You are a pediatric nurse practitioner caring for a child who has
just been diagnosed with asthma. You provide the parents with information
that includes potential causative agents for an asthmatic reaction. What
would this information include as a potential causative agent for an
asthma attack?
A) Pets
B) Watching television
C) Hot shower
D) Rainstorm
19. The nurse is caring for a client with COPD. It is time to do
discharge teaching with this client. The nurse teaches the client about
breathing exercises. What should the nurse include in the teaching?
A) Make inhalation longer than exhalation
B) Exhale through an open mouth
C) Use diaphragmatic breathing
D) Use chest breathing
20. A nurse is caring for a patient with chronic bronchiectasis. The
nurse should assess the patient for which of the following clinical
manifestations?
A) Hemoptysis
B) Angina
C) Pigeon chest
D) Pulmonary hypertension

21. What is the hallmark pathology of CF?

A) Alveolar mucus plugging, infection, and eventual bronchiectasis
B) Bronchial mucus plugging, inflammation, and eventual bronchiectasis
C) Atelectasis, infection, and eventual COPD
D) Bronchial mucus plugging, infection, and eventual COPD

22. There are two types of risk factors associated with COPD. What is a
host factor(
A) Smoking
B) Genetic tendency
C) Indoor toxins
D) Impaired breathing mechanism
23. As the nurse is performing an admission assessment on a patient with
COPD, it is important for the nurse to review what?
A) Physician's progress notes
B) Nutritional assessment
C) Lab work ordered
D) Available diagnostic tests
24. The admitting nurse is assessing a client with COPD. The nurse
auscultates diminished breath sounds, which signify changes in the
airway. These changes indicate to the nurse to monitor the patient for
what?
A) Hypoxemia and clubbing of the fingers
B) Dyspnea and hypoxemia
C) Clubbing of the fingers and cyanosis
D) Bronchospasm and clubbing of the fingers
25. When caring for a client with COPD, the nurse knows it is important
to monitor what?
A) Cognitive changes
B) Support systems
C) Increasing hyperpnea
D) Bradycardia

26. Nursing management of the client with COPD involves a great deal of
teaching. Which self-care activity would it be important for you to teach
a client with COPD to do to avoid bronchospasm?
A) Encourage the patient to be immunized against influenza and S.
pneumoniae
B) Avoid going outdoors if the pollen count is high
C) Monitor signs and symptoms of respiratory infection
D) Assess the client for familiarity with potential side effects of
prescribed medications
27. You are the case manager for a group of patients with COPD. You have
planned to teach these clients self-management of their disease process
and their therapeutic regimen. What is important for you to assess when
providing instructions on self-management to these patients?
A) Ability of the patient to perform required procedures
B) Family support
C) Knowledge of the disease process
D) Knowledge of the patients about self-care and their therapeutic
regimen
28. A student nurse is developing a teaching plan for a patient with
COPD. What should the student include as a major area of teaching?
A) Avoiding extremes of heat and cold
B) Setting and accepting realistic short-term and long-range goals
C) Adopting a lifestyle of moderate activity, ideally in a climate
with minimal shifts in temperature and humidity
D) Avoiding emotional disturbances and stressful situations that might
trigger a coughing episode
29. Bronchiectasis is now considered a pulmonary disease separate and
apart from COPD. Bronchiectasis can be caused by a variety of conditions,
including what? (Mark all that apply.)
A) Pulmonary hypertension
B) Airway obstruction
C) Pulmonary infections
D) Genetic disorders
E) Atelectasis
30. When caring for a client with bronchiectasis, nursing management
focuses on what?
A) Alleviating symptoms
B) Helping patients clear atelectasis
C) Preventing pulmonary secretions
D) Decreasing pulmonary hypotension
31. Medical management of bronchiectasis may include what? (Mark all that
apply.)
A) Physical therapy
B) Antimicrobial therapy
C) Isolation
D) Chest physiotherapy
E) Smoking cessation
32. You are caring for a patient with bronchiectasis who is scheduled for
surgery. You know that the goals of surgery are what?
A) To remove all of the diseased lung tissue
B) To increase infection in the lung
C) To conserve normal pulmonary tissue
D) To increase lung tissue
33. One of the aspects of teaching patients with bronchiectasis self-care
is to include their
families in the teaching of postural drainage. Why is it so important for
the nurse to include families in their self-care teaching?
A) Because the patient physically cannot do it himself
B) To avoid having to go to a center for treatment twice a day
C) Because the patient gets so tired that he cannot manage a postural
drainage treatment regimen without other people to help
D) To avoid exposure to people with upper respiratory infections
34. Asthma is a chronic inflammatory disease of the airways. Ultimately
it leads to recurrent episodes of asthma symptoms. What are the symptoms
of asthma? (Mark all that apply.)
A) Chest tightness
B) Crackles
C) Hypopnea
D) Wheezing
E) Cough
35. You are the nurse caring for a patient with asthma hospitalized with
an acute asthma exacerbation. What drugs would you expect to have ordered
for this patient to gain underlying control of persistent asthma?
A) Rescue inhalers
B) Anti-inflammatory drugs
C) Antibiotics
D) Antitussives
36. You are teaching a patient with asthma about Azmacort. Which adverse
effect would you be sure to include in your patient teaching?
A) Dyspnea
B) Nausea
C) Dysphonia
D) Fatigue
37. The clinic nurse is explaining to the patient with asthma what
prednisone is used for. What would be the best explanation the nurse
could give?
A) To give repeated quick bursts of long-term control of asthma
exacerbations
B) To cure any underlying systemic infection
C) To prevent recurrent pulmonary infections
D) To gain prompt control of inadequately controlled, persistent
asthma
38. You are an asthma nurse educator working with a group of adolescent
asthma patients. You teach your patients that the early treatment of
asthma exacerbations includes what?
A) Written action plans
B) Antibiotics
C) IV corticosteroids
D) Physical therapy
39. As an asthma educator, you are teaching a patient newly diagnosed
with asthma and her family about the use of a peak flow meter. What does
a peak flow meter measure?
A) Highest airflow during a forced inspiration
B) Highest airflow during a forced expiration
C) Highest airflow during a normal inspiration
D) Highest airflow during a normal expiration
40. You are admitting a new patient to the unit who has a history of
chronic cough with sputum production, persistent infection, and x-ray
evidence of bronchiectasis and chronic sinusitis with nasal polyps. Which
disease process would you suspect this patient has?
A) Emphysema
B) COPD
C) Cystic fibrosis
D) Chronic bronchitis
Answer Key
1.D
2. C
3. B
4. C
5.A
6.A
7.C
8.C
9.C
10. A
11. C
12.C
13. B
14.D
15.D
16.D
17.A
18.A
19.C
20.A
21.B
22. B
23.D
24. B
25.A
26.B
27.D
28. B
29. B, C, D
30.A
31. B, D, E
32. C
33.D
34. A, D, E
35. B
36. C
37.D
38.A
39.B
40. C