COPD NCLEX Questions and Answers 100% Pass Latest 2025
A 10-year-old child with asthma is treated for acute exacerbation in the emergency department. The
nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the
condition?
a.
Warm, dry skin
b.
Decreased wheezing
c.
Pulse rate of 90 beats/minute
d.
Respirations of 18 breaths/minute - Answers b. decreased wheezing
Rationale: Asthma is a chronic inflammatory disease of the airways. Decreased wheezing in a child with
asthma may be interpreted incorrectly as a positive sign when it may actually signal an inability to move
air. A "silent chest" is an ominous sign during an asthma episode. With treatment, increased wheezing
actually may signal that the child's condition is improving. Warm, dry skin indicates an improvement in
the child's condition because the child is normally diaphoretic during exacerbation. The normal pulse
rate in a 10 year old is 70-110 beats/min and normal respiratory rate is 16-20 breaths/minute.
The patient asks the nurse why the physician ordered beclomethasone (Beclovent) for his COPD. Which
statement by the nurse is most appropriate?
a.
"Beclovent prevents airway dilation."
b.
"Beclovent decreases inflammation, and makes it easier to breathe."
c.
"Beclovent suppresses the immune response."
d.
,"Beclovent decreases responsiveness to medications that dilate the airway." - Answers b. Beclovent
decreases inflammation and makes it easier to breathe
Rationale: Beclovent is an inhaled corticosteroid that is thought to decrease inflammation and dilate the
airway. Preventing airway dilation is undesirable for this patient, and the exact opposite action of
Beclovent. The exact mechanism of action is unknown. Becolvent, like any other corticosteroid, does
suppress the immune response, but this is not the rationale for administration of the medication.
Inhaled corticosteroids are thought to increase responsiveness of bronchial smooth muscle to beta-
agonist drugs.
The nurse teaches a client with COPD to assess for s/sx of right-sided heart failure. Which of the
following s/sx would be included in the teaching plan?
a.
Clubbing of nail beds
b.
Hypertension
c.
Peripheral edema
d.
Increased appetite - Answers c. peripheral edema
Rationale: Right-sided heart failure is a complication of COPD that occurs because of pulmonary
hypertension. Signs and symptoms of right-sided heart failure include peripheral edema, jugular venous
distention, hepatomegaly, and weight gain due to increased fluid volume. Clubbing of nail beds is
associated with conditions of chronic hypoxia. Hypertension is associated with left-sided heart failure.
Clients with heart failure have decreased appetites.
A client with asthma has started to take a beta-adrenergic agent. The client also takes a monoamine
oxidase inhibitor (MAOI). For what complication should the nurse asses the client?
a.
Hypotension
b.
, Hypertension
c.
Tachycardia
d.
Bradycardia - Answers b. hypertension
Rationale: Concurrent use of an MAOI and a beta-agonist can lead to hypertensive crisis. Hypotension is
not of concern with this combination of medications; the client is at risk for a hypertensive crisis. The
beta-agonist could lead to tachycardia, but since no specific agent is listed the nurse should consider the
potential interaction of the MAOI and the beta-agonist first. Bradycardia is not of concern with this
combination of medication; it is more likely that the client will experience tachycardia.
A 7-year-old client is brought to the E.R. He's tachypneic and afebrile and has a respiratory rate of 36
breaths/minute and a nonproductive cough. He recently had a cold. From his history, the client may
have which of the following?
a.
Acute asthma
b.
Bronchial pneumonia
c.
Chronic obstructive pulmonary disease (COPD)
d.
Emphysema - Answers a acute asthma
Rationale: Based on the client's history and symptoms, acute asthma is the most likely diagnosis. He's
unlikely to have bronchial pneumonia without a productive cough and fever and he's too young to have
developed COPD or emphysema.
A 34-year-old woman with a history of asthma is admitted to the emergency department. The nurse
notes that the client is dyspneic, with a respiratory rate of 35 breaths/minute, nasal flaring, and use of
accessory muscles. Auscultation of the lung fields reveals greatly diminished breath sounds. Based on
these findings, what action should the nurse take to initiate care of the client?
A 10-year-old child with asthma is treated for acute exacerbation in the emergency department. The
nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the
condition?
a.
Warm, dry skin
b.
Decreased wheezing
c.
Pulse rate of 90 beats/minute
d.
Respirations of 18 breaths/minute - Answers b. decreased wheezing
Rationale: Asthma is a chronic inflammatory disease of the airways. Decreased wheezing in a child with
asthma may be interpreted incorrectly as a positive sign when it may actually signal an inability to move
air. A "silent chest" is an ominous sign during an asthma episode. With treatment, increased wheezing
actually may signal that the child's condition is improving. Warm, dry skin indicates an improvement in
the child's condition because the child is normally diaphoretic during exacerbation. The normal pulse
rate in a 10 year old is 70-110 beats/min and normal respiratory rate is 16-20 breaths/minute.
The patient asks the nurse why the physician ordered beclomethasone (Beclovent) for his COPD. Which
statement by the nurse is most appropriate?
a.
"Beclovent prevents airway dilation."
b.
"Beclovent decreases inflammation, and makes it easier to breathe."
c.
"Beclovent suppresses the immune response."
d.
,"Beclovent decreases responsiveness to medications that dilate the airway." - Answers b. Beclovent
decreases inflammation and makes it easier to breathe
Rationale: Beclovent is an inhaled corticosteroid that is thought to decrease inflammation and dilate the
airway. Preventing airway dilation is undesirable for this patient, and the exact opposite action of
Beclovent. The exact mechanism of action is unknown. Becolvent, like any other corticosteroid, does
suppress the immune response, but this is not the rationale for administration of the medication.
Inhaled corticosteroids are thought to increase responsiveness of bronchial smooth muscle to beta-
agonist drugs.
The nurse teaches a client with COPD to assess for s/sx of right-sided heart failure. Which of the
following s/sx would be included in the teaching plan?
a.
Clubbing of nail beds
b.
Hypertension
c.
Peripheral edema
d.
Increased appetite - Answers c. peripheral edema
Rationale: Right-sided heart failure is a complication of COPD that occurs because of pulmonary
hypertension. Signs and symptoms of right-sided heart failure include peripheral edema, jugular venous
distention, hepatomegaly, and weight gain due to increased fluid volume. Clubbing of nail beds is
associated with conditions of chronic hypoxia. Hypertension is associated with left-sided heart failure.
Clients with heart failure have decreased appetites.
A client with asthma has started to take a beta-adrenergic agent. The client also takes a monoamine
oxidase inhibitor (MAOI). For what complication should the nurse asses the client?
a.
Hypotension
b.
, Hypertension
c.
Tachycardia
d.
Bradycardia - Answers b. hypertension
Rationale: Concurrent use of an MAOI and a beta-agonist can lead to hypertensive crisis. Hypotension is
not of concern with this combination of medications; the client is at risk for a hypertensive crisis. The
beta-agonist could lead to tachycardia, but since no specific agent is listed the nurse should consider the
potential interaction of the MAOI and the beta-agonist first. Bradycardia is not of concern with this
combination of medication; it is more likely that the client will experience tachycardia.
A 7-year-old client is brought to the E.R. He's tachypneic and afebrile and has a respiratory rate of 36
breaths/minute and a nonproductive cough. He recently had a cold. From his history, the client may
have which of the following?
a.
Acute asthma
b.
Bronchial pneumonia
c.
Chronic obstructive pulmonary disease (COPD)
d.
Emphysema - Answers a acute asthma
Rationale: Based on the client's history and symptoms, acute asthma is the most likely diagnosis. He's
unlikely to have bronchial pneumonia without a productive cough and fever and he's too young to have
developed COPD or emphysema.
A 34-year-old woman with a history of asthma is admitted to the emergency department. The nurse
notes that the client is dyspneic, with a respiratory rate of 35 breaths/minute, nasal flaring, and use of
accessory muscles. Auscultation of the lung fields reveals greatly diminished breath sounds. Based on
these findings, what action should the nurse take to initiate care of the client?
