Final 203 review

Which respiratory condition is characterized by irreversible airflow obstruction and chronic inflammation of the airways?

• Asthma

• Chronic obstructive pulmonary disease (COPD)

• Pneumonia

• Pulmonary embolism

Answer explanation

COPD is characterized by irreversible airflow obstruction due to chronic inflammation of the airways, leading to symptoms such as chronic cough, sputum production, and dyspnea.

The classic triad of symptoms for pulmonary embolism includes dyspnea, pleuritic chest pain, and ____________.

Which assessment finding is most indicative of acute respiratory distress syndrome (ARDS)?

• Hypertension

• Bradycardia

• Crackles upon auscultation

• Hyperthermia

Answer explanation

Crackles upon auscultation are indicative of fluid accumulation in the alveoli, a hallmark sign of ARDS.

Which intervention should the nurse prioritize for a client experiencing an asthma exacerbation?

• Administering corticosteroids

• Providing supplemental oxygen

• Encouraging deep breathing exercises

• Administering bronchodilators

Answer explanation

Bronchodilators help to relieve bronchoconstriction and improve airflow, making them a priority intervention during an asthma exacerbation.

Which medication is commonly prescribed as a first-line treatment for tuberculosis (TB)?

• Amoxicillin

• Vancomycin

• Isoniazid (INH)

• Acyclovir

Which nursing intervention is appropriate when caring for a client with cystic fibrosis?

• Limiting fluid intake to prevent pulmonary edema

• Encouraging a low-protein diet

• Administering pancreatic enzyme replacements with meals

• Encouraging a sedentary lifestyle to conserve energy

Answer explanation

Clients with cystic fibrosis often have pancreatic insufficiency, so administering pancreatic enzyme replacements with meals helps with digestion and absorption of nutrients.

In chronic bronchitis, there is chronic inflammation and excessive ____________ production.

A client with a history of chronic obstructive pulmonary disease (COPD) presents with increased dyspnea, cyanosis, and altered mental status. Arterial blood gas (ABG) analysis reveals pH 7.25, PaCO2 70 mm Hg, PaO2 55 mm Hg, and HCO3 28 mEq/L. Which intervention should the nurse prioritize?

• Administering supplemental oxygen

• Initiating noninvasive positive pressure ventilation (NPPV)

• Administering a bronchodilator

• Performing endotracheal intubation and initiating mechanical ventilation

Answer explanation

The ABG findings indicate respiratory acidosis with severe hypoxemia. Given the client's altered mental status and the severity of respiratory distress, endotracheal intubation and mechanical ventilation are necessary to improve oxygenation and ventilation.

A client is admitted with suspected acute respiratory distress syndrome (ARDS). Which diagnostic finding is consistent with ARDS?

• Decreased lung compliance

• Increased forced vital capacity (FVC)

• Decreased alveolar-arterial (A-a) oxygen gradient

• Normal pulmonary capillary wedge pressure (PCWP)

Answer explanation

ARDS is characterized by decreased lung compliance due to increased stiffness of the lungs, resulting in difficulty in inflating the alveoli. Increased FVC, decreased A-a oxygen gradient, and normal PCWP are not typical findings in ARDS.

A client is receiving mechanical ventilation. Which finding indicates that the client's endotracheal tube has migrated into the right mainstem bronchus?

• Bilateral breath sounds on auscultation

• Absent breath sounds on the left side

• Equal chest expansion

• Decreased peak airway pressure