BSNC 6000 MOD. 1 QUESTIONS WITH VERIFIED
ACCURATE ANSWERS
A 58-year-old client with a 40-year history of smoking one to two packs of cigarettes a
day has a chronic cough producing thick sputum, peripheral edema, and cyanotic nail
beds. Based on this information, he most likely has which of the following conditions?
A. Adult respiratory distress syndrome (ARDS)
B. Asthma
C. Chronic obstructive bronchitis
D. Emphysema - Answers - C. Chronic obstructive bronchitis
Because of his extensive smoking history and symptoms, the client most likely has
chronic obstructive bronchitis. Chronic bronchitis is a type of chronic obstructive
pulmonary disease (COPD) that is defined as a productive cough of more than 3
months occurring within a span of 2 years. Patients typically present with chronic
productive cough, malaise, and symptoms of excessive coughing such as chest or
abdominal pain.
A nurse plans care for a client with chronic obstructive pulmonary disease, knowing that
the client is most likely to experience what type of acid-base imbalance?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis - Answers - A. Respiratory acidosis
Respiratory acidosis is most often due to hypoventilation. Chronic respiratory acidosis is
most commonly caused by COPD. In end-stage disease, pathological changes lead to
airway collapse, air trapping, and disturbance of ventilation-perfusion relationships.
Respiratory acidosis is a state in which there is usually a failure of ventilation and an
accumulation of carbon dioxide. The primary disturbance of elevated arterial PCO2 is
the decreased ratio of arterial bicarbonate to arterial PCO2, which leads to a lowering of
the pH.
A 66-year-old client has marked dyspnea at rest, is thin, and uses accessory muscles to
breathe. He's tachypneic, with a prolonged expiratory phase. He has no cough. He
leans forward with his arms braced on his knees to support his chest and shoulders for
breathing. This client has symptoms of which of the following respiratory disorders?
A. ARDS
B. Asthma
C. Chronic obstructive bronchitis
D. Emphysema - Answers - D. Emphysema
These are classic signs and symptoms of a client with emphysema. In the early stages
of the disease, the physical examination may be normal. Patients with emphysema are
typically referred to as "pink puffers," meaning cachectic and non-cyanotic. Expiration
, through pursed lips increases airway pressure and prevents airway collapse during
respiration, and the use of accessory muscles of respiration indicates advanced
disease.
It's highly recommended that clients with asthma, chronic bronchitis, and emphysema
have Pneumovax and flu vaccinations for which of the following reasons?
A. All clients are recommended to have these vaccines.
B. These vaccines produce bronchodilation and improve oxygenation.
C. These vaccines help reduce the tachypnea these clients experience.
D. Respiratory infections can cause severe hypoxia and possibly death in these clients.
- Answers - D. Respiratory infections can cause severe hypoxia and possibly death in
these clients.
Teaching for a client with chronic obstructive pulmonary disease (COPD) should include
which of the following topics?
A. How to have his wife learn to listen to his lungs with a stethoscope from Wal-Mart.
B. How to increase his oxygen therapy.
C. How to treat respiratory infections without going to the physician.
D. How to recognize the signs of an impending respiratory infection. - Answers - D. How
to recognize the signs of an impending respiratory infection.
Respiratory infection in clients with a respiratory disorder can be fatal. It's important that
the client understands how to recognize the signs and symptoms of an impending
respiratory infection. Acute exacerbation of COPD is an acute worsening of respiratory
symptoms. Assessing severity is often based on the model developed by Anthonisen
and colleagues which classifies severity by the presence of worsening dyspnea, sputum
volume, and purulence. Mild exacerbations are defined by the presence of 1 of these
symptoms in addition to one of the following: increased wheezing, increased cough,
fever without another cause, upper respiratory infection within 5 days, or an increase in
heart rate or respiratory rate from the patient's baseline.
Which of the following respiratory disorders is most common in the first 24 to 48 hours
after surgery?
A. Atelectasis
B. Bronchitis
C. Pneumonia
D. Pneumothorax - Answers - A. Atelectasis
Atelectasis develops when there's interference with the normal negative pressure that
promotes lung expansion. Clients in the postoperative phase often splint their breathing
because of pain and positioning, which causes hypoxia. Postoperative atelectasis
typically occurs within 72 hours of general anesthesia and is a well-known postoperative
complication. The decrease in pressure allows for passive movement of air into the
lungs. This process is inhibited by general anesthesia due to diaphragm relaxation.
Patients lying supine have cephalad displacement of the diaphragm further decreasing
ACCURATE ANSWERS
A 58-year-old client with a 40-year history of smoking one to two packs of cigarettes a
day has a chronic cough producing thick sputum, peripheral edema, and cyanotic nail
beds. Based on this information, he most likely has which of the following conditions?
A. Adult respiratory distress syndrome (ARDS)
B. Asthma
C. Chronic obstructive bronchitis
D. Emphysema - Answers - C. Chronic obstructive bronchitis
Because of his extensive smoking history and symptoms, the client most likely has
chronic obstructive bronchitis. Chronic bronchitis is a type of chronic obstructive
pulmonary disease (COPD) that is defined as a productive cough of more than 3
months occurring within a span of 2 years. Patients typically present with chronic
productive cough, malaise, and symptoms of excessive coughing such as chest or
abdominal pain.
A nurse plans care for a client with chronic obstructive pulmonary disease, knowing that
the client is most likely to experience what type of acid-base imbalance?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis - Answers - A. Respiratory acidosis
Respiratory acidosis is most often due to hypoventilation. Chronic respiratory acidosis is
most commonly caused by COPD. In end-stage disease, pathological changes lead to
airway collapse, air trapping, and disturbance of ventilation-perfusion relationships.
Respiratory acidosis is a state in which there is usually a failure of ventilation and an
accumulation of carbon dioxide. The primary disturbance of elevated arterial PCO2 is
the decreased ratio of arterial bicarbonate to arterial PCO2, which leads to a lowering of
the pH.
A 66-year-old client has marked dyspnea at rest, is thin, and uses accessory muscles to
breathe. He's tachypneic, with a prolonged expiratory phase. He has no cough. He
leans forward with his arms braced on his knees to support his chest and shoulders for
breathing. This client has symptoms of which of the following respiratory disorders?
A. ARDS
B. Asthma
C. Chronic obstructive bronchitis
D. Emphysema - Answers - D. Emphysema
These are classic signs and symptoms of a client with emphysema. In the early stages
of the disease, the physical examination may be normal. Patients with emphysema are
typically referred to as "pink puffers," meaning cachectic and non-cyanotic. Expiration
, through pursed lips increases airway pressure and prevents airway collapse during
respiration, and the use of accessory muscles of respiration indicates advanced
disease.
It's highly recommended that clients with asthma, chronic bronchitis, and emphysema
have Pneumovax and flu vaccinations for which of the following reasons?
A. All clients are recommended to have these vaccines.
B. These vaccines produce bronchodilation and improve oxygenation.
C. These vaccines help reduce the tachypnea these clients experience.
D. Respiratory infections can cause severe hypoxia and possibly death in these clients.
- Answers - D. Respiratory infections can cause severe hypoxia and possibly death in
these clients.
Teaching for a client with chronic obstructive pulmonary disease (COPD) should include
which of the following topics?
A. How to have his wife learn to listen to his lungs with a stethoscope from Wal-Mart.
B. How to increase his oxygen therapy.
C. How to treat respiratory infections without going to the physician.
D. How to recognize the signs of an impending respiratory infection. - Answers - D. How
to recognize the signs of an impending respiratory infection.
Respiratory infection in clients with a respiratory disorder can be fatal. It's important that
the client understands how to recognize the signs and symptoms of an impending
respiratory infection. Acute exacerbation of COPD is an acute worsening of respiratory
symptoms. Assessing severity is often based on the model developed by Anthonisen
and colleagues which classifies severity by the presence of worsening dyspnea, sputum
volume, and purulence. Mild exacerbations are defined by the presence of 1 of these
symptoms in addition to one of the following: increased wheezing, increased cough,
fever without another cause, upper respiratory infection within 5 days, or an increase in
heart rate or respiratory rate from the patient's baseline.
Which of the following respiratory disorders is most common in the first 24 to 48 hours
after surgery?
A. Atelectasis
B. Bronchitis
C. Pneumonia
D. Pneumothorax - Answers - A. Atelectasis
Atelectasis develops when there's interference with the normal negative pressure that
promotes lung expansion. Clients in the postoperative phase often splint their breathing
because of pain and positioning, which causes hypoxia. Postoperative atelectasis
typically occurs within 72 hours of general anesthesia and is a well-known postoperative
complication. The decrease in pressure allows for passive movement of air into the
lungs. This process is inhibited by general anesthesia due to diaphragm relaxation.
Patients lying supine have cephalad displacement of the diaphragm further decreasing
