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WorksheetsExam 2 (MedSurg): Asthma/COPD
Total questions: 85
Worksheet time: 44mins
What is the definition of asthma? Fill in the blank: Asthma is a ______ inflammatory disorder of airways.
chronic
acute
bacterial
temporary
SATA: Asthma leads to recurrent episodes of which of the following?
Wheezing
Breathlessness
Chest tightness
Cough
Fever
Asthma exacerbations are reversible.
True
False
Which of the following is NOT a trigger for increased inflammation and hyperresponsiveness of the tracheobronchial system in asthma?
Allergic rhinitis
Nasal polyps
Sensitivity to aspirin
Diabetes
What are the three components of the asthma triad?
Nasal polyps, asthma, and sensitivity to aspirin and NSAIDs
Bronchitis, emphysema, and chronic cough
Allergic rhinitis, eczema, and food allergy
COPD, pneumonia, and sinusitis
Wheezing in the asthma triad typically develops in about how many hours?
2 hours
6 hours
12 hours
24 hours
Sensitivity to salicylates is found in which of the following?
Foods
Beverages
Flavorings
All of the above
GERD (gastroesophageal reflux disease) may trigger bronchoconstriction as well as cause aspiration.
True
False
Asthma medications may worsen which of the following conditions?
Allergic rhinitis
GERD
Nasal polyps
Edema formation
What is the primary response in asthma pathophysiology from exposure to allergens/irritants?
Chronic inflammation
Bronchial dilation
Decreased mucus production
Reduced airway sensation
If the airway is not treated or does not resolve in the late-phase response of asthma, what may it lead to?
Irreversible lung damage
Temporary relief of symptoms
Complete recovery without intervention
Improved lung function
Structural changes in the bronchial wall during the late-phase response of asthma are known as ________.
Remodeling
Bronchospasm
Emphysema
Fibrosis
Expiration may be prolonged in asthma due to:
Forcing air out of constricted airways
Increased lung capacity
Decreased mucus production
Open bronchioles
Fill in the blank: The inspiration/expiration ratio in asthma may be _______.
1:2, 1:3, or 1:4
2:1, 3:1, or 4:1
1:1
1:1.5, 1:1.2, or 1:1.1
Severe asthma attacks always have audible wheezing.
True
False
Fill in the blank: An acute asthma attack usually reveals signs of ________ such as restlessness, anxiety, inappropriate behaviour, increased HR and BP.
hypoxemia
hyperglycemia
hypertension
hypothermia
In acute asthma exacerbations, treatment depends on:
Patient's age
Severity and response to therapy
Type of medication
Time of day
Severity of acute asthma exacerbations are measured with ______.
flow rates
SpO2%
respiratory rates
heart rate
Which bronchodilator is most commonly used in severe exacerbations of asthma?
Salmeterol
Albuterol
Ipratropium
Theophylline
IV corticosteroids are administered every ___ hours, then given PO in severe asthma exacerbations.
4-6
1-2
8-10
12-14
IV magnesium sulfate is given as a ________ in severe asthma exacerbations.
bronchodilator
antitussive
antihistamine
decongestant
Asthma Drug Therapy: Which of the following is NOT a function of corticosteroids?
Reduces bronchial hyperresponsiveness
Increases mucus production
Suppresses inflammatory response
Used in long-term control
The inhaled form of corticosteroids is used in long-term control of asthma.
True
False
Oropharyngeal candidiasis (thrush), hoarseness, and a dry cough are local side effects of which form of corticosteroid?
Inhaled form
Oral form
Topical form
Intravenous form
Leukotriene modifiers/inhibitors are indicated for acute asthma attacks.
True
False
Anti-IgE therapy prevents IgE from attaching to mast cells, preventing release of ________.
chemical mediators
antibodies
red blood cells
platelets
How often is SQ administration of Anti-IgE therapy given for asthma?
Every 2-4 weeks
Every day
Every 6 months
Every 12 hours
Which medication is a B2 adrenergic agonist used as a bronchodilator?
Albuterol
Atenolol
Lisinopril
Furosemide
Albuterol is effective for relieving acute ________.
bronchospasm
hypoxia
croup
bronchodilation
What is the onset of action for Albuterol?
Onset of action in minutes, duration of action of 4-8 hours
Onset of action in hours, duration of action of 24 hours
Onset of action in seconds, duration of action of 1 hour
Onset of action in days, duration of action of 1 week
Albuterol is used for long-term management of asthma.
True
False
DPIs (dry powder inhalers) require less manual ________ than standard inhalers.
dexterity
strength
speed
pressure
Inhalation of drugs is preferable to avoid ________ side effects.
systemic
local
topical
digestive
Ephedrine stimulates CNS and cardiovascular system: used in ________ airway attacks.
EMERGENCY
CHRONIC
MILD
ALLERGIC
Fill in the blank: To maintain asthma control, a patient should maintain greater than ___% of personal best PEFR.
80
60
70
90
Which of the following should be avoided to help prevent asthma exacerbations?
Opioids
Aspirin/NSAIDs
Leukotriene Modifiers
Mucolytics
Fluid intake of ___ L every day is recommended for asthma patients.
2-3
0.5-1
4-5
6-7
Fill in the blank: Asthmatic individuals should ________ at bare minimum.
Measure peak flow DAILY
Measure peak flow WEEKLY
Measure peak flow MONTHLY
Measure peak flow ANUALLY
Asthmatic individuals frequently do not perceive changes in their breathing.
True
False
Fill in the blank: The Yellow Zone in peak flow monitoring is defined as ________% of personal best and indicates caution, something is triggering asthma.
50-80%
80-100%
30-50%
0-30%
The Red Zone in peak flow monitoring indicates serious problem and definitive action must be taken with a HCP.
True
False
What does COPD stand for?
Chronic Obstructive Pulmonary Disease
Chronic Obstructive Pancreatic Disease
Chronic Obstructive Peripheral Disease
Chronic Obstructive Pulmonary Dysfunction
COPD includes chronic bronchitis and emphysema.
True
False
What percentage of COPD deaths are related to tobacco smoking?
10-20%
30-40%
80-90%
100%
Which of the following is NOT an effect of nicotine?
Increases HR
Decreases BP
Increases platelet aggregation
Compounds problems in CAD
Fill in the blank: Nicotine stimulates the ______ nervous system.
sympathetic
parasympathetic
central
enteric
Which of the following is an effect of cigarette smoking on the respiratory tract?
Decreased production of mucus
Increased ciliary activity
Chronic, enhanced inflammation
Decreased HR
Fill in the blank: Carbon monoxide exposure leads to decreased ______ carrying capacity.
O2
CO2
H2O
Glucose
What is the main pathophysiological change in COPD during forced exhalation?
Irreversible airflow limitations due to loss of elastic recoil
Increased surfactant production in alveoli
Bronchial hyperresponsiveness to allergens
Acute inflammation of the pleura
Airflow obstruction in COPD is due to which three factors?
Mucous hypersecretion, mucosal edema, and bronchospasm
Alveolar destruction, pulmonary fibrosis, and pleural effusion
Pulmonary embolism, pneumothorax, and atelectasis
Tracheal stenosis, laryngeal edema, and vocal cord paralysis
In COPD, air goes in easily but ______ in the lungs (barrel chest).
remains
escapes
dissolves
condenses
What tends to collapse in COPD?
Bronchioles
Alveoli
Trachea
Pleura
Which of the following is NOT a common characteristic of COPD?
Mucus hypersecretion
Dysfunction of cilia
Hyperinflation of lungs
Viral infection
SATA: COPD is a systemic disease as a result of chronic inflammation and often coexists with what heart conditions?
Right-sided heart failure
Mitral valve prolapse
Atrial fibrillation
Cor pulmonale
Pericardial effusion
In COPD, blood vessels thicken and the surface area for diffusion of O2 ________.
decreases
increases
remains unchanged
fluctuates
Asthma can be either seasonal or perennial.
True
False
Lung exposure to ______ air can exacerbate asthma symptoms.
still
hot
cold
smelly
In patients with asthma, respiratory infections can trigger inflammation and ______ of the ______ system.
hyporesponsiveness, tracheobronchial
hyperresponsiveness, tracheobronchial
hyporesponsiveness, bronchiovesicular
hyperresponsiveness, bronchiovesicular
SATA: Select all of the clinical manifestations of the EARLY phase of an acute asthma attack.
vascular congestion
edema formation
remodeling
irreversible lung damage
production of thick, tenacious mucus
In a severe asthma exacerbation, a PEFR of _____ or less is considered life threatening.
80%
50%
40%
60%
For patients with intermittent or persistent asthma, it is important that they medicate _______ exercise.
before
after
during
instead of
The severity of asthma exacerbations are primarily determined by _______.
loudness of wheezing
peak flow rates
SpO2%
speed of respiratory rate
For patients admitted to the ICU with a life-threatening asthma exacerbation, a ______ line may be established to facilitate frequent monitoring of ABGs.
peripheral
central
arterial
PICC
How should the RN educate an asthma patient on how to reduce oral thrush after inhaler use?
Tell patient to drink one half gallon of milk after each use of their inhaler
Tell patient to gargle and rinse with water after each use of their inhaler
Tell patient to use their inhaled corticosteroids after each use of their inhaler
Tell patient to take an antitussive after each use of their inhaler
Leukotriene modifiers are used as both a ______ and an ______ , and act as a ______ medication for asthma.
bronchodilator, anti-inflammatory, maintenance
bronchodilator, antihistamine, rescue
bronchoconstrictor, anti-inflammatory, rescue
bronchoconstrictor, antihistamine, maintenance
COPD is generally a progressive disease, but is fully reversible with enough effective treatment.
True
False
Nicotine ______ platelet aggregation and _____ ciliary activity.
increases, increases
decreases, decreases
increases, decreases
decreases, increases
Clinical manifestations of COPD develop _____.
quickly
instantly
slowly
genetically
Patients with advanced COPD experience dyspnea, even while not performing physical activities.
True
False
A patient with COPD will use their _____ muscles to breathe.
pulmonary
vesicular
accessory
pelvic
A patient with COPD may be _______, even if they are on a healthy and well-balanced diet.
overweight
obese
bulimic
underweight
SATA: Select the possible complications of COPD.
Cor Pulmonale
Acute Respiratory Failure
Peptic Ulcer Disease
Depression
Acute Pyelonephritis
For patients with COPD-induced Cor Pulmonale, ______ are the MOST integral to monitor disease progression.
skin turgor assessments
ABGs
daily weights
neurological assessments
Central cyanosis is an indicator of a _____ COPD exacerbation.
mild
moderate
severe
complete
SATA: Overuse of which of the following medications can trigger COPD-induced respiratory failure?
opioids
sedatives
benzodiazepines
salicylates
selective serotonin reuptake inhibitors
A diagnosis of COPD would be confirmed by a _____ FEV1/FVC ratio.
increased
decreased
absent
secondary
To determine the amount of O2 desaturation during exercise, the RN can perform the ______ test with a COPD patient.
5 mile run
6 minute walk
2 minute walk
2 mile run
30 minute walk
What is CO2 narcosis?
A phenomenon in which COPD patients develop a high CO2 tolerance.
A phenomenon in which COPD patients develop a low CO2 tolerance.
A phenomenon in which COPD patients develop a CO2 poisoning.
A phenomenon in which COPD patients develop lesions comprised of CO2 in the airway.
Because of CO2 narcosis, the only physiological drive to breathe for some patients with advanced COPD is _____.
hypotension
hypoxemia
hyperkalemia
hypophosphatemia
Why would patients with COPD use an Acapella device?
To dilate their bronchioles
To decrease mucus production
To shake free mucus plugs
To kill bacterial pathogens in the upper airways
Why are many COPD patients malnourished?
they find it difficult to eat and breathe at the same time
food will often travel to the lungs in these patients
their airways are too small to swallow most food
eating increases the width of their barrel chests
What kind of nutritional plan should COPD patients follow?
Eat three meals a day with very chewy foods.
Eat one large meal a day at a very slow pace.
Eat 10 meals comprised of low calorie, gas-forming food per day.
Eat 5-6 meals per day with high protein and high calorie foods.
A bullectomy is a procedure that is used for _____.
acute brochitis
emphysema
acute asthma
croup
SATA: Which comorbidities of COPD patients REQUIRE acute interventions?
pneumonia
respiratory failure
asthma
bronchitis
Cor Pulmonale
Activity recommendations for COPD patients include walking for ______ minutes a day, a minimum of ____ times per week.
5-10, 2
60-90, 6
15-20, 3
30-50, 5
