NU 300 EXAM 4 | COMPREHENSIVE MEDICAL-SURGICAL NURSING STUDY GUIDE,
PRACTICE QUESTIONS & ANSWERS 2026/2027
Common triggers for bronchospasms - ANS ✔✔Pollutants, respiratory viruses, NSAIDs, GERD
Asthma Physiological process - ANS ✔✔-Inflammation
-Vasodilation and capillary leak
-Swelling
- Increase in secretions
-Broncho-constriction
-Decreasing ventilation
Common asthma S&S - ANS ✔✔-Dyspnea
-SOB
-Chest tightness
-Coughing
-Wheezing loudest on exhalation
-Increased mucus production
-Rash
-Itching
-Rhinitis
-Accessory muscle use
-Barrel chest
-Aspirin/NSAID
-GERD
-Cold within 1-2 months
-ABG decreased CO2 initially then increased
Nursing action/intervention to prevent episodic asthmatic flare ups - ANS ✔✔-Teach how to manage
daily control meds and rescue meds
-Measure symptom severity 2x/day with peak flow meter and adjust meds based on plan of action
-Symptom and treatment diary
-Aerobic exercise
-Maintain O2 therapy during attack
-Avoid triggers
-Reduce stress
Asthma: Short acting bronchodilators(Beta2 agonist SABA) - ANS ✔✔Albuterol, Levalbuterol
Asthma: Long acting bronchodilators(Beta2 agonist LABA) - ANS ✔✔Salmeterol, Indacaterol
Asthma: Cholinergic antagonist
-pium - ANS ✔✔Ipratropium, Tiotropium
Asthma: Corticosteroids
-one - ANS ✔✔Fluticasone, Beclomethasone
, Asthma: Cromones - ANS ✔✔Nedocromil
Asthma: Leukotriene modifiers - ANS ✔✔Montelukast (PO)
Asthma: Monoclonal antibodies - ANS ✔✔Benralizumab, Mepolizumab (SUBQ)
Goals during Asthmatic events - ANS ✔✔-Patent airway
-No hypoxemia S&S
-O2 sat 95-100%
-Baseline VS
-No anxiety
-Patient can verbalize/demonstrate plan of care
Status Asthmaticus S&S - ANS ✔✔-Use of rescue inhaler did not cure/ worsened symptoms
-Extreme labored breathing and wheezing
-Accessory muscle use
-Neck vein distension
-May result in pneumothorax
-Cardiac/respiratory arrest
What is the nurse to do during status asthmaticus events? - ANS ✔✔-Administer IV fluids
-Potent systematic bronchodilators/steroids/Epi/O2
-Be prepared for intubation/
tracheotomy once emergency is over
-RX is same as asthma
Pathophysiological process of Emphysema - ANS ✔✔-Loss of lung elasticity
-Lung hyperinflation
-Excess proteases
-Collapsing of alveoli and destruction of alveolar walls
-Decreased gas exchange surface and increased air trapping
-Increasing work of breathing and flattening diaphragm
-Use of accessory muscles
-Further increase work of breathing and O2 demand
-Compensation: increased RR
Pathophysiological process of Bronchitis - ANS ✔✔-Inflammation of airways in response to trigger
-Vasodilation
-Capillary leak
-Edema
-Thick congestion
-Bronchial spasms
-Thickening of bronchial walls
-Impaired flow and obstruction
-Hypoxemia
-Hypercarbia
PRACTICE QUESTIONS & ANSWERS 2026/2027
Common triggers for bronchospasms - ANS ✔✔Pollutants, respiratory viruses, NSAIDs, GERD
Asthma Physiological process - ANS ✔✔-Inflammation
-Vasodilation and capillary leak
-Swelling
- Increase in secretions
-Broncho-constriction
-Decreasing ventilation
Common asthma S&S - ANS ✔✔-Dyspnea
-SOB
-Chest tightness
-Coughing
-Wheezing loudest on exhalation
-Increased mucus production
-Rash
-Itching
-Rhinitis
-Accessory muscle use
-Barrel chest
-Aspirin/NSAID
-GERD
-Cold within 1-2 months
-ABG decreased CO2 initially then increased
Nursing action/intervention to prevent episodic asthmatic flare ups - ANS ✔✔-Teach how to manage
daily control meds and rescue meds
-Measure symptom severity 2x/day with peak flow meter and adjust meds based on plan of action
-Symptom and treatment diary
-Aerobic exercise
-Maintain O2 therapy during attack
-Avoid triggers
-Reduce stress
Asthma: Short acting bronchodilators(Beta2 agonist SABA) - ANS ✔✔Albuterol, Levalbuterol
Asthma: Long acting bronchodilators(Beta2 agonist LABA) - ANS ✔✔Salmeterol, Indacaterol
Asthma: Cholinergic antagonist
-pium - ANS ✔✔Ipratropium, Tiotropium
Asthma: Corticosteroids
-one - ANS ✔✔Fluticasone, Beclomethasone
, Asthma: Cromones - ANS ✔✔Nedocromil
Asthma: Leukotriene modifiers - ANS ✔✔Montelukast (PO)
Asthma: Monoclonal antibodies - ANS ✔✔Benralizumab, Mepolizumab (SUBQ)
Goals during Asthmatic events - ANS ✔✔-Patent airway
-No hypoxemia S&S
-O2 sat 95-100%
-Baseline VS
-No anxiety
-Patient can verbalize/demonstrate plan of care
Status Asthmaticus S&S - ANS ✔✔-Use of rescue inhaler did not cure/ worsened symptoms
-Extreme labored breathing and wheezing
-Accessory muscle use
-Neck vein distension
-May result in pneumothorax
-Cardiac/respiratory arrest
What is the nurse to do during status asthmaticus events? - ANS ✔✔-Administer IV fluids
-Potent systematic bronchodilators/steroids/Epi/O2
-Be prepared for intubation/
tracheotomy once emergency is over
-RX is same as asthma
Pathophysiological process of Emphysema - ANS ✔✔-Loss of lung elasticity
-Lung hyperinflation
-Excess proteases
-Collapsing of alveoli and destruction of alveolar walls
-Decreased gas exchange surface and increased air trapping
-Increasing work of breathing and flattening diaphragm
-Use of accessory muscles
-Further increase work of breathing and O2 demand
-Compensation: increased RR
Pathophysiological process of Bronchitis - ANS ✔✔-Inflammation of airways in response to trigger
-Vasodilation
-Capillary leak
-Edema
-Thick congestion
-Bronchial spasms
-Thickening of bronchial walls
-Impaired flow and obstruction
-Hypoxemia
-Hypercarbia
