Med Surg Exam 3 Study Guide Quizzes
with Correct Answers
When preparing a patient with possible asthma for pulmonary function testing, the nurse will
teach the patient to
a. avoid eating or drinking for several hours before the testing.
b. use rescue medications immediately before the tests are done.
c. take oral corticosteroids at least 2 hours before the examination.
d. withhold bronchodilators for 6 to 12 hours before the examination. ✔️✔️ANS: D
Rationale: Bronchodilators are held before pulmonary function testing so that a baseline
assessment of airway function can be determined. Testing is repeated after bronchodilator use to
determine whether the decrease in lung function is reversible. There is no need for the patient to
be NPO. Oral corticosteroids also should be held before the examination and corticosteroids
given 2 hours before the examination would be at a high level. Rescue medications (which are
bronchodilators) would not be given until after the baseline pulmonary function was assessed.
When the nurse is evaluating the effectiveness of therapy for a patient who has received
treatment during an asthma attack, which finding is the best indicator that the therapy has been
effective?
a. No wheezes are audible.
b. Oxygen saturation is >90%.
c. Accessory muscle use has decreased.
d. Respiratory rate is 16 breaths|minute. ✔️✔️ANS: B
,Rationale: The goal for treatment of an asthma attack is to keep the oxygen saturation >90%. The
other patient data may occur when the patient is too fatigued to continue with the increased work
of breathing required in an asthma attack
A patient seen in the asthma clinic has recorded daily peak flows that are 85% of the baseline.
Which action will the nurse plan to take?
a. Teach the patient about the use of oral corticosteroids.
b. Administer a bronchodilator and recheck the peak flow.
c. Instruct the patient to continue to use current medications.
d. Evaluate whether the peak flow meter is being used correctly. ✔️✔️ANS: C
Rationale: The patient's peak flow readings indicate good asthma control, and no changes are
needed. The other actions would be used for patients in the yellow or red zones for peak flow
A 32-year-old patient who denies any history of smoking is seen in the clinic with a new
diagnosis of emphysema. The nurse will anticipate teaching the patient about
a. Alpha-1-antitrypsin testing.
b. use of the nicotine patch.
c. continuous pulse oximetry.
d. effects of leukotriene modifiers. ✔️✔️ANS: A
Rationale: When emphysema occurs in young patients, especially without a smoking history, a
congenital deficiency in alpha-1-antitrypsin should be suspected. Because the patient does not
smoke, a nicotine patch would not be ordered. There is no indication that the patient requires
, continuous pulse oximetry. Leukotriene modifiers would be used in patients with asthma, not
with emphysema
Which information about a newly admitted patient with chronic obstructive pulmonary
disease(COPD) indicates that the nurse should consult with the health care provider before
administering the prescribed theophylline?
a. The patient has had a recent 10-pound weight gain.
b. The patient has a cough productive of green mucus.
c. The patient denies any shortness of breath at present.
d. The patient takes cimetidine (Tagamet) 150 mg daily. ✔️✔️ANS: D
Rationale: Cimetidine interferes with the metabolism of theophylline, and concomitant
administration may lead rapidly to theophylline toxicity. The other patient information would not
impact on whether the theophylline should be administered or not
When the nurse is interviewing a patient with a new diagnosis of chronic obstructive pulmonary
disease (COPD), which information will help most in confirming a diagnosis of chronic
bronchitis?
a. The patient tells the nurse about a family history of bronchitis.
b. The patient's history indicates a 40 pack-year cigarette history.
c. The patient denies having any respiratory problems until the last 6 months.
d. The patient complains about a productive cough every winter for 3 months. ✔️✔️ANS: D
Rationale: A diagnosis of chronic bronchitis is based on a history of having a productive cough
for 3months for at least 2 consecutive years. There is no familial tendency for chronic bronchitis.
with Correct Answers
When preparing a patient with possible asthma for pulmonary function testing, the nurse will
teach the patient to
a. avoid eating or drinking for several hours before the testing.
b. use rescue medications immediately before the tests are done.
c. take oral corticosteroids at least 2 hours before the examination.
d. withhold bronchodilators for 6 to 12 hours before the examination. ✔️✔️ANS: D
Rationale: Bronchodilators are held before pulmonary function testing so that a baseline
assessment of airway function can be determined. Testing is repeated after bronchodilator use to
determine whether the decrease in lung function is reversible. There is no need for the patient to
be NPO. Oral corticosteroids also should be held before the examination and corticosteroids
given 2 hours before the examination would be at a high level. Rescue medications (which are
bronchodilators) would not be given until after the baseline pulmonary function was assessed.
When the nurse is evaluating the effectiveness of therapy for a patient who has received
treatment during an asthma attack, which finding is the best indicator that the therapy has been
effective?
a. No wheezes are audible.
b. Oxygen saturation is >90%.
c. Accessory muscle use has decreased.
d. Respiratory rate is 16 breaths|minute. ✔️✔️ANS: B
,Rationale: The goal for treatment of an asthma attack is to keep the oxygen saturation >90%. The
other patient data may occur when the patient is too fatigued to continue with the increased work
of breathing required in an asthma attack
A patient seen in the asthma clinic has recorded daily peak flows that are 85% of the baseline.
Which action will the nurse plan to take?
a. Teach the patient about the use of oral corticosteroids.
b. Administer a bronchodilator and recheck the peak flow.
c. Instruct the patient to continue to use current medications.
d. Evaluate whether the peak flow meter is being used correctly. ✔️✔️ANS: C
Rationale: The patient's peak flow readings indicate good asthma control, and no changes are
needed. The other actions would be used for patients in the yellow or red zones for peak flow
A 32-year-old patient who denies any history of smoking is seen in the clinic with a new
diagnosis of emphysema. The nurse will anticipate teaching the patient about
a. Alpha-1-antitrypsin testing.
b. use of the nicotine patch.
c. continuous pulse oximetry.
d. effects of leukotriene modifiers. ✔️✔️ANS: A
Rationale: When emphysema occurs in young patients, especially without a smoking history, a
congenital deficiency in alpha-1-antitrypsin should be suspected. Because the patient does not
smoke, a nicotine patch would not be ordered. There is no indication that the patient requires
, continuous pulse oximetry. Leukotriene modifiers would be used in patients with asthma, not
with emphysema
Which information about a newly admitted patient with chronic obstructive pulmonary
disease(COPD) indicates that the nurse should consult with the health care provider before
administering the prescribed theophylline?
a. The patient has had a recent 10-pound weight gain.
b. The patient has a cough productive of green mucus.
c. The patient denies any shortness of breath at present.
d. The patient takes cimetidine (Tagamet) 150 mg daily. ✔️✔️ANS: D
Rationale: Cimetidine interferes with the metabolism of theophylline, and concomitant
administration may lead rapidly to theophylline toxicity. The other patient information would not
impact on whether the theophylline should be administered or not
When the nurse is interviewing a patient with a new diagnosis of chronic obstructive pulmonary
disease (COPD), which information will help most in confirming a diagnosis of chronic
bronchitis?
a. The patient tells the nurse about a family history of bronchitis.
b. The patient's history indicates a 40 pack-year cigarette history.
c. The patient denies having any respiratory problems until the last 6 months.
d. The patient complains about a productive cough every winter for 3 months. ✔️✔️ANS: D
Rationale: A diagnosis of chronic bronchitis is based on a history of having a productive cough
for 3months for at least 2 consecutive years. There is no familial tendency for chronic bronchitis.
