NUR 330 EXAM 3 REVIEW QUESTIONS AND ANSWERS | COMPLETE NURSING
EXAM 3 STUDY GUIDE 2026/2027
Know how to instruct a pt. to use a metered dose inhaler (MDI) - ✔✔1. Take cap off and shake inhaler
2. Breathe out all the way
3. Hold the inhaler the way your doc said: A) 1-2 inches in front of your mouth B) Use spacer/holding
chamber C) Put the inhaler in your mouth, you will see a lot of people do this
4. Breathe in slowly: as you start breathing in slowly, through your mouth, press down on the inhaler one
time. Keep breathing in slowly, as deeply as you can
5. Hold you breath as you count to 10 slowly, if you can. For inhaled quick-relief meds wait about one
minute between puffs if it is NOT a quick relief med. Rinse mouth after inhaling a steroid or could cause
thrush (a yeast infection in the mouth identified by while painful patches)
6. Clean MDI PRN with hot water only. Dry overnight
7. Know when it will run out. Most MDIs have 200 puffs. If you are to take 8 puffs per day, divide this by
the number of puffs in the inhaler (200/8=25). You will have 25 days to use this inhaler. write the dates
on the canister in which it will run out.
Know what to teach pt about a pulmonary function test (PFT) and what to instruct them for the test. -
✔✔Teach: It is used to evaluate lung function. It involves the use of spirometer to assess air movement
as pt. performs prescribed respiratory maneuvers.
Instruct: Avoid scheduling immediately after meal time. Avoid administration of inhaled bronchodilator 6
hours before procedure. Explain procedure to pt. Assess for resp. distress before procedure and report.
Provide rest after the procedure
How to find your personal best peak flow number... - ✔✔- The highest peak flow number you can
achieve over a 2 week period when asthma is under control
- Because each pt. asthma is different, each pt. PEF may be higher or lower than the PEF of another pt.
similar to body weight and height.
- To find the best peak flow number:
* Do at least 2x/day for 2-3 weeks
* When you wake up & in later afternoon or early evening
* 15-20 minutes after taking inhaled short acting beta2-agonist for quick relief
* As instructed by health care provider
What to do for a patient once you know their peak flow number... - ✔✔- Let your health care provider
know
- They will give you the number's that will tell pt. what to do
- The peak flow numbers are put into zone set up like traffic lights, that help you know what to do when
your peak flow number changes...
Peak flow number: Green Zone - ✔✔80% of your personal best numbers signals good control. No
asthma symptoms present. Take your medications as usual
Peak flow number: Yellow Zone - ✔✔50% to less than 80% of your personal number signals caution. If
remain in this zone after several measures of peak flow, take inhaled short-acting beta 2 agonist.
,If continue in yellow zone, asthma may not be under good control. Ask doctor if need to change or
increase your patient's daily medications
Peak flow number: Red zone - ✔✔Les than 50% of your personal best numbers signals a medical alert.
You MUST take an inhaled short acting beta 2 agonist immediately.
Call health care provider or ED & ask what to do, or go directly to hospital ED
Actions to take when Peak Flow Numbers change - ✔✔PEF goes between ____L/min and ____ L/min
(50% less than 80% of personal best, yellow zone)
ACTION: take inhaled short acting beta 2 agonist as prescribed by your doctor
PEF increases 20% or more when measured before & after taking an inhaled short-acting beta 2 agonist
ACTION: Talk to your doctor about adding more medicine to control your asthma better
What should nurses teach patients with asthma.. - ✔✔- What is asthma
- What is good asthma control
- Environmental/ trigger control
- Medications
- How to use an inhaler, spacer, nebulizer
- Breathing techniques
- Correct use of peak flow meter
- Asthma action plan
Asthma: Subjective Data - ✔✔Past- Allergic reactions, sinus issues, previous sinus attacks &
hospitalizations, Gastroesophageal reflux, Occupational exposures to chemical irritants
Medications- Adherence, inhaler technique, meds that may precipitate attack in susceptible asthmatics
Activity- exercise; fatigue; decreased or absent exercise tolerance
Sleep- rest: awaken from sleep due to cough or breathing problems; insomnia
Coping- stress tolerance: emotional distress, stress in work environment or home
Nursing Diagnosis fro Asthma - ✔✔- Ineffective airway clearance
- Anxiety
- Deficient knowledge
ABG Normal Values - ✔✔pH: 7.35 - 7.45
pCO2: 35-45 mmHg
HCO3-: 22- 26 mEq/L
PaO2: 80-100 mmHg
SaO2: >95%
How to recognize respiratory acidosis - ✔✔pH <7.35
PaCO2 >45
, Know the values of PaO2 to identify if hypoxia is an issue... - ✔✔Two best indicators is SATS >90 (to
prevent hypoxia) and ABGs
PaO2 above 80 to prevent hypoxia
Know the importance of pursed lip breathing - ✔✔Breathing exercises may assist patient during rest
and activity by:
- Decreasing dyspnea
- Improving oxygenation
- Slowing the respiratory rate
How to teach patient pursed lip breathing and when - ✔✔Smell the roses; blow out the candles
Practice 8-10 reps of PLB 3-4 times a day
Nursing Diagnosis for COPD - ✔✔- Ineffective airway clearance
- Anxiety
- Deficient knowledge
- Imbalanced nutrition
- Impaired gas exchange
- Ineffective breathing patterns
- Decreased cardiac output
- Risk for infection
- Insomnia
What is Cor Pulmonale - ✔✔Right sided hypertrophy of the heart caused by pulmonary hypertension
What would you want to teach a patient with COPD who needs oxygen therapy? - ✔✔- O2 therapy
should not exceed 2 L
- Critical to start on low level O2 and monitor them with ABGs
Know when, why, and what is important for a patient that needs a venturi mask - ✔✔- Used when it is
important to control the delivery of O2
- This mask is high-flow delivery device that delivers fixed precise concentrations of O2 specific to pt.
needs
- Method especially helpful for administering low, constant O2 concentrations to patients with COPD
- Adapters can be attached to increase humidification
- Mask must be removed when eating
What do you want to teach a patient with COPD about exercising and what things they should do before,
during, and after? - ✔✔Before:
- Make a schedule and plan daily and weekly activities and leave plenty of time for rest periods
- May need O2 before ambulating
- Some pt. may benefit from using their beta 2- adrenergic agonist about 10 minutes before
During:
- SOB will probably increase during
EXAM 3 STUDY GUIDE 2026/2027
Know how to instruct a pt. to use a metered dose inhaler (MDI) - ✔✔1. Take cap off and shake inhaler
2. Breathe out all the way
3. Hold the inhaler the way your doc said: A) 1-2 inches in front of your mouth B) Use spacer/holding
chamber C) Put the inhaler in your mouth, you will see a lot of people do this
4. Breathe in slowly: as you start breathing in slowly, through your mouth, press down on the inhaler one
time. Keep breathing in slowly, as deeply as you can
5. Hold you breath as you count to 10 slowly, if you can. For inhaled quick-relief meds wait about one
minute between puffs if it is NOT a quick relief med. Rinse mouth after inhaling a steroid or could cause
thrush (a yeast infection in the mouth identified by while painful patches)
6. Clean MDI PRN with hot water only. Dry overnight
7. Know when it will run out. Most MDIs have 200 puffs. If you are to take 8 puffs per day, divide this by
the number of puffs in the inhaler (200/8=25). You will have 25 days to use this inhaler. write the dates
on the canister in which it will run out.
Know what to teach pt about a pulmonary function test (PFT) and what to instruct them for the test. -
✔✔Teach: It is used to evaluate lung function. It involves the use of spirometer to assess air movement
as pt. performs prescribed respiratory maneuvers.
Instruct: Avoid scheduling immediately after meal time. Avoid administration of inhaled bronchodilator 6
hours before procedure. Explain procedure to pt. Assess for resp. distress before procedure and report.
Provide rest after the procedure
How to find your personal best peak flow number... - ✔✔- The highest peak flow number you can
achieve over a 2 week period when asthma is under control
- Because each pt. asthma is different, each pt. PEF may be higher or lower than the PEF of another pt.
similar to body weight and height.
- To find the best peak flow number:
* Do at least 2x/day for 2-3 weeks
* When you wake up & in later afternoon or early evening
* 15-20 minutes after taking inhaled short acting beta2-agonist for quick relief
* As instructed by health care provider
What to do for a patient once you know their peak flow number... - ✔✔- Let your health care provider
know
- They will give you the number's that will tell pt. what to do
- The peak flow numbers are put into zone set up like traffic lights, that help you know what to do when
your peak flow number changes...
Peak flow number: Green Zone - ✔✔80% of your personal best numbers signals good control. No
asthma symptoms present. Take your medications as usual
Peak flow number: Yellow Zone - ✔✔50% to less than 80% of your personal number signals caution. If
remain in this zone after several measures of peak flow, take inhaled short-acting beta 2 agonist.
,If continue in yellow zone, asthma may not be under good control. Ask doctor if need to change or
increase your patient's daily medications
Peak flow number: Red zone - ✔✔Les than 50% of your personal best numbers signals a medical alert.
You MUST take an inhaled short acting beta 2 agonist immediately.
Call health care provider or ED & ask what to do, or go directly to hospital ED
Actions to take when Peak Flow Numbers change - ✔✔PEF goes between ____L/min and ____ L/min
(50% less than 80% of personal best, yellow zone)
ACTION: take inhaled short acting beta 2 agonist as prescribed by your doctor
PEF increases 20% or more when measured before & after taking an inhaled short-acting beta 2 agonist
ACTION: Talk to your doctor about adding more medicine to control your asthma better
What should nurses teach patients with asthma.. - ✔✔- What is asthma
- What is good asthma control
- Environmental/ trigger control
- Medications
- How to use an inhaler, spacer, nebulizer
- Breathing techniques
- Correct use of peak flow meter
- Asthma action plan
Asthma: Subjective Data - ✔✔Past- Allergic reactions, sinus issues, previous sinus attacks &
hospitalizations, Gastroesophageal reflux, Occupational exposures to chemical irritants
Medications- Adherence, inhaler technique, meds that may precipitate attack in susceptible asthmatics
Activity- exercise; fatigue; decreased or absent exercise tolerance
Sleep- rest: awaken from sleep due to cough or breathing problems; insomnia
Coping- stress tolerance: emotional distress, stress in work environment or home
Nursing Diagnosis fro Asthma - ✔✔- Ineffective airway clearance
- Anxiety
- Deficient knowledge
ABG Normal Values - ✔✔pH: 7.35 - 7.45
pCO2: 35-45 mmHg
HCO3-: 22- 26 mEq/L
PaO2: 80-100 mmHg
SaO2: >95%
How to recognize respiratory acidosis - ✔✔pH <7.35
PaCO2 >45
, Know the values of PaO2 to identify if hypoxia is an issue... - ✔✔Two best indicators is SATS >90 (to
prevent hypoxia) and ABGs
PaO2 above 80 to prevent hypoxia
Know the importance of pursed lip breathing - ✔✔Breathing exercises may assist patient during rest
and activity by:
- Decreasing dyspnea
- Improving oxygenation
- Slowing the respiratory rate
How to teach patient pursed lip breathing and when - ✔✔Smell the roses; blow out the candles
Practice 8-10 reps of PLB 3-4 times a day
Nursing Diagnosis for COPD - ✔✔- Ineffective airway clearance
- Anxiety
- Deficient knowledge
- Imbalanced nutrition
- Impaired gas exchange
- Ineffective breathing patterns
- Decreased cardiac output
- Risk for infection
- Insomnia
What is Cor Pulmonale - ✔✔Right sided hypertrophy of the heart caused by pulmonary hypertension
What would you want to teach a patient with COPD who needs oxygen therapy? - ✔✔- O2 therapy
should not exceed 2 L
- Critical to start on low level O2 and monitor them with ABGs
Know when, why, and what is important for a patient that needs a venturi mask - ✔✔- Used when it is
important to control the delivery of O2
- This mask is high-flow delivery device that delivers fixed precise concentrations of O2 specific to pt.
needs
- Method especially helpful for administering low, constant O2 concentrations to patients with COPD
- Adapters can be attached to increase humidification
- Mask must be removed when eating
What do you want to teach a patient with COPD about exercising and what things they should do before,
during, and after? - ✔✔Before:
- Make a schedule and plan daily and weekly activities and leave plenty of time for rest periods
- May need O2 before ambulating
- Some pt. may benefit from using their beta 2- adrenergic agonist about 10 minutes before
During:
- SOB will probably increase during
