OBSTRUCTIVE PULMONARY DISEASES QUIZ

1. A patient is presenting with chronic obstructive pulmonary disease. The patient has a chronic

productive cough with dyspnea on excretion. Arterial blood gases show a low oxygen level and high

carbon dioxide level in the blood. On assessment, the patient is cyanotic and is wheezing. Based on your

nursing knowledge and the patient's symptoms, you suspect the patient suffers from what type of

COPD? (2 pts)

a) Emphysema

b) Pneumonia

c) Chronic Bronchitis

2. A patient with emphysema may have the following symptoms EXCEPT? (2 pts)

a) Hyperinflated lungs on X-ray

b) Barrel chest

c) Hypoventilation

3. When providing teaching to a patient with COPD on how to perform diaphragmatic breathing, you tell

him/her that the purpose of this technique is to: (2 pts)

a) Decrease the use of the abdominal muscles

b) Strengthen the diaphragm

c) Encourages the use of accessory muscles to help with breathing

4. A nurse teaches a client about the use of a respiratory inhaler. Which action by the client indicated a

need for further teaching? (2 pts)

a) Press the canister down with your finger as he breathes in.

b) Inhales the mist and quickly exhales.

c) Removes the cap and shakes the inhaler well before use.
5. A client has an order to have radial ABG drawn. Before drawing the sample, a nurse occludes the: (2
pts)

a) Radial and ulnar arteries, releases one, evaluates the color of the hand, and repeats the process with

the other artery.

b) Brachial and radial arteries, and then releases them and observes the circulation of the hand.

c) Ulnar artery and observes for color changes in the affected hand.

6. Which of the following is the primary reason to teach pursed lip breathing to clients with

emphysema? (2 pts)

a) To strengthen the diaphragm.

b) To promote carbon dioxide elimination.

c) To strengthen the intercostal muscles.

7. Which of the following is a priority goal for the client with COPD? (2 pts)

a) Minimizing chest pain.

b) Maintaining functional ability.

c) Increasing carbon dioxide levels in the blood.

8. When teaching a client with COPD to conserve energy, the nurse should teach the client to lift

objects: (2 pts)

a) While exhaling through pursed lips.

b) While inhaling through an open mouth.

c) After exhaling but before inhaling.

9. Which of the following ABG abnormalities should the nurse anticipate in a client with severe

exacerbation of COPD? (2 pts)

a) Increased PaO2

b) Increased pH

c) Increased PaCO2
10. A 28-year-old woman with a history of asthma is admitted to the emergency department. The nurse

notes that the client is dyspneic, with a respiratory rate of 37 cpm, nasal flaring, and use of accessory

muscles. Auscultation of the lung fields reveals greatly diminished breath sounds. Based on these

findings, what would you expect to be ordered by the physician? (2 pts)

a) administer bronchodilators

b) administer oxygen at 10 liters/min via face mask

c) Draw blood for ABG analysis

11. The nurse would anticipate which of the following ABG results in a client experiencing a prolonged,

severe asthma attack? (2 pts)

a) Decreased PaCO2, increased PaO2, decreased pH

b) Increased PaCO2, decreased paO2, decreased pH

c) Increased PaCO2, decreased PaO2, increased pH

12. The best method of oxygen administration for client with COPD uses: (2 pts)

a) Simple face mask

b) Venturi mask

c) Non-rebreather mask

13. An older adult patient experiences an asthma attack that is severe enough to warrant the use of a

rescue drug. Which medication is best to use for the acute symptoms? (2 pts)

a) Albuterol

b) Montelukast

c) Fluticasone

14. Which statement is correct in the relationship of smoking cessation to the pathophysiology of COPD?
(2 pts)

a) smoking cessation slows the rate of disease progression

b) smoking cessation completely reverses the damage to the lungs

c) smoking cessation is an important therapy for asthma but not for COPD

15. The nurse has assessment findings of dusky appearance with bluish mucous membranes and

production of lots of mucus in her pt. The nurse suspects which illness? (2 pts)

a) Chronic bronchitis

b) Emphysema

c) Asthma

16. A 12-year-old child with asthma is being treated for acute exacerbation in the ER. Which of the

following signs indicates worsening of the condition? (2 pts)

a) Pulse rate of 90 bpm

b) Decreased wheezing

c) Respirations of 18 cpm

17. A 30-year-old woman with a history of asthma is admitted to the emergency department. The nurse

notes that the client is dyspneic, with a respiratory rate of 38 cpm and uses accessory muscles in

breathing. Auscultation reveals greatly diminished breath sounds on lung fields. Based on these findings,

what action should the nurse take to initiate care of the client? (2 pts)

a) Administer ordered bronchodilators

b) Encourage the client to relax and breathe slowly through the mouth

c) Draw blood for an ABG analysis and send the client for a chest x-ray.

18. Which of the following outcomes would be appropriate for a client with COPD who has been

discharged to home? The client: (2 pts)

a) States that he will use oxygen via a nasal cannula at 5 L/minute.

b) Knows to call the physician if dyspnea on exertion increases.

c) States actions to reduce pain.

19. The nurse is caring for a client hospitalized with acute exacerbation of COPD. Which finding would

the nurse expect to note on assessment of this client? (2 pts)

a) Hyperinflated chest noted on chest X-ray

b) Hypocapnia

c) A widened diaphragm noted on chest x-ray

20. A 19-year-old comes into the emergency department with acute asthma. His respiratory rate is 44

cpm, and he appears to be in acute respiratory distress. Which of the following actions should be taken

first? (2 pts)

a) Nebulize the patient with ordered bronchodilator

b) Take a full medication history

c) Provide emotional support for the patient

21. A client with acute asthma is prescribed short-term corticosteroid therapy. What is the rationale for

the use of steroids in clients with asthma? (2 pts)

a) Corticosteroids have an anti-inflammatory effect

b) Corticosteroids act as an expectorant

c) Corticosteroids prevent development of respiratory infections.

22. A client with acute exacerbation COPD has been ordered for ABG. The results are as follows: pH:

7.16; PaCO2 80 mm Hg; PaO2 46 mm Hg; HCO3- 24 mEq/L; SaO2 81%. This ABG result represents which

of the following conditions? (2 pts)

a) Compensated Metabolic Acidosis

b) Uncompensated Respiratory Acidosis

c) Compensated Respiratory Acidosis

23. Which of these factors if present suggest the diagnosis of COPD? (2 pts)

a) History of cigarette smoking

b) Chronic cough with large amount of mucus productions

c) both A and B

24. Which of the following statements is not true about COPD? (2 pts)

a) COPD is an internationally recognized term used to indicate chronic bronchitis and emphysema.

b) COPD is more common in young age.

c) Key feature of COPD is poor reversibility of airflow limitation even after giving bronchodilators.

25. The nurse reviews the ABG values of a client with COPD. The results indicate respiratory acidosis.

Which of the following values would indicate that this acid-base imbalance exists? (2 pts)

a) pH of 7.50

b) PaCO2 of 32 mmHg

c) pH of 7.28

26. A nurse reviews the ABG values of a client and notes a pH of 7.50, a PCO2 of 30 mm Hg, and an

HCO3 of 25 mEq/L. The nurse interprets these values as indicating: (2 pts)

a) Uncompensated Respiratory Acidosis

b) Uncompensated Respiratory Alkalosis

c) Uncompensated Metabolic Alkalosis

27. Management for COPD includes: (2 pts)

a) Pulmonary rehabilitation

b) Medications

c) both A and B

28. People in what age group are most likely to say they have symptoms of COPD? (2 pts)

a) 20-30 years old

b) 15-25 years old

c) 40 years old and above

29. Respiratory infections are major health risks for someone with COPD. Which of the following steps

helps prevent these infections? (2 pts)

a) Annual flu shots

b) Pneumonia vaccine as advised by your physician

c) both A and B

30. A patient with severe COPD is having an episode of extreme shortness of breath and requests their

inhaler. Which type of inhaler ordered by the physician would provide the FASTEST relief for the patient

based on this situation? (2 pts)

a) Salmeterol

b) Albuterol

c) Symbicort