COPD EXAM TEST BANK EXAM 2025 | ACTUAL REAL EXAM ACCURATE QUESTIONS AND ANSWERS WITH RATIONALES | VERIFIED AND LATEST UPDATED |GUARANTEED PASS

1. A patient has been receiving oxygen via nasal cannula for COPD during hospitalization. The patient asks the nurse whether oxygen will be needed at home. What is the most appropriate response? A) "Long-term home oxygen therapy should be used to prevent respiratory failure." B) "Oxygen will not be needed until or unless you are in the terminal stages of this disease." C) "Long-term home oxygen therapy should be used to prevent heart problems related to COPD." D) "You will not need oxygen until your oxygen saturation drops to 88% and you have symptoms of hypoxia." Rationale: Home oxygen therapy is typically initiated when oxygen saturation drops to 88% or lower or PaO₂ is ≤ 55 mm Hg, especially if the patient has symptoms of tissue hypoxia (e.g., cor pulmonale, erythrocytosis, altered mental status). 2. Before discharge, a 61-year-old patient with COPD and pneumonia asks about exercise goals after recovery. What is the most appropriate recommendation? A) Slightly increase activity over the current level. B) Swim for 10 minutes/day, gradually increasing to 30 minutes/day. C) Limit exercise to activities of daily living to conserve energy. D) Walk for 20 minutes/day, keeping the pulse rate less than 130 beats/min. Rationale: Walking 20 minutes daily while keeping the pulse below 75–80% of the maximum heart rate (220 minus age) promotes aerobic fitness without straining the cardiopulmonary system. 3. The nurse evaluates that a patient is experiencing the expected beneficial effects of ipratropium (Atrovent) when which outcome is noted? A) Decreased respiratory rate B) Increased respiratory rate C) Increased peak flow readings D) Decreased sputum production Rationale: Ipratropium is a bronchodilator. Its effectiveness is best measured by increased peak expiratory flow rate (PEFR), indicating improved airway patency. 4. Which instruction should the nurse give to ensure proper self-administration of ipratropium (Atrovent) via metered-dose inhaler (MDI)? A) "Avoid shaking the inhaler before use." B) "Breathe out slowly before positioning the inhaler." C) "Using a spacer should be avoided for this type of medication." D) "After taking a puff, hold the breath for 30 seconds before exhaling." Rationale: Exhaling slowly before positioning the inhaler allows for a deep inhalation of the medication. The inhaler should be shaken, and holding the breath for about 10 seconds (not 30) enhances deposition of the drug. 5. Which statement made by a patient using an ipratropium inhaler indicates the need for further teaching? A) "I can rinse my mouth following the two puffs to get rid of the bad taste." B) "I should wait at least 1 to 2 minutes between each puff of the inhaler." C) "Because this medication is not fast-acting, I cannot use it in an emergency if my breathing gets worse." D) "If my breathing gets worse, I should keep taking extra puffs of the inhaler until I can breathe more easily." Rationale: Overusing ipratropium can lead to paradoxical bronchospasm. It is not a rescue medication and should not be used excessively during acute respiratory distress. 6. When teaching a patient with COPD about smoking cessation, which effect of smoking on the lungs should the nurse emphasize in relation to increased pulmonary infections? A) Smoking causes a hoarse voice. B) Cough will become nonproductive. C) Decreased alveolar macrophage function D) Sense of smell is decreased with smoking. Rationale: Smoking impairs alveolar macrophages, reducing the lungs' ability to fight infections. This leads to a higher risk of respiratory infections in smokers. **7. Which interventions should be included in a plan of care for a patient with COPD? (Select all that apply) ** A) Exercise such as walking B) High flow rate of O₂ administration C) Low-dose chronic oral corticosteroid therapy D) Use of peak flow meter to monitor COPD progression E) Breathing exercises such as pursed-lip breathing that focus on exhalation Rationale: Walking improves endurance and cardiovascular health. Pursed-lip breathing prolongs exhalation and prevents air trapping. High-flow oxygen can suppress respiratory drive in COPD, and peak flow meters are primarily used in asthma, not COPD. 8. Which effect does cigarette smoking have on the respiratory system? A) Hypertrophy of capillaries causing hemoptysis B) Hyperplasia of goblet cells and increased production of mucus C) Increased proliferation of cilia and decreased clearance of mucus D) Proliferation of alveolar macrophages to decrease the risk for infection Rationale: Smoking leads to goblet cell hyperplasia and increased mucus production, contributing to airway obstruction and infection risk. It also paralyzes or destroys cilia and impairs macrophage function. 9. Which of the following is a common and dangerous misconception about using ipratropium (Atrovent) during worsening respiratory symptoms in COPD? A) "I can rinse my mouth following the two puffs to get rid of the bad taste." B) "I should wait at least 1 to 2 minutes between each puff of the inhaler." C) "Because this medication is not fast-acting, I cannot use it in an emergency if my breathing gets worse." D) "If my breathing gets worse, I should keep taking extra puffs of the inhaler until I can breathe more easily." Rationale: This statement reflects a misunderstanding. Overuse of ipratropium may lead to paradoxical bronchospasm, worsening the patient's breathing. Ipratropium is not a rescue inhaler and should not be used excessively in acute situations. 10. When planning smoking cessation education for a COPD patient, what should the nurse emphasize regarding smoking’s effect on the immune defense of the lungs? A) Smoking causes a hoarse voice. B) Cough will become nonproductive. C) Decreased alveolar macrophage function D) Sense of smell is decreased with smoking. Rationale: Alveolar macrophages play a key role in clearing pathogens from the lungs. Smoking reduces their effectiveness, increasing the risk of respiratory infections. Other symptoms like hoarseness or smell changes do occur but are less directly linked to infection risk. **11. A plan of care for a patient with COPD should include which of the following? (Select all that apply) ** A) Exercise such as walking B) High flow rate of oxygen administration C) Low-dose chronic oral corticosteroid therapy D) Use of peak flow meter to monitor the progression of COPD E) Breathing exercises such as pursed-lip breathing that focus on exhalation Rationale: • Walking improves aerobic capacity without excessive exertion. • Pursed-lip breathing helps prevent air trapping and reduce dyspnea. • High-flow oxygen can suppress respiratory drive in COPD patients, making it inappropriate unless absolutely necessary. • Oral corticosteroids are not recommended for chronic use due to systemic side effects. • Peak flow meters are more commonly used in asthma, not routinely for COPD monitoring. 12. What is one of the effects of cigarette smoking on the respiratory system? A) Hypertrophy of capillaries causing hemoptysis B) Hyperplasia of goblet cells and increased production of mucus C) Increased proliferation of cilia and decreased clearance of mucus D) Proliferation of alveolar macrophages to decrease the risk for infection Rationale: Smoking causes goblet cell hyperplasia, which leads to excessive mucus production and contributes to airway obstruction. It also impairs cilia function and alveolar macrophage activity, increasing infection risk—not decreasing it. The nurse teaches pursed lip breathing to a patient who is newly diagnosed with chronic obstructive pulmonary disease (COPD). The nurse reinforces that this technique will assist respiration by which mechanism? a) Loosening secretions so that they may be coughed up more easily b) Promoting maximal inhalation for better oxygenation of the lungs c) Preventing bronchial collapse and air trapping in the lungs during exhalation d) Increasing the respiratory rate and giving the patient control of respiratory patterns - Ans - c) Preventing bronchial collapse and air trapping in the lungs during exhalation The purpose of pursed lip breathing is to slow down the exhalation phase of respiration, which decreases bronchial collapse and subsequent air trapping in the lungs during exhalation. It does not affect secretions, inhalation, or increase the rate of breathing. Nursing assessment findings of jugular venous distention and pedal edema would be indicative of what complication of chronic obstructive pulmonary disease (COPD)? a) Acute respiratory failure b) Secondary respiratory infection c) Fluid volume excess resulting from cor pulmonale d) Pulmonary edema caused by left-sided heart failure - Ans - c) Fluid volume excess resulting from cor pulmonale Cor pulmonale is a right-sided heart failure caused by resistance to right ventricular outflow resulting from lung disease. With failure of the right ventricle, the blood emptying into the right atrium and ventricle would be slowed, leading to jugular venous distention and pedal edema. The major advantage of a Venturi mask is that it can: a. deliver up to 80% O2. b. provide continuous 100% humidity c. deliver a precise concentration of O2. d. be used while a patient eats and sleeps - Ans - c. deliver a precise concentration of O2. A patient with an acute exacerbation of chronic obstructive pulmonary disease (COPD) needs to receive precise amounts of oxygen. Which equipment should the nurse prepare to use? a) Oxygen tent b) Venturi mask c) Nasal cannula d Oxygen-conserving cannula - Ans - b) Venturi mask The Venturi mask delivers precise concentrations of oxygen and should be selected whenever this is a priority concern. The other methods are less precise in terms of amount of oxygen delivered. The nurse determines that a patient is experiencing common adverse effects from the inhaled corticosteroid beclomethasone (Beclovent) after what occurs? a) Hypertension and pulmonary edema b) Oropharyngeal candidiasis and hoarseness c) Elevation of blood glucose and calcium levels d) Adrenocortical dysfunction and hyperglycemia - Ans - b) Oropharyngeal candidiasis and hoarseness Oropharyngeal candidiasis and hoarseness are common adverse effects from the use of inhaled corticosteroids because the medication can lead to overgrowth of organisms and local irritation if the patient does not rinse the mouth following each dose. The nurse determines that the patient is not experiencing adverse effects of albuterol (Proventil) after noting which patient vital sign? a) Pulse rate of 72/minute b) Temperature of 98.4° F c) Oxygen saturation 96% d) Respiratory rate of 18/minute - Ans - a) Pulse rate of 72/minute Albuterol is a β2-agonist that can sometimes cause adverse cardiovascular effects. These would include tachycardia and angina. A pulse rate of 72 indicates that the patient did not experience tachycardia as an adverse effect.