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WRONG
Second.
B Third.
Fourth.
D Fifth.
Question 1 Explanation:
COPD is the fourth leading cause of death in the United States.
Question 2
CORRECT
Question 3
CORRECT
Question 3 Explanation:
Inflammation, hypersecretion of mucus, and alveolar wall destruction are included in the
pathophysiology of COPD.Option A: Inflammation occurs through the proximal and
peripheral airways, lung parenchyma, and pulmonary vasculature. Option B:
Hypersecretion occurs due to the increase in the number of goblet cells. Option C:
Alveolar wall destruction leads to loss of alveolar attachments and a decrease in elastic
recoil.
Question 4
WRONG
Airways.
B Parenchyma.
C Pulmonary vasculature.
Areas identified in all of the above.
Question 4 Explanation:
The airways, parenchyma, and pulmonary vasculature undergo inflammation in
COPD.Option A: The airways are inflamed in COPD. Option B: The lung parenchyma
undergoes an inflammatory response in COPD. Option C: The pulmonary vasculature is
affected by inflammation in COPD.
Question 5
CORRECT
A Air pollution.
B Allergens.
C Infectious agents.
Cigarette smoking.
Question 5 Explanation:
Cigarette smoking is the foremost factor in the development of emphysema.Option A:
Air pollution is a risk factor in the development of emphysema but it is not the primary
factor. Option B: Allergens may contribute to the development of emphysema but it is
not the main factor. Option C: Infectious agents are part of the risk factors for
emphysema but it is not the main factor.
1. True or False: COPD is reversible and tends to happens gradually.
True
False
The answer is FALSE. COPD IRREVERSIBLE and tends to happens gradually.
A. Emphysema
B. Pneumonia
C. Chronic bronchitis
D. Pneumothorax
The answer is C. The key words to let you know the patient is experiencing chronic
bronchitis are: cyanosis and edema in the abdomen and legs. Remember chronic
bronchitis is sometimes referred to as "blue bloaters".
3. A patient with emphysema may present with all of the following symptoms
EXCEPT?
A. Barrel chest
B. Hyperinflation of the lungs
C. Hypoventilation
D. Hypercapnia
The answer is C. Patients with emphysema present with HYPERventilation. The body
will try to compensate for the low oxygen blood levels and will cause the patient to
hyperventilate. Remember emphysema patients are sometimes called "pink puffers".
They will have a barrel chest (due to the use of accessory muscles for breathing),
hyperinflation of the lungs (due to damage of the alveoli sacs and creation of air sacs),
and hypercapnia (high carbon dioxide levels).
4. The term" blue bloaters" is used to describe patients with?
A. Pulmonary hypertension
6. An alarm beeps notifying you that one of your patient's oxygen saturation is
reading 89%. You arrive to the patient's room, and see the patient comfortably
resting in bed watching television. The patient is already on 2 L of oxygen via
nasal cannula. The patient is admitted for COPD exacerbation. Your next nursing
action would be:
7. You are providing teaching to a patient with chronic COPD on how to perform
diaphragmatic breathing. This technique helps do the following:
A. Spiriva
B. Salmeterol
C. Symbicort
D. Albuterol
The answer is D. The patient would best benefit from a SHORT-ACTING bronchodilator
to help with the shortness of breath. The only short-acting bronchodilator listed is
Albuterol. Spiriva is a long-acting bronchodilator. Symbicort is a combination of long-
acting bronchodilator and corticosteroid. Salmeterol is a long-acting bronchodilator.
9. Which of the following statements are incorrect about discharge teaching that
you would provide to a patient with COPD? Select-all-that-apply:
A. "It is best to eat three large meals a day that are relatively low in
calories."
B. "Avoid going outside during extremely hot or cold days."
10. A patient is ordered by the physician to take Pulmicort and Spiriva via inhaler.
How should the patient take this medication?
A. The patient should use the medications every 2 hours for acute episodes of
shortness of breath.
B. The patient should use the Spiriva first and then 5 minutes later the
Pulmicort.
C. The patient should use the Pulmicort first and then the Spiriva 5 minutes later.
D. The patient should use the medications at the same exact time, regardless of
the order.
The answer is B. The patient should use the bronchodilator first which is the Spiriva to
open the airways and THEN the Pulmicort which is a corticosteroid. Using the inhalers
in this order will allow the corticosteroid to work properly after the lung fields are opened
due to bronchodilation.
11. In regards to question 10, which action by the patient demonstrates they know
how to properly use this medication?
A. The patient rinses their mouth after using the Spiriva inhaler.
B. The patient rinses their mouth after using the Pulmicort inhaler.
12. A patient with COPD is reporting depression and thoughts of suicide. The
patient states, "I just feel like ending it all." You assess the patient’s health
history and note that the patient was recently started on which medication that
could cause this side effect:
A. Atrovent
B. Prednisone
C. Roflumilast
D. Theophylline
The answer is C. Roflumilast is a phosphodiestrace-4 inhibitor that is used in the
treatment of patients with severe COPD due to chronic bronchitis. This medication can
caused increased suicidal thoughts, and the patient should be monitored for this while
taking Roflumilast.
A. Prednisone
B. Atrovent
C. Flagyl
D. Levaquin
The answer is A. Prednisone is a corticosterioid and can cause hyperglycemia and
brusing.