COPD NCLEX Exam Questions and answers
Which of the following statements best describes COPD?
A. It is a completely reversible obstructive lung disease.
B. It is a chronic disease with airflow limitation that is not fully reversible.
C. It primarily affects younger adults and has minimal systemic effects.
D. It is a rare disease that affects fewer than 1 million Americans.
B. It is a chronic disease with airflow limitation that is not fully reversible.
Rationale: COPD is characterized by chronic airflow limitation due to an abnormal inflammatory
response to noxious stimuli (e.g., smoking, pollutants). It is not fully reversible and worsens over time. It
is one of the leading causes of death in older adults and affects millions in the U.S.
Which of the following is the most significant risk factor for COPD?
A. Occupational exposure to dust
B. Air pollution
C. Smoking
D. Genetic predisposition
C. Smoking
Rationale: Smoking is the most important risk factor for COPD, as it causes chronic inflammation and
damage to lung tissues. While air pollution, occupational exposure, and genetics contribute, smoking
remains the primary cause.
COPD causes which of the following systemic effects? (Select all that apply.)
A. Increased work absences due to frequent exacerbations
B. High healthcare costs and financial burden
C. Enhanced immune system function
D. Increased risk of respiratory infections
A. Increased work absences due to frequent exacerbations
B. High healthcare costs and financial burden
D. Increased risk of respiratory infections
Rationale: COPD can lead to frequent exacerbations, resulting in missed workdays and financial
strain due to medical expenses. It also weakens the immune response, making patients
more susceptible to infections. However, it does not enhance the immune system (C is incorrect).
,A patient with COPD asks how the disease can be "cured." What is the best nursing response?
A. "With the right treatment, your lungs can fully recover."
B. "COPD is a chronic disease that cannot be reversed, but treatment can help manage symptoms and
slow progression."
C. "You should avoid all medications, as they will not help your condition."
D. "As long as you take antibiotics regularly, COPD will not worsen."
B. "COPD is a chronic disease that cannot be reversed, but treatment can help manage symptoms and
slow progression."
Rationale: COPD is not fully reversible, but treatment can help manage symptoms and prevent
worsening. Medications, lifestyle changes, and smoking cessation are key to slowing disease
progression.
A patient with Stage IV COPD is admitted with worsening dyspnea. Which assessment finding is most
concerning?
A) Clubbing of the fingers
B) Increased anteroposterior (AP) chest diameter
C) PaO₂ of 50 mmHg and PaCO₂ of 80 mmHg
D) Barrel chest appearance
C) PaO₂ of 50 mmHg and PaCO₂ of 80 mmHg
Rationale:Stage IV COPD involves severe respiratory compromise. A PaO₂ of 50 mmHg (hypoxemia)
and PaCO₂ of 80 mmHg (hypercapnia) indicate acute respiratory failure, which is life-threatening.
A (Clubbing) suggests chronic hypoxia but is not immediately life-threatening.
B (Increased AP chest diameter) and D (Barrel chest) are typical in COPD but not emergency findings.
Which statement by a patient with chronic bronchitis indicates the need for further teaching?
A) "I should drink plenty of fluids to thin my mucus."
B) "I should take my bronchodilator before my corticosteroid inhaler."
C) "I will use my albuterol inhaler daily, even if I’m not short of breath."
D) "I will avoid large crowds to prevent infections."
C) "I will use my albuterol inhaler daily, even if I’m not short of breath."
Rationale:Albuterol (a short-acting beta-agonist) is a rescue inhaler and should be used only when
needed for acute symptoms. Daily use without symptoms may indicate poor disease control.
Which pathophysiologic changes occur in emphysema? (Select All That Apply)
, A) Destruction of alveolar walls
B) Increased gas exchange surface area
C) Loss of elastic recoil in lungs
D) Excess mucus production
E) Air trapping and hyperinflation
A) Destruction of alveolar walls
C) Loss of elastic recoil in lungs
E) Air trapping and hyperinflation
Rationale:
A (Destruction of alveolar walls) leads to reduced gas exchange.
C (Loss of elastic recoil) causes air trapping and difficulty exhaling.
E (Air trapping and hyperinflation) result in the characteristic "barrel chest."
A patient with COPD asks why they feel short of breath even at rest. What is the best explanation?
A) "Your airways are swollen, making it harder for air to pass through."
B) "You have excess mucus production, which is blocking airflow."
C) "Your alveoli are damaged, reducing the surface area for oxygen exchange."
D) "You are not taking deep enough breaths to get enough oxygen."
C) "Your alveoli are damaged, reducing the surface area for oxygen exchange."
Rationale:In emphysema, alveoli become overstretched and lose surface area, reducing oxygen
exchange and causing dyspnea.
Which intervention is most important for a patient in the end stage of COPD (Stage IV)?
A) Encourage pursed-lip breathing
B) Administer oxygen at 6L/min via nasal cannula
C) Advise bed rest to conserve energy
D) Encourage a high-carbohydrate diet for energy
A) Encourage pursed-lip breathing
Rationale:Pursed-lip breathing prevents airway collapse and helps control exhalation, reducing air
trapping.
Which statement by a patient indicates understanding of the primary risk factor for developing COPD?
Which of the following statements best describes COPD?
A. It is a completely reversible obstructive lung disease.
B. It is a chronic disease with airflow limitation that is not fully reversible.
C. It primarily affects younger adults and has minimal systemic effects.
D. It is a rare disease that affects fewer than 1 million Americans.
B. It is a chronic disease with airflow limitation that is not fully reversible.
Rationale: COPD is characterized by chronic airflow limitation due to an abnormal inflammatory
response to noxious stimuli (e.g., smoking, pollutants). It is not fully reversible and worsens over time. It
is one of the leading causes of death in older adults and affects millions in the U.S.
Which of the following is the most significant risk factor for COPD?
A. Occupational exposure to dust
B. Air pollution
C. Smoking
D. Genetic predisposition
C. Smoking
Rationale: Smoking is the most important risk factor for COPD, as it causes chronic inflammation and
damage to lung tissues. While air pollution, occupational exposure, and genetics contribute, smoking
remains the primary cause.
COPD causes which of the following systemic effects? (Select all that apply.)
A. Increased work absences due to frequent exacerbations
B. High healthcare costs and financial burden
C. Enhanced immune system function
D. Increased risk of respiratory infections
A. Increased work absences due to frequent exacerbations
B. High healthcare costs and financial burden
D. Increased risk of respiratory infections
Rationale: COPD can lead to frequent exacerbations, resulting in missed workdays and financial
strain due to medical expenses. It also weakens the immune response, making patients
more susceptible to infections. However, it does not enhance the immune system (C is incorrect).
,A patient with COPD asks how the disease can be "cured." What is the best nursing response?
A. "With the right treatment, your lungs can fully recover."
B. "COPD is a chronic disease that cannot be reversed, but treatment can help manage symptoms and
slow progression."
C. "You should avoid all medications, as they will not help your condition."
D. "As long as you take antibiotics regularly, COPD will not worsen."
B. "COPD is a chronic disease that cannot be reversed, but treatment can help manage symptoms and
slow progression."
Rationale: COPD is not fully reversible, but treatment can help manage symptoms and prevent
worsening. Medications, lifestyle changes, and smoking cessation are key to slowing disease
progression.
A patient with Stage IV COPD is admitted with worsening dyspnea. Which assessment finding is most
concerning?
A) Clubbing of the fingers
B) Increased anteroposterior (AP) chest diameter
C) PaO₂ of 50 mmHg and PaCO₂ of 80 mmHg
D) Barrel chest appearance
C) PaO₂ of 50 mmHg and PaCO₂ of 80 mmHg
Rationale:Stage IV COPD involves severe respiratory compromise. A PaO₂ of 50 mmHg (hypoxemia)
and PaCO₂ of 80 mmHg (hypercapnia) indicate acute respiratory failure, which is life-threatening.
A (Clubbing) suggests chronic hypoxia but is not immediately life-threatening.
B (Increased AP chest diameter) and D (Barrel chest) are typical in COPD but not emergency findings.
Which statement by a patient with chronic bronchitis indicates the need for further teaching?
A) "I should drink plenty of fluids to thin my mucus."
B) "I should take my bronchodilator before my corticosteroid inhaler."
C) "I will use my albuterol inhaler daily, even if I’m not short of breath."
D) "I will avoid large crowds to prevent infections."
C) "I will use my albuterol inhaler daily, even if I’m not short of breath."
Rationale:Albuterol (a short-acting beta-agonist) is a rescue inhaler and should be used only when
needed for acute symptoms. Daily use without symptoms may indicate poor disease control.
Which pathophysiologic changes occur in emphysema? (Select All That Apply)
, A) Destruction of alveolar walls
B) Increased gas exchange surface area
C) Loss of elastic recoil in lungs
D) Excess mucus production
E) Air trapping and hyperinflation
A) Destruction of alveolar walls
C) Loss of elastic recoil in lungs
E) Air trapping and hyperinflation
Rationale:
A (Destruction of alveolar walls) leads to reduced gas exchange.
C (Loss of elastic recoil) causes air trapping and difficulty exhaling.
E (Air trapping and hyperinflation) result in the characteristic "barrel chest."
A patient with COPD asks why they feel short of breath even at rest. What is the best explanation?
A) "Your airways are swollen, making it harder for air to pass through."
B) "You have excess mucus production, which is blocking airflow."
C) "Your alveoli are damaged, reducing the surface area for oxygen exchange."
D) "You are not taking deep enough breaths to get enough oxygen."
C) "Your alveoli are damaged, reducing the surface area for oxygen exchange."
Rationale:In emphysema, alveoli become overstretched and lose surface area, reducing oxygen
exchange and causing dyspnea.
Which intervention is most important for a patient in the end stage of COPD (Stage IV)?
A) Encourage pursed-lip breathing
B) Administer oxygen at 6L/min via nasal cannula
C) Advise bed rest to conserve energy
D) Encourage a high-carbohydrate diet for energy
A) Encourage pursed-lip breathing
Rationale:Pursed-lip breathing prevents airway collapse and helps control exhalation, reducing air
trapping.
Which statement by a patient indicates understanding of the primary risk factor for developing COPD?
