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Exam 2 (MedSurg): Asthma/COPD

Total questions: 85

Worksheet time: 44mins

Name
Class
Date
1.

What is the definition of asthma? Fill in the blank: Asthma is a ______ inflammatory disorder of airways.

a)

chronic

b)

acute

c)

bacterial

d)

temporary

2.

SATA: Asthma leads to recurrent episodes of which of the following?

a)

Wheezing

b)

Breathlessness

c)

Chest tightness

d)

Cough

e)

Fever

3.

Asthma exacerbations are reversible.

a)

True

b)

False

4.

Which of the following is NOT a trigger for increased inflammation and hyperresponsiveness of the tracheobronchial system in asthma?

a)

Allergic rhinitis

b)

Nasal polyps

c)

Sensitivity to aspirin

d)

Diabetes

5.

What are the three components of the asthma triad?

a)

Nasal polyps, asthma, and sensitivity to aspirin and NSAIDs

b)

Bronchitis, emphysema, and chronic cough

c)

Allergic rhinitis, eczema, and food allergy

d)

COPD, pneumonia, and sinusitis

6.

Wheezing in the asthma triad typically develops in about how many hours?

a)

2 hours

b)

6 hours

c)

12 hours

d)

24 hours

7.

Sensitivity to salicylates is found in which of the following?

a)

Foods

b)

Beverages

c)

Flavorings

d)

All of the above

8.

GERD (gastroesophageal reflux disease) may trigger bronchoconstriction as well as cause aspiration.

a)

True

b)

False

9.

Asthma medications may worsen which of the following conditions?

a)

Allergic rhinitis

b)

GERD

c)

Nasal polyps

d)

Edema formation

10.

What is the primary response in asthma pathophysiology from exposure to allergens/irritants?

a)

Chronic inflammation

b)

Bronchial dilation

c)

Decreased mucus production

d)

Reduced airway sensation

11.

If the airway is not treated or does not resolve in the late-phase response of asthma, what may it lead to?

a)

Irreversible lung damage

b)

Temporary relief of symptoms

c)

Complete recovery without intervention

d)

Improved lung function

12.

Structural changes in the bronchial wall during the late-phase response of asthma are known as ________.

a)

Remodeling

b)

Bronchospasm

c)

Emphysema

d)

Fibrosis

13.

Expiration may be prolonged in asthma due to:

a)

Forcing air out of constricted airways

b)

Increased lung capacity

c)

Decreased mucus production

d)

Open bronchioles

14.

Fill in the blank: The inspiration/expiration ratio in asthma may be _______.

a)

1:2, 1:3, or 1:4

b)

2:1, 3:1, or 4:1

c)

1:1

d)

1:1.5, 1:1.2, or 1:1.1

15.

Severe asthma attacks always have audible wheezing.

a)

True

b)

False

16.

Fill in the blank: An acute asthma attack usually reveals signs of ________ such as restlessness, anxiety, inappropriate behaviour, increased HR and BP.

a)

hypoxemia

b)

hyperglycemia

c)

hypertension

d)

hypothermia

17.

In acute asthma exacerbations, treatment depends on:

a)

Patient's age

b)

Severity and response to therapy

c)

Type of medication

d)

Time of day

18.

Severity of acute asthma exacerbations are measured with ______.

a)

flow rates

b)

SpO2%

c)

respiratory rates

d)

heart rate

19.

Which bronchodilator is most commonly used in severe exacerbations of asthma?

a)

Salmeterol

b)

Albuterol

c)

Ipratropium

d)

Theophylline

20.

IV corticosteroids are administered every ___ hours, then given PO in severe asthma exacerbations.

a)

4-6

b)

1-2

c)

8-10

d)

12-14

21.

IV magnesium sulfate is given as a ________ in severe asthma exacerbations.

a)

bronchodilator

b)

antitussive

c)

antihistamine

d)

decongestant

22.

Asthma Drug Therapy: Which of the following is NOT a function of corticosteroids?

a)

Reduces bronchial hyperresponsiveness

b)

Increases mucus production

c)

Suppresses inflammatory response

d)

Used in long-term control

23.

The inhaled form of corticosteroids is used in long-term control of asthma.

a)

True

b)

False

24.

Oropharyngeal candidiasis (thrush), hoarseness, and a dry cough are local side effects of which form of corticosteroid?

a)

Inhaled form

b)

Oral form

c)

Topical form

d)

Intravenous form

25.

Leukotriene modifiers/inhibitors are indicated for acute asthma attacks.

a)

True

b)

False

26.

Anti-IgE therapy prevents IgE from attaching to mast cells, preventing release of ________.

a)

chemical mediators

b)

antibodies

c)

red blood cells

d)

platelets

27.

How often is SQ administration of Anti-IgE therapy given for asthma?

a)

Every 2-4 weeks

b)

Every day

c)

Every 6 months

d)

Every 12 hours

28.

Which medication is a B2 adrenergic agonist used as a bronchodilator?

a)

Albuterol

b)

Atenolol

c)

Lisinopril

d)

Furosemide

29.

Albuterol is effective for relieving acute ________.

a)

bronchospasm

b)

hypoxia

c)

croup

d)

bronchodilation

30.

What is the onset of action for Albuterol?

a)

Onset of action in minutes, duration of action of 4-8 hours

b)

Onset of action in hours, duration of action of 24 hours

c)

Onset of action in seconds, duration of action of 1 hour

d)

Onset of action in days, duration of action of 1 week

31.

Albuterol is used for long-term management of asthma.

a)

True

b)

False

32.

DPIs (dry powder inhalers) require less manual ________ than standard inhalers.

a)

dexterity

b)

strength

c)

speed

d)

pressure

33.

Inhalation of drugs is preferable to avoid ________ side effects.

a)

systemic

b)

local

c)

topical

d)

digestive

34.

Ephedrine stimulates CNS and cardiovascular system: used in ________ airway attacks.

a)

EMERGENCY

b)

CHRONIC

c)

MILD

d)

ALLERGIC

35.

Fill in the blank: To maintain asthma control, a patient should maintain greater than ___% of personal best PEFR.

a)

80

b)

60

c)

70

d)

90

36.

Which of the following should be avoided to help prevent asthma exacerbations?

a)

Opioids

b)

Aspirin/NSAIDs

c)

Leukotriene Modifiers

d)

Mucolytics

37.

Fluid intake of ___ L every day is recommended for asthma patients.

a)

2-3

b)

0.5-1

c)

4-5

d)

6-7

38.

Fill in the blank: Asthmatic individuals should ________ at bare minimum.

a)

Measure peak flow DAILY

b)

Measure peak flow WEEKLY

c)

Measure peak flow MONTHLY

d)

Measure peak flow ANUALLY

39.

Asthmatic individuals frequently do not perceive changes in their breathing.

a)

True

b)

False

40.

Fill in the blank: The Yellow Zone in peak flow monitoring is defined as ________% of personal best and indicates caution, something is triggering asthma.

a)

50-80%

b)

80-100%

c)

30-50%

d)

0-30%

41.

The Red Zone in peak flow monitoring indicates serious problem and definitive action must be taken with a HCP.

a)

True

b)

False

42.

What does COPD stand for?

a)

Chronic Obstructive Pulmonary Disease

b)

Chronic Obstructive Pancreatic Disease

c)

Chronic Obstructive Peripheral Disease

d)

Chronic Obstructive Pulmonary Dysfunction

43.

COPD includes chronic bronchitis and emphysema.

a)

True

b)

False

44.

What percentage of COPD deaths are related to tobacco smoking?

a)

10-20%

b)

30-40%

c)

80-90%

d)

100%

45.

Which of the following is NOT an effect of nicotine?

a)

Increases HR

b)

Decreases BP

c)

Increases platelet aggregation

d)

Compounds problems in CAD

46.

Fill in the blank: Nicotine stimulates the ______ nervous system.

a)

sympathetic

b)

parasympathetic

c)

central

d)

enteric

47.

Which of the following is an effect of cigarette smoking on the respiratory tract?

a)

Decreased production of mucus

b)

Increased ciliary activity

c)

Chronic, enhanced inflammation

d)

Decreased HR

48.

Fill in the blank: Carbon monoxide exposure leads to decreased ______ carrying capacity.

a)

O2

b)

CO2

c)

H2O

d)

Glucose

49.

What is the main pathophysiological change in COPD during forced exhalation?

a)

Irreversible airflow limitations due to loss of elastic recoil

b)

Increased surfactant production in alveoli

c)

Bronchial hyperresponsiveness to allergens

d)

Acute inflammation of the pleura

50.

Airflow obstruction in COPD is due to which three factors?

a)

Mucous hypersecretion, mucosal edema, and bronchospasm

b)

Alveolar destruction, pulmonary fibrosis, and pleural effusion

c)

Pulmonary embolism, pneumothorax, and atelectasis

d)

Tracheal stenosis, laryngeal edema, and vocal cord paralysis

51.

In COPD, air goes in easily but ______ in the lungs (barrel chest).

a)

remains

b)

escapes

c)

dissolves

d)

condenses

52.

What tends to collapse in COPD?

a)

Bronchioles

b)

Alveoli

c)

Trachea

d)

Pleura

53.

Which of the following is NOT a common characteristic of COPD?

a)

Mucus hypersecretion

b)

Dysfunction of cilia

c)

Hyperinflation of lungs

d)

Viral infection

54.

SATA: COPD is a systemic disease as a result of chronic inflammation and often coexists with what heart conditions?

a)

Right-sided heart failure

b)

Mitral valve prolapse

c)

Atrial fibrillation

d)

Cor pulmonale

e)

Pericardial effusion

55.

In COPD, blood vessels thicken and the surface area for diffusion of O2 ________.

a)

decreases

b)

increases

c)

remains unchanged

d)

fluctuates

56.

Asthma can be either seasonal or perennial.

a)

True

b)

False

57.

Lung exposure to ______ air can exacerbate asthma symptoms.

a)

still

b)

hot

c)

cold

d)

smelly

58.

In patients with asthma, respiratory infections can trigger inflammation and ______ of the ______ system.

a)

hyporesponsiveness, tracheobronchial

b)

hyperresponsiveness, tracheobronchial

c)

hyporesponsiveness, bronchiovesicular

d)

hyperresponsiveness, bronchiovesicular

59.

SATA: Select all of the clinical manifestations of the EARLY phase of an acute asthma attack.

a)

vascular congestion

b)

edema formation

c)

remodeling

d)

irreversible lung damage

e)

production of thick, tenacious mucus

60.

In a severe asthma exacerbation, a PEFR of _____ or less is considered life threatening.

a)

80%

b)

50%

c)

40%

d)

60%

61.

For patients with intermittent or persistent asthma, it is important that they medicate _______ exercise.

a)

before

b)

after

c)

during

d)

instead of

62.

The severity of asthma exacerbations are primarily determined by _______.

a)

loudness of wheezing

b)

peak flow rates

c)

SpO2%

d)

speed of respiratory rate

63.

For patients admitted to the ICU with a life-threatening asthma exacerbation, a ______ line may be established to facilitate frequent monitoring of ABGs.

a)

peripheral

b)

central

c)

arterial

d)

PICC

64.

How should the RN educate an asthma patient on how to reduce oral thrush after inhaler use?

a)

Tell patient to drink one half gallon of milk after each use of their inhaler

b)

Tell patient to gargle and rinse with water after each use of their inhaler

c)

Tell patient to use their inhaled corticosteroids after each use of their inhaler

d)

Tell patient to take an antitussive after each use of their inhaler

65.

Leukotriene modifiers are used as both a ______ and an ______ , and act as a ______ medication for asthma.

a)

bronchodilator, anti-inflammatory, maintenance

b)

bronchodilator, antihistamine, rescue

c)

bronchoconstrictor, anti-inflammatory, rescue

d)

bronchoconstrictor, antihistamine, maintenance

66.

COPD is generally a progressive disease, but is fully reversible with enough effective treatment.

a)

True

b)

False

67.

Nicotine ______ platelet aggregation and _____ ciliary activity.

a)

increases, increases

b)

decreases, decreases

c)

increases, decreases

d)

decreases, increases

68.

Clinical manifestations of COPD develop _____.

a)

quickly

b)

instantly

c)

slowly

d)

genetically

69.

Patients with advanced COPD experience dyspnea, even while not performing physical activities.

a)

True

b)

False

70.

A patient with COPD will use their _____ muscles to breathe.

a)

pulmonary

b)

vesicular

c)

accessory

d)

pelvic

71.

A patient with COPD may be _______, even if they are on a healthy and well-balanced diet.

a)

overweight

b)

obese

c)

bulimic

d)

underweight

72.

SATA: Select the possible complications of COPD.

a)

Cor Pulmonale

b)

Acute Respiratory Failure

c)

Peptic Ulcer Disease

d)

Depression

e)

Acute Pyelonephritis

73.

For patients with COPD-induced Cor Pulmonale, ______ are the MOST integral to monitor disease progression.

a)

skin turgor assessments

b)

ABGs

c)

daily weights

d)

neurological assessments

74.

Central cyanosis is an indicator of a _____ COPD exacerbation.

a)

mild

b)

moderate

c)

severe

d)

complete

75.

SATA: Overuse of which of the following medications can trigger COPD-induced respiratory failure?

a)

opioids

b)

sedatives

c)

benzodiazepines

d)

salicylates

e)

selective serotonin reuptake inhibitors

76.

A diagnosis of COPD would be confirmed by a _____ FEV1/FVC ratio.

a)

increased

b)

decreased

c)

absent

d)

secondary

77.

To determine the amount of O2 desaturation during exercise, the RN can perform the ______ test with a COPD patient.

a)

5 mile run

b)

6 minute walk

c)

2 minute walk

d)

2 mile run

e)

30 minute walk

78.

What is CO2 narcosis?

a)

A phenomenon in which COPD patients develop a high CO2 tolerance.

b)

A phenomenon in which COPD patients develop a low CO2 tolerance.

c)

A phenomenon in which COPD patients develop a CO2 poisoning.

d)

A phenomenon in which COPD patients develop lesions comprised of CO2 in the airway.

79.

Because of CO2 narcosis, the only physiological drive to breathe for some patients with advanced COPD is _____.

a)

hypotension

b)

hypoxemia

c)

hyperkalemia

d)

hypophosphatemia

80.

Why would patients with COPD use an Acapella device?

a)

To dilate their bronchioles

b)

To decrease mucus production

c)

To shake free mucus plugs

d)

To kill bacterial pathogens in the upper airways

81.

Why are many COPD patients malnourished?

a)

they find it difficult to eat and breathe at the same time

b)

food will often travel to the lungs in these patients

c)

their airways are too small to swallow most food

d)

eating increases the width of their barrel chests

82.

What kind of nutritional plan should COPD patients follow?

a)

Eat three meals a day with very chewy foods.

b)

Eat one large meal a day at a very slow pace.

c)

Eat 10 meals comprised of low calorie, gas-forming food per day.

d)

Eat 5-6 meals per day with high protein and high calorie foods.

83.

A bullectomy is a procedure that is used for _____.

a)

acute brochitis

b)

emphysema

c)

acute asthma

d)

croup

84.

SATA: Which comorbidities of COPD patients REQUIRE acute interventions?

a)

pneumonia

b)

respiratory failure

c)

asthma

d)

bronchitis

e)

Cor Pulmonale

85.

Activity recommendations for COPD patients include walking for ______ minutes a day, a minimum of ____ times per week.

a)

5-10, 2

b)

60-90, 6

c)

15-20, 3

d)

30-50, 5