COPD NCLEX EXAM SCRIPT 2025/2026 QUESTIONS WITH
SOLUTIONS MARKED A+
✔✔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 - ✔✔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.
Initiate oxygen therapy and reassess the client in 10 minutes.
b.
Draw blood for an ABG analysis and send the client for a chest x-ray.
c.
Encourage the client to relax and breathe slowly through the mouth
d.
Administer ordered bronchodilators - ✔✔d. Administer ordered bronchodilators
Rationale: In an acute asthma attack, diminished or absent breath sounds can be an
ominous sign of indicating lack of air movement in the lungs and impending respiratory
failure. The client requires immediate intervention with inhaled bronchodilators,
intravenous corticosteroids, and possibly intravenous theophylline. Administering
oxygen and reassessing the client 10 minutes later would delay needed medical
intervention, as would drawing an ABG and obtaining a chest x-ray. It would be futile to
encourage the client to relax and breathe slowly without providing necessary
pharmacologic intervention.
✔✔The nurse is planning to teach a client with COPD how to cough effectively. Which
of the following instructions should be included?
a.
, Take three deep abdominal breath, bend forward, and cough while saying the word
"who" on exhalation.
b.
Lie flat on back, splint the thorax, take two deep breaths and cough.
c.
Take several rapid, shallow breaths and then cough forcefully.
d.
Assume a side-lying position, extend the arm over the head, and alternate deep
breathing with coughing. - ✔✔a. Take three deep abdominal breaths, bend forward, and
cough while saying the word "who"
Rationale: The goal of effective coughing is to conserve energy, facilitate removal of
secretions, and minimize airway collapse. The client should assume a sitting position
with feet on the floor if possible. The client should bend forward slightly and, using
pursed-lip breathing, exhale. After resuming an upright position, the client should use
abdominal breathing to slowly and deeply inhale. After repeating this process 3 or 4
times, the client should take a deep abdominal breath, bend forward and cough while
saying the word "WHO" . This intervention is called "huff" cough. Lying flat does not
enhance lung expansion; sitting upright promotes full expansion of the thorax. Shallow
breathing does not facilitate removal of secretions, and forceful coughing promotes
collapse of airways. A side-lying position does not allow for adequate chest expansion
to promote deep breathing.
✔✔A school-age child with CF asks the nurse what sports she can be involved in as
she becomes older. Which of the following activities would be most appropriate for the
nurse to suggest?
a.
swimming
b.
track
c.
baseball
d.
javelin throwing - ✔✔a. Swimming
Rationale: Swimming would be the most appropriate suggestion because it coordinates
breathing and movement of all muscle groups and can be done on an individual basis or
as a team sport. Because track events, baseball and javelin throwing usually are
performed outdoors, the child would be breathing in large amounts of dust and dirt,
which would be irritating to her mucous membranes and pulmonary system. The
strenuous activity and increased energy expenditure associated with track events, in
conjunction with the dust and possible heat, would play a role in placing the child at risk
for an URTI and compromising her respiratory function.
✔✔When developing a discharge plan to manage the care of a client with COPD, the
nurse should anticipate that the client will do which of the following?
SOLUTIONS MARKED A+
✔✔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 - ✔✔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.
Initiate oxygen therapy and reassess the client in 10 minutes.
b.
Draw blood for an ABG analysis and send the client for a chest x-ray.
c.
Encourage the client to relax and breathe slowly through the mouth
d.
Administer ordered bronchodilators - ✔✔d. Administer ordered bronchodilators
Rationale: In an acute asthma attack, diminished or absent breath sounds can be an
ominous sign of indicating lack of air movement in the lungs and impending respiratory
failure. The client requires immediate intervention with inhaled bronchodilators,
intravenous corticosteroids, and possibly intravenous theophylline. Administering
oxygen and reassessing the client 10 minutes later would delay needed medical
intervention, as would drawing an ABG and obtaining a chest x-ray. It would be futile to
encourage the client to relax and breathe slowly without providing necessary
pharmacologic intervention.
✔✔The nurse is planning to teach a client with COPD how to cough effectively. Which
of the following instructions should be included?
a.
, Take three deep abdominal breath, bend forward, and cough while saying the word
"who" on exhalation.
b.
Lie flat on back, splint the thorax, take two deep breaths and cough.
c.
Take several rapid, shallow breaths and then cough forcefully.
d.
Assume a side-lying position, extend the arm over the head, and alternate deep
breathing with coughing. - ✔✔a. Take three deep abdominal breaths, bend forward, and
cough while saying the word "who"
Rationale: The goal of effective coughing is to conserve energy, facilitate removal of
secretions, and minimize airway collapse. The client should assume a sitting position
with feet on the floor if possible. The client should bend forward slightly and, using
pursed-lip breathing, exhale. After resuming an upright position, the client should use
abdominal breathing to slowly and deeply inhale. After repeating this process 3 or 4
times, the client should take a deep abdominal breath, bend forward and cough while
saying the word "WHO" . This intervention is called "huff" cough. Lying flat does not
enhance lung expansion; sitting upright promotes full expansion of the thorax. Shallow
breathing does not facilitate removal of secretions, and forceful coughing promotes
collapse of airways. A side-lying position does not allow for adequate chest expansion
to promote deep breathing.
✔✔A school-age child with CF asks the nurse what sports she can be involved in as
she becomes older. Which of the following activities would be most appropriate for the
nurse to suggest?
a.
swimming
b.
track
c.
baseball
d.
javelin throwing - ✔✔a. Swimming
Rationale: Swimming would be the most appropriate suggestion because it coordinates
breathing and movement of all muscle groups and can be done on an individual basis or
as a team sport. Because track events, baseball and javelin throwing usually are
performed outdoors, the child would be breathing in large amounts of dust and dirt,
which would be irritating to her mucous membranes and pulmonary system. The
strenuous activity and increased energy expenditure associated with track events, in
conjunction with the dust and possible heat, would play a role in placing the child at risk
for an URTI and compromising her respiratory function.
✔✔When developing a discharge plan to manage the care of a client with COPD, the
nurse should anticipate that the client will do which of the following?
