Exam 2 Practice Q
1. The nurse prepares the patient diagnosed with chronic obstructive pulmonary disease
(COPD) for which diagnostic test to monitor acid–base balance?
1. Pulse Ox
2. Bronchoscopy
3. Sputum studies
4. ABG
2. The results of a patient’s arterial blood gas sample indicate an oxygen level of 72 mm Hg.
Based on this result the nurse needs to closely assess which parameter when providing care to
this patient?
1. Perfusion
2. Level of consciousness
3. Urine output
4. Fluid and electrolytes
3. The nurse is providing care to patient with the following laboratory values: pH 7.31; PaCO2 48
mm Hg; and HCO3 24 mEq/L. The nurse correlates these values to which acid–base disorder?
1. Metabolic acidosis
2. Metabolic alkalosis
3. Respiratory acidosis
4. Respiratory alkalosis
4. In analyzing an arterial blood gas, the nurse correlates which findings to an uncompensated
respiratory acidosis? Select all that apply.
1. pH 7.30
2. PaO2 82 mm Hg
3. PaCO2 48 mm Hg
4. HCO3 29 mEq/L
5. SaO2 90%
5. Which clinical manifestation in the patient with chronic obstructive pulmonary disease
(COPD) is more indicative of emphysema?
1. Cyanosis
2. Obesity
3. Reddish complexion
4. Non-productive cough
6. The nurse is providing care to a patient diagnosed with emphysema. Which clinical
manifestation does the nurse correlate with this diagnosis?
1. Tachycardia
2. Cough
3. Barrel chest
4. Wheezing
,7. The nurse teaches a patient how to implement pursed-lip breathing. Which patient
statement indicates a need for additional instruction?
1. “I will sit up with my shoulders relaxed”
2. “I will be sure to exhale twice as long as I inhale”
3. “I will inhale through my mouth while slowly counting”
4. “I will exhale through my mouth as if I’m blowing out candles”
8. A patient diagnosed with COPD has a pulse oximetry reading of 93%, increased red blood and
white blood cell count, temperature of 101°F, pulse 100 bpm, respirations 35 bpm, and a chest
x-ray examination that showed a flattened diaphragm with infiltrates. Based on this data, which
prescription does the nurse question for this patient?
1. Antibiotic therapy
2. NSAIDs
3. Oxygen via NC 3-4L/min
4. Bronchodilators such as an adrenergic stimulating drug or anticholinergic agents
9. The nurse is providing care to a patient diagnosed with chronic obstructive pulmonary
disease (COPD). Which factors in the patient’s history support the current diagnosis?
Select all that apply.
1. Working in an industrial environment
2. Working in an office setting with air conditioning
3. History of asthma
4. Current cigarette smoker
5. Playing golf several times a week
10. The community health nurse is preparing an educational program for local residents. Which
information does the nurse include about COPD?
Select all that apply.
1. Cigarette smoking is the leading cause of COPD
2. Approximately 80-90% of deaths from COPD deaths are related to smoking
3. The is an increased incidence of COPD in people who abuse alcohol
4. Less than 5% of all COPD cases are caused by an Alpha1-antitrypsin deficiency
5. COPD is completely reversible with smoking cessation
11. nurse is providing discharge teaching to client w/ COPD & new script for albuterol. Which
statement by client indicates understanding of teaching?
a) This med can increase my blood sugar levels
b) This med can decrease my immune response
c) I can have an increase in my heart rate when taking this med
d) I can have mouth sores when taking this med
,12. nurse is preparing to administer an initial dose of prednisone to client w/ COPD. Nurse
should monitor for which adverse effects of this med? (select all that apply)
a) Hypokalemia
b) Tachycardia
c) Fluid retention
d) Nausea
e) Black, tarry stools
13. nurse is discharging a client / COPD. Client is concerned about not being able to leave the
house due to the need for staying on continuous oxygen. Which response should nurse make?
a) There are portable oxygen delivery systems that you can take with you
b) When you go out, you can remove the oxygen and then reapply it when you get home
c) You probably will not be able to go out as much as you used to
d) Home health services will come get you so you will not need to get out
14. nurse is instructing client on the use of an incentive spirometer. Which statement by client
indicates an understanding of the teaching?
a) I will place the adapter on my finger to read my blood oxygen sat level
b) I will lie on my back w/ my knees bent
c) I will rest my hand over my abdomen to create resistance
d) I will take in a deep breath and hold it before exhaling
15. nurse is planning to instruct a client on how to perform pursed-lip breathing. Which
statement should nurse include?
a) Take quick breaths upon inhalation
b) Place your hand over your stomach
c) Take a deep breath in through your nose
d) Puff your cheeks upon exhalation
16. nurse is planning care for client w/ COPD, required continuous O2 therapy & is being
discharged to return home. Which referral should nurse recommend
a) Spiritual advisor
b) Social worker
c) Physical therapist
d) Occupational therapist
17. nurse is planning care for group of clients receiving O2 therapy. Which client should nurse
see first?
a) Client w/ heart failure & receiving 100% O2 via partial rebreather mask
b) Client w/ emphysema & receiving O2 @ 3L/min via transtracheal O2 cannula
c) Client w/ old tracheostomy & receiving 40% humidified O2 via tracheostomy collar
d) Client w/ COPD & receiving O2 @ 2L/min via nasal cannula
, 18. nurse is caring for older adult client w/ COPD w/ pneumonia. Nurse should monitor client
for which acid-base imbalance?
a) Respiratory alkalosis
b) Respiratory acidosis
c) Metabolic alkalosis
d) Metabolic acidosis
19. nurse is caring for client w/ COPD & is experiencing shortness of breath. Which action
should nurse perform first?
a) Monitor client’s ABG results
b) Instruct client to perform controlled coughing
c) Teach client how to use pursed-lip breathing
d) Place client in an upright position
20. nurse is caring for client w/ emphysema. Client has not stopped smoking cigarettes & states
“It’s too late for me to quit” which action should nurse take?
a) Assist client in finding local smoking-cessation assistance programs
b) Tell client she will be all right after receiving medical care
c) Inform client that she must stop smoking or the provider will not be able to care for her
d) Advocate for client by supporting her statement about not quitting
21. nurse is planning care for client who has COPD & is malnourished. Which recommendations
to promote nutritional intake should nurse include in the plan?
a) Eat high-calorie foods first
b) Increase intake of water at meal times
c) Perform active range-of-motion exercises before meals
d) Keep saltine crackers nearby for snacking
22. nurse is providing instructions about pursed-lip breathing for a client who has COPD w/
emphysema. This breathing technique accomplishes which of the following?
a) Increases O2 intake
b) Promotes CO2 elimination
c) Uses intercostal muscles
d) Strengthens the diaphragm
23. nurse is caring for group of clients on meg-surg unit. Which disorders should nurse identify
as increasing client’s metabolic needs? (select all that apply)
a) COPD
b) Hypothyroidism
c) Cancer
d) Parkinson’s disease
e) Major burns
1. The nurse prepares the patient diagnosed with chronic obstructive pulmonary disease
(COPD) for which diagnostic test to monitor acid–base balance?
1. Pulse Ox
2. Bronchoscopy
3. Sputum studies
4. ABG
2. The results of a patient’s arterial blood gas sample indicate an oxygen level of 72 mm Hg.
Based on this result the nurse needs to closely assess which parameter when providing care to
this patient?
1. Perfusion
2. Level of consciousness
3. Urine output
4. Fluid and electrolytes
3. The nurse is providing care to patient with the following laboratory values: pH 7.31; PaCO2 48
mm Hg; and HCO3 24 mEq/L. The nurse correlates these values to which acid–base disorder?
1. Metabolic acidosis
2. Metabolic alkalosis
3. Respiratory acidosis
4. Respiratory alkalosis
4. In analyzing an arterial blood gas, the nurse correlates which findings to an uncompensated
respiratory acidosis? Select all that apply.
1. pH 7.30
2. PaO2 82 mm Hg
3. PaCO2 48 mm Hg
4. HCO3 29 mEq/L
5. SaO2 90%
5. Which clinical manifestation in the patient with chronic obstructive pulmonary disease
(COPD) is more indicative of emphysema?
1. Cyanosis
2. Obesity
3. Reddish complexion
4. Non-productive cough
6. The nurse is providing care to a patient diagnosed with emphysema. Which clinical
manifestation does the nurse correlate with this diagnosis?
1. Tachycardia
2. Cough
3. Barrel chest
4. Wheezing
,7. The nurse teaches a patient how to implement pursed-lip breathing. Which patient
statement indicates a need for additional instruction?
1. “I will sit up with my shoulders relaxed”
2. “I will be sure to exhale twice as long as I inhale”
3. “I will inhale through my mouth while slowly counting”
4. “I will exhale through my mouth as if I’m blowing out candles”
8. A patient diagnosed with COPD has a pulse oximetry reading of 93%, increased red blood and
white blood cell count, temperature of 101°F, pulse 100 bpm, respirations 35 bpm, and a chest
x-ray examination that showed a flattened diaphragm with infiltrates. Based on this data, which
prescription does the nurse question for this patient?
1. Antibiotic therapy
2. NSAIDs
3. Oxygen via NC 3-4L/min
4. Bronchodilators such as an adrenergic stimulating drug or anticholinergic agents
9. The nurse is providing care to a patient diagnosed with chronic obstructive pulmonary
disease (COPD). Which factors in the patient’s history support the current diagnosis?
Select all that apply.
1. Working in an industrial environment
2. Working in an office setting with air conditioning
3. History of asthma
4. Current cigarette smoker
5. Playing golf several times a week
10. The community health nurse is preparing an educational program for local residents. Which
information does the nurse include about COPD?
Select all that apply.
1. Cigarette smoking is the leading cause of COPD
2. Approximately 80-90% of deaths from COPD deaths are related to smoking
3. The is an increased incidence of COPD in people who abuse alcohol
4. Less than 5% of all COPD cases are caused by an Alpha1-antitrypsin deficiency
5. COPD is completely reversible with smoking cessation
11. nurse is providing discharge teaching to client w/ COPD & new script for albuterol. Which
statement by client indicates understanding of teaching?
a) This med can increase my blood sugar levels
b) This med can decrease my immune response
c) I can have an increase in my heart rate when taking this med
d) I can have mouth sores when taking this med
,12. nurse is preparing to administer an initial dose of prednisone to client w/ COPD. Nurse
should monitor for which adverse effects of this med? (select all that apply)
a) Hypokalemia
b) Tachycardia
c) Fluid retention
d) Nausea
e) Black, tarry stools
13. nurse is discharging a client / COPD. Client is concerned about not being able to leave the
house due to the need for staying on continuous oxygen. Which response should nurse make?
a) There are portable oxygen delivery systems that you can take with you
b) When you go out, you can remove the oxygen and then reapply it when you get home
c) You probably will not be able to go out as much as you used to
d) Home health services will come get you so you will not need to get out
14. nurse is instructing client on the use of an incentive spirometer. Which statement by client
indicates an understanding of the teaching?
a) I will place the adapter on my finger to read my blood oxygen sat level
b) I will lie on my back w/ my knees bent
c) I will rest my hand over my abdomen to create resistance
d) I will take in a deep breath and hold it before exhaling
15. nurse is planning to instruct a client on how to perform pursed-lip breathing. Which
statement should nurse include?
a) Take quick breaths upon inhalation
b) Place your hand over your stomach
c) Take a deep breath in through your nose
d) Puff your cheeks upon exhalation
16. nurse is planning care for client w/ COPD, required continuous O2 therapy & is being
discharged to return home. Which referral should nurse recommend
a) Spiritual advisor
b) Social worker
c) Physical therapist
d) Occupational therapist
17. nurse is planning care for group of clients receiving O2 therapy. Which client should nurse
see first?
a) Client w/ heart failure & receiving 100% O2 via partial rebreather mask
b) Client w/ emphysema & receiving O2 @ 3L/min via transtracheal O2 cannula
c) Client w/ old tracheostomy & receiving 40% humidified O2 via tracheostomy collar
d) Client w/ COPD & receiving O2 @ 2L/min via nasal cannula
, 18. nurse is caring for older adult client w/ COPD w/ pneumonia. Nurse should monitor client
for which acid-base imbalance?
a) Respiratory alkalosis
b) Respiratory acidosis
c) Metabolic alkalosis
d) Metabolic acidosis
19. nurse is caring for client w/ COPD & is experiencing shortness of breath. Which action
should nurse perform first?
a) Monitor client’s ABG results
b) Instruct client to perform controlled coughing
c) Teach client how to use pursed-lip breathing
d) Place client in an upright position
20. nurse is caring for client w/ emphysema. Client has not stopped smoking cigarettes & states
“It’s too late for me to quit” which action should nurse take?
a) Assist client in finding local smoking-cessation assistance programs
b) Tell client she will be all right after receiving medical care
c) Inform client that she must stop smoking or the provider will not be able to care for her
d) Advocate for client by supporting her statement about not quitting
21. nurse is planning care for client who has COPD & is malnourished. Which recommendations
to promote nutritional intake should nurse include in the plan?
a) Eat high-calorie foods first
b) Increase intake of water at meal times
c) Perform active range-of-motion exercises before meals
d) Keep saltine crackers nearby for snacking
22. nurse is providing instructions about pursed-lip breathing for a client who has COPD w/
emphysema. This breathing technique accomplishes which of the following?
a) Increases O2 intake
b) Promotes CO2 elimination
c) Uses intercostal muscles
d) Strengthens the diaphragm
23. nurse is caring for group of clients on meg-surg unit. Which disorders should nurse identify
as increasing client’s metabolic needs? (select all that apply)
a) COPD
b) Hypothyroidism
c) Cancer
d) Parkinson’s disease
e) Major burns
