NUR 330: Exam 3 Review – UPDATED Questions with 100% Verified Answers
NUR 330: Exam 3 Review – UPDATED Questions
with 100% Verified Answers
Ball State University
NUR 330
Section 1: Peak, Flow, Number (Q1–Q13)
Question & Answer
Q1 Know how to instruct a pt. to use a metered dose inhaler (MDI)
A 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.
Q2 Know what to teach pt about a pulmonary function test (PFT) and what to instruct them
for the test.
A 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
Q3 How to find your personal best peak flow number...
A - 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
Q4 What to do for a patient once you know their peak flow number...
A - 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...
Q5 Peak flow number: Green Zone
A 80% of your personal best numbers signals good control. No asthma symptoms present. Take your
medications as usual
Page 1 of 19
,NUR 330: Exam 3 Review – UPDATED Questions with 100% Verified Answers
Question & Answer
Q6 Peak flow number: Yellow Zone
A 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
Q7 Peak flow number: Red zone
A 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
Q8 Actions to take when Peak Flow Numbers change
A 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
Q9 What should nurses teach patients with asthma..
A - 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
Q10 Asthma: Subjective Data
A 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
Q11 Nursing Diagnosis fro Asthma
A - Ineffective airway clearance - Anxiety - Deficient knowledge
Q12 ABG Normal Values
A pH: 7.35 - 7.45 pCO2: 35-45 mmHg HCO3-: 22- 26 mEq/L PaO2: 80-100 mmHg SaO2: >95%
Q13 How to recognize respiratory acidosis
A pH <7.35 PaCO2 >45
Section 2: Patient, Copd, Failure (Q14–Q26)
Question & Answer
Q14 Know the values of PaO2 to identify if hypoxia is an issue...
A Two best indicators is SATS >90 (to prevent hypoxia) and ABGs PaO2 above 80 to prevent hypoxia
Page 2 of 19
, NUR 330: Exam 3 Review – UPDATED Questions with 100% Verified Answers
Question & Answer
Q15 Know the importance of pursed lip breathing
A Breathing exercises may assist patient during rest and activity by: - Decreasing dyspnea -
Improving oxygenation - Slowing the respiratory rate
Q16 How to teach patient pursed lip breathing and when
A Smell the roses; blow out the candles Practice 8-10 reps of PLB 3-4 times a day
Q17 Nursing Diagnosis for COPD
A - Ineffective airway clearance - Anxiety - Deficient knowledge - Imbalanced nutrition - Impaired gas
exchange - Ineffective breathing patterns - Decreased cardiac output - Risk for infection - Insomnia
Q18 What is Cor Pulmonale
A Right sided hypertrophy of the heart caused by pulmonary hypertension
Q19 What would you want to teach a patient with COPD who needs oxygen therapy?
A - O2 therapy should not exceed 2 L - Critical to start on low level O2 and monitor them with ABGs
Q20 Know when, why, and what is important for a patient that needs a venturi mask
A - 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
Q21 What do you want to teach a patient with COPD about exercising and what things they
should do before, during, and after?
A 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 - Coordinate walking with slow, pursed-lips while taking
two to four steps - Pulse rate after walking should not exceed 75% to 80% of maximum heart rate
After: - Slow pursed lip breathing should be used to return to baseline (within 5 minutes) after
exercise
Q22 Diagnostic tests for COPD patients
A ABGs: Often low-normal pH and PaO2 & High-normal PaCO2 with high HCO3
pH: normal or below PaO2: Normal or below PaCO2: Normal or above
Chest x-ray: hyperinflation; may have cardiac enlargement, flattened diaphragm; never normalized
Q23 Heart Failure Risks
A Primary risk factors: CAD & advancing age Other: HTN; Diabetes; smoking; obesity; high chol.
Q24 Systolic Failure
A Results from an inability of the heart to pump blood effectively.
Caused: by impaired contractile function; increased after load; cardiomyopathy & mechanical
abnormalities
The left ventricle in systolic dysfunction loses its ability to generate enough pressure to eject blood
forward through the aorta.
Over time the LV becomes dilated and hypertrophied.
HALLMARK SIGN: decrease in LV ejection fraction (EF)
Page 3 of 19
NUR 330: Exam 3 Review – UPDATED Questions
with 100% Verified Answers
Ball State University
NUR 330
Section 1: Peak, Flow, Number (Q1–Q13)
Question & Answer
Q1 Know how to instruct a pt. to use a metered dose inhaler (MDI)
A 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.
Q2 Know what to teach pt about a pulmonary function test (PFT) and what to instruct them
for the test.
A 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
Q3 How to find your personal best peak flow number...
A - 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
Q4 What to do for a patient once you know their peak flow number...
A - 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...
Q5 Peak flow number: Green Zone
A 80% of your personal best numbers signals good control. No asthma symptoms present. Take your
medications as usual
Page 1 of 19
,NUR 330: Exam 3 Review – UPDATED Questions with 100% Verified Answers
Question & Answer
Q6 Peak flow number: Yellow Zone
A 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
Q7 Peak flow number: Red zone
A 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
Q8 Actions to take when Peak Flow Numbers change
A 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
Q9 What should nurses teach patients with asthma..
A - 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
Q10 Asthma: Subjective Data
A 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
Q11 Nursing Diagnosis fro Asthma
A - Ineffective airway clearance - Anxiety - Deficient knowledge
Q12 ABG Normal Values
A pH: 7.35 - 7.45 pCO2: 35-45 mmHg HCO3-: 22- 26 mEq/L PaO2: 80-100 mmHg SaO2: >95%
Q13 How to recognize respiratory acidosis
A pH <7.35 PaCO2 >45
Section 2: Patient, Copd, Failure (Q14–Q26)
Question & Answer
Q14 Know the values of PaO2 to identify if hypoxia is an issue...
A Two best indicators is SATS >90 (to prevent hypoxia) and ABGs PaO2 above 80 to prevent hypoxia
Page 2 of 19
, NUR 330: Exam 3 Review – UPDATED Questions with 100% Verified Answers
Question & Answer
Q15 Know the importance of pursed lip breathing
A Breathing exercises may assist patient during rest and activity by: - Decreasing dyspnea -
Improving oxygenation - Slowing the respiratory rate
Q16 How to teach patient pursed lip breathing and when
A Smell the roses; blow out the candles Practice 8-10 reps of PLB 3-4 times a day
Q17 Nursing Diagnosis for COPD
A - Ineffective airway clearance - Anxiety - Deficient knowledge - Imbalanced nutrition - Impaired gas
exchange - Ineffective breathing patterns - Decreased cardiac output - Risk for infection - Insomnia
Q18 What is Cor Pulmonale
A Right sided hypertrophy of the heart caused by pulmonary hypertension
Q19 What would you want to teach a patient with COPD who needs oxygen therapy?
A - O2 therapy should not exceed 2 L - Critical to start on low level O2 and monitor them with ABGs
Q20 Know when, why, and what is important for a patient that needs a venturi mask
A - 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
Q21 What do you want to teach a patient with COPD about exercising and what things they
should do before, during, and after?
A 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 - Coordinate walking with slow, pursed-lips while taking
two to four steps - Pulse rate after walking should not exceed 75% to 80% of maximum heart rate
After: - Slow pursed lip breathing should be used to return to baseline (within 5 minutes) after
exercise
Q22 Diagnostic tests for COPD patients
A ABGs: Often low-normal pH and PaO2 & High-normal PaCO2 with high HCO3
pH: normal or below PaO2: Normal or below PaCO2: Normal or above
Chest x-ray: hyperinflation; may have cardiac enlargement, flattened diaphragm; never normalized
Q23 Heart Failure Risks
A Primary risk factors: CAD & advancing age Other: HTN; Diabetes; smoking; obesity; high chol.
Q24 Systolic Failure
A Results from an inability of the heart to pump blood effectively.
Caused: by impaired contractile function; increased after load; cardiomyopathy & mechanical
abnormalities
The left ventricle in systolic dysfunction loses its ability to generate enough pressure to eject blood
forward through the aorta.
Over time the LV becomes dilated and hypertrophied.
HALLMARK SIGN: decrease in LV ejection fraction (EF)
Page 3 of 19
