QUESTIONS WITH SOLUTIONS MARKED A+
✔✔A school-age child with CF asks the nurse what sports she can be involved in as
she becomes older. Which of the following activities would be most appropriate for the
nurse to suggest?
a.
swimming
b.
track
c.
baseball
d.
javelin throwing - ✔✔a. Swimming
Rationale: Swimming would be the most appropriate suggestion because it coordinates
breathing and movement of all muscle groups and can be done on an individual basis or
as a team sport. Because track events, baseball and javelin throwing usually are
performed outdoors, the child would be breathing in large amounts of dust and dirt,
which would be irritating to her mucous membranes and pulmonary system. The
strenuous activity and increased energy expenditure associated with track events, in
conjunction with the dust and possible heat, would play a role in placing the child at risk
for an URTI and compromising her respiratory function.
✔✔When developing a discharge plan to manage the care of a client with COPD, the
nurse should anticipate that the client will do which of the following?
a.
Develop infections easily
b.
Maintain current status
c.
Require less supplemental oxygen
d.
Show permanent improvement. - ✔✔a. Develop infections easily
A client with COPD is at high risk for development of respiratory infections. COPD is a
slowly progressive; therefore, maintaining current status and establishing a goal that the
client will require less supplemental oxygen are
✔✔The nurse assesses the respiratory status of a client who is experiencing an
exacerbation of COPD secondary to an upper respiratory tract infection. Which of the
following findings would be expected?
a.
Normal breath sounds
b.
Prolonged inspiration
, c.
Normal chest movement
d.
Coarse crackles and rhonchi - ✔✔d. Coarse crackles and rhonchi
Rationale: Exacerbations of COPD are frequently caused by respiratory infections.
Coarse crackles and rhonchi would be auscultated as air moves through airways
obstructed with secretions. In COPD, breath sounds are diminished because of an
enlarged anteroposterior diameter of the chest. Expiration, not inspiration, becomes
prolonged. Chest movement is decreased as lungs become over-distended.
✔✔The nurse who is explaining the pathophysiology of COPD to a client includes the
fact that alveolar destruction results in which manifestations? Select all that apply.
a.
Decrease surface area for gas exchange
b.
Increased dead space air
c.
Development of pulmonary emboli
d.
Chronic dilation of bronchioles
e.
Airway collapse related to loss of elasticity - ✔✔a. decrease surface area for gas
exchange
e. Airway collapse related to loss of elasticity
Rationale: The loss of elasticity in the airway of a client with COPD can be airway
attributed to repeated infections and inflammation, which leads to airway collapse.
Airway collapse can cause alveolar destruction because of either over or under inflation
of alveolar sacs. The impaired gas exchange occurring with COPD is caused by the
loss of alveolar surface area available for gas exchange. Destruction of alveoli is not
related to increased dead space air, pulmonary emboli, or chronic dilation of
bronchioles.
✔✔What should the nurse include when teaching health maintenance strategies to the
client with COPD? Select all that apply.
a.
Yearly influenza immunizations
b.
Immunization against pneumonia
c.
Limitation of physical activity
d.
Oral fluid restrictions
e.
Adequate caloric intake - ✔✔a. yearly influenza immunizations