NCLEX REVIEW: PNEUMONIA, COPD, ASTHMA TEST QUESTIONS
AND ANSWERS RATED A
The nurse reviews an arterial blood gas report for at home. 2. The client states actions to reduce
a client with chronic obstructive pulmonary pain.
disease (COPD). pH 7.35; PC02 62; PO2 70; 3. The client says that he will use oxygen via a
HCO3 34 The nurse should: nasal cannula at 5 L/ minute.
1. Apply a 100% non-rebreather mask. 4. The client agrees to call the physician if
2. Assess the vital signs. dyspnea on exertion increases. -
3. Reposition the client. ANSWER -4.
4. Prepare for intubation. - ANSWER -2. Increasing dyspnea on exertion indicates that the
Clients with chronic COPD have CO2 retention client may be experiencing complications of
and the respiratory drive is stimulated when the COPD. Therefore, the nurse should notify the
PO2 decreases. The heart rate, respiratory rate, physician. Extracting promises from clients is not
and blood pressure should be evaluated to an outcome criterion. Pain is not a common
determine if the client is hemodynamically stable. symptom of COPD. Clients with COPD use low-
Symptoms, such as dyspnea, should also be flow oxygen supplementation (1 to 2 L/ minute) to
assessed. Oxygen supplementation, if indicated, avoid suppressing the respiratory drive, which,
should be titrated upward in small increments. for these clients, is stimulated by hypoxia.
There is no indication that the client is .
experiencing respiratory distress requiring
intubation.
Which of the following physical assessment
findings are normal for a client with advanced
When developing a discharge plan to manage chronic obstructive pulmonary disease (COPD)?
the care of a client with chronic obstructive 1. Increased anteroposterior chest diameter.
pulmonary disease (COPD), the nurse should 2. Underdeveloped neck muscles.
advise the the client to expect to: 3. Collapsed neck veins.
1. Develop respiratory infections easily. 4. Increased chest excursions with respiration. -
2. Maintain current status. ANSWER -1.
3. Require less supplemental oxygen. Increased anteroposterior chest diameter is
4. Show permanent improvement. - characteristic of advanced COPD. Air is trapped
ANSWER -1. in the overextended alveoli, and the ribs are fixed
A client with COPD is at high risk for in an inspiratory position. The result is the typical
development of respiratory infections. COPD is barrel-chested appearance. Overly developed,
slowly progressive; therefore, maintaining current not underdeveloped, neck muscles are
status and establishing a goal that the client will associated with COPD because of their
require less supplemental oxygen are unrealistic increased use in the work of breathing.
expectations. Treatment may slow progression of Distended, not collapsed, neck veins are
the disease, but permanent improvement is associated with COPD as a symptom of the heart
highly unlikely. failure that the client may experience secondary
to the increased workload on the heart to pump
blood into the pulmonary vasculature.
Which of the following indicates that the client Diminished, not increased, chest excursion is
with chronic obstructive pulmonary disease associated with COPD.
(COPD) who has been discharged to home
understands his care plan?
1. The client promises to do pursed-lip breathing When instructing clients on how to decrease the
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, NCLEX REVIEW: PNEUMONIA, COPD, ASTHMA TEST QUESTIONS
AND ANSWERS RATED A
risk of chronic obstructive pulmonary disease A priority goal for the client with COPD is to
(COPD), the nurse should emphasize which of manage the signs and symptoms of the disease
the following? process so as to maintain the client's functional
1. Participate regularly in aerobic exercises. ability. Chest pain is not a typical symptom of
2. Maintain a high-protein diet. COPD. The carbon dioxide concentration in the
3. Avoid exposure to people with known blood is increased to an abnormal level in clients
respiratory infections. with COPD; it would not be a goal to increase the
4. Abstain from cigarette smoking. - level further. Preventing infection would be a goal
ANSWER -4. of care for the client with COPD.
Cigarette smoking is the primary cause of COPD.
Other risk factors include exposure to
environmental pollutants and chronic asthma. A client's arterial blood gas values are as follows:
Participating in an aerobic exercise program, pH, 7.31; PaO2, 80 mm Hg; PaCO2, 65 mm Hg;
although beneficial, will not decrease the risk of HCO3 −, 36 mEq/ L. The nurse should assess
COPD. Insufficient protein intake and exposure the client for?
to people with respiratory infections do not 1. Cyanosis.
increase the risk of COPD. 2. Flushed skin.
3. Irritability.
4. Anxiety. - ANSWER -2.
Which of the following is an expected outcome of The high PaCO2 level causes flushing due to
pursed-lip breathing for clients with emphysema? vasodilation. The client also becomes drowsy
1. To promote oxygen intake. and lethargic because carbon dioxide has a
2. To strengthen the diaphragm. depressant effect on the central nervous system.
3. To strengthen the intercostal muscles. Cyanosis is a sign of hypoxia. Irritability and
4. To promote carbon dioxide elimination. - anxiety are not common with a PaCO2 level of 65
ANSWER -4. mm Hg but are associated with hypoxia.
Pursed-lip breathing prolongs exhalation and
prevents air trapping in the alveoli, thereby
promoting carbon dioxide elimination. By When performing postural drainage, which of the
prolonging exhalation and helping the client following factors promotes the movement of
relax, pursed-lip breathing helps the client learn secretions from the lower to the upper respiratory
to control the rate and depth of respiration. tract?
Pursed-lip breathing does not promote the intake 1. Friction between the cilia.
of oxygen, strengthen the diaphragm, or 2. Force of gravity.
strengthen intercostal muscles. 3. Sweeping motion of cilia.
4. Involuntary muscle contractions. -
ANSWER -2.
Which of the following is a priority goal for the The principle behind using postural drainage is
client with chronic obstructive pulmonary disease that gravity will help move secretions from
(COPD)? smaller to larger airways. Postural drainage is
1. Maintaining functional ability. best used after percussion has loosened
2. Minimizing chest pain. secretions. Coughing or suctioning is then used
3. Increasing carbon dioxide levels in the blood. to remove secretions. Movement of cilia is not
4. Treating infectious agents. - ANSWER - sufficient to move secretions. Muscle
1. contractions do not move secretions within the
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AND ANSWERS RATED A
The nurse reviews an arterial blood gas report for at home. 2. The client states actions to reduce
a client with chronic obstructive pulmonary pain.
disease (COPD). pH 7.35; PC02 62; PO2 70; 3. The client says that he will use oxygen via a
HCO3 34 The nurse should: nasal cannula at 5 L/ minute.
1. Apply a 100% non-rebreather mask. 4. The client agrees to call the physician if
2. Assess the vital signs. dyspnea on exertion increases. -
3. Reposition the client. ANSWER -4.
4. Prepare for intubation. - ANSWER -2. Increasing dyspnea on exertion indicates that the
Clients with chronic COPD have CO2 retention client may be experiencing complications of
and the respiratory drive is stimulated when the COPD. Therefore, the nurse should notify the
PO2 decreases. The heart rate, respiratory rate, physician. Extracting promises from clients is not
and blood pressure should be evaluated to an outcome criterion. Pain is not a common
determine if the client is hemodynamically stable. symptom of COPD. Clients with COPD use low-
Symptoms, such as dyspnea, should also be flow oxygen supplementation (1 to 2 L/ minute) to
assessed. Oxygen supplementation, if indicated, avoid suppressing the respiratory drive, which,
should be titrated upward in small increments. for these clients, is stimulated by hypoxia.
There is no indication that the client is .
experiencing respiratory distress requiring
intubation.
Which of the following physical assessment
findings are normal for a client with advanced
When developing a discharge plan to manage chronic obstructive pulmonary disease (COPD)?
the care of a client with chronic obstructive 1. Increased anteroposterior chest diameter.
pulmonary disease (COPD), the nurse should 2. Underdeveloped neck muscles.
advise the the client to expect to: 3. Collapsed neck veins.
1. Develop respiratory infections easily. 4. Increased chest excursions with respiration. -
2. Maintain current status. ANSWER -1.
3. Require less supplemental oxygen. Increased anteroposterior chest diameter is
4. Show permanent improvement. - characteristic of advanced COPD. Air is trapped
ANSWER -1. in the overextended alveoli, and the ribs are fixed
A client with COPD is at high risk for in an inspiratory position. The result is the typical
development of respiratory infections. COPD is barrel-chested appearance. Overly developed,
slowly progressive; therefore, maintaining current not underdeveloped, neck muscles are
status and establishing a goal that the client will associated with COPD because of their
require less supplemental oxygen are unrealistic increased use in the work of breathing.
expectations. Treatment may slow progression of Distended, not collapsed, neck veins are
the disease, but permanent improvement is associated with COPD as a symptom of the heart
highly unlikely. failure that the client may experience secondary
to the increased workload on the heart to pump
blood into the pulmonary vasculature.
Which of the following indicates that the client Diminished, not increased, chest excursion is
with chronic obstructive pulmonary disease associated with COPD.
(COPD) who has been discharged to home
understands his care plan?
1. The client promises to do pursed-lip breathing When instructing clients on how to decrease the
1/7
, NCLEX REVIEW: PNEUMONIA, COPD, ASTHMA TEST QUESTIONS
AND ANSWERS RATED A
risk of chronic obstructive pulmonary disease A priority goal for the client with COPD is to
(COPD), the nurse should emphasize which of manage the signs and symptoms of the disease
the following? process so as to maintain the client's functional
1. Participate regularly in aerobic exercises. ability. Chest pain is not a typical symptom of
2. Maintain a high-protein diet. COPD. The carbon dioxide concentration in the
3. Avoid exposure to people with known blood is increased to an abnormal level in clients
respiratory infections. with COPD; it would not be a goal to increase the
4. Abstain from cigarette smoking. - level further. Preventing infection would be a goal
ANSWER -4. of care for the client with COPD.
Cigarette smoking is the primary cause of COPD.
Other risk factors include exposure to
environmental pollutants and chronic asthma. A client's arterial blood gas values are as follows:
Participating in an aerobic exercise program, pH, 7.31; PaO2, 80 mm Hg; PaCO2, 65 mm Hg;
although beneficial, will not decrease the risk of HCO3 −, 36 mEq/ L. The nurse should assess
COPD. Insufficient protein intake and exposure the client for?
to people with respiratory infections do not 1. Cyanosis.
increase the risk of COPD. 2. Flushed skin.
3. Irritability.
4. Anxiety. - ANSWER -2.
Which of the following is an expected outcome of The high PaCO2 level causes flushing due to
pursed-lip breathing for clients with emphysema? vasodilation. The client also becomes drowsy
1. To promote oxygen intake. and lethargic because carbon dioxide has a
2. To strengthen the diaphragm. depressant effect on the central nervous system.
3. To strengthen the intercostal muscles. Cyanosis is a sign of hypoxia. Irritability and
4. To promote carbon dioxide elimination. - anxiety are not common with a PaCO2 level of 65
ANSWER -4. mm Hg but are associated with hypoxia.
Pursed-lip breathing prolongs exhalation and
prevents air trapping in the alveoli, thereby
promoting carbon dioxide elimination. By When performing postural drainage, which of the
prolonging exhalation and helping the client following factors promotes the movement of
relax, pursed-lip breathing helps the client learn secretions from the lower to the upper respiratory
to control the rate and depth of respiration. tract?
Pursed-lip breathing does not promote the intake 1. Friction between the cilia.
of oxygen, strengthen the diaphragm, or 2. Force of gravity.
strengthen intercostal muscles. 3. Sweeping motion of cilia.
4. Involuntary muscle contractions. -
ANSWER -2.
Which of the following is a priority goal for the The principle behind using postural drainage is
client with chronic obstructive pulmonary disease that gravity will help move secretions from
(COPD)? smaller to larger airways. Postural drainage is
1. Maintaining functional ability. best used after percussion has loosened
2. Minimizing chest pain. secretions. Coughing or suctioning is then used
3. Increasing carbon dioxide levels in the blood. to remove secretions. Movement of cilia is not
4. Treating infectious agents. - ANSWER - sufficient to move secretions. Muscle
1. contractions do not move secretions within the
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